Lung CancerPhase 2NCT00062439
S0220: Chemoradiotherapy Followed By Surgery and Docetaxel in Treating Patients With Pancoast Tumors
A Phase 2 study testing cisplatin, docetaxel and etoposide in people with Lung Cancer, run by SWOG Cancer Research Network at 154 sites in United States.
Trial summary
RATIONALE: Drugs used in chemotherapy, such as cisplatin, etoposide, and docetaxel, 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. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Lung Cancer
- What is being tested?
- cisplatin, docetaxel and etoposide
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 154 sitesUnited States
- Study dates
- Jul 2003to Dec 2010
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
DISEASE CHARACTERISTICS:
- Histologically or cytologically confirmed non-small cell lung cancer
- Any of the following stages due to involvement of the superior sulcus:
- Stage IIB (T3, N0), IIIA (T3, N1), or IIIB (T4, N0-1)
- Newly diagnosed
- Primary bronchogenic
- Must meet 1 of the following tumor involvement criteria:
- An apical tumor associated with the Pancoast syndrome (arm or shoulder pain and/or neurologic findings corresponding to the roots of C-8 and/or T-1 or the inferior trunk of the bronchial plexus with or without Horner's syndrome) without rib or vertebral body involvement
- Superior sulcus tumors with involvement of the chest wall (T3), usually ribs 1 and 2 by CT scan or MRI, with or without an associated Pancoast syndrome
- Superior sulcus tumors with invasion of the vertebral bodies or involvement of the subclavian vessels (T4) by CT scan or MRI, with or without an associated Pancoast syndrome
- No more than 1 parenchymal lesion in the same lung or in both lungs
- No involvement of the following lymph node groups as determined by mediastinal exploration* (i.e., mediastinoscopy, mediastinotomy, thoracoscopy, or thoracotomy) within the past 42 days:
- Single-level or multi-level ipsilateral or contralateral mediastinal nodal (N2 or N3) disease by mediastinoscopy, thoracoscopy, mediastinotomy, thoracotomy, or transbronchial Wang needle biopsy, regardless of whether enlarged nodes are visible or not on chest x-ray or CT scan
- Supraclavicular (scalene) nodes
- Any nodes evident on physical exam must be biopsied by fine needle aspiration or open biopsy
- Left upper lobe tumors with left vocal cord paralysis by indirect laryngoscopy (presumes N2 nodes in the A-P window) NOTE: *Mediastinal exploration is not required for patients whose mediastinum is negative by both positron-emission tomography (PET) and CT scan
- No pleural effusions except if 1 of the following criteria are met:
- Pleural effusion present before mediastinoscopy or thoracotomy with negative cytology on 2 separate thoracenteses
- Pleural effusion present only after exploratory or staging thoracotomy, with negative cytology on a single thoracentesis
- Present only on CT scan and too small to tap
- No pericardial effusions or superior vena cava syndrome
- No brain metastases by CT scan or MRI
- No evidence of distant metastatic disease by bone scan or PET
- Must be a candidate for potential future pulmonary resection
PATIENT CHARACTERISTICS:
Age
- Not specified
Performance status
- Zubrod 0-2
- Patients with Zubrod performance status 2 must have an albumin level at least 0.85 times lower limit of normal and weight loss no greater than 10%
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count at least 1,500/mm^3
- Platelet count at least 100,000/mm^3
Hepatic
- Bilirubin no greater than 1.5 times upper limit of normal (ULN)*
- SGOT or SGPT no greater than 1.5 times ULN* NOTE: *Unless due to a documented benign disease
Renal
- Creatinine clearance at least 50 mL/min
Cardiovascular
- No myocardial infarction within the past 3 months
- No active angina
- No unstable heart rhythms
- No clinically evident congestive heart failure
Pulmonary
- Preresection FEV_1 at least 2.0 L OR
- Predicted postresection FEV_1 greater than 1.0 L
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No uncontrolled peptic ulcer disease
- No grade 2 or greater sensory neuropathy
- No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No concurrent colony-stimulating factors during chemoradiotherapy or course 1 of consolidation therapy
Chemotherapy
- No prior chemotherapy for lung cancer
Endocrine therapy
- Not specified
Radiotherapy
- No prior radiotherapy to the neck or thorax
- No concurrent intensity-modulated radiotherapy
Surgery
- Prior exploratory thoracotomy allowed only for diagnosis or staging purposes
Other
- No concurrent amifostine
Trial locations and contacts
154 sites in 1 country.
154 sites in 1 country
United States154 sites
Hickman Cancer Center at Bixby Medical Center
Adrian, Michigan, 49221
American Fork Hospital
American Fork, Utah, 84003
AnMed Cancer Center
Anderson, South Carolina, 29621
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, 48106-0995
CCOP - Michigan Cancer Research Consortium
Ann Arbor, Michigan, 48106
Auburn Regional Center for Cancer Care
Auburn, Washington, 98002
Rush-Copley Cancer Care Center
Aurora, Illinois, 60507
Battle Creek Health System Cancer Care Center
Battle Creek, Michigan, 49017
St. Joseph Cancer Center
Bellingham, Washington, 98225
Mecosta County Medical Center
Big Rapids, Michigan, 49307
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
Hematology-Oncology Centers of the Northern Rockies - Billings
Billings, Montana, 59101
Northern Rockies Radiation Oncology Center
Billings, Montana, 59101
St. Vincent Healthcare Cancer Care Services
Billings, Montana, 59101
Billings Clinic - Downtown
Billings, Montana, 59107-7000
Bismarck Cancer Center
Bismarck, North Dakota, 58501
Medcenter One Hospital Cancer Care Center
Bismarck, North Dakota, 58501
Mid Dakota Clinic, PC
Bismarck, North Dakota, 58501
St. Alexius Medical Center Cancer Center
Bismarck, North Dakota, 58502
Wood County Oncology Center
Bowling Green, Ohio, 43402
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
Olympic Hematology and Oncology
Bremerton, Washington, 98310
St. James Healthcare Cancer Care
Butte, Montana, 59701
Sandra L. Maxwell Cancer Center
Cedar City, Utah, 84720
Providence Centralia Hospital
Centralia, Washington, 98531-9027
Cancer Center of Kansas, PA - Chanute
Chanute, Kansas, 66720
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
Charles M. Barrett Cancer Center at University Hospital
Cincinnati, Ohio, 45267
Veterans Affairs Medical Center - Columbia (Truman Memorial)
Columbia, Missouri, 65201
Ellis Fischel Cancer Center at University of Missouri - Columbia
Columbia, Missouri, 65203
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center
Columbus, Ohio, 43210-1240
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, 48123-2500
Cancer Center of Kansas, PA - Dodge City
Dodge City, Kansas, 67801
Duluth Clinic Cancer Center - Duluth
Duluth, Minnesota, 55805-1983
CCOP - Duluth
Duluth, Minnesota, 55805
Miller - Dwan Medical Center
Duluth, Minnesota, 55805
Cancer Center of Kansas, PA - El Dorado
El Dorado, Kansas, 67042
St. Francis Hospital
Federal Way, Washington, 98003
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
Poudre Valley Hospital
Fort Collins, Colorado, 80524
Fredericksburg Oncology, Incorporated
Fredericksburg, Virginia, 22401
Fremont Memorial Hospital
Fremont, Ohio, 43420
Wayne Memorial Hospital, Incorporated
Goldsboro, North Carolina, 27534
Butterworth Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
CCOP - Grand Rapids
Grand Rapids, Michigan, 49503
Lacks Cancer Center at Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Metro Health Hospital
Grand Rapids, Michigan, 49506
Big Sky Oncology
Great Falls, Montana, 59405-5309
Great Falls Clinic - Main Facility
Great Falls, Montana, 59405
Sletten Cancer Institute at Benefis Healthcare
Great Falls, Montana, 59405
Study site
Great Falls, Montana, 59405
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, 48236
St. Peter's Hospital
Helena, Montana, 59601
Holland Community Hospital
Holland, Michigan, 49423
Holden Comprehensive Cancer Center at University of Iowa
Iowa City, Iowa, 52242-1002
Foote Memorial Hospital
Jackson, Michigan, 49201
University of Mississippi Cancer Clinic
Jackson, Mississippi, 39216
Mayo Clinic - Jacksonville
Jacksonville, Florida, 32224
Joliet Oncology-Hematology Associates, Limited - West
Joliet, Illinois, 60435
Borgess Medical Center
Kalamazoo, Michigan, 49001
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
Glacier Oncology, PLLC
Kalispell, Montana, 59901
Kalispell Medical Oncology at KRMC
Kalispell, Montana, 59901
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Columbia Basin Hematology
Kennewick, Washington, 99336
Cancer Center of Kansas, PA - Kingman
Kingman, Kansas, 67068
Kinston Medical Specialists
Kinston, North Carolina, 28501
Haematology-Oncology Associates of Ohio and Michigan, PC
Lambertville, Michigan, 48144
Sparrow Regional Cancer Center
Lansing, Michigan, 48912-1811
Southwest Medical Center
Liberal, Kansas, 67901
St. Rita's Medical Center
Lima, Ohio, 45801
Lima Memorial Hospital
Lima, Ohio, 45804
Logan Regional Hospital
Logan, Utah, 84321
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Madison, Wisconsin, 53792-6164
Northwest Ohio Oncology Center
Maumee, Ohio, 43537
St. Luke's Hospital
Maumee, Ohio, 43537
Cardinal Bernardin Cancer Center at Loyola University Medical Center
Maywood, Illinois, 60153
Saint Anthony Memorial Health Centers
Michigan City, Indiana, 46360
Community Medical Center
Missoula, Montana, 59801
Guardian Oncology and Center for Wellness
Missoula, Montana, 59804
Montana Cancer Specialists at Montana Cancer Center
Missoula, Montana, 59807-7877
Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
Missoula, Montana, 59807
Mobile Infirmary Medical Center
Mobile, Alabama, 36652-2144
Community Cancer Center of Monroe
Monroe, Michigan, 48162
Mercy Memorial Hospital - Monroe
Monroe, Michigan, 48162
Cottonwood Hospital Medical Center
Murray, Utah, 84107
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
Murray, Utah, 84157
Hackley Hospital
Muskegon, Michigan, 49442
MBCCOP - Meharry Medical College - Nashville
Nashville, Tennessee, 37208-3599
Cancer Center of Kansas, PA - Newton
Newton, Kansas, 67114
Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
Ogden, Utah, 84403
Providence St. Peter Hospital Regional Cancer Center
Olympia, Washington, 98506-5166
St. Charles Mercy Hospital
Oregon, Ohio, 43616
Toledo Clinic - Oregon
Oregon, Ohio, 43616
Community Comprehensive Cancer Center at Camden-Clark Memorial Hospital
Parkersburg, West Virginia, 26102
Cancer Center of Kansas, PA - Parsons
Parsons, Kansas, 67357
Northwest Cancer Specialists at Rose Quarter Cancer Center
Portland, Oregon, 97227
Cancer Center of Kansas, PA - Pratt
Pratt, Kansas, 67124
Utah Valley Regional Medical Center - Provo
Provo, Utah, 84604
Good Samaritan Cancer Center
Puyallup, Washington, 98372
Mayo Clinic Cancer Center
Rochester, Minnesota, 55905
Rutherford Hospital
Rutherfordton, North Carolina, 28139
Seton Cancer Institute at Saint Mary's - Saginaw
Saginaw, Michigan, 48601
Cancer Center of Kansas, PA - Salina
Salina, Kansas, 67042
LDS Hospital
Salt Lake City, Utah, 84103
Utah Cancer Specialists at UCS Cancer Center
Salt Lake City, Utah, 84106
Firelands Regional Medical Center
Sandusky, Ohio, 44870
North Coast Cancer Care, Incorporated
Sandusky, Ohio, 44870
Fred Hutchinson Cancer Research Center
Seattle, Washington, 98104
Harborview Medical Center
Seattle, Washington, 98104
Minor and James Medical, PLLC
Seattle, Washington, 98104
Group Health Central Hospital
Seattle, Washington, 98112
Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
Seattle, Washington, 98122-4307
Polyclinic First Hill
Seattle, Washington, 98122
University Cancer Center at University of Washington Medical Center
Seattle, Washington, 98195-6043
Welch Cancer Center at Sheridan Memorial Hospital
Sheridan, Wyoming, 82801
Providence Cancer Institute at Providence Hospital - Southfield Campus
Southfield, Michigan, 48075
CCOP - Upstate Carolina
Spartanburg, South Carolina, 29303
Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
Spartanburg, South Carolina, 29303
Cancer Care Northwest - Spokane South
Spokane, Washington, 99202
Regional Cancer Center at Memorial Medical Center
Springfield, Illinois, 62781-0001
Missouri Baptist Cancer Center
St Louis, Missouri, 63131
Arch Medical Services, Incorporated at Center for Cancer Care and Research
St Louis, Missouri, 63141
Dixie Regional Medical Center - East Campus
St. George, Utah, 84770
Flower Hospital Cancer Center
Sylvania, Ohio, 43560
Franciscan Cancer Center at St. Joseph Medical Center
Tacoma, Washington, 98405-3004
Allenmore Hospital
Tacoma, Washington, 98405
CCOP - Northwest
Tacoma, Washington, 98405
MultiCare Regional Cancer Center at Tacoma General Hospital
Tacoma, Washington, 98405
St. Clare Hospital
Tacoma, Washington, 98499
Mercy Hospital of Tiffin
Tiffin, Ohio, 44883
Toledo Hospital
Toledo, Ohio, 43606
St. Vincent Mercy Medical Center
Toledo, Ohio, 43608
Medical University of Ohio Cancer Center
Toledo, Ohio, 43614
CCOP - Toledo Community Hospital
Toledo, Ohio, 43617
Toledo Clinic, Incorporated - Main Clinic
Toledo, Ohio, 43623
Munson Medical Center
Traverse City, Michigan, 49684
Carle Cancer Center at Carle Foundation Hospital
Urbana, Illinois, 61801
CCOP - Carle Cancer Center
Urbana, Illinois, 61801
Northwest Cancer Specialists at Vancouver Cancer Center
Vancouver, Washington, 98684
St. John Macomb Hospital
Warren, Michigan, 48093
Fulton County Health Center
Wauseon, Ohio, 43567
Cancer Center of Kansas, PA - Wellington
Wellington, Kansas, 67152
Wenatchee Valley Medical Center
Wenatchee, Washington, 98801-2028
Associates in Womens Health, PA - North Review
Wichita, Kansas, 67203
Cancer Center of Kansas, PA - Medical Arts Tower
Wichita, Kansas, 67208
Cancer Center of Kansas, PA - Wichita
Wichita, Kansas, 67214
CCOP - Wichita
Wichita, Kansas, 67214
Via Christi Cancer Center at Via Christi Regional Medical Center
Wichita, Kansas, 67214
Wesley Medical Center
Wichita, Kansas, 67214
Willmar Cancer Center at Rice Memorial Hospital
Willmar, Minnesota, 56201
Cancer Center of Kansas, PA - Winfield
Winfield, Kansas, 67156
About this study
Official title: A Phase II Trial of Induction Chemoradiotherapy With Cisplatin/Etoposide Followed by Surgical Resection, Followed by Docetaxel, for Non-Small Cell Lung Cancer Involving the Superior Sulcus (Pancoast Tumors)
RATIONALE: Drugs used in chemotherapy, such as cisplatin, etoposide, and docetaxel, 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. Combining cisplatin and etoposide with radiation therapy may shrink the tumor so it can be removed by surgery. Giving docetaxel after surgery may kill any remaining tumor cells.
PURPOSE: This phase II trial is studying how well giving chemoradiotherapy together with cisplatin and etoposide followed by surgery and docetaxel works in treating patients with newly diagnosed Pancoast tumors, a type of non-small cell lung cancer.
Read the detailed description
OBJECTIVES:
- Determine the feasibility of administering induction chemoradiotherapy comprising cisplatin and etoposide followed by surgical resection and adjuvant docetaxel in patients with non-small cell lung cancer involving the superior sulcus (Pancoast tumors).
- Determine overall survival of patients treated with this regimen.
- Determine time to progression in patients treated with this regimen.
- Determine confirmed and unconfirmed and complete and partial response during induction in patients treated with this regimen.
- Determine the toxicity of this regimen in these patients.
OUTLINE:
- Induction chemoradiotherapy: Patients receive etoposide IV over 1 hour on days 1-5 and 29-33 and cisplatin IV over 1 hour on days 1, 8, 29, and 36. Patients also undergo concurrent radiotherapy once daily 5 days a week for 5 weeks.
Within 2-4 weeks after completion of induction chemoradiotherapy, patients undergo disease evaluation. Patients with no evidence of local or overall disease progression undergo a thoracotomy within 3-7 weeks. Patients who do not qualify for surgery proceed to consolidation chemotherapy within 3-8 weeks after chemoradiotherapy is complete.
- Consolidation chemotherapy: Within 3-8 weeks after thoracotomy, patients with no evidence of disease progression receive docetaxel IV over 1 hour on day 1. Treatment repeats every 21 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed at 4-6 weeks, every 3 months for 2 years, and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 45 patients will be accrued for this study.
- Conditions
- Lung Cancer
- Being tested
- cisplatin, docetaxel, etoposide, conventional surgery, radiation therapy
- Keywords
- stage II non-small cell lung cancer, stage IIIA non-small cell lung cancer, stage IIIB non-small cell lung cancer
- Medical subject headings
- Lung Neoplasms, Carcinoma, Non-Small-Cell Lung
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
cisplatinDrug
During induction:50 mg/m2,IV on Days 1, 8, 29 \& 36. In any appropriate vehicle over 60 minutes
docetaxelDrug
During consolidation: 75 mg/m2 IV on Day 1, every 21 days for 3 cycles over 60 minutes
etoposideDrug
During induction: 50 mg/m2, IV on Days 1 - 5 Days 29 - 33. In 250 ml of NS over 60 minutes.
conventional surgeryProcedure or surgery
If, based upon the evaluation in Section 7.4a, there is no evidence of progression (see Section 10.2d for definition), patients will proceed to the next appropriate step: Registration #2 and surgery followed by Registration #3 and additional chemotherapy (Sections 7.5 and 7.6). Response determinations (CR,PR, SD) will be required. If criteria for progressive measurable or nonmeasurable disease (see Section 10.0) are met, the patient will then be removed from protocol treatment and receive follow-up according to the schedule. Surgery will be performed 3 - 7 weeks after completion of chemoradiotherapy.
radiation therapyRadiation
Radiotherapy is to begin within 24 hours following the start of chemotherapy. Day 1 of radiotherapy must be a Monday, Tuesday or Wednesday, but no later in the week to insure simultaneous therapy for the majority of each chemotherapy cycle. The total dose to the prescription point will be 4,500 cGy given in 25 fractions. The patient will be treated with one fraction per day with all fields treated per day. 180 cGy will be delivered to the isocenter.
| Study group | Role | What they receive |
|---|---|---|
| Etoposide, Cisplatin, Thoracic RT, Surgery, Docetaxel | Experimental | Not described Receives: Drug: cisplatin; Drug: docetaxel; Drug: etoposide; Procedure: conventional surgery; Radiation: radiation therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Feasibility of Treating Patients With Stage IIB/IIIB Pancoast Tumors With a Regimen of Cisplatin and Etoposide Plus Concurrent Radiotherapy Followed by Surgical Resection Followed by Consolidation Therapy With Docetaxel.
Feasibility was assessed by estimating the percentage of participants who would be able to complete the entire treatment regimen.
Measured: After completion of 5 weeks of radiotherapy given concurrently with cisplatin+etoposide, surgery + 8 weeks of recovery time, and 6 weeks of consolidation therapy with docetaxel
Secondary outcomes (4)
Adverse Events
Only adverse events that are possibly, probably or definitely related to study drug are reported.
Measured: Weekly for the first 13 weeks, then every 3 weeks for the next 6 weeks.
Overall Survival
The duration from the date of enrollment until the date of death due to any cause. Patients last known to be alive were censored at the date of last contact.
Measured: daily for 12 weeks then every 3 weeks for 12 weeks, then every 6 months thereafter.
Progression-Free Survival at 3 Years
Duration from date of enrollment to date of progression (per RECIST), symptomatic deterioration, or death due to any cause. Patients last known to be alive and progression-free were censored at the date of last contact.
Measured: At the completion of induction therapy, then again 4 weeks after the completion of consolidation therapy, then every 3 months for 2 years, then every 6 months until up to a maximum of 5 years after enrollment.
Response
Response was defined as achieving a confirmed or unconfirmed complete or partial response as determined by RECIST. Patients who dropped out due to any cause prior to getting their response assessment were counted as non-responders. A complete response (CR) was defined as disappearance of all disease. A partial response was defined as a >= 30% decrease in the sum of longest diameters of target lesions. A CR or PR was defined as confirmed if two consecutive determinations were documented at least 4 weeks apart.
Measured: After completion of induction therapy.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jun 2003 (estimated)
- Study startJul 2003
- Primary completionDec 2010
- Study completionDec 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Lung CancerStudies of the same condition, open and under way.
- More trials run by SWOG Cancer Research NetworkThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 46 participants (actual)
Sponsor and investigators
- Lead sponsor
- SWOG Cancer Research Network
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI), Eastern Cooperative Oncology Group, American College of Surgeons, North Central Cancer Treatment Group, NCIC Clinical Trials Group, Cancer and Leukemia Group B
- Responsible party
- Sponsor
- Investigators
- Michael J. Kraut, MD, Study chair, Providence HospitalTien Hoang, MD, Study chair, University of Wisconsin, MadisonValerie W. Rusch, MD, FACS, Study chair, Memorial Sloan Kettering Cancer CenterJames R. Jett, MD, Study chair, Mayo ClinicScott A. Laurie, MD, FRCPC, Study chair, Ottawa Regional Cancer CentreAlan P. Lyss, MD, Study chair, Missouri Baptist Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00062439
- Sponsor's protocol ID
- CDR0000304777
- Other IDs
- U10CA032102, S0220
- Status last verified
- Oct 2013
- First submitted
- 5 Jun 2003
- Last updated
- 25 Nov 2013
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 25 Nov 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II Trial of Induction Chemoradiotherapy With Cisplatin/Etoposide Followed by Surgical Resection, Followed by Docetaxel, for Non-Small Cell Lung Cancer Involving the Superior Sulcus (Pancoast Tumors)
- ClinicalTrials.gov ID
- NCT00062439
- Acronym / sponsor ID
- CDR0000304777
- Conditions
- Lung Cancer
- Keywords
- stage II non-small cell lung cancer, stage IIIA non-small cell lung cancer, stage IIIB non-small cell lung cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 46 participants (actual)
- Lead sponsor
- SWOG Cancer Research NetworkResearch network
- Collaborators
- National Cancer Institute (NCI), Eastern Cooperative Oncology Group, American College of Surgeons, North Central Cancer Treatment Group, NCIC Clinical Trials Group, Cancer and Leukemia Group B
- Study start
- Jul 2003
- Primary completion
- Dec 2010 (actual)
- Study completion
- Dec 2010 (actual)
- First posted
- 6 Jun 2003 (estimated)
- Results
- Posted 25 Nov 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Drugs used in chemotherapy, such as cisplatin, etoposide, and docetaxel, 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. Combining cisplatin and etoposide with radiation therapy may shrink the tumor so it can be removed by surgery. Giving docetaxel after surgery may kill any remaining tumor cells.
PURPOSE: This phase II trial is studying how well giving chemoradiotherapy together with cisplatin and etoposide followed by surgery and docetaxel works in treating patients with newly diagnosed Pancoast tumors, a type of non-small cell lung cancer.
Detailed description
OBJECTIVES:
- Determine the feasibility of administering induction chemoradiotherapy comprising cisplatin and etoposide followed by surgical resection and adjuvant docetaxel in patients with non-small cell lung cancer involving the superior sulcus (Pancoast tumors).
- Determine overall survival of patients treated with this regimen.
- Determine time to progression in patients treated with this regimen.
- Determine confirmed and unconfirmed and complete and partial response during induction in patients treated with this regimen.
- Determine the toxicity of this regimen in these patients.
OUTLINE:
- Induction chemoradiotherapy: Patients receive etoposide IV over 1 hour on days 1-5 and 29-33 and cisplatin IV over 1 hour on days 1, 8, 29, and 36. Patients also undergo concurrent radiotherapy once daily 5 days a week for 5 weeks.
Within 2-4 weeks after completion of induction chemoradiotherapy, patients undergo disease evaluation. Patients with no evidence of local or overall disease progression undergo a thoracotomy within 3-7 weeks. Patients who do not qualify for surgery proceed to consolidation chemotherapy within 3-8 weeks after chemoradiotherapy is complete.
- Consolidation chemotherapy: Within 3-8 weeks after thoracotomy, patients with no evidence of disease progression receive docetaxel IV over 1 hour on day 1. Treatment repeats every 21 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.
Patients are followed at 4-6 weeks, every 3 months for 2 years, and then every 6 months for 3 years.
PROJECTED ACCRUAL: A total of 45 patients will be accrued for this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Etoposide, Cisplatin, Thoracic RT, Surgery, Docetaxel | Experimental | Drug: cisplatin, Drug: docetaxel, Drug: etoposide, Procedure: conventional surgery, Radiation: radiation therapy |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| cisplatinDuring induction:50 mg/m2,IV on Days 1, 8, 29 \& 36. In any appropriate vehicle over 60 minutes | Drug | Etoposide, Cisplatin, Thoracic RT, Surgery, Docetaxel |
| docetaxelDuring consolidation: 75 mg/m2 IV on Day 1, every 21 days for 3 cycles over 60 minutes | Drug | Etoposide, Cisplatin, Thoracic RT, Surgery, Docetaxel |
| etoposideDuring induction: 50 mg/m2, IV on Days 1 - 5 Days 29 - 33. In 250 ml of NS over 60 minutes. | Drug | Etoposide, Cisplatin, Thoracic RT, Surgery, Docetaxel |
| conventional surgeryIf, based upon the evaluation in Section 7.4a, there is no evidence of progression (see Section 10.2d for definition), patients will proceed to the next appropriate step: Registration #2 and surgery followed by Registration #3 and additional chemotherapy (Sections 7.5 and 7.6). Response determinations (CR,PR, SD) will be required. If criteria for progressive measurable or nonmeasurable disease (see Section 10.0) are met, the patient will then be removed from protocol treatment and receive follow-up according to the schedule. Surgery will be performed 3 - 7 weeks after completion of chemoradiotherapy. | Procedure or surgery | Etoposide, Cisplatin, Thoracic RT, Surgery, Docetaxel |
| radiation therapyRadiotherapy is to begin within 24 hours following the start of chemotherapy. Day 1 of radiotherapy must be a Monday, Tuesday or Wednesday, but no later in the week to insure simultaneous therapy for the majority of each chemotherapy cycle. The total dose to the prescription point will be 4,500 cGy given in 25 fractions. The patient will be treated with one fraction per day with all fields treated per day. 180 cGy will be delivered to the isocenter. | Radiation | Etoposide, Cisplatin, Thoracic RT, Surgery, Docetaxel |
Primary outcome
Feasibility of Treating Patients With Stage IIB/IIIB Pancoast Tumors With a Regimen of Cisplatin and Etoposide Plus Concurrent Radiotherapy Followed by Surgical Resection Followed by Consolidation Therapy With Docetaxel.
Time frame: After completion of 5 weeks of radiotherapy given concurrently with cisplatin+etoposide, surgery + 8 weeks of recovery time, and 6 weeks of consolidation therapy with docetaxel
Feasibility was assessed by estimating the percentage of participants who would be able to complete the entire treatment regimen.
4 secondary outcomes
Adverse Events
Time frame: Weekly for the first 13 weeks, then every 3 weeks for the next 6 weeks.
Overall Survival
Time frame: daily for 12 weeks then every 3 weeks for 12 weeks, then every 6 months thereafter.
Progression-Free Survival at 3 Years
Time frame: At the completion of induction therapy, then again 4 weeks after the completion of consolidation therapy, then every 3 months for 2 years, then every 6 months until up to a maximum of 5 years after enrollment.
Response
Time frame: After completion of induction therapy.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Nov 2013.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michael J. Kraut, MD study chair
Providence Hospital
Tien Hoang, MD study chair
University of Wisconsin, Madison
Valerie W. Rusch, MD, FACS study chair
Memorial Sloan Kettering Cancer Center
154 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing cisplatin, docetaxel and etoposide in people with Lung Cancer, run by SWOG Cancer Research Network at 154 sites in United States.
The full registered description is in the About this study section and the official record.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 25 Nov 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 154 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 25 Nov 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Feasibility of Treating Patients With Stage IIB/IIIB Pancoast Tumors With a Regimen of Cisplatin and Etoposide Plus Concurrent Radiotherapy Followed by Surgical Resection Followed by Consolidation Therapy With Docetaxel. (time frame: After completion of 5 weeks of radiotherapy given concurrently with cisplatin+etoposide, surgery + 8 weeks of recovery time, and 6 weeks of consolidation therapy with docetaxel). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Nov 2013.