Phase II Study of ZD6474 in Advanced NSCLC

ZD6474 is a new investigational drug that is thought to block the formation of new blood vessels. The growth of new blood vessels is called angiogenesis. Angiogenesis is thought to be essential for the growth of tumors beyond a small size. It is hoped that ZD6474 will limit new blood vessel growth in the tumor and "starve" the tumor by limiting blood flow to it. The second part of this study also includes paclitaxel (Taxol) and carboplatin (Paraplatin). Both paclitaxel and carboplatin are standard chemotherapy drugs that are approved by the FDA for use in the treatment of lung cancer. Before beginning treatment on this study, you will have a biopsy of your tumor. The tissue taken during this biopsy will be compared with the tissue taken after you receive ZD6474. The tumor samples will be compared to see what effect ZD6474 has had on tumor cell death. During the biopsy procedure, you will receive either a local or general anesthetic depending on the location of your tumor and a small piece of tumor will be removed with a large needle. Before treatment starts, you will have a complete physical exam by a physician. You will have routine blood (about 4 teaspoons) and urine tests. Women who are able to have children must have a negative blood pregnancy test. You will have a chest x-ray and a CT or MRI scan, a functional MRI, a bone scan if your doctor thinks it is necessary, and a brain scan. You will also have an ECG (test to measure the electrical activity of the heart) and a ECHO scan to make sure your heart is healthy enough to receive this treatment. Treatment on this study will be given in 3-week cycles. During the first three cycles (i.e., the first 9 weeks) you will take a ZD6474 tablet by mouth each morning on an empty stomach. While on this study you will receive a physical exam every week. You will also receive weekly blood tests (about 4 teaspoons) for the first 4 weeks of treatment. After that you will receive blood tests (about 4 teaspoons) before every 3-week cycle. After 2 weeks of treatment you will have another biopsy of your tumor, and another functional MRI. After every 9 weeks of treatment and every 2 cycles thereafter you will have a repeat CT or MRI to evaluate your tumor. If your disease has responded to ZD6474 or stayed the same, you will go on to the second part of this study. If your disease has gotten worse or intolerable side effects occur, you will be taken off this study and your doctor will discuss treatment options with you. If you continue on to the second part of this study, you will be randomly assigned (as in the toss of a coin) to receive either: a) daily ZD6474 alone, or b) paclitaxel and carboplatin every 3 weeks along with daily ZD6474. You have an equal chance of being assigned to either group. If you receive paclitaxel, you will receive it as a 3-hour infusion into a vein on the first day of each treatment cycle. If you receive carboplatin, you will receive it by vein immediately following the paclitaxel infusion. The carboplatin infusion will take between 15 and 30 minutes. Treatment with either daily ZD6474 or ZD6474 plus paclitaxel and carboplatin will continue until your diseases worsens or until severe side effects occur. This is an investigational study. ZD6474 is an investigational drug that has been approved by the FDA for research use only. A total of up to 120 patients will take part in this study. All will be enrolled at M. D. Anderson.