Radiation Therapy, Chemotherapy, and Bevacizumab in Treating Patients With Recurrent, Unresectable or Stage III or Stage IV Non-Small Cell Lung Cancer
Phase II Study of Radiation Followed by Paclitaxel, Carboplatin, and Bevacizumab (PCA) in Patients With Stage IIIB and IV Squamous Non-Small Cell Lung Cancer
RATIONALE: Radiation therapy uses high-energy x-rays to kill tumor cells. Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving radiation therapy together with chemotherapy and monoclonal antibody therapy may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving radiation therapy together with chemotherapy and bevacizumab works in treating patients with recurrent, unresectable or stage III or stage IV non-small cell lung cancer.
調査の概要
詳細な説明
OBJECTIVES:
Primary
- Evaluate reduction in toxicity, in terms of pulmonary hemorrhage, in patients with recurrent, unresectable or stage IIIB or IV squamous non-small cell lung cancer treated with radiotherapy followed by paclitaxel, carboplatin, and bevacizumab.
Secondary
- Determine the overall and progression-free survival of patients treated with this regimen.
OUTLINE: Patients undergo radiotherapy to the primary tumor, clinically involved lymph nodes, and any other disease-causing symptoms or bronchial compression once daily, 5 days a week, for 2 weeks in weeks 1 and 2. Beginning in week 4, patients receive paclitaxel IV over 3 hours, carboplatin IV over 15-30 minutes, and bevacizumab IV over 30-90 minutes on day 1. Treatment with paclitaxel, carboplatin, and bevacizumab repeats every 3 weeks for 4 courses in the absence of unacceptable toxicity. Patients achieving complete response, partial response, or stable disease after 4 courses receive bevacizumab alone as above in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed every 6 months.
PROJECTED ACCRUAL: A total of 32 patients will be accrued for this study.
研究の種類
入学 (予想される)
段階
- フェーズ2
連絡先と場所
研究場所
-
-
Alabama
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Birmingham、Alabama、アメリカ、35294
- Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
-
-
Illinois
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Chicago、Illinois、アメリカ、60611-3013
- Robert H. Lurie Comprehensive Cancer Center at Northwestern University
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Evanston、Illinois、アメリカ、60201-1781
- Evanston Northwestern Healthcare - Evanston Hospital
-
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Tennessee
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Nashville、Tennessee、アメリカ、37232-6838
- Vanderbilt-Ingram Cancer Center
-
-
Texas
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Dallas、Texas、アメリカ、75390
- Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)
- Predominantly squamous cell histology
- Cytologic or histologic elements can be established on metastatic tumor aspirates or biopsy
Advanced disease, meeting 1 of the following staging criteria:
- Stage IIIB disease with malignant pleural effusion
- Stage IV disease
- Recurrent, unresectable disease
- Measurable or nonmeasurable disease
- No extrathoracic only disease
- No known CNS metastases by head CT scan with contrast or MRI
PATIENT CHARACTERISTICS:
- ECOG performance status 0-1
- Platelet count > 100,000/mm^3
- Absolute neutrophil count > 1,500/mm^3
- Bilirubin < 1.5 mg/dL
- Transaminases < 5 times upper limit of normal (ULN)
- Creatinine clearance ≥ 45 mL/min
- Urine protein:creatinine ratio ≤ 1.0 by spot urinalysis
- INR < 1.5 ULN
- PTT normal
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients use effective contraception
- No serious nonhealing wound, ulcer, or bone fracture
- No ongoing or active infection
- No ongoing fever
- No myocardial infarction within the past 6 months
- No stroke within the past 6 months
- No history of hypertension unless well-controlled (i.e., blood pressure < 150/100 mmHg on a stable regimen of antihypertensive therapy)
- No New York Heart Association grade III or IV congestive heart failure
- No serious cardiac arrhythmia requiring medication
- No unstable angina pectoris
- No peripheral vascular disease ≥ grade 2
- No other clinically significant cardiovascular disease
- No abdominal fistula
- No gastrointestinal perforation
- No intra-abdominal abscess within the past 6 months
- No psychiatric illness or social situation that would preclude study compliance
- No other malignancy curatively treated within the past 5 years
- No history of thrombotic or hemorrhagic disorders
- No gross hemoptysis (i.e., red blood ≥ ½ teaspoon) within the past 3 months
- No bleeding requiring intervention or ≥ grade 2
PRIOR CONCURRENT THERAPY:
- Recovered from prior therapy
- No prior systemic chemotherapy for metastatic NSCLC
- More than 6 months since prior adjuvant chemotherapy for early stage (i.e., stage IB-IIIA) NSCLC
- More than 3 weeks since prior immunotherapy, hormonal therapy, or radiotherapy
- More than 28 days since prior and no concurrent major surgery
- More than 7 days since prior minor surgery, fine-needle aspiration, or core biopsy
- More than 4 weeks since prior and no concurrent participation in another experimental drug study
No concurrent therapeutic anticoagulation
- Concurrent prophylactic anticoagulation of venous access device allowed
- No concurrent chronic treatment with aspirin (> 325 mg/day) or nonsteroidal anti-inflammatory drugs known to inhibit platelet function
- No concurrent dipyridamole, ticlopidine, clopidogrel, or cilostazol
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- マスキング:なし(オープンラベル)
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
---|
Reduction in toxicity measured by pulmonary hemorrhage rate
|
二次結果の測定
結果測定 |
---|
毒性
|
回答率
|
Overall survival by Kaplan-Meier
|
協力者と研究者
スポンサー
捜査官
- 主任研究者:Jyoti D. Patel、Robert H. Lurie Cancer Center
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- NU 05L1
- NU-05L1
- NU-1362-038
- GENENTECH-AVF3646s
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
肺癌の臨床試験
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Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI); Highlight Therapeutics積極的、募集していない平滑筋肉腫 | 悪性末梢神経鞘腫瘍 | 滑膜肉腫 | 未分化多形肉腫 | 骨の未分化高悪性度多形肉腫 | 粘液線維肉腫 | II期の体幹および四肢の軟部肉腫 AJCC v8 | III期の体幹および四肢の軟部肉腫 AJCC v8 | IIIA 期の体幹および四肢の軟部肉腫 AJCC v8 | IIIB 期の体幹および四肢の軟部肉腫 AJCC v8 | 切除可能な軟部肉腫 | 多形性横紋筋肉腫 | 切除可能な脱分化型脂肪肉腫 | 切除可能な未分化多形肉腫 | 軟部組織線維肉腫 | 紡錘細胞肉腫 | ステージ I 後腹膜肉腫 AJCC (American Joint Committee on Cancer) v8 | 体幹および四肢の I 期軟部肉腫 AJCC v8 | ステージ... およびその他の条件アメリカ
カルボプラチンの臨床試験
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Virginia Commonwealth UniversityNational Cancer Institute (NCI)引きこもったステージ IIIA 非小細胞肺がん | ステージ IIIB 非小細胞肺がん | 扁平上皮肺がん | 肺の腺癌 | 大細胞肺がん | ステージ IIA 非小細胞肺がん | ステージ IIB 非小細胞肺がん
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Children's Oncology GroupNational Cancer Institute (NCI)完了脳腫瘍 | 中枢神経系腫瘍アメリカ, カナダ, オーストラリア, スイス, オランダ, ニュージーランド