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Combination Chemotherapy and Computer-Planned Radiation Therapy in Treating Patients With Unresectable Stage III Non-Small Cell Lung Cancer

15 de julio de 2016 actualizado por: Alliance for Clinical Trials in Oncology

Induction/Concurrent Chemotherapy and Dose-Escalated Three Dimensional Thoracic Radiation for Patients With Stage III Non Small Cell Lung Cancer: A Randomized Phase II Study

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Computer systems that allow doctors to create a 3-dimensional picture of the tumor to plan treatment may result in more effective radiation therapy. It is not yet known which chemotherapy and/or radiation therapy regimen is more effective in treating non-small cell lung cancer.

PURPOSE: Randomized phase II trial to compare the effectiveness of different combination chemotherapy regimens and 3-dimensional radiation therapy in treating patients who have unresectable stage III non-small cell lung cancer.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

OBJECTIVES:

  • Compare the overall response rate, failure-free survival, and survival of patients with inoperable stage IIIA or IIIB non-small cell lung cancer treated with paclitaxel and carboplatin with concurrent 3-dimensional conformal radiotherapy (3-D XRT) vs gemcitabine and carboplatin with concurrent 3-D XRT.
  • Compare the toxicity of these regimens in these patients.
  • Compare the pattern of failure (locoregional vs distant failure) in patients treated with these regimens.
  • Determine the feasibility of delivering 3-D XRT to patients in this multicenter study.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to one of two treatment arms.

  • Arm I: Patients receive paclitaxel IV over 3 hours followed by carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 2 courses. Patients then receive paclitaxel IV over 1 hour followed by carboplatin IV over 30 minutes once weekly and 3-dimensional conformal radiotherapy (3-D XRT) once daily 5 days a week. Treatment repeats weekly for 7 courses.
  • Arm II: Patients receive gemcitabine IV over 30 minutes on days 1 and 8 followed by carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 2 courses. Patients then receive gemcitabine IV over 30 minutes twice weekly and 3-D XRT as in arm I. Treatment repeats weekly for 7 courses.

In both arms, treatment continues in the absence of disease progression.

Patients are followed every 2 months for 2 years, every 4 months for 2 years, and then annually for 2 years.

PROJECTED ACCRUAL: A total of 82 patients (41 per treatment arm) will be accrued for this study within 9 months.

Tipo de estudio

Intervencionista

Inscripción (Actual)

69

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Estados Unidos
    • Alabama
      • Anniston, Alabama, Estados Unidos, 36207
        • Northeast Alabama Regional Medical Center
    • California
      • La Jolla, California, Estados Unidos, 92093-0658
        • Rebecca and John Moores UCSD Cancer Center
      • Los Angeles, California, Estados Unidos, 90048
        • Cedars-Sinai Comprehensive Cancer Center at Cedars-Sinai Medical Center
      • San Diego, California, Estados Unidos, 92161
        • Veterans Affairs Medical Center - San Diego
      • San Diego, California, Estados Unidos, 92134-3202
        • Naval Medical Center - San Diego
      • San Francisco, California, Estados Unidos, 94115
        • UCSF Comprehensive Cancer Center
      • San Francisco, California, Estados Unidos, 94121
        • Veterans Affairs Medical Center - San Francisco
    • Delaware
      • Newark, Delaware, Estados Unidos, 19713
        • CCOP - Christiana Care Health Services
    • District of Columbia
      • Washington, District of Columbia, Estados Unidos, 20422
        • Veterans Affairs Medical Center - Washington, DC
      • Washington, District of Columbia, Estados Unidos, 20007
        • Lombardi Cancer Center at Georgetown University Medical Center
      • Washington, District of Columbia, Estados Unidos, 20307-5001
        • Walter Reed Army Medical Center
    • Florida
      • Fort Lauderdale, Florida, Estados Unidos, 33316
        • Broward General Medical Center
      • Hollywood, Florida, Estados Unidos, 33021
        • Memorial Regional Cancer Center at Memorial Regional Hospital
      • Miami Beach, Florida, Estados Unidos, 33140
        • CCOP - Mount Sinai Medical Center
      • Orlando, Florida, Estados Unidos, 32804
        • Florida Hospital Cancer Institute
    • Illinois
      • Chicago, Illinois, Estados Unidos, 60612
        • Veterans Affairs Medical Center - Chicago (Westside Hospital)
      • Chicago, Illinois, Estados Unidos, 60637-1470
        • University of Chicago Cancer Research Center
      • Chicago, Illinois, Estados Unidos, 60640
        • Louis A. Weiss Memorial Hospital
      • Peoria, Illinois, Estados Unidos, 61615-7828
        • CCOP - Illinois Oncology Research Association
      • River Forest, Illinois, Estados Unidos, 60305
        • West Suburban Center for Cancer Care
    • Indiana
      • Fort Wayne, Indiana, Estados Unidos, 46885-5099
        • Fort Wayne Medical Oncology and Hematology, Incorporated
      • South Bend, Indiana, Estados Unidos, 46601
        • CCOP - Northern Indiana CR Consortium
    • Iowa
      • Iowa City, Iowa, Estados Unidos, 52242-1009
        • Holden Comprehensive Cancer Center at University of Iowa
    • Kentucky
      • Louisville, Kentucky, Estados Unidos, 40207
        • Baptist Hospital East - Louisville
    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02115
        • Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
      • Worcester, Massachusetts, Estados Unidos, 01655
        • UMASS Memorial Cancer Center - University Campus
    • Michigan
      • Saint Joseph, Michigan, Estados Unidos, 49085
        • Lakeland Cancer Care Center at Lakeland Hospital - St. Joseph
    • Minnesota
      • Minneapolis, Minnesota, Estados Unidos, 55417
        • Veterans Affairs Medical Center - Minneapolis
      • Minneapolis, Minnesota, Estados Unidos, 55455
        • University of Minnesota Cancer Center
    • Missouri
      • Columbia, Missouri, Estados Unidos, 65201
        • Veterans Affairs Medical Center - Columbia (Truman Memorial)
      • Columbia, Missouri, Estados Unidos, 65203
        • Ellis Fischel Cancer Center at University of Missouri - Columbia
      • Kansas City, Missouri, Estados Unidos, 64131
        • CCOP - Kansas City
      • Saint Louis, Missouri, Estados Unidos, 63131
        • Missouri Baptist Cancer Center
      • Saint Louis, Missouri, Estados Unidos, 63110
        • Siteman Cancer Center at Barnes-Jewish Hospital
    • Nebraska
      • Omaha, Nebraska, Estados Unidos, 68198-7680
        • UNMC Eppley Cancer Center at the University of Nebraska Medical Center
    • Nevada
      • Las Vegas, Nevada, Estados Unidos, 89106
        • CCOP - Southern Nevada Cancer Research Foundation
      • Las Vegas, Nevada, Estados Unidos, 89106
        • Veterans Affairs Medical Center - Las Vegas
    • New Hampshire
      • Hooksett, New Hampshire, Estados Unidos, 03106
        • New Hampshire Oncology-Hematology, PA - Hooksett
      • Lebanon, New Hampshire, Estados Unidos, 03756-0002
        • Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
    • New Jersey
      • Camden, New Jersey, Estados Unidos, 08103
        • Cancer Institute of New Jersey at the Cooper University Hospital
    • New York
      • Buffalo, New York, Estados Unidos, 14263-0001
        • Roswell Park Cancer Institute
      • Buffalo, New York, Estados Unidos, 14215
        • Veterans Affairs Medical Center - Buffalo
      • East Syracuse, New York, Estados Unidos, 13057
        • CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
      • Elmhurst, New York, Estados Unidos, 11373
        • Elmhurst Hospital Center
      • Jamaica, New York, Estados Unidos, 11432
        • Queens Cancer Center of Queens Hospital
      • Manhasset, New York, Estados Unidos, 11030
        • CCOP - North Shore University Hospital
      • Manhasset, New York, Estados Unidos, 11030
        • North Shore University Hospital
      • New York, New York, Estados Unidos, 10021
        • Memorial Sloan-Kettering Cancer Center
      • New York, New York, Estados Unidos, 10021
        • New York Weill Cornell Cancer Center at Cornell University
      • New York, New York, Estados Unidos, 10029
        • Mount Sinai Medical Center
      • Syracuse, New York, Estados Unidos, 13210
        • Veterans Affairs Medical Center - Syracuse
      • Syracuse, New York, Estados Unidos, 13210
        • SUNY Upstate Medical University Hospital
    • North Carolina
      • Asheville, North Carolina, Estados Unidos, 28805
        • Veterans Affairs Medical Center - Asheville
      • Chapel Hill, North Carolina, Estados Unidos, 27599-7295
        • Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
      • Concord, North Carolina, Estados Unidos, 28025
        • NorthEast Oncology Associates - Concord
      • Durham, North Carolina, Estados Unidos, 27705
        • Veterans Affairs Medical Center - Durham
      • Durham, North Carolina, Estados Unidos, 27710
        • Duke Comprehensive Cancer Center
      • Fayetteville, North Carolina, Estados Unidos, 28302-2000
        • Cape Fear Valley Health System
      • Goldsboro, North Carolina, Estados Unidos, 27534-9479
        • CCOP - Southeast Cancer Control Consortium
      • Kinston, North Carolina, Estados Unidos, 28503-1678
        • Lenoir Memorial Cancer Center
      • Pinehurst, North Carolina, Estados Unidos, 28374
        • Comprehensive Cancer Center at Moore Regional Hospital
      • Wilmington, North Carolina, Estados Unidos, 28402-9025
        • Zimmer Cancer Center at New Hanover Regional Medical Center
      • Winston-Salem, North Carolina, Estados Unidos, 27157-1082
        • Comprehensive Cancer Center at Wake Forest University
    • Ohio
      • Columbus, Ohio, Estados Unidos, 43210-1240
        • Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University
    • Oklahoma
      • Oklahoma City, Oklahoma, Estados Unidos, 73104
        • Oklahoma University Medical Center
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Estados Unidos, 15224
        • Western Pennsylvania Hospital
    • Rhode Island
      • Providence, Rhode Island, Estados Unidos, 02906
        • Lifespan: The Miriam Hospital
    • Texas
      • Dallas, Texas, Estados Unidos, 75219
        • Veterans Affairs Medical Center - Dallas
    • Vermont
      • Burlington, Vermont, Estados Unidos, 05401-3498
        • Vermont Cancer Center at University of Vermont
    • Virginia
      • Charlottesville, Virginia, Estados Unidos, 22902
        • Martha Jefferson Hospital
      • Norfolk, Virginia, Estados Unidos, 23502
        • Virginia Oncology Associates - Norfolk
      • Richmond, Virginia, Estados Unidos, 23298-0037
        • MBCCOP - Massey Cancer Center
      • Roanoke, Virginia, Estados Unidos, 24014
        • Oncology and Hematology Associates of Southwest Virginia, Incorporated - Roanoke
    • West Virginia
      • Huntington, West Virginia, Estados Unidos, 25701
        • St. Mary's Medical Center

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)

    • Squamous cell carcinoma
    • Adenocarcinoma, including bronchoalveolar cell carcinoma
    • Large cell anaplastic carcinoma, including giant and clear cell carcinoma
  • Inoperable stage IIIA or IIIB disease

  • No direct invasion of vertebral body

    • Tumors adjacent to a vertebral body without bone invasion allowed if all gross disease can be encompassed in radiotherapy boost field
  • Contralateral mediastinal disease (N3) allowed if all gross disease can be encompassed in radiotherapy boost field
  • No scalene, supraclavicular, or contralateral hilar node involvement

  • Transudate, cytologically negative, non-bloody pleural effusion allowed if it can be encompassed in radiotherapy field

    • No exudative, bloody, or cytologically malignant pleural effusion
    • Evidence of pleural effusion by chest CT scan but not chest x-ray that is too small to tap allowed

  • At least 1 unidimensionally measurable lesion

    • At least 20 mm by conventional techniques OR
    • At least 10 mm by spiral CT scan

    • The following are not considered measurable disease:

      • Bone lesions
      • Leptomeningeal disease
      • Ascites
      • Pleural/pericardial effusion
      • Abdominal masses that are not confirmed and followed by imaging techniques
      • Cystic lesions
      • Tumor lesions in a previously irradiated field

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • ECOG 0-1

Life expectancy:

  • Not specified

Hematopoietic:

  • Granulocyte count at least 1,500/mm3
  • Platelet count at least 100,000/mm3

Hepatic:

  • Bilirubin less than 1.5 mg/dL
  • AST less than 2 times upper limit of normal

Renal:

  • Creatinine clearance 20-130 mL/min for females
  • Creatinine clearance 20-150 mL/min for males

Pulmonary:

  • FEV1 at least 1.2 L

Other:

  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • No other currently active malignancy (defined as completed prior therapy and considered to be at less than 30% risk of relapse) except non-melanoma skin cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • Not specified

Chemotherapy:

  • No prior chemotherapy for NSCLC
  • No other concurrent chemotherapy

Endocrine therapy:

  • No concurrent hormonal therapy except steroids for adrenal failure or septic shock, hormones for non-disease-related conditions (e.g., insulin for diabetes), or glucocorticosteroids as antiemetics

Radiotherapy:

  • See Disease Characteristics
  • No prior radiotherapy for NSCLC

Surgery:

  • At least 2 weeks since prior exploratory thoracotomy

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Paclitaxel + Carboplatin
Paclitaxel and carboplatin induction (2 cycles)followed by chemotherapy with the addition of radiotherapy for 7 cycles
Droga: carboplatin
Arm A: AUC=6 IV over 30 min for 2 cycles then AUC=2 IV over 30 min q wk for 7 wks Arm B: AUC=5 IV over 30 min for 2 cycles
Droga: paclitaxel
225 mg/sq m IV over 3 hrs q 21 days for 2 cycles, then 45 mg/sq m IV over 1 hr q wk for 7 wks
Radiación: radiation therapy
3-D XRT 7400 cGy total after induction (during cycles 3-9)
Experimental: Gemcitabine + Carboplatin
Gemcitabine and carboplatin induction (2cycles) followed by chemotherapy with the addition of radiotherapy for 7 cycles
Droga: carboplatin
Arm A: AUC=6 IV over 30 min for 2 cycles then AUC=2 IV over 30 min q wk for 7 wks Arm B: AUC=5 IV over 30 min for 2 cycles
Radiación: radiation therapy
3-D XRT 7400 cGy total after induction (during cycles 3-9)
Droga: gemcitabine hydrochloride
1000 mg/sq m IV over 30 min days 1 & 8 repeat q 21 days for 2 cycles; then 35 mg/sq m IV over 30 min 2X wk for 7 wks

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Response
Periodo de tiempo: 18 months post treatment
Response is assessed as failure free survival
18 months post treatment

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Overall Survival
Periodo de tiempo: 6 years post treatment
6 years post treatment
Toxicity
Periodo de tiempo: 13 weeks
Toxicity will be assessed during treatment
13 weeks

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Alliance for Clinical Trials in Oncology

Colaboradores

National Cancer Institute (NCI)

Investigadores

  • Silla de estudio: Arthur William Blackstock, MD, Wake Forest University Health Sciences

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de marzo de 2002

Finalización primaria (Actual)

1 de septiembre de 2006

Finalización del estudio (Actual)

1 de junio de 2010

Fechas de registro del estudio

Enviado por primera vez

9 de abril de 2002

Primero enviado que cumplió con los criterios de control de calidad

26 de enero de 2003

Publicado por primera vez (Estimar)

27 de enero de 2003

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

19 de julio de 2016

Última actualización enviada que cumplió con los criterios de control de calidad

15 de julio de 2016

Última verificación

1 de julio de 2016

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • CALGB-30105
  • U10CA031946 (Subvención/contrato del NIH de EE. UU.)
  • CDR0000069300 (Identificador de registro: NCI Physician Data Query)

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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