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Lung NeoplasmsPhase 2/3ECTOP-1004NCT03380468

Adjuvant Chemotherapy for High Risk Stage I Lung Adenocarcinoma

A Phase 2/3 study testing cisplatin plus pemetrexed in people with Lung Neoplasms, run by Fudan University at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a clinical trial from Eastern Cooperative Thoracic Oncology Project (ECTOP), numbered as ECTOP-1004. Solid subtype, micropapillary subtype, vascular involvement, pleural involvement and low differentiation are high risk factors of post-operative recurrence for early-stage lung adenocarcinoma patients. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Lung Neoplasms
What is being tested?
cisplatin plus pemetrexed
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
300 participants
Where
1 siteChina
Study dates
1 Jan 2018to 31 Dec 2025
Phase
Phase 2/3
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

  • Stage pI lung adenocarcinoma confirmed through formalin-fixed paraffin-embedded tumor tissue, complete resection with mediastinal lymph node dissection
  • Meet one of following conditions: a, Solid predominant adenocarcinomas; b, micropapillary predominant adenocarcinoma; c, low differentiation, unable to identify histological subtypes; d, pleural involvement; e, vascular involvement with solid subtype component or micropapillary component.
  • Aged 18-70 years old.
  • Eastern Cooperative Oncology Group score standard (ECOG) status 0-1.
  • Medical condition permits adjuvant chemotherapy.
  • Patients accept the clinical trial protocol and Informed Consent Form (ICF) signed.

Who cannot join

  • Concurrent other malignancies
  • Prior chemotherapy and/or radiation therapy for lung cancer
  • Central type lung cancer
  • Concurrent other unresected suspicious nodules or masses in lung
  • Medical condition that will not permit treatment or follow up according to the protocol, or ECOG status >1.
  • Pregnant or nursing women.

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Fudan University Cancer Center

    Shanghai, Shanghai Municipality, 200032

    Chen Haiquan, MD, +86-21 64175590 ext. 1707, hqchen1@yahoo.com

    Recruiting

Other trials in China

About this study

Official title: Adjuvant Chemotherapy Versus Observation in Fully Resected Stage I Lung Adenocarcinoma With High Risk of Post-operative Recurrence

This is a clinical trial from Eastern Cooperative Thoracic Oncology Project (ECTOP), numbered as ECTOP-1004. Solid subtype, micropapillary subtype, vascular involvement, pleural involvement and low differentiation are high risk factors of post-operative recurrence for early-stage lung adenocarcinoma patients. The purpose of this clinical trial is to determine whether the widely used adjuvant chemotherapy strategy cisplatin/ pemetrexed is more effective than no further treatment for Stage pI lung adenocarcinoma patients with high post-operative recurrence risk - in terms of no dose related toxicities, premature treatment withdrawal or death.

Read the detailed description

Background:

Management of lung cancer varies according to the clinical and pathological stage. For stage I lung adenocarcinoma, radical surgery is the preferred initial treatment and adjuvant chemotherapy is usually not recommended due to a fine prognosis and relatively low post-operative recurrence rate. Still, a number of stage pI patients will suffer a relapse after surgery, among which are highly associated with solid subtype, micropapillary subtype, vascular involvement, pleural involvement and low differentiation. Recently, some retrospective researches have shown a significant survival benefit of adjuvant chemotherapy for such stage pI high-recurrent-risk patients, but there lacks evidence from prospective randomized clinical trails.

Objective:

  1. Major: to compare disease free survival and over all survival of fully resected stage pI high-recurrent-risk patients from both arms (adjuvant chemotherapy vs. observation)
  2. To assess the safety and efficacy of chemotherapy regimen cisplatin plus pemetrexed to fully resected stage pI high-recurrent-risk patients.
  3. To collect clinical pathological characteristics and prognosis information of stage pI patients with solid subtype, micropapillary subtype, vascular involvement, pleural involvement and low differentiation.
  4. To determine the association among age, gender, smoking history, pathological subtypes, histological differentiation, pleural involvement, vascular involvement and driving mutations.

Randomization:

Each of the patients enrolled will be recorded in the computer system. Blank randomization will be done using a digital randomization software, at least 1 week before the first time of chemotherapy or observation.

Prechemotherapy assessment: For all the patients enrolled, the postoperative physical or laboratory examination should be equally qualified no matter which group they will be in. For Group Adjuvant Chemotherapy patients, they will receive laboratory examinations before chemotherapy to test blood cells and liver function in consideration of safety as routine.

Follow up:

Patients will be followed up per 4 months for the first three years and each six months for the forth to fifth years during the research. Lung multi-detector row computed tomography (MDCT) and abdominal ultrasonography tests will be done twice a year; bone SPECT scan and enhanced brain MRI scan will be conducted per year routinely. Patients will be suggested to continue the annual follow-up after the research.

Main research variables:

Primary end point: Disease free survival in the two arms

Secondary endpoints:

  1. Overall survival
  2. Recurrence pattern: Locoregional recurrence, metastatic recurrence, or both
  3. Quality of life: assessed with Eastern Cooperative Oncology Group- quality of life questionnaire(EORTC QLQ-C30/- LC13) scale.

This study is recognized in our institute as "Eastern Cooperative Thoracic Oncology Projects (ECTOP-1004)"

Conditions
Lung Neoplasms
Being tested
cisplatin plus pemetrexed
Keywords
Lung adenocarcinoma, adjuvant chemotherapy
Medical subject headings
Lung Neoplasms, Adenocarcinoma of Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • cisplatin plus pemetrexedDrug

    cisplatin 75mg/m2 iv; pemetrexed 500mg/m2 iv

Study groups in NCT03380468
Study groupRoleWhat they receive
Cisplatin plus pemetrexedExperimentalDrug: cisplatin 75mg/m2 iv Drug: pemetrexed 500mg/m2 iv
Receives: Drug: cisplatin plus pemetrexed
ObservationNo interventionObservation and follow up only

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Recurrence free survival (RFS)

    from date of randomization until the date of showing signs of relapse, including evidence of medical image or pathology.

    Measured: up to 5 years

Secondary outcomes (1)
  1. Overall survival (OS)

    from date of randomization until the date of death from any cause, withdrawal of consent, or the end of the study.

    Measured: up to 5 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Dec 2017
  2. Study start1 Jan 2018
  3. Primary completion1 Jan 2024 (estimated)
  4. Study completion31 Dec 2025 (estimated)

Resources

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03380468
Sponsor's protocol ID
ECTOP-1004
Acronym
ECTOP-1004
Status last verified
Jul 2023
First submitted
1 Nov 2017
Last updated
20 Jul 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J. Cancer statistics in China, 2015. CA Cancer J Clin. 2016 Mar-Apr;66(2):115-32. doi: 10.3322/caac.21338. Epub 2016 Jan 25.

    PubMed 26808342
  • Kelsey CR, Marks LB, Hollis D, Hubbs JL, Ready NE, D'Amico TA, Boyd JA. Local recurrence after surgery for early stage lung cancer: an 11-year experience with 975 patients. Cancer. 2009 Nov 15;115(22):5218-27. doi: 10.1002/cncr.24625.

    PubMed 19672942
  • Zhang Y, Li J, Wang R, Li Y, Pan Y, Cai D, Hu H, Li H, Ye T, Luo X, Zhang Y, Li B, Shen L, Sun Y, Chen H. The prognostic and predictive value of solid subtype in invasive lung adenocarcinoma. Sci Rep. 2014 Nov 24;4:7163. doi: 10.1038/srep07163.

    PubMed 25418354
  • Zhang Y, Wang R, Cai D, Li Y, Pan Y, Hu H, Wang L, Li H, Ye T, Luo X, Zhang Y, Li B, Shen L, Sun Y, Chen H. A comprehensive investigation of molecular features and prognosis of lung adenocarcinoma with micropapillary component. J Thorac Oncol. 2014 Dec;9(12):1772-8. doi: 10.1097/JTO.0000000000000341.

    PubMed 25226429
  • Yoshizawa A, Motoi N, Riely GJ, Sima CS, Gerald WL, Kris MG, Park BJ, Rusch VW, Travis WD. Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol. 2011 May;24(5):653-64. doi: 10.1038/modpathol.2010.232. Epub 2011 Jan 21.

    PubMed 21252858
  • Shimada Y, Saji H, Yoshida K, Kakihana M, Honda H, Nomura M, Usuda J, Kajiwara N, Ohira T, Ikeda N. Pathological vascular invasion and tumor differentiation predict cancer recurrence in stage IA non-small-cell lung cancer after complete surgical resection. J Thorac Oncol. 2012 Aug;7(8):1263-70. doi: 10.1097/JTO.0b013e31825cca6e.

    PubMed 22673056
  • Al-Alao BS, Gately K, Nicholson S, McGovern E, Young VK, O'Byrne KJ. Prognostic impact of vascular and lymphovascular invasion in early lung cancer. Asian Cardiovasc Thorac Ann. 2014 Jan;22(1):55-64. doi: 10.1177/0218492313478431. Epub 2013 Sep 4.

    PubMed 24585645
  • Chen YY, Huang TW, Tsai WC, Lin LF, Cheng JB, Lee SC, Chang H. Lymphovascular space invasion and tumor differentiation are predictors for postoperative recurrence in patients with pathological stage I nonsmall cell lung cancer. J Chin Med Assoc. 2014 Aug;77(8):416-21. doi: 10.1016/j.jcma.2014.05.008. Epub 2014 Jul 12.

    PubMed 25028298
  • Park C, Lee IJ, Jang SH, Lee JW. Factors affecting tumor recurrence after curative surgery for NSCLC: impacts of lymphovascular invasion on early tumor recurrence. J Thorac Dis. 2014 Oct;6(10):1420-8. doi: 10.3978/j.issn.2072-1439.2014.09.31.

    PubMed 25364519
  • Yano M, Sasaki H, Moriyama S, Kawano O, Hikosaka Y, Fujii Y. Prognostic factors of pathologic stage IB non-small cell lung cancer. Ann Thorac Cardiovasc Surg. 2011;17(1):58-62. doi: 10.5761/atcs.cr.09.01481.

    PubMed 21587131
  • Huang H, Wang T, Hu B, Pan C. Visceral pleural invasion remains a size-independent prognostic factor in stage I non-small cell lung cancer. Ann Thorac Surg. 2015 Apr;99(4):1130-9. doi: 10.1016/j.athoracsur.2014.11.052. Epub 2015 Feb 20.

    PubMed 25704861
  • Jiang L, Liang W, Shen J, Chen X, Shi X, He J, Yang C, He J. The impact of visceral pleural invasion in node-negative non-small cell lung cancer: a systematic review and meta-analysis. Chest. 2015 Oct;148(4):903-911. doi: 10.1378/chest.14-2765.

    PubMed 25675151
  • Butts CA, Ding K, Seymour L, Twumasi-Ankrah P, Graham B, Gandara D, Johnson DH, Kesler KA, Green M, Vincent M, Cormier Y, Goss G, Findlay B, Johnston M, Tsao MS, Shepherd FA. Randomized phase III trial of vinorelbine plus cisplatin compared with observation in completely resected stage IB and II non-small-cell lung cancer: updated survival analysis of JBR-10. J Clin Oncol. 2010 Jan 1;28(1):29-34. doi: 10.1200/JCO.2009.24.0333. Epub 2009 Nov 23.

    PubMed 19933915
  • Strauss GM, Herndon JE 2nd, Maddaus MA, Johnstone DW, Johnson EA, Harpole DH, Gillenwater HH, Watson DM, Sugarbaker DJ, Schilsky RL, Vokes EE, Green MR. Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small-cell lung cancer: CALGB 9633 with the Cancer and Leukemia Group B, Radiation Therapy Oncology Group, and North Central Cancer Treatment Group Study Groups. J Clin Oncol. 2008 Nov 1;26(31):5043-51. doi: 10.1200/JCO.2008.16.4855. Epub 2008 Sep 22.

    PubMed 18809614
  • Luo J, Huang Q, Wang R, Han B, Zhang J, Zhao H, Fang W, Luo Q, Yang J, Yang Y, Zhu L, Chen T, Cheng X, Wang Y, Zheng J, Wu H, Xia W, Chen H. Prognostic and predictive value of the novel classification of lung adenocarcinoma in patients with stage IB. J Cancer Res Clin Oncol. 2016 Sep;142(9):2031-40. doi: 10.1007/s00432-016-2192-6. Epub 2016 Jul 5.

    PubMed 27379889

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing cisplatin plus pemetrexed in people with Lung Neoplasms, run by Fudan University at 1 site in China.

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 6 inclusion and 6 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 20 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. 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 combined 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.

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?

Contact Haiquan Chen, MD (+86-21 64175590 ext. 1707, hqchen1@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Recurrence free survival (RFS) (time frame: up to 5 years). 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 NCT03380468, which also lists 21 linked publications.

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 20 Jul 2023.

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