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Carboplatin, Paclitaxel, Selenomethionine, and Radiation Therapy in Treating Patients With Stage III Non-Small Cell Lung Cancer That Cannot Be Removed by Surgery

23 ottobre 2017 aggiornato da: Roswell Park Cancer Institute

Concurrent Carboplatin, Paclitaxel and Selenomethionine in Combination With Radiation for Patients With Unresectable Stage III Non-Small Cell Lung Cancer: A Phase II, Multi-Center Trial

RATIONALE: Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Selenomethionine may slow the growth of tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving combination chemotherapy together with selenomethionine and radiation therapy may kill more tumor cells.

PURPOSE: This phase II trial is studying the side effects and how well selenomethionine works when given together with carboplatin, paclitaxel, and radiation therapy in treating patients with stage III non-small cell lung cancer that cannot be removed by surgery.

Panoramica dello studio

Descrizione dettagliata

OBJECTIVES:

Primary

  • Determine the safety and tolerability of selenomethionine in combination with chemotherapy and radiotherapy in patients with unresectable stage IIIA or IIIB non-small cell lung cancer.
  • Determine if the incidence of excessive adverse events, in the form of esophagitis, pneumonitis, and myelosuppression, can be reduced with this regimen.

Secondary

  • Estimate response rate, failure-free survival, and overall survival of these patients.
  • Correlate selenium levels with degree of observed adverse events.

OUTLINE: This is a multicenter study.

Patients receive oral selenomethionine twice daily for 1 week and then once daily for 6 weeks. Patients also receive paclitaxel IV over 1 hour once weekly and carboplatin IV over 30 minutes once weekly for 6 weeks and undergo radiotherapy 5 days a week for 6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.

Blood samples are collected at baseline and weekly during treatment and analyzed by absorption spectrophotometry for selenium measurement of drug concentration

After the completion of study treatment, patients are followed periodically.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

16

Fase

  • Fase 2

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • New York
      • Buffalo, New York, Stati Uniti, 14263-0001
        • Roswell Park Cancer Institute

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 120 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed non-small cell lung cancer (NSCLC), including any of the following histologic subtypes:

    • Squamous cell carcinoma
    • Adenocarcinoma (including bronchoalveolar cell carcinoma)
    • Large cell anaplastic carcinoma (including giant and clear cell carcinoma)
  • Stage IIIA disease OR selected stage IIIB disease

    • T1-2, N2 disease OR T3, N2 or T4, N0-N2 disease (if based on tumor closeness to the carina, invasion of the mediastinum, or invasion of the chest wall)

      • Contralateral mediastinal disease (N3) allowed if all gross disease can be encompassed in the radiation boost field
  • Tumors adjacent to a vertebral body allowed unless there is demonstrable bone invasion

    • All gross disease must be able to be encompassed in the radiation boost field
    • No direct invasion of a vertebrae body
  • Unresectable or inoperable disease
  • Measurable disease
  • Suitable for radiotherapy, as deemed by the radiation oncologist
  • No scalene, supraclavicular, or contralateral hilar node involvement
  • Pleural effusion allowed provided it is transudate, cytologically negative, and non-bloody, and, according to the radiation oncologist, the tumor can be encompassed within a reasonable radiation field

    • Pleural effusion seen on chest CT scan, but not on chest x-ray, that is too small to tap is allowed
    • No exudative, bloody, or cytologically malignant effusions
  • No known brain metastases

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-1
  • ANC ≥ 1,500/mm³
  • Platelet count ≥ 75,000/mm³
  • Total bilirubin ≤ 1.5 mg/dL
  • Creatinine normal
  • Alkaline phosphatase AND AST or ALT meeting 1 of the following criteria:

    • Alkaline phosphatase normal AND AST or ALT ≤ 5 times upper limit of normal (ULN)
    • Alkaline phosphatase ≤ 2.5 times ULN AND AST or ALT ≤ 1.5 times ULN
    • Alkaline phosphatase ≤ 5 times ULN AND AST or ALT normal
  • Able to swallow oral medications
  • No peripheral neuropathy > grade 1
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to selenomethionine or agents formulated with Cremophor EL
  • No concurrent uncontrolled illness including, but not limited to, any of the following:

    • Ongoing or active infection
    • Symptomatic congestive heart failure
    • Unstable angina pectoris
    • Clinically significant cardiac arrhythmia
    • Psychiatric illness or social situations that would limit compliance with study requirements
  • No currently "active" second malignancy other than non-melanoma skin cancer

    • Patients are considered not to have an "active" malignancy if they have completed therapy and are considered by their physician to be at less than 30% risk of relapse
  • Not pregnant
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • At least 2 weeks since prior formal exploratory thoracotomy (N2 node identified making patient ineligible for surgery)
  • No prior chemotherapy or radiotherapy for NSCLC
  • No prior taxanes or platinum drugs
  • No other concurrent investigational agents or anticancer therapy
  • No concurrent combination antiretroviral therapy for HIV-positive patients
  • No other concurrent chemotherapy or hormonal therapy, except for the following:

    • Steroids administered for adrenal failure or septic shock
    • Hormones administered for non-disease-related conditions (e.g., insulin for diabetes)
    • Glucocorticosteroids administered as antiemetics

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: CPSR
Concurrent Carboplatin, Paclitaxel and Selenomethionine in Combination with Radiation
Studio correlato
Oral Twice daily
Weekly IV
Weekly IV
Undergoing radiation Therapy

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Lasso di tempo
Incidence of Grade 3-4 Esophagitis
Lasso di tempo: During study treatment, up to 6 weeks
During study treatment, up to 6 weeks
Incidence of Grade 3-4 Pneumonitis
Lasso di tempo: During study treatment, up to 6 weeks
During study treatment, up to 6 weeks
Incidence of Grade 3-4 Myelosuppression
Lasso di tempo: During study treatment, up to 6 weeks
During study treatment, up to 6 weeks

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Response Rate
Lasso di tempo: 1 month post-treatment, then q 3 months x 4
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.
1 month post-treatment, then q 3 months x 4
Failure-free Survival
Lasso di tempo: Post-treatment follow-up every 3 months x4, then per institute standard of practice every 6 months for 2 years, then yearly therafter.
Post-treatment follow-up every 3 months x4, then per institute standard of practice every 6 months for 2 years, then yearly therafter.
Overall Survival
Lasso di tempo: Post-treatment follow-up every 3 months x4, then per institute standard of practice every 6 months for 2 years, then yearly therafter
Post-treatment follow-up every 3 months x4, then per institute standard of practice every 6 months for 2 years, then yearly therafter
Selenium Level by Incidence of SAE
Lasso di tempo: Pre-treatment and every week for 6 weeks prior to chemotherapy.
Median Selenium level by Incidence of SAE. Mann-Whitney-Wilcoxon test was used to test the correlation between selenium levels and serious adverse events.
Pre-treatment and every week for 6 weeks prior to chemotherapy.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Investigatori

  • Investigatore principale: Jorge Gomez, MD, Roswell Park Cancer Institute

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 ottobre 2006

Completamento primario (Effettivo)

1 agosto 2010

Completamento dello studio (Effettivo)

1 settembre 2010

Date di iscrizione allo studio

Primo inviato

7 settembre 2007

Primo inviato che soddisfa i criteri di controllo qualità

7 settembre 2007

Primo Inserito (Stima)

10 settembre 2007

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

28 novembre 2017

Ultimo aggiornamento inviato che soddisfa i criteri QC

23 ottobre 2017

Ultimo verificato

1 ottobre 2017

Maggiori informazioni

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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