Bevacizumab in Extensive Small Cell Lung Cancer (CPC)
Randomized Phase II-III Study of Bevacizumab 7,5 mg/kg in Combination With Chemotherapy Versus Chemotherapy in Extensive-Disease Small-Cell Lung Cancer After Response to Chemotherapy : PCDE (cisPlatin - Cyclophosphamide - epiDoxorubicin - Etoposide) or PE (cisPlatin - Etoposide)
Despite the fact that a substantial response rate may be obtained in small-cell lung cancers (using double-drug chemotherapy: cisplatin-etoposide, PE), a cure remains an exception. More aggressive regimens remain controversial and recent attempts at increasing dose-intensity have been restricted to patients with a more favourable presentation.
Bevacizumab is a humanized monoclonal antibody which binds to VEGF (Vascular Endothelial Growth Factor). In association with double-drug standard chemotherapies, it has been proven that bevacizumab can improve survival of previously untreated advanced non-small-cell lung cancers (NSCLC), compared to chemotherapy without bevacizumab). Such promising effects on NSCLC deserve to be tested on small-cell lung cancers.
In this trial (IFCT-0802), standard chemotherapy (PCDE or PE) will be compared to experimental treatment (PCDE or PE + bevacizumab 7.5 mg/kg) for previously untreated SCLC patients.
調査の概要
状態
条件
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
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Ambilly、フランス、74100
- Annemasse - CH
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Angers、フランス、49000
- Angers - CHU
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Armentières、フランス
- Armentières - CH
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Besancon、フランス、25000
- CHU Besancon - Pneumologie
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Caen、フランス、14000
- Centre F. Baclesse
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Caen、フランス、14000
- CHU - Pneumologie
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Cahors、フランス、46000
- Cahors - CH
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Chalons-en-Champagne、フランス
- Chalons-en-Champagne - CH
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Chauny、フランス
- Chauny - CH
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Clamart、フランス、92140
- Hôpital Percy-Armées - Pneumologie
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Clermont Ferrand、フランス、63000
- Clermont Ferrand - CHU
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Colmar、フランス、68000
- Colmar - CH
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Compiègne、フランス、60300
- CH - Compiegne
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Créteil、フランス、94000
- Créteil - CHI
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Dijon、フランス、21000
- Dijon - CAC
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Dijon、フランス、63000
- Dijon - CHU
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Draguignan、フランス、83300
- Draguignan - CH
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Grenoble、フランス、38000
- CHU Grenoble - pneumologie
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Harfleur、フランス、76700
- Harfleur - Clinique du Petit Colmoulins
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Helfaut、フランス、62570
- Saint Omer - CHI
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Jonzac、フランス、17500
- Jonzac - CH
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Le Coudray、フランス、28630
- Chartres - CH
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Le Mans、フランス、72000
- Centre Hospitalier - Pneumologie
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Longjumeau、フランス
- CH
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Marseille、フランス、13000
- APHM - Hôpital Sainte Marguerite
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Marseille、フランス
- Marseille - CRLCC
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Maubeuge、フランス、59600
- Maubeuge - Polyclinique du Parc
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Meaux、フランス、77100
- Meaux - CH
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Metz、フランス、57000
- Metz - CHR
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Mont de Marsan、フランス、40000
- Mont de Marsan - CH
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Montpellier、フランス、34295
- Montpellier - CHRU
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Mulhouse、フランス、68000
- Mulhouse - CH
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Neuilly、フランス、92200
- Neuilly - Hôpital Américain de Paris
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Nevers、フランス、58033
- Nevers - CH
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Nice、フランス、06000
- Nice - CAC
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Orléans、フランス、45000
- Orléans - CH
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Paris、フランス、75012
- APHP - Saint-Antoine - pneumologie
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Paris、フランス、75020
- APHP - Hopital Tenon - Pneumologie
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Pau、フランス、64046
- Pau - CH
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Pierre Bénite、フランス、69495
- HCL - Lyon Sud (Pneumologie)
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Reims、フランス、51092
- Reims - CHU
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Reims、フランス
- Reims - CRLCC
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Rouen、フランス、76000
- Rouen - CHU
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Saint Brieuc、フランス、22000
- Saint Brieuc - CHG
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Saint Nazaire、フランス、44600
- Saint Nazaire - Centre Etienne Dolet
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Saint Priest en Jarez、フランス、42270
- Saint Priest en Jarez - ICL
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Saint Quentin、フランス、02100
- Saint Quentin - CH
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Saverne、フランス
- Saverne - CH
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Senlis、フランス、60300
- Senlis - CH
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Strasbourg、フランス、63000
- Nouvel Hopital Civil - Pneumologie
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Suresnes、フランス、92151
- Suresnes - Hopital Foch
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Thonon les bains、フランス、74200
- Thonon les bains
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Toulon、フランス、83000
- Toulon - HIA
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Toulouse、フランス
- CHU Toulouse - Pneumologie
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Toulouse、フランス
- Toulouse - Clinique Pasteur
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Tours、フランス、37000
- Tours - CHU
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Vandoeuvre lès Nancy、フランス、54500
- Nancy - CHU
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Verdun、フランス
- Verdun - CHG
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Vesoul、フランス、70000
- Vesoul - CHI
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Villejuif、フランス、94800
- Institut Gustave Roussy
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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
Inclusion Criteria (must be checked at the inclusion, week -8):
- Small-Cell Lung Cancer histologically or cytologically proved
- Extended disease as defined by Veteran's Administration Lung Cancer Group (VALG)
- At least one unidimensionally measurable lesion (RECIST criterion)
- Age between 18 and 75 years
- Weight loss < 10% for the last three month
- Performance Status (PS)≤ 2
- Creatininemia < 110 µmol/L and creatinin clearance > 60 mL/min
- Neutrophils ≥ 1,500/µL and platelets ≥ 100,000/µL
- Bilirubin ≤ 1.5 x normal value
- Transaminases, Alkaline Phosphatase ≤ 2.5 x ULN excepted in case of liver metastasis (5xULN)
- Left ventricular ejection fraction (measured by echocardiographic or isotopic method) > 50% if PCDE is planned
- Electrocardiogram without uncontrolled coronaropathy
- Signed informed consent
Randomization Criteria (to be checked during the randomization (week 0)):
- Partial or complete tumoral response as defined by RECIST
- All chemotherapy-induced toxicities decreased to level ≤ 2 as defined by NCI CTC VS 3 (except for alopecia)
- Inclusion criteria concerning creatininemia, clearance, neutrophils, platelets, transaminases, alkaline phosphatases and left ventricular ejection fraction must be checked again
Exclusion Criteria:
- Non-Small-Cell Lung Cancer or mixed cancer (small-cell / non-small-cell)
- Previous antitumoral treatment of the small-cell lung cancer (chemotherapy, radiotherapy, immunotherapy, surgery)
- Non-extended disease as defined by VALG
- Natremia < 125 mmol/L
- Hypercalcemia whereas a corrective treatment
- Pathology contra-indicating the hyper-hydration
- Hemoptysis in the last three months
- Tumor invading large vessels or invading the proximal trachea-bronchial tree (visible at the medical imagery). Investigator or radiologist must reject tumors adjoining, merging or extending to large vessel's lumen (for example : pulmonary artery, superior vena cava)
- Symptomatic cerebral or meningeal metastasis
- Other cancer in progress or medical history of cancer in the five last years (excepted basal cell carcinoma or in situ cervical cancer of the uterus.
- Important surgical intervention (including surgical biopsy), traumatic lesion during 28 days before starting the treatment, or anticipation of an important surgical intervention during the study
- Minor surgical intervention, including implanting permanent catheter during the 24 hours before the first administration of bevacizumab
- Unhealed wound, evolutive gastroduodenal ulcer, fractured bone
- Medical history of abdominal fistula, trachea-oesophageal fistula, of another type with a severity rank of 4, gastrointestinal perforation or intraabdominal abscess during 6 month before inclusion
- Ongoing or recent use of aspirin (during 10 days before the first administration of bevacizumab) (>325 mg/day) or use of another platelet aggregation inhibitor (dipyridamole, ticlopidine, clopidogrel > 75 mg/day), or ongoing or recent use of a therapeutic dose (during 10 days before the first administration of bevacizumab) of anticoagulant or thrombolytic drugs per os or in parenteral injection. Prophylactic use of anticoagulant drug is allowed
- Medical history or genetic predisposition to bleeding or coagulopathy
- Clinically significative cardiac disease: infarct or CVA during 6 month before inclusion, unstable angina, congestive cardiac failure level > II as defined by New York Heart Association (NYHA) or cardiac arrythmia needing a specific treatment which risk to interfere with the study, or uncontrolled arrythmia.
- Known allergy or hypersensibility to monoclonal antibodies (bevacizumab), to chinese hamster ovary cells or to any humanized or recombinant antibody
- Uncontrolled high blood pressure (systolic pressure > 150 mm Hg and/or diastolic pressure > 100 mm Hg), with or without hypotension treatment. Patients presenting an high blood pressure are eligibles if their treatment can decrease their blood pressure to the values required by the protocol.
- Severe ongoing infectious disease or fever > 38.5°C or evidence of any other pathology, organic or neurologic functions deterioration, physical examination or laboratory result which cause suspicion of a disease which contra-indicate use of any studied treatment.
- Woman with a positive pregnancy test or who has not made a pregnancy test (unless pregnancy risk can be excluded)
- Lactating woman
- Sexually active woman who don't use hormonal or mechanical contraceptive method or sexually active man who has a sexually active partner who don't want to use an effective contraceptive method during the course of the study and during the 6 months after last treatment administration
- Patient who as already been included and treated in the present study
- Patient who participate or who has participated in another study during 4 weeks before treatment administration
- Patient who receive a previous antiangiogenic treatment (experimental or commercial : bevacizumab, thalidomide, CP-547632, sunitinib, sorafenib...)
- Geographical or psychological condition which not allowed a good comprehension or compliance to protocol
- Liberty deprived patient
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
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ:Arm A
4 additional cycles of chemotherapy
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PCDE: cisPlatin 75 mg/m² D2 ; Cyclophosphamide 300 mg/m² D1 to D3; 4'-epiDoxorubicin 30 mg/m² D1; Etoposide 75 mg/m² D1 to D3, 4 cycles PE: cisPlatin 80 mg/m², D2; Etoposide 120 mg/m² D1 to D3, 4 cycles PCDE: cisPlatin 75 mg/m² D2; Cyclophosphamide 300 mg/m² D1 to D3; 4'-epiDoxorubicin 30 mg/m² D1; Etoposide 75 mg/m² D1 to D3, 2 cycles PE: cisplatin 80 mg/m², D2; Etoposide 120 mg/m² D1 to D3, 2 cycles |
|
実験的:Arm B
4 additional cycles of chemotherapy + bevacizumab
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PCDE: cisPlatin 75 mg/m² D2; Cyclophosphamide 300 mg/m² D1 to D3; 4'-epiDoxorubicin 30 mg/m² D1; Etoposide 75 mg/m² D1 to D3, 2 cycles PE: cisplatin 80 mg/m², D2; Etoposide 120 mg/m² D1 to D3, 2 cycles PCDE: cisPlatin 75 mg/m² D2; Cyclophosphamide 300 mg/m² D1 to D3; 4'-epiDoxorubicin 30 mg/m² D1; Etoposide 75 mg/m² D1 to D3, 4 cycles Bevacizumab 7.5 mg/kg, D1, until progression PE: cisPlatin 80 mg/m², D2; Etoposide 120 mg/m² D1 to D3, 4 cycles Bevacizumab 7.5 mg/kg, D1, until progression |
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 |
時間枠 |
|---|---|
|
Response rate (complete response + partial response)
時間枠:6 weeks after randomization
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6 weeks after randomization
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
|
Progression-free survival
時間枠:12 weeks
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12 weeks
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Complete response length
時間枠:12 weeks
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12 weeks
|
|
生活の質
時間枠:12週間
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12週間
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Toxicities
時間枠:12 weeks
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12 weeks
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協力者と研究者
捜査官
- 主任研究者:Jean-Louis PUJOL, Pr、CHRU Montpellier
出版物と役立つリンク
一般刊行物
- Pujol JL, Breton JL, Gervais R, Tanguy ML, Quoix E, David P, Janicot H, Westeel V, Gameroff S, Geneve J, Maraninchi D. Phase III double-blind, placebo-controlled study of thalidomide in extensive-disease small-cell lung cancer after response to chemotherapy: an intergroup study FNCLCC cleo04 IFCT 00-01. J Clin Oncol. 2007 Sep 1;25(25):3945-51. doi: 10.1200/JCO.2007.11.8109.
- Pujol JL, Daures JP, Riviere A, Quoix E, Westeel V, Quantin X, Breton JL, Lemarie E, Poudenx M, Milleron B, Moro D, Debieuvre D, Le Chevalier T. Etoposide plus cisplatin with or without the combination of 4'-epidoxorubicin plus cyclophosphamide in treatment of extensive small-cell lung cancer: a French Federation of Cancer Institutes multicenter phase III randomized study. J Natl Cancer Inst. 2001 Feb 21;93(4):300-8. doi: 10.1093/jnci/93.4.300.
- Horn L, Dahlberg SE, Sandler AB, Dowlati A, Moore DF, Murren JR, Schiller JH. Phase II study of cisplatin plus etoposide and bevacizumab for previously untreated, extensive-stage small-cell lung cancer: Eastern Cooperative Oncology Group Study E3501. J Clin Oncol. 2009 Dec 10;27(35):6006-11. doi: 10.1200/JCO.2009.23.7545. Epub 2009 Oct 13.
- Pujol JL, Lavole A, Quoix E, Molinier O, Souquet PJ, Barlesi F, Le Caer H, Moro-Sibilot D, Fournel P, Oster JP, Chatellain P, Barre P, Jeannin G, Mourlanette P, Derollez M, Herman D, Renault A, Dayen C, Lamy PJ, Langlais A, Morin F, Zalcman G; French Cooperative Thoracic Intergroup (IFCT). Randomized phase II-III study of bevacizumab in combination with chemotherapy in previously untreated extensive small-cell lung cancer: results from the IFCT-0802 trialdagger. Ann Oncol. 2015 May;26(5):908-914. doi: 10.1093/annonc/mdv065. Epub 2015 Feb 16.
- Negre E, Coffy A, Langlais A, Daures JP, Lavole A, Quoix E, Molinier O, Greillier L, Audigier-Valette C, Moro-Sibilot D, Westeel V, Morin F, Roch B, Pujol JL. Development and Validation of a Simplified Prognostic Score in SCLC. JTO Clin Res Rep. 2020 Feb 12;1(1):100016. doi: 10.1016/j.jtocrr.2020.100016. eCollection 2020 Mar.
便利なリンク
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
- IFCT-0802
- 2009-010187-42
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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。