Pemetrexed Disodium Plus Gemcitabine in Treating Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer
A Phase II Clinical Trial Evaluating Three Schedules Of ALIMTA Plus Gemcitabine As Frontline Chemotherapy For Patients With Locally Advanced Or Metastatic Non-Small Cell Lung Cancer
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Giving more than one drug and giving the drugs in different ways may kill more tumor cells.
PURPOSE: Randomized phase II trial to compare the effectiveness of three different regimens of pemetrexed disodium plus gemcitabine in treating patients who have locally advanced or metastatic non-small cell lung cancer.
研究概览
详细说明
OBJECTIVES:
- Compare the tumor response rates in patients with locally advanced or metastatic non-small cell lung cancer treated with 3 different schedules of pemetrexed disodium and gemcitabine.
- Compare the duration of response, time to progressive disease, time to treatment failure, and survival time in patients treated with these regimens.
- Compare the quantitative and qualitative toxic effects of these regimens in these patients.
OUTLINE: This is a randomized, open-label study. Patients are stratified according to stage of disease (IIIB vs IV) and ECOG performance status (0 vs 1). Patients are randomized to one of three treatment arms.
- Arm I: Patients receive pemetrexed disodium IV over 10 minutes on day 1 followed by gemcitabine IV over 30 minutes on days 1 and 8.
- Arm II: Patients receive gemcitabine IV over 30 minutes on days 1 and 8 followed by pemetrexed disodium IV over 10 minutes on day 1.
- Arm III: Patients receive gemcitabine IV over 30 minutes on day 1 and pemetrexed disodium IV over 10 minutes followed by gemcitabine IV over 30 minutes on day 8.
Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. Patients with stable or responding disease may receive up to 6 additional courses of therapy.
Patients are followed every 2 months for 1 year and then every 6 months for 4 years.
PROJECTED ACCRUAL: A total of 180 patients (60 per treatment arm) will be accrued for this study within 20 months.
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Arizona
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Scottsdale、Arizona、美国、85259-5404
- CCOP - Scottsdale Oncology Program
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Florida
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Jacksonville、Florida、美国、32224
- Mayo Clinic
-
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Illinois
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Peoria、Illinois、美国、61602
- CCOP - Illinois Oncology Research Association
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Urbana、Illinois、美国、61801
- CCOP - Carle Cancer Center
-
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Iowa
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Cedar Rapids、Iowa、美国、52403-1206
- CCOP - Cedar Rapids Oncology Project
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Des Moines、Iowa、美国、50309-1016
- CCOP - Iowa Oncology Research Association
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Sioux City、Iowa、美国、51101-1733
- Siouxland Hematology-Oncology
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Kansas
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Wichita、Kansas、美国、67214-3882
- CCOP - Wichita
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Michigan
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Ann Arbor、Michigan、美国、48106
- CCOP - Ann Arbor Regional
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Minnesota
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Duluth、Minnesota、美国、55805
- CCOP - Duluth
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Rochester、Minnesota、美国、55905
- Mayo Clinic Cancer Center
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Saint Cloud、Minnesota、美国、56303
- CentraCare Health Plaza
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Saint Louis Park、Minnesota、美国、55416
- CCOP - Metro-Minnesota
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Nebraska
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Omaha、Nebraska、美国、68106
- CCOP - Missouri Valley Cancer Consortium
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North Dakota
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Bismarck、North Dakota、美国、58501
- Medcenter One Health System
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Fargo、North Dakota、美国、58122
- CCOP - Merit Care Hospital
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Grand Forks、North Dakota、美国、58201
- Altru Health Systems
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Ohio
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Toledo、Ohio、美国、43623-3456
- CCOP - Toledo Community Hospital
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Pennsylvania
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Danville、Pennsylvania、美国、17822-2001
- CCOP - Geisinger Clinic and Medical Center
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Pittsburgh、Pennsylvania、美国、15212-4772
- Allegheny General Hospital
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South Dakota
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Rapid City、South Dakota、美国、57709
- Rapid City Regional Hospital
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Sioux Falls、South Dakota、美国、57104
- CCOP - Sioux Community Cancer Consortium
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed locally advanced or metastatic non-small cell lung cancer
- Stage IIIB disease that is ineligible for combined modality therapy OR
- Stage IV disease
- Measurable disease
- No clinically detectable (by physical exam) third-space fluid collection (e.g., ascites or pleural effusions) that cannot be controlled by drainage or other procedures
- No brain metastases (even if treated)
PATIENT CHARACTERISTICS:
Age:
- 18 and over
Performance status:
- ECOG 0-1
Life expectancy:
- At least 12 weeks
Hematopoietic:
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
- Hemoglobin at least 9 g/dL
Hepatic:
- Bilirubin no greater than 1.5 times upper limit of normal (ULN)
- AST and ALT no greater than 3 times ULN (5 times ULN if liver metastases present)
- Alkaline phosphatase no greater than 3 times ULN (5 times ULN if liver metastases present)
Renal:
- Creatinine clearance at least 45 mL/min
Other:
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Able to take folic acid or cyanocobalamin (vitamin B12) supplementation
- No uncontrolled infection
- No concurrent chronic debilitating disease
- No weight loss of 10% or more within the past 6 weeks
- No other prior malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or noninvasive carcinoma
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- No prior biologic or genetic therapy for lung cancer
- No concurrent immunomodulating agents
Chemotherapy:
- No prior chemotherapy for lung cancer
Endocrine therapy:
- Not specified
Radiotherapy:
- At least 4 weeks since prior radiotherapy to a different site and recovered
- No prior radiotherapy to 25% or more of bone marrow
- No prior radiotherapy to whole pelvis
- No prior radiotherapy for primary disease
- No concurrent radiotherapy
Surgery:
- More than 4 weeks since prior major surgery
Other:
- No aspirin or nonsteroidal anti-inflammatory agents 2 days before, during, and for 2 days after pemetrexed disodium administration (5 days for long-acting agents such as piroxicam, naproxen, diflunisal, or nabumetone)
- No other concurrent cytostatic or cytotoxic therapy
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:Arm I: pemetrexed + gemcitabine
Patients receive pemetrexed disodium IV over 10 minutes on day 1 followed by gemcitabine IV over 30 minutes on days 1 and 8.
|
|
实验性的:Arm II: pemetrexed + gemcitabine
Patients receive gemcitabine IV over 30 minutes on days 1 and 8 followed by pemetrexed disodium IV over 10 minutes on day 1.
|
|
实验性的:Arm III: pemetrexed + gemcitabine
Patients receive gemcitabine IV over 30 minutes on day 1 and pemetrexed disodium IV over 10 minutes followed by gemcitabine IV over 30 minutes on day 8.
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
tumor response rate
大体时间:Up to 4 years
|
Up to 4 years
|
次要结果测量
结果测量 |
大体时间 |
---|---|
duration of response
大体时间:Up to 4 years
|
Up to 4 years
|
time to treatment failure
大体时间:Up to 4 years
|
Up to 4 years
|
survival
大体时间:Up to 4 years
|
Up to 4 years
|
time to disease progression
大体时间:Up to 4 years
|
Up to 4 years
|
合作者和调查者
出版物和有用的链接
一般刊物
- Jatoi A, Hillman S, Stella P, Green E, Adjei A, Nair S, Perez E, Amin B, Schild SE, Castillo R, Jett JR; North Central Cancer Treatment Group. Should elderly non-small-cell lung cancer patients be offered elderly-specific trials? Results of a pooled analysis from the North Central Cancer Treatment Group. J Clin Oncol. 2005 Dec 20;23(36):9113-9. doi: 10.1200/JCO.2005.03.7465.
- An MW, Mandrekar SJ, Branda ME, Hillman SL, Adjei AA, Pitot HC, Goldberg RM, Sargent DJ. Comparison of continuous versus categorical tumor measurement-based metrics to predict overall survival in cancer treatment trials. Clin Cancer Res. 2011 Oct 15;17(20):6592-9. doi: 10.1158/1078-0432.CCR-11-0822. Epub 2011 Aug 31.
- Campbell ME, Mandrekar SJ, Hillman SL, et al.: What is the added value of actual tumor measurements (TM) in predicting overall survival (OS)? The North Central Cancer Treatment Group (NCCTG) findings. [Abstract] J Clin Oncol 26 (Suppl 15): A-6520, 2008.
- Adjei AA, Salavaggione OE, Mandrekar SJ, Dy GK, Ziegler KL, Endo C, Molina JR, Schild SE, Adjei AA. Correlation between polymorphisms of the reduced folate carrier gene (SLC19A1) and survival after pemetrexed-based therapy in non-small cell lung cancer: a North Central Cancer Treatment Group-based exploratory study. J Thorac Oncol. 2010 Sep;5(9):1346-53. doi: 10.1097/JTO.0b013e3181ec18c4.
- Ma CX, Nair S, Thomas S, Mandrekar SJ, Nikcevich DA, Rowland KM, Fitch TR, Windschitl HE, Hillman SL, Schild SE, Jett JR, Obasaju C, Adjei AA; North Central Cancer Treatment Group; Mayo Clinic; Eli Lilly & Company. Randomized phase II trial of three schedules of pemetrexed and gemcitabine as front-line therapy for advanced non-small-cell lung cancer. J Clin Oncol. 2005 Sep 1;23(25):5929-37. doi: 10.1200/JCO.2005.13.953.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- NCCTG-N0026
- NCI-2012-02399 (注册表标识符:CTRP (Clinical Trials Reporting System))
- CDR0000068838 (注册表标识符:PDQ (Physician Data Query))
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
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