Tax First-line Chemotherapy With Different Doses and Then Maintenance Therapy (TFINE)

Randomized, Controlled Study Comparing the Efficacy and Safety of Docetaxel （60mg/m2）Maintenance Treatment vs. Best Supportive Care Following First Line Chemotherapy With Different Doses of Docetaxel（75/60mg/m2）in Combination With Cisplatin in Patients With Local Advanced or Metastatic （Stage IIIB/IV）Non-Small Cell Lung Cancer

The Primary Objective is to evaluate the progression-free survival (PFS).

The secondary objectives are:

• To compare the disease control rates of different doses of Docetaxel+Cisplatin as first-line treatment according to Response Evaluation Criteria In Solid Tumors (RECIST) criteria;
• To evaluate the overall response rate (ORR);
• To evaluate the time to disease progression (TTP);
• To evaluate the overall survival (OS);
• To evaluate the toxicity.

Study Overview

• Status: Completed
• Conditions: Lung Neoplasms
• Intervention / Treatment: Drug: Docetaxel; Drug: Cisplatin; Other: Best supportive care (BSC)

Detailed Description

The study consists in:

• A first line treatment phase: participants receive 4 cycles of chemotherapy (each cycle contains 3 weeks) with either docetaxel (75 mg/m2) plus cisplatin (75 mg/m2) or docetaxel (60 mg/m2) plus cisplatin (75 mg/m2) ,
• A maintenance treatment phase: participants with disease control (complete response [CR], partial response [PR] or stable disease [SD]) after the initial treatment receive up to 6 cycles of chemotherapy with docetaxel (60 mg/m2) or best supportive care (BSC).
• A follow-up period from the end of study treatment until participant death or end of study.

• Study Type: Interventional
• Enrollment (Actual): 375
• Phase: Phase 3

Contacts and Locations

Study Locations

• China
  • Shanghai, China
    • Sanofi-Aventis Administrative Office

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion criteria:

• Histologic or cytologic diagnosis of advanced non-small-cell lung cancer (NSCLC)
• Based on International Association for the Study of Lung Cancer (IASLC) 2009 new Tumor-Node-Metastasis (TNM) stage criteria of lung cancer, local advanced stage IIIB (not applicable for radical radiation therapy) disease or metastatic stage IV disease or recurrent disease
• At least one evaluable tumor lesion based on RECIST criteria (>= 20 mm with conventional techniques or >= 10 mm with spiral Computed Tomography scan)
• Eastern Cooperative Oncology Group performance status (ECOG PS) 0/1

• Adequate bone marrow reserve

  • absolute neutrophil count >= 2.0×10^9/L
  • platelets >= 100×10^9/L
  • hemoglobin >= 9.0 g/dL

• Adequate hepatic function

  • total bilirubin <= Upper Normal Limit (UNL)
  • Aspartate Amino Transferase (AST), Alanine Amino Transferase (ALT) <= 2.5 UNL
  • alkaline phosphatase (ALP) <= 5 UNL
• Adequate renal function (serum creatinine <= UNL or creatinine clearance >= 60 mL/min)
• No prior chemotherapy was allowed or only (neo) adjuvant chemotherapy ended more than 6 months before treatment (patients should not have been heavily pre-treated, the maximum cumulative dose of cisplatin allowed is 350 mg/m²)
• Prior surgery was permitted only if the operation performed more than 4 weeks ago and the patient was completely recovery
• Childbearing potential either terminated or attenuated by the use of an approved contraceptive method
• Inform consent signed

Exclusion criteria:

• Other tumour type than advanced / metastatic NSCLC in recent 5 years (except cone-biopsied carcinoma-in-situ of the cervix or adequately treated basal or squamous cell carcinoma of the skin).
• Presence of symptomatic central nervous system metastases

• Inadequate liver function

  • total bilirubin > 1 UNL
  • ALT and/or AST>1.5 UNL associated with alkaline phosphatase > 2.5 UNL
  • inadequate renal function (creatinine > 1.0 times UNL and in case of limit value, creatinine clearance < 60 mL/min)
• Prior radiation therapy, or surgery operation within 4 weeks
• Prior use of taxoids
• Active infection, or serious concomitant systemic disorder incompatible with the study
• Childbearing potential but unwilling to use of an approved contraceptive method
• Receive treatment from other clinical trials during this study treatment
• History of hypersensitivity to any of study medication
• Other serious concomitant abnormal or illness

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: First line treatment: docetaxel 75 mg/m² + cisplatin 75 mg/m²; Docetaxel 75 mg/m² + cisplatin 75 mg/m² on day 1, repeated every 3 weeks, up to 4 cycles	Drug: Docetaxel; Formulation: concentrated solution for intravenous infusion (IV) Route(s) of administration: 1-hour IV; Other Names: Taxotere®; Drug: Cisplatin; Formulation: concentrated solution for intravenous infusion (IV) Route(s) of administration: 1-3-hour IV
Experimental: First line treatment:: docetaxel 60 mg/m² + cisplatin 75 mg/m²; Docetaxel 60 mg/m² + cisplatin 75 mg/m² on day 1, repeated every 3 weeks, up to 4 cycles	Drug: Docetaxel; Formulation: concentrated solution for intravenous infusion (IV) Route(s) of administration: 1-hour IV; Other Names: Taxotere®; Drug: Cisplatin; Formulation: concentrated solution for intravenous infusion (IV) Route(s) of administration: 1-3-hour IV
Experimental: Maintenance treatment: docetaxel (60 mg/m2); Docetaxel 60 mg/m² on day 1, repeated every 3 weeks until progressive disease or up to 6 cycles	Drug: Docetaxel; Formulation: concentrated solution for intravenous infusion (IV) Route(s) of administration: 1-hour IV; Other Names: Taxotere®
Active Comparator: Maintenance treatment: best supportive care (BSC); BSC until progressive disease	Other: Best supportive care (BSC); Any treatment including palliative radiotherapy for pain relief-but not chemotherapy - that is considered appropriate by the investigator

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Progression-free survival (PFS) during the maintenance treatment phase	From 2nd randomization to progression or death of any cause (every 2 cycles (6 weeks) during study treatment, and then every 8 weeks during follow-up period)

Secondary Outcome Measures

Outcome Measure	Time Frame
Disease control rate (DCR) during the first line treatment phase	Every 2 cycles (6 weeks)
Overall response rate (ORR) during the first line treatment phase	Every 2 cycles (6 weeks)
Time to disease progression (TTP) during the maintenance treatment phase	From 2nd randomization up to disease progression (every 2 cycles (6 weeks))
Overall survival (OS)	From 1st randomization to death of any cause (every 2 cycles (6 weeks) during study treatment, and then every 8 weeks during follow-up period)

Collaborators and Investigators

• Sponsor: Sanofi

Publications and helpful links

General Publications

• Zhang L, Lu S, Cheng Y, Hu Z, Wu YL, Chen Z, Chen G, Liu X, Yang J, Zhang L, Chen J, Huang M, Tao M, Cheng G, Huang C, Zhou C, Zhang W, Zhao H, Sun Y. Docetaxel maintenance therapy versus best supportive care after first-line chemotherapy with different dose docetaxel plus cisplatin for advanced non-small cell lung cancer (TFINE study, CTONG-0904): an open-label, randomized, phase III trial. Ann Transl Med. 2021 Feb;9(4):338. doi: 10.21037/atm-20-8078.

Study record dates

Study Major Dates

• Study Start: November 1, 2009
• Primary Completion (Actual): August 1, 2012
• Study Completion (Actual): August 1, 2012

Study Registration Dates

• First Submitted: December 22, 2009
• First Submitted That Met QC Criteria: December 22, 2009
• First Posted (Estimate): December 24, 2009

Study Record Updates

• Last Update Posted (Estimate): February 28, 2014
• Last Update Submitted That Met QC Criteria: February 27, 2014
• Last Verified: February 1, 2014

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Neoplasms; Lung Diseases; Neoplasms by Site; Respiratory Tract Neoplasms; Thoracic Neoplasms; Lung Neoplasms; Molecular Mechanisms of Pharmacological Action; Antineoplastic Agents; Tubulin Modulators; Antimitotic Agents; Mitosis Modulators; Docetaxel; Cisplatin
• Other Study ID Numbers: DOCET_L_04827