Non-squamous Nonsmall Cell Neoplasm of LungPhase 3ERACLENCT01303926
Quality of Life Comparison in Advanced Non-squamous Non Small Cell Lung Cancer
A Phase 3 study testing cisplatin pemetrexed and carboplatin paclitaxel bevacizumab in people with Non-squamous Nonsmall Cell Neoplasm of Lung, run by Gruppo Oncologico Italia Meridionale at 12 sites in Italy.
Trial summary
Cisplatin and pemetrexed combination or carboplatin, paclitaxel and bevacizumab are now considered as standard treatment in non-squamous cell lung carcinoma (NSCLC). Both main registrative trials are considered positive because they reached their objectives, but within them, the Quality of Life (QoL) of patients was… Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Non-squamous Nonsmall Cell Neoplasm of Lung
- What is being tested?
- cisplatin pemetrexed and carboplatin paclitaxel bevacizumab
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 118 participants
- Where
- 12 sitesItaly
- Study dates
- Jan 2010to Jun 2012
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Written informed consent(as approved by the local Ethical Committee)
- Histological type consisting mainly of non-squamous histology defined preferably with stage IV metastatic disease or stage IIIB in the presence of supraclavicular lymph nodes according to the parameters of TNM 7th Ed, not amenable to curative therapy
- ECOG PS 0-1
- Adequate bone marrow reserve
- Adequate hepatic, coagulative and renal function
Who cannot join
- Mixed NSCLC tumors or mixed adenosquamous carcinomas with a predominant squamous component histotype (NSCLC and SCLC) or adenosquamous forms, with predominant squamous component
- History of gross hemoptysis <3 months prior to enrollment or history or evidence of inherited bleeding diathesis or coagulopathy with the risk of bleeding.
- Tumors invading or abutting major blood vessels (based on radiologist assessment)
- Evidence of brain metastases not previously treated with RT (or any loco-regional treatment)
- Prior neoadjuvant or adjuvant chemotherapy within six months prior to study enrollment
- Previous radiotherapy in the last month before study entry (except for radiotherapy to symptomatic bone sites at risk and not covered in the premises of measurable disease and assessable)
Show all 20Show fewer
- A major surgery (including open biopsy) in the month preceding study enrollment or anticipation of a major surgery during the study
- Unable or unwilling to take folic acid or vitamin B12 supplementation
- Unable or unwilling to take corticosteroids
- History of gastrointestinal fistula, perforation, or abscess, inflammatory bowel disease, or diverticulitis
- Clinically significant third-space fluid collections, for example, ascites or pleural effusions that cannot be controlled by drainage or other procedures prior to study entry
- Need for taking or have recently taken (within 10 days of enrollment) aspirin (>325 mg/d), clopidogrel at doses >75 mg/d, dipyramidole, ticlopidine, or cilostazol. Patients are also excluded if they cannot hold nonsteroidal anti-inflammatory agents, other than prophylactic therapy with low-dose aspirin, for a 5-day period during each cycle (8-day period for long-acting agents, such as piroxicam)
- Need for taking or have recently taken (within 10 days of enrollment) fulldose oral or parenteral anticoagulants or thrombolytic agents for therapeutic purposes. Prophylactic use of anticoagulants is allowed; international normalized ratio (INR) should be <1.5 at study enrollment
- History of thrombotic disorders within the last 6 months prior to entry History of hypertension, unless hypertension is well controlled study entry (≤150/90 mm Hg) and the patient is on a stable regimen of antihypertensive therapy. Patients should not have any prior history of hypertensive crisis or hypertensive encephalopathy
- Serious cardiac condition, such as myocardial infarction within 6 months, angina, or heart disease, as defined by the New York Heart Association Class III or IV
- Serious concomitant systemic disorder (for example, active infection including human immunodeficiency virus) that, in the opinion of the investigator, would compromise the patient's ability to adhere to the protocol
- Receiving concurrent administration of any other antitumor therapy
- Have a second primary malignancy that is clinically detectable at the time of consideration for study enrollment
- Have had a prior malignancy other than NSCLC, carcinoma in situ of the cervix, or nonmelanoma skin cancer, unless that prior malignancy was diagnosed and definitively treated at least 5 years previously with no subsequent evidence of recurrence. Patients with a history of low grade (Gleason score ≤6) localized prostate cancer will be eligible even if diagnosed less than 5 years previously
- Patients with known hypersensitivity to Chinese hamster ovary cell products or other recombinant human antibodies
Trial locations and contacts
12 sites in 1 country.
12 sites in 1 country
Italy12 sites
"Giovanni Paolo II" Oncology Institute
Bari, BA, 70124
"San Paolo Hospital" Oncology Service
Bari, BA
Division of Medical Oncology, "Fatebenefratelli" Hospital
Benevento, BN
Division of Medical Oncology, "Sen. Perrino" Hospital, Brindisi, Italy
Brindisi, BR, 72100
Division of Medical Oncology, Castellaneta Hospital
Castellaneta, TA
Medical Oncology Division "Vito Fazzi" Hospital
Lecce, Le
Clinical Trials Office, Department of Medical Sciences, Azienda ULSS 13
Mirano, VE
National Cancer Institute "G. Pascale" Thoracic Dept.
Naples
Division of Medical Oncology, "Buccheri-La Ferla" Hospital
Palermo, PA
Division of Medical Oncology, "La Maddalena" Hospital
Palermo, PA
7 Division of Medical Oncology, "Casa Sollievo della Sofferenza" Hospital,
San Giovanni Rotondo, FG
Division of Medical Oncology "San Giuseppe Moscati Hospital"
Taranto, TA
About this study
Official title: Induction Pemetrexed and Cisplatin Followed by Pemetrexed as Maintenance vs Carboplatin-paclitaxel and Bevacizumab Followed by Bevacizumab as Maintenance:Multicenter Randomized Phase III Study in Patients With Advanced Non-Squamous Non Small-cell Lung Cancer: a Quality of Life Oriented Phase III Trial of the GOIM
Cisplatin and pemetrexed combination or carboplatin, paclitaxel and bevacizumab are now considered as standard treatment in non-squamous cell lung carcinoma (NSCLC). Both main registrative trials are considered positive because they reached their objectives, but within them, the Quality of Life (QoL) of patients was not detailed neither has represented as primary objective of the studies. It is considered that, together with enhancements that are added to the knowledge of the biology of NSCLC, QoL may influence the therapeutic choice if one of the associations show to be better tolerated by the patient and favours an amelioration of his QoL.
Read the detailed description
The study aims primarily to verify the null hypothesis that between the two schemes under consideration there is no minimal interesting difference (MID) (i.e. a difference of clinical interest) after initial 3 months of maintenance.EuroQ5D (EQ5D) questionnaire total score and EQ5D visual analog scale (VAS)are validated and very simple to be administered.The statistical hypothesis tests described above are performed with t-test for unpaired data (or equivalent non-parametric, pending verification of normality of distribution by Shapiro-Wilk test), with alpha error = 0.05 (2-sided). It is assumed that:
- about 20% of randomized patients experienced a progression of disease before the time of evaluation of the primary endpoint, and that
- this eventuality was not significantly different between the two treatments. The total sample to be enrolled for this study will then be increased to 118 patients [(49 +49) +20%)]
- Being tested
- cisplatin pemetrexed, carboplatin paclitaxel bevacizumab
- Keywords
- QoL, EQ5D score, cisplatin pemetrexed, carboplatin paclitaxel bevacizumab, maintenance
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
cisplatin pemetrexedDrug
Cisplatin 75 mg / m2 d1 with Pemetrexed 500 mg / m2 d1 every 3 weeks for 6 cycles followed (in responding or stable patients) by Pemetrexed 500 mg / m2 every 3 weeks, until progression or unacceptable toxicity
carboplatin paclitaxel bevacizumabDrug
Carboplatin AUC 6 d1 plus Paclitaxel 200 mg/m2 d1 and Bevacizumab 15 mg/kg every 3 weeks for 6 cycles followed in stable or responding patients by Bevacizumab 15 mg/kg every 3 weeks, until progression or unacceptable toxicity
| Study group | Role | What they receive |
|---|---|---|
| Cisplatin and Pemetrexed | Active comparator | Not described Receives: Drug: cisplatin pemetrexed |
| Carboplatin paclitaxel bevacizumab | Active comparator | Not described Receives: Drug: carboplatin paclitaxel bevacizumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Difference in terms of quality of life (QOL) between treatment arms
Measured: Treatment efficacy will be evaluated at baseline and every 3 cycles during chemo period and every two months during the maintenance phase
Secondary outcomes (3)
treatment activity in terms of response rate
Measured: Two year
toxicity evaluation
Measured: Two years
Evaluation of QoL across time
Measured: Two years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Feb 2011 (estimated)
- Study startJan 2010
- Primary completionJun 2012 (estimated)
- Study completionJun 2012 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Non-squamous Nonsmall Cell Neoplasm of LungStudies of the same condition, open and under way.
- 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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 118 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Gruppo Oncologico Italia Meridionale
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Giuseppe Colucci MD, Gruppo Oncologico Italia Meridionale
- Investigators
- Giuseppe Colucci, MD, Principal investigator, Oncology Institute of BariDomenico Galetta, MD, Study director, "Giovanni Paolo II" Oncology Instutute Medical Oncology Dept. Bari (Italy)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01303926
- Sponsor's protocol ID
- Goim 2903
- Other IDs
- 2009-015807-19, 2009
- Acronym
- ERACLE
- Status last verified
- Apr 2012
- First submitted
- 13 Jan 2011
- Last updated
- 10 Apr 2012
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Galetta D, Cinieri S, Pisconti S, Gebbia V, Morabito A, Borsellino N, Maiello E, Febbraro A, Catino A, Rizzo P, Montrone M, Misino A, Logroscino A, Rizzi D, Di Maio M, Colucci G. Cisplatin/Pemetrexed Followed by Maintenance Pemetrexed Versus Carboplatin/Paclitaxel/Bevacizumab Followed by Maintenance Bevacizumab in Advanced Nonsquamous Lung Cancer: The GOIM (Gruppo Oncologico Italia Meridionale) ERACLE Phase III Randomized Trial. Clin Lung Cancer. 2015 Jul;16(4):262-73. doi: 10.1016/j.cllc.2014.12.002. Epub 2014 Dec 9.
PubMed 25582493
Study at a glance
From the registry record, last updated by the sponsor on 10 Apr 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Induction Pemetrexed and Cisplatin Followed by Pemetrexed as Maintenance vs Carboplatin-paclitaxel and Bevacizumab Followed by Bevacizumab as Maintenance:Multicenter Randomized Phase III Study in Patients With Advanced Non-Squamous Non Small-cell Lung Cancer: a Quality of Life Oriented Phase III Trial of the GOIM
- ClinicalTrials.gov ID
- NCT01303926
- Acronym / sponsor ID
- ERACLE / Goim 2903
- Keywords
- QoL, EQ5D score, cisplatin pemetrexed, carboplatin paclitaxel bevacizumab, maintenance
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 118 participants (estimated)
- Lead sponsor
- Gruppo Oncologico Italia MeridionaleUniversity, hospital or other
- Study start
- Jan 2010
- Primary completion
- Jun 2012 (estimated)
- Study completion
- Jun 2012 (estimated)
- First posted
- 25 Feb 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Cisplatin and pemetrexed combination or carboplatin, paclitaxel and bevacizumab are now considered as standard treatment in non-squamous cell lung carcinoma (NSCLC). Both main registrative trials are considered positive because they reached their objectives, but within them, the Quality of Life (QoL) of patients was not detailed neither has represented as primary objective of the studies. It is considered that, together with enhancements that are added to the knowledge of the biology of NSCLC, QoL may influence the therapeutic choice if one of the associations show to be better tolerated by the patient and favours an amelioration of his QoL.
Detailed description
The study aims primarily to verify the null hypothesis that between the two schemes under consideration there is no minimal interesting difference (MID) (i.e. a difference of clinical interest) after initial 3 months of maintenance.EuroQ5D (EQ5D) questionnaire total score and EQ5D visual analog scale (VAS)are validated and very simple to be administered.The statistical hypothesis tests described above are performed with t-test for unpaired data (or equivalent non-parametric, pending verification of normality of distribution by Shapiro-Wilk test), with alpha error = 0.05 (2-sided). It is assumed that:
- about 20% of randomized patients experienced a progression of disease before the time of evaluation of the primary endpoint, and that
- this eventuality was not significantly different between the two treatments. The total sample to be enrolled for this study will then be increased to 118 patients [(49 +49) +20%)]
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Cisplatin and Pemetrexed | Active comparator | Drug: cisplatin pemetrexed |
| Carboplatin paclitaxel bevacizumab | Active comparator | Drug: carboplatin paclitaxel bevacizumab |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Written informed consent(as approved by the local Ethical Committee)
- Histological type consisting mainly of non-squamous histology defined preferably with stage IV metastatic disease or stage IIIB in the presence of supraclavicular lymph nodes according to the parameters of TNM 7th Ed, not amenable to curative therapy
- ECOG PS 0-1
- Adequate bone marrow reserve
- Adequate hepatic, coagulative and renal function
Key exclusion criteria (20 listed)
- Mixed NSCLC tumors or mixed adenosquamous carcinomas with a predominant squamous component histotype (NSCLC and SCLC) or adenosquamous forms, with predominant squamous component
- History of gross hemoptysis <3 months prior to enrollment or history or evidence of inherited bleeding diathesis or coagulopathy with the risk of bleeding.
- Tumors invading or abutting major blood vessels (based on radiologist assessment)
- Evidence of brain metastases not previously treated with RT (or any loco-regional treatment)
- Prior neoadjuvant or adjuvant chemotherapy within six months prior to study enrollment
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 |
|---|---|---|
| cisplatin pemetrexedCisplatin 75 mg / m2 d1 with Pemetrexed 500 mg / m2 d1 every 3 weeks for 6 cycles followed (in responding or stable patients) by Pemetrexed 500 mg / m2 every 3 weeks, until progression or unacceptable toxicity | Drug | Cisplatin and Pemetrexed |
| carboplatin paclitaxel bevacizumabCarboplatin AUC 6 d1 plus Paclitaxel 200 mg/m2 d1 and Bevacizumab 15 mg/kg every 3 weeks for 6 cycles followed in stable or responding patients by Bevacizumab 15 mg/kg every 3 weeks, until progression or unacceptable toxicity | Drug | Carboplatin paclitaxel bevacizumab |
Primary outcome
Difference in terms of quality of life (QOL) between treatment arms
Time frame: Treatment efficacy will be evaluated at baseline and every 3 cycles during chemo period and every two months during the maintenance phase
3 secondary outcomes
treatment activity in terms of response rate
Time frame: Two year
toxicity evaluation
Time frame: Two years
Evaluation of QoL across time
Time frame: Two years
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Apr 2012.
- Derived from this study: PubMed 25582493Galetta D, Cinieri S, Pisconti S, Gebbia V, Morabito A, Borsellino N, Maiello E, Febbraro A, Catino A, Rizzo P, Montrone M, Misino A, Logroscino A, Rizzi D, Di Maio M, Colucci G. Cisplatin/Pemetrexed Followed by Maintenance Pemetrexed Versus Carboplatin/Paclitaxel/Bevacizumab Followed by Maintenance Bevacizumab in Advanced Nonsquamous Lung Cancer: The GOIM (Gruppo Oncologico Italia Meridionale) ERACLE Phase III Randomized Trial. Clin Lung Cancer. 2015 Jul;16(4):262-73. doi: 10.1016/j.cllc.2014.12.002. Epub 2014 Dec 9.
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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.
Giuseppe Colucci, MD principal investigator
Oncology Institute of Bari
Domenico Galetta, MD study director
"Giovanni Paolo II" Oncology Instutute Medical Oncology Dept. Bari (Italy)
12 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing cisplatin pemetrexed and carboplatin paclitaxel bevacizumab in people with Non-squamous Nonsmall Cell Neoplasm of Lung, run by Gruppo Oncologico Italia Meridionale at 12 sites in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 10 Apr 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 12 sites in Italy. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
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?
Difference in terms of quality of life (QOL) between treatment arms (time frame: Treatment efficacy will be evaluated at baseline and every 3 cycles during chemo period and every two months during the maintenance phase). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01303926, which also lists 1 linked publication.
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 10 Apr 2012.