Patient case: 57-year-old male with lung cancer; genetic feature: FGFR1

Clinical trial: Combination Chemotherapy Plus Oblimersen in Treating Patients With Previously Untreated Extensive-Stage Small Cell Lung Cancer

Summary: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Oblimersen may make tumor cells more sensitive to chemotherapy drugs. Phase I trial to study the effectiveness of combination chemotherapy and oblimersen in treating patients who have extensive-stage small cell lung cancer

Detailed description: PRIMARY OBJECTIVES:
  I. Determine the maximum tolerated dose of oblimersen when combined with standard dose carboplatin and etoposide in patients with previously untreated extensive stage small cell lung cancer.
  II. Determine the toxicity and feasibility of this regimen in these patients. III. Determine potential antitumor activity of this regimen as assessed by objective response in these patients.
  OUTLINE: This is a multicenter, dose-escalation study of oblimersen (G3139).
  Patients receive G3139 IV continuously on days 1-8, carboplatin IV over 30 minutes on day 6, and etoposide IV over 1 hour on days 6-8. Treatment repeats every 3 weeks for up to 6 courses in the absence of unacceptable toxicity or disease progression.
  Cohorts of 3-6 patients receive escalating doses of G3139 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.
  PROJECTED ACCRUAL: Approximately 6-12 patients will be accrued for this study within 5 months.

Eligibility: Inclusion Criteria:
  -  Histologically or cytologically confirmed extensive stage small cell lungcancer
  -  No active CNS disease
  -  CNS metastasis allowed provided patient completed 1 course of CNS radiotherapy
  -  Performance status - ECOG 0-2
  -  Performance status - Karnofsky 60-100%
  -  More than 2 months
  -  WBC at least 3,000/mm^3
  -  Absolute neutrophil count at least 1,500/mm^3
  -  Platelet count at least 100,000/mm^3
  -  Bilirubin normal
  -  AST and ALT no greater than 2.5 times upper limit of normal (ULN)
  -  PT and PTT no greater than 1.5 times ULN
  -  Creatinine normal
  -  Creatinine clearance at least 60 mL/min
  -  No symptomatic congestive heart failure
  -  No unstable angina pectoris
  -  No cardiac arrhythmia
  -  Not pregnant or nursing
  -  Negative pregnancy test
  -  Fertile patients must use effective contraception
  -  No prior allergic reactions to compounds of similar chemical or biologic composition to study agents
  -  No other uncontrolled concurrent illness
  -  No ongoing or active infection
  -  No psychiatric illness or social situation that would preclude study compliance
  -  See Disease Characteristics
  -  At least 1 week since prior CNS radiotherapy and recovered
  -  No prior radiotherapy to more than 25% of skeleton
  -  No other prior anticancer therapy
  -  No other concurrent investigational agents
  -  No other concurrent anticancer therapy
  -  No concurrent anticoagulation therapy
  -  No concurrent combination antiretroviral therapy for HIV-positive patients

Relevance to patient case: not relevant