Randomized Phase III Trial Of Carboplatin And Paclitaxel Plus Tirapazamine Versus Carboplatin And Paclitaxel In Patients With Advanced Non-Small Cell Lung Cancer
Combination Chemotherapy With or Without Tirapazamine in Treating Patients With Stage IIIB or Stage IV Non-small Cell Lung Cancer
Sponsors
Source
National Cancer Institute (NCI)
Brief Summary
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so
they stop growing or die. Combining more than one drug may kill more tumor cells. It is not
yet known which combination chemotherapy regimen is more effective for non-small cell lung
cancer.
PURPOSE: Randomized phase III trial to compare the effectiveness of carboplatin plus
paclitaxel with or without tirapazamine in treating patients who have stage IIIB or stage IV
non-small cell lung cancer.
Detailed Description
OBJECTIVES:
- Compare the effects of paclitaxel and carboplatin with or without tirapazamine on
progression-free survival and overall survival in patients with stage IV and selected
stage IIIB non-small cell lung cancer.
- Compare response rates in patients treated with these regimens.
- Compare the toxic effects of these regimens in these patients.
OUTLINE: This is a randomized study. Patients are stratified according to weight loss (less
than 5% vs 5% or more), stage of disease (IIIB vs IV), and lactate dehydrogenase level
(normal vs abnormal). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive tirapazamine IV over 2 hours followed by paclitaxel IV over 3
hours and carboplatin IV over 30 minutes on day 1.
- Arm II: Patients receive paclitaxel and carboplatin as in arm I. Treatment continues
every 21 days for a total of 6 courses in the absence of disease progression or
unacceptable toxicity.
Patients are followed every 3 months for one year, and then every 6 months for 2 years, or
until death.
PROJECTED ACCRUAL: Approximately 500 patients (250 per arm) will be accrued for this study
within 20 months.
Overall Status
Completed
Start Date
2000-11-01
Completion Date
2006-04-01
Primary Completion Date
N/A
Phase
Phase 3
Study Type
Interventional
Condition
Intervention
Eligibility
Criteria
DISEASE CHARACTERISTICS:
- Histologically or cytologically proven newly diagnosed advanced primary non-small cell
lung cancer (NSCLC), including the following cellular types:
- Adenocarcinoma
- Large cell carcinoma
- Squamous cell carcinoma
- Unspecified carcinoma OR
- Recurrent disease after prior surgery and/or radiotherapy
- Stage IIIB disease
- T4 lesion due to malignant pleural effusion OR
- Stage IV disease
- Any T, any N, M1 (distant metastasis, including lesions in multiple lobes of the
ipsilateral lung)
- Measurable or evaluable disease
- Pleural effusions, ascites, and laboratory parameters not considered as only
evidence of disease
- Must be outside prior radiated field or area of prior surgical resection or new
lesion must be present
- No known brain metastases
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- Zubrod 0-1
Life expectancy:
- Not specified
Hematopoietic:
- Absolute granulocyte count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- Hemoglobin at least 9 g/dL
Hepatic:
- Bilirubin no greater than 2 times upper limit of normal (ULN)
- SGOT or SGPT no greater than 2 times ULN
- Alkaline phosphatase no greater than 2 times ULN
Renal:
- Creatinine no greater than ULN
- Creatinine clearance at least 50 mL/min
Other:
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No peripheral neuropathy (motor or sensory) of grade 2 or greater
- No other malignancy within the past 5 years except adequately treated basal cell or
squamous cell skin cancer, carcinoma in situ of the cervix, or stage I/II cancer in
complete remission
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- No prior biologic therapy for NSCLC
Chemotherapy:
- No prior systemic chemotherapy for NSCLC
Endocrine therapy:
- Not specified
Radiotherapy:
- See Disease Characteristics
- At least 3 weeks since prior radiotherapy and recovered
- No concurrent radiotherapy
Surgery:
- See Disease Characteristics
- At least 2 weeks since prior thoracic or other major surgery and recovered
Gender
All
Minimum Age
18 Years
Maximum Age
N/A
Healthy Volunteers
No
Overall Official
Last Name |
Role |
Affiliation |
Stephen K. Williamson, MD |
Study Chair |
University of Kansas |
Location
Facility |
MBCCOP - Gulf Coast Mobile Alabama 36688 United States |
CCOP - Greater Phoenix Phoenix Arizona 85006-2726 United States |
Veterans Affairs Medical Center - Phoenix (Hayden) Phoenix Arizona 85012 United States |
Veterans Affairs Medical Center - Tucson Tucson Arizona 85723 United States |
Arizona Cancer Center Tucson Arizona 85724 United States |
University of Arkansas for Medical Sciences Little Rock Arkansas 72205 United States |
Veterans Affairs Medical Center - Little Rock (McClellan) Little Rock Arkansas 72205 United States |
Cancer Center and Beckman Research Institute, City of Hope Duarte California 91010-3000 United States |
USC/Norris Comprehensive Cancer Center and Hospital Los Angeles California 90033-0804 United States |
Jonsson Comprehensive Cancer Center, UCLA Los Angeles California 90095-1781 United States |
Veterans Affairs Outpatient Clinic - Martinez Martinez California 94553 United States |
CCOP - Bay Area Tumor Institute Oakland California 94609-3305 United States |
Chao Family Comprehensive Cancer Center Orange California 92868 United States |
University of California Davis Cancer Center Sacramento California 95817 United States |
UCSF Cancer Center and Cancer Research Institute San Francisco California 94143-0128 United States |
CCOP - Santa Rosa Memorial Hospital Santa Rosa California 95403 United States |
David Grant Medical Center Travis Air Force Base California 94535 United States |
University of Colorado Cancer Center Denver Colorado 80010 United States |
Veterans Affairs Medical Center - Denver Denver Colorado 80220 United States |
CCOP - Atlanta Regional Atlanta Georgia 30342-1701 United States |
Dwight David Eisenhower Army Medical Center Fort Gordon Georgia 30905-5650 United States |
Cancer Research Center of Hawaii Honolulu Hawaii 96813 United States |
MBCCOP - University of Illinois at Chicago Chicago Illinois 60612-7323 United States |
Veterans Affairs Medical Center - Chicago (Westside Hospital) Chicago Illinois 60612 United States |
CCOP - Central Illinois Decatur Illinois 62526 United States |
Veterans Affairs Medical Center - Hines (Hines Junior VA Hospital) Hines Illinois 60141 United States |
Loyola University Medical Center Maywood Illinois 60153 United States |
Hematology Oncology Associates of the Quad Cities Bettendorf Iowa 52722 United States |
University of Kansas Medical Center Kansas City Kansas 66160-7357 United States |
CCOP - Wichita Wichita Kansas 67214-3882 United States |
Veterans Affairs Medical Center - Wichita Wichita Kansas 67218 United States |
Veterans Affairs Medical Center - Lexington Lexington Kentucky 40511-1093 United States |
Albert B. Chandler Medical Center, University of Kentucky Lexington Kentucky 40536-0084 United States |
MBCCOP - LSU Health Sciences Center New Orleans Louisiana 70112 United States |
Tulane University School of Medicine New Orleans Louisiana 70112 United States |
Louisiana State University Health Sciences Center - Shreveport Shreveport Louisiana 71130-3932 United States |
Veterans Affairs Medical Center - Shreveport Shreveport Louisiana 71130 United States |
Boston Medical Center Boston Massachusetts 02118 United States |
Veterans Affairs Medical Center - Boston (Jamaica Plain) Jamaica Plain Massachusetts 02130 United States |
Veterans Affairs Medical Center - Ann Arbor Ann Arbor Michigan 48105 United States |
CCOP - Ann Arbor Regional Ann Arbor Michigan 48106 United States |
University of Michigan Comprehensive Cancer Center Ann Arbor Michigan 48109-0752 United States |
Barbara Ann Karmanos Cancer Institute Detroit Michigan 48201-1379 United States |
Veterans Affairs Medical Center - Detroit Detroit Michigan 48201-1932 United States |
Henry Ford Hospital Detroit Michigan 48202 United States |
Providence Hospital - Southfield Southfield Michigan 48075-9975 United States |
CCOP - Duluth Duluth Minnesota 55805 United States |
Veterans Affairs Medical Center - Biloxi Biloxi Mississippi 39531-2410 United States |
University of Mississippi Medical Center Jackson Mississippi 39216-4505 United States |
Veterans Affairs Medical Center - Jackson Jackson Mississippi 39216 United States |
Keesler Medical Center - Keesler AFB Keesler AFB Mississippi 39534-2576 United States |
Veterans Affairs Medical Center - Kansas City Kansas City Missouri 64128 United States |
CCOP - Kansas City Kansas City Missouri 64131 United States |
St. Louis University Health Sciences Center Saint Louis Missouri 63110-0250 United States |
CCOP - St. Louis-Cape Girardeau Saint Louis Missouri 63141 United States |
CCOP - Cancer Research for the Ozarks Springfield Missouri 65807 United States |
CCOP - Montana Cancer Consortium Billings Montana 59101 United States |
Veterans Affairs Medical Center - Albuquerque Albuquerque New Mexico 87108-5138 United States |
MBCCOP - University of New Mexico HSC Albuquerque New Mexico 87131 United States |
Veterans Affairs Medical Center - Albany Albany New York 12208 United States |
Herbert Irving Comprehensive Cancer Center New York New York 10032 United States |
University of Rochester Medical Center Rochester New York 14642 United States |
CCOP - Southeast Cancer Control Consortium Winston-Salem North Carolina 27104-4241 United States |
Veterans Affairs Medical Center - Cincinnati Cincinnati Ohio 45220-2288 United States |
Barrett Cancer Center, The University Hospital Cincinnati Ohio 45267-0502 United States |
Cleveland Clinic Taussig Cancer Center Cleveland Ohio 44195 United States |
CCOP - Columbus Columbus Ohio 43206 United States |
Veterans Affairs Medical Center - Dayton Dayton Ohio 45428 United States |
CCOP - Dayton Kettering Ohio 45429 United States |
CCOP - Toledo Community Hospital Oncology Program Toledo Ohio 43623-3456 United States |
Oklahoma Medical Research Foundation Oklahoma City Oklahoma 73104 United States |
Veterans Affairs Medical Center - Oklahoma City Oklahoma City Oklahoma 73104 United States |
Oregon Cancer Center Portland Oregon 97201-3098 United States |
Veterans Affairs Medical Center - Portland Portland Oregon 97207 United States |
CCOP - Columbia River Program Portland Oregon 97213 United States |
Veterans Affairs Medical Center - Charleston Charleston South Carolina 29401-5799 United States |
Medical University of South Carolina Charleston South Carolina 29425-0721 United States |
CCOP - Greenville Greenville South Carolina 29615 United States |
CCOP - Upstate Carolina Spartanburg South Carolina 29303 United States |
Brooke Army Medical Center Fort Sam Houston Texas 78234 United States |
University of Texas Medical Branch Galveston Texas 77555-0209 United States |
Veterans Affairs Medical Center - Houston Houston Texas 77030 United States |
University of Texas Health Science Center at San Antonio San Antonio Texas 78284-7811 United States |
Veterans Affairs Medical Center - San Antonio (Murphy) San Antonio Texas 78284 United States |
Veterans Affairs Medical Center - Temple Temple Texas 76504 United States |
CCOP - Scott and White Hospital Temple Texas 76508 United States |
Huntsman Cancer Institute Salt Lake City Utah 84112 United States |
Veterans Affairs Medical Center - Salt Lake City Salt Lake City Utah 84148 United States |
CCOP - Virginia Mason Research Center Seattle Washington 98101 United States |
Swedish Cancer Institute Seattle Washington 98104 United States |
Veterans Affairs Medical Center - Seattle Seattle Washington 98108 United States |
CCOP - Northwest Tacoma Washington 98405-0986 United States |
Madigan Army Medical Center Tacoma Washington 98431-5000 United States |
Location Countries
Country
United States
Verification Date
2002-01-01
Lastchanged Date
N/A
Firstreceived Date
N/A
Keywords
Has Expanded Access
No
Condition Browse
Secondary Id
SWOG-S0003
Intervention Browse
Mesh Term
Paclitaxel
Albumin-Bound Paclitaxel
Carboplatin
Tirapazamine
Results Reference
Citation
Mack PC, Redman MW, Chansky K, Williamson SK, Farneth NC, Lara PN Jr, Franklin WA, Le QT, Crowley JJ, Gandara DR; SWOG. Lower osteopontin plasma levels are associated with superior outcomes in advanced non-small-cell lung cancer patients receiving platinum-based chemotherapy: SWOG Study S0003. J Clin Oncol. 2008 Oct 10;26(29):4771-6. doi: 10.1200/JCO.2008.17.0662. Epub 2008 Sep 8.
PMID
18779603
Citation
Mack PC, Redman MW, Chansky K, et al.: Elevated osteopontin (OPN) plasma levels are highly prognostic in advanced non-small cell lung cancer (NSCLC): analysis of SWOG S0003. [Abstract] J Clin Oncol 24 (Suppl 18): A-7198, 413s, 2006.
Citation
Williamson SK, Crowley JJ, Lara PN Jr, McCoy J, Lau DH, Tucker RW, Mills GM, Gandara DR; Southwest Oncology Group Trial S0003. Phase III trial of paclitaxel plus carboplatin with or without tirapazamine in advanced non-small-cell lung cancer: Southwest Oncology Group Trial S0003. J Clin Oncol. 2005 Dec 20;23(36):9097-104.
PMID
16361616
Citation
Kimura T, Holland WS, Kawaguchi T, Williamson SK, Chansky K, Crowley JJ, Doroshow JH, Lenz HJ, Gandara DR, Gumerlock PH. Mutant DNA in plasma of lung cancer patients: potential for monitoring response to therapy. Ann N Y Acad Sci. 2004 Jun;1022:55-60.
PMID
15251940
Citation
Williamson SK, Crowley JJ, Lara PN, et al.: S0003: paclitaxel/carboplatin (PC) versus PC + tirapazamine (PCT) in advanced non-small cell lung cancer (NSCLC). A phase III Southwest Oncology Group (SWOG) trial. [Abstract] Lung Cancer 41 (Suppl 2): A-O-89, S29, 2003.
Firstreceived Results Date
N/A
Reference
Citation
Lara PN Jr, Redman MW, Kelly K, Edelman MJ, Williamson SK, Crowley JJ, Gandara DR; Southwest Oncology Group. Disease control rate at 8 weeks predicts clinical benefit in advanced non-small-cell lung cancer: results from Southwest Oncology Group randomized trials. J Clin Oncol. 2008 Jan 20;26(3):463-7. doi: 10.1200/JCO.2007.13.0344.
PMID
18202421
Citation
Gandara DR, Kawaguchi T, Crowley JJ, et al.: Pharmacogenomic (PG) analysis of Japan-SWOG common arm study in advanced stage non-small cell lung cancer (NSCLC): a model for testing population-related pharmacogenomics. [Abstract] J Clin Oncol 25 (Suppl 18): A-7500, 2007.
Citation
Lara PN Jr, Redman MW, Kelly K, et al.: Alternative measures predicting clinical benefit in advanced non-small cell lung cancer (NSCLC) from Southwest Oncology Group (SWOG) randomized trials: implications for clinical trial design. [Abstract] J Clin Oncol 24 (Suppl 18): A-7006, 365s, 2006.
Firstreceived Results Disposition Date
N/A
Study Design Info
Allocation
Randomized
Primary Purpose
Treatment
Study First Submitted
November 6, 2000
Study First Submitted Qc
May 30, 2003
Study First Posted
June 2, 2003
Last Update Submitted
June 20, 2013
Last Update Submitted Qc
June 20, 2013
Last Update Posted
June 24, 2013
ClinicalTrials.gov processed this data on December 13, 2019
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Interventions can also include less intrusive possibilities such as surveys, education, and interviews.
Study Phase
Most clinical trials are designated as phase 1, 2, 3, or 4, based on the type of questions
that study is seeking to answer:
In Phase 1 (Phase I) clinical trials, researchers test a new drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
In Phase 2 (Phase II) clinical trials, the study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.
In Phase 3 (Phase III) clinical trials, the study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
In Phase 4 (Phase IV) clinical trials, post marketing studies delineate additional information including the drug's risks, benefits, and optimal use.
These phases are defined by the Food and Drug Administration in the Code of Federal Regulations.
In Phase 1 (Phase I) clinical trials, researchers test a new drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
In Phase 2 (Phase II) clinical trials, the study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.
In Phase 3 (Phase III) clinical trials, the study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
In Phase 4 (Phase IV) clinical trials, post marketing studies delineate additional information including the drug's risks, benefits, and optimal use.
These phases are defined by the Food and Drug Administration in the Code of Federal Regulations.