RATIONALE: Drugs used in chemotherapy such as docetaxel use different ways to stop tumor cells from dividing so they stop growing or die. Oblimersen may increase the effectiveness of docetaxel by making the tumor cells more sensitive to the drug. It is not yet known if docetaxel is more effective with or without oblimersen in treating non-small cell lung cancer.

PURPOSE: Randomizedphase II/III trial to compare the effectiveness of docetaxel with or without oblimersen in treating patients who have relapsed or refractory non-small cell lung cancer that has been previously treated.

Condition	Treatment or Intervention	Phase
recurrent non-small cell lung cancer stage IIIB non-small cell lung cancer stage IV non-small cell lung cancer	Drug: docetaxel  Drug: oblimersen  Procedure: antisense therapy  Procedure: chemosensitization/potentiation  Procedure: chemotherapy	Phase II Phase III

Further Study Details: 

OBJECTIVES:

• Compare the survival of patients with non-small cell lung cancer treated with docetaxel with or without oblimersen (G3139).
• Compare the proportion of major antitumor responses in patients treated with these regimens.
• Compare the response duration and time to progression in patients treated with these regimens.
• Compare the safety and clinical benefit of these regimens, in terms of changes in performance status and tumor-related symptoms, in these patients.
• Compare the proportion of patients surviving 6 and 12 months after treatment with these regimens.

OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to response to prior first-line chemotherapy regimen (progression vs stable disease, partial response, or complete response), ECOG performance status (0-1 vs 2), and prior paclitaxel treatment (yes vs no). Patients are randomized to 1 of 2 treatment arms.

• Arm I: Patients receive oblimersen (G3139) IV continuously on days 1-7 and docetaxel IV over 1 hour on day 5. Treatment repeats every 21 days for up to 8 courses in the absence of disease progression or unacceptable toxicity. Patients with responding or stable disease upon completion of 8 courses may receive 8 or more additional courses at physician's discretion.
• Arm II: Patients receive docetaxel IV over 1 hour on day 1. Treatment repeats every 21 days for 8 courses in the absence of disease progression or unacceptable toxicity. Upon completion of 8 courses, patients may continue to receive docetaxel off study at physician's discretion. Patients are followed every 9 weeks for up to 18 months.

PROJECTED ACCRUAL: A total of 280 patients (140 per treatment arm) will be accrued for this study.

Ages Eligible for Study:  18 Years and above,  Genders Eligible for Study:  Both

Criteria

DISEASE CHARACTERISTICS:

• Diagnosis of non-small lung cancer (NSCLC)
• Stage IIIB (malignant pleural/pericardial effusion) or IV
• Relapsed or refractory disease
• Measurable disease that has not been irradiated
• Previously treated with 1, and only 1, cytotoxic chemotherapy regimen in the neoadjuvant, adjuvant, or metastatic setting
• No untreated or symptomatic brain metastases or leptomeningeal disease

PATIENT CHARACTERISTICS: Age:

• 18 and over

Performance status:

• ECOG 0-2

Life expectancy:

• At least 12 weeks

Hematopoietic:

• Absolute neutrophil count at least 1,500/mm^3 (without growth factor support)
• Platelet count at least 100,000/mm^3
• No bleeding or coagulation disorder

Hepatic:

• Bilirubin no greater than 1.5 times upper limit of normal (ULN)
• ALT and AST no greater than 2.5 times ULN
• Alkaline phosphatase no greater than 2.5 times ULN
• Albumin at least 3.0 g/dL
• PT no greater than 1.5 times ULN OR INR no greater than 1.3
• PTT no greater than 1.5 times ULN
• No chronic hepatitis
• No chronic cirrhosis

Renal:

• Creatinine no greater than 1.5 times ULN

Cardiovascular:

• No New York Heart Association class III or IV heart disease
• No uncontrolled congestive heart failure

Pulmonary:

• No severe pulmonary disease
• No requirement for oxygen due to pneumonectomy
• No severe pleural effusion secondary to NSCLC

Immunologic:

• HIV negative
• No active infection
• No active autoimmune disease

Other:

• No other concurrent active cancer
• No uncontrolled diabetes mellitus
• No uncontrolled seizure disorder
• No peripheral neuropathy grade 2 or greater
• No active peptic ulcer disease
• No other significant medical disease
• No intellectual, emotional, or physical disability that would preclude study participation
• No neurologic disorders, overt psychosis, mental disability, or evidence of a limited capacity to give informed consent or to comply with study treatment
• No known hypersensitivity to phosphorothioate-containing oligonucleotides
• No history of hypersensitivity to drugs containing the excipient Tween 80 (polysorbate 80)
• Satisfactory venous access for multi-day continuous infusion
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY: Biologic therapy:

• At least 3 weeks since prior cytokines or vaccine therapy for NSCLC
• At least 3 weeks since prior immunotherapy or biologic therapy for NSCLC
• No concurrent anticancer biologic therapy

Chemotherapy:

• See Disease Characteristics
• At least 3 weeks since prior chemotherapy for NSCLC
• No prior docetaxel
• No other concurrent anticancer chemotherapy

Endocrine therapy:

• No concurrent corticosteroids* except for the following conditions:
• CNS disease
• Underlying lung disease NOTE: *Dose must be stable or decreasing for at least 4 weeks before study participation

Radiotherapy:

• See Disease Characteristics
• At least 3 weeks since prior radiotherapy for NSCLC
• No prior radiotherapy to 25% or more of bone marrow (e.g., whole pelvis)
• No concurrent anticancer radiotherapy

Surgery:

• At least 3 weeks since prior surgery for NSCLC
• No prior organ allograft

Other:

• Recovered from prior therapy
• Prior first-line epidermal growth factor receptors (EGFR) administered with cytotoxic therapy are allowed
• At least 3 weeks since prior investigational drugs
• At least 3 weeks since other prior therapy NSCLC
• No prior anticancer therapy subsequent to the first (and only) prior cytotoxic chemotherapy regimen
• No prior second-line EGFR therapy
• No prior oblimersen (G3139)
• No other concurrent investigational or anticancer therapies
• No concurrent anticoagulation therapy except for warfarin (1 mg/day) for central line prophylaxis

Alabama
      Montgomery Cancer Center, Montgomery,  Alabama,  36106-2801,  United States
      University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham,  Alabama,  35294-3300,  United States
Arkansas
      Little Rock Hematology-Oncology Associates, Little Rock,  Arkansas,  72205,  United States
California
      East Bay Medical Oncology, Concord,  California,  94520,  United States
      John Wayne Cancer Institute at Saint John's Health Center, Santa Monica,  California,  90404,  United States
      Jonsson Comprehensive Cancer Center, UCLA, Los Angeles,  California,  90095,  United States
      Medical Oncology Care Associates, Orange,  California,  92868,  United States
      Pacific Hematology/Oncology, San Francisco,  California,  94115,  United States
Colorado
      University of Colorado Cancer Center at University of Colorado Health Sciences Center, Aurora,  Colorado,  80010,  United States
Connecticut
      Whittingham Cancer Center, Norwalk,  Connecticut,  06856,  United States
Florida
      Lakeland Regional Cancer Center, Lakeland,  Florida,  33805,  United States
Georgia
      Augusta Oncology Associates, Augusta,  Georgia,  30901,  United States
      Georgia Cancer Specialists - Northside Office, Atlanta,  Georgia,  30342,  United States
Illinois
      University of Chicago Cancer Research Center, Chicago,  Illinois,  60637,  United States
Indiana
      CCOP - Northern Indiana CR Consortium, South Bend,  Indiana,  46601,  United States
Kentucky
      Central Baptist Hospital, Lexington,  Kentucky,  40503,  United States
Louisiana
      Hematology Oncology Services, New Orleans,  Louisiana,  70115,  United States
      Louisiana State University Health Sciences Center - Shreveport, Shreveport,  Louisiana,  71130-3932,  United States
Michigan
      Josephine Ford Cancer Center at Henry Ford Hospital, Detroit,  Michigan,  48202,  United States
Nebraska
      Methodist Hospital Cancer Center at Nebraska Methodist Hospital - Omaha, Omaha,  Nebraska,  68114-4199,  United States
New Jersey
      Summit Medical Group, P.A., Summit,  New Jersey,  07901,  United States
New York
      North General Hospital, New York,  New York,  10035,  United States
      Winthrop University Hospital, Mineola,  New York,  11501,  United States
Oklahoma
      Veterans Affairs Medical Center - Oklahoma City, Oklahoma City,  Oklahoma,  73104,  United States
South Carolina
      Charleston Cancer Center, Charleston,  South Carolina,  29406,  United States
Texas
      Arlington Cancer Center, Arlington,  Texas,  76012-2510,  United States
      Harold Simmons Cancer Center, Dallas,  Texas,  75390-8852,  United States
      Joe Arrington Cancer Research and Treatment Center, Lubbock,  Texas,  79410-1894,  United States
      Medical City Dallas Hospital, Dallas,  Texas,  75230,  United States
      Texas Cancer Care, Weatherford,  Texas,  76086,  United States
      University of Texas - MD Anderson Cancer Center, Houston,  Texas,  77030-4009,  United States
Washington
      Madigan Army Medical Center, Tacoma,  Washington,  98431-5048,  United States
      Yakima Regional Cancer Care Center, Yakima,  Washington,  98902,  United States
West Virginia
      Morgantown Internal Medicine Group, Morgantown,  West Virginia,  26505,  United States
      West Virginia University Hospitals, Morgantown,  West Virginia,  26506-9162,  United States
Canada, Ontario
      Princess Margaret Hospital, Toronto,  Ontario,  M5G 2M9,  Canada
Canada, Quebec
      Hopital Charles Lemoyne, Greenfield Park,  Quebec,  J4V 2H1,  Canada
      L'Hopital Laval, Ste Foy,  Quebec,  G1V 4G5,  Canada
      McGill University, Montreal,  Quebec,  H2W 1S6,  Canada
Russian Federation
      Medical Radiological Research Center RAMS, Kaluga Region,  249020,  Russian Federation
      Municipal Oncological Dispensary, Saint Petersburg,  197022,  Russian Federation
      P.A. Hertzen Research Oncology Institute, Moscow,  125284,  Russian Federation
      Petrov Research Institute of Oncology, Saint Petersburg,  197758,  Russian Federation
      Russian Academy of Medical Sciences Cancer Research Center, Moscow,  115478,  Russian Federation

Study chairs or principal investigators

Deborah Braccia,  Study Chair,  Genta   

Study ID Numbers:  CDR0000069185; GENTA-GN304; NCI-G01-2046; UCLA-0301058
Record last reviewed:  June 2004
Last Updated:  October 13, 2004
Record first received:  February 14, 2002
ClinicalTrials.gov Identifier:  NCT00030641
Health Authority: Unspecified
ClinicalTrials.gov processed this record on 2005-04-08