- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00280748
Whole-Brain Radiation Therapy and Pemetrexed in Treating Patients With Brain Metastases From Non-Small Cell Lung Cancer (NRR)
A Phase II Study of Treatment of Brain Metastases From Non-Small Cell Lung Cancer With Concurrent Whole Brain Radiation Therapy and Pemetrexed
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Pemetrexed may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving radiation therapy together with pemetrexed may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving whole-brain radiation therapy together with pemetrexed works in treating patients with brain metastases from non-small cell lung cancer.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
OBJECTIVES:
Primary
- Estimate the response in patients with intracranial brain metastases from non-small cell lung cancer treated with whole-brain radiotherapy and pemetrexed disodium.
Secondary
- Determine the toxicity of this regimen in these patients.
- Estimate the overall survival of patients treated with this regimen.
- Evaluate the functional status of patients treated with this regimen.
- Assess neurological function and progression in patients treated with this regimen.
- Determine the response of patients with extracranial disease treated with pemetrexed disodium.
OUTLINE: Patients undergo whole-brain radiotherapy 5 days a week for 3 weeks beginning on day 1. Patients also receive pemetrexed disodium IV on day 1, 2, or 3 and day 28 of course 1, and on day 1 of each subsequent course. Treatment with pemetrexed disodium repeats every 21 days for a total of 4 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed at 30 days and then every 2 months for 2 years.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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North Carolina
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Burlington, North Carolina, Vereinigte Staaten, 27216
- Alamance Oncology/Hematology Associates, LLP
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Chapel Hill, North Carolina, Vereinigte Staaten, 27599-7295
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)
- Must have evidence of brain metastases by MRI or CT scan
PRIOR CONCURRENT THERAPY:
- Recovered from prior oncologic or major surgery
- Prior resection of all brain metastases or only site of brain metastases allowed provided there is radiologically evaluable intracranial metastases
- No prior cranial irradiation, including stereotactic radiosurgery
- More than 30 days since prior non-approved or investigational drug
No other concurrent chemotherapy, immunotherapy, hormonal therapy, radiotherapy, surgery, or experimental medications
- No single brain metastases or oligometastatic disease amenable to surgical resection or radiosurgery
- Relapsed NSCLC with brain metastases allowed
- Not a candidate for double-agent or platinum-based chemotherapy
- No leptomeningeal metastases
- No clinically relevant (defined by physical exam) pleural effusions or ascites that cannot be controlled with drainage or other procedures
Inclusion Criteria:
- Karnofsky performance status 70-100% OR ≥ 70 years of age
- Life expectancy > 3 months
- Absolute neutrophil count (ANC) > 1,500/mm³
- Platelet count > 100,000/mm³
- Hemoglobin ≥ 8 g/dL
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3 times upper limit of normal (ULN)
- Bilirubin ≤ 1.5 times ULN
- Creatinine clearance ≥ 45 mL/min
- Able to take vitamins, folic acid, and corticosteroids
Exclusion Criteria:
- Contraindication or intolerance to corticosteroid therapy
- Other malignancies within the past 5 years and disease-free OR prognosis is best defined by the NSCLC in the opinion of the attending physician
- Pregnant or nursing
- Positive pregnancy test
- Fertile patients must use effective contraception
- HIV positive
- Severe hypersensitivity to pemetrexed disodium
- Unable to discontinue NSAIDs for ≥ 5 days
- History of underlying dementia, Parkinson's disease, or Alzheimer's disease
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Sonstiges: Single Arm Study
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500 mg/m2 once every 21 days up to 126 days
Andere Namen:
Patients will receive cranial irradiation at 2.5 Gy per fraction, 5 days a week, for 3 weeks to a total dose of 37.5 Gy
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Response of Intracranial Metastases (Complete and Partial Response)
Zeitfenster: 126 days
|
Radiographic response will be measured by RECIST, Response Evaluation Criteria In Solid Tumors Criteria, indicating if subject experienced a Complete Response (CR), disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Stable Disease (SD), no response or less response than Partial or Progressive; or Progressive Disease (PD), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
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126 days
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Number of Subjects Experiencing Adverse Events
Zeitfenster: maximum 5 months
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Toxicities was assessed using Common Terminology Criteria for Adverse Events (CTCAE) grading scale.
Only toxicities with attribution to chemotherapy of "definite" or "probable" are considered, as determined by treating physician.
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maximum 5 months
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Estimate the Overall Survival of Patients Treated With This Regimen.
Zeitfenster: 4 years
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Patients were followed for survival from start of treatment until death from any cause (up to 4 years)
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4 years
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Evaluate the Functional Status of Patients Treated With This Regimen.
Zeitfenster: baseline functional status only
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Functional status evaluated using the Karnofsky functional status scale.
The Karnofsky Performance Scale (KPS) Index allows patients to be classified as to their functional impairment.
This can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients.
The lower the Karnofsky score, the worse the survival for most serious illnesses.
The Karnofsky score runs from 100 to 0, where 100 is "perfect" health and 0 is death.
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baseline functional status only
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Neurological Function by Radiation Oncology Group (RTOG) Neurological Function Classification
Zeitfenster: At Baseline, 30 days, and at end of treatment (maximum 5 months).
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A classification score defined as follows:
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At Baseline, 30 days, and at end of treatment (maximum 5 months).
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Neurological Function by Mini Mental State Examination
Zeitfenster: Baseline (pre-treatment), 30 days (Cycle 2 Day 1), and maximum 5 months (end of treatment).
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The Mini Mental State Examination is a 30-point questionnaire that is used to measure cognitive impairment.
Score totals range from normal cognition (24-30 points), mild impairment (19-23 points), moderate impairment (10-18 points), to severe impairment (≤9 points).
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Baseline (pre-treatment), 30 days (Cycle 2 Day 1), and maximum 5 months (end of treatment).
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Response of Patients With Extracranial Disease Treated With Pemetrexed
Zeitfenster: maximum 5 months
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Response was measured by Response Evaluation Criteria In Solid Tumors RECIST criteria v1.0.
Complete Response (CR) - Disappearance of all lesions Partial Response (PR) - at least a 30% decrease in the sum of the longest diameter of target lesions, taking as reference the baseline sum longest diameter.
Stable Disease (SD) - neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease, taking as reference the smallest sum longest diameter since the treatment started.
Progressive Disease (PD) - at least a 20% increase in the sum of the longest diameter of target lesions, taking as reference the smallest sum longest diameter recorded since the treatment started or the appearance of one or more new lesions or unequivocal progression of existing nontarget lesions.
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maximum 5 months
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Mitarbeiter und Ermittler
Mitarbeiter
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen des Gehirns
- Erkrankungen des zentralen Nervensystems
- Erkrankungen des Nervensystems
- Erkrankungen der Atemwege
- Neubildungen
- Lungenkrankheit
- Neubildungen nach Standort
- Neubildungen der Atemwege
- Thoraxneoplasmen
- Karzinom, bronchogen
- Bronchiale Neubildungen
- Neubildungen des zentralen Nervensystems
- Neubildungen des Nervensystems
- Lungentumoren
- Karzinom, nicht-kleinzellige Lunge
- Neubildungen des Gehirns
- Molekulare Mechanismen der pharmakologischen Wirkung
- Inhibitoren der Nukleinsäuresynthese
- Enzym-Inhibitoren
- Antineoplastische Mittel
- Folsäure-Antagonisten
- Pemetrexed
Andere Studien-ID-Nummern
- LCCC 0409
- CDR0000551069 (Andere Kennung: PDQ number)
Plan für individuelle Teilnehmerdaten (IPD)
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