Prognostic Study of Metastases in Patients With Stage I, Stage II, or Stage III Non-small Cell Lung Cancer That Can Be Removed by Surgery

NCT ID: NCT00003901

Last Updated: 2017-02-16

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1310 participants

Study Classification

INTERVENTIONAL

Study Start Date

1999-07-31

Study Completion Date

2011-10-31

Brief Summary

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RATIONALE: Prognostic testing for early signs of metastases may help doctors detect metastases early and plan more effective treatment.

PURPOSE: Phase III trial to study the relationship between early signs of metastases and survival in patients who have stage I, stage II, or stage III non-small cell lung cancer that can be removed by surgery.

Detailed Description

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OBJECTIVES:

* Determine the relationship between three indicators of occult metastases (cytological examination of pleural lavage, immunohistochemistry (IHC) assay of lymph nodes, and IHC assay of rib bone marrow) and survival of patients with resectable non-small cell lung cancer.
* Determine the relationship between these indicators and conventional histology.
* Model survival considering the indicators and other patient attributes that are of prime prognostic significance.
* Determine the relationships between the indicators and the site of first recurrence in these patients.
* Determine the prevalence of the indicators in these patients.
* Determine the relationships between the indicators and disease free survival in these patients.

Conditions

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Lung Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Surgery

All patients undergo complete lymph node sampling or dissection. A small portion of rib is removed at this time. Some patients may have primary tumor completely removed.

Lymph nodes and bone marrow from the rib section are examined for occult metastases using immunohistochemical staining methods and standard staining methods.

Patients are followed at 1, 4, 8, and 12 months, every 6 months for 2 years, and then annually for 2 years.

Group Type EXPERIMENTAL

immunohistochemistry staining method

Intervention Type OTHER

biopsy

Intervention Type PROCEDURE

surgery

Intervention Type PROCEDURE

Interventions

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immunohistochemistry staining method

Intervention Type OTHER

biopsy

Intervention Type PROCEDURE

surgery

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patient must be ≥ 18 years old.
2. Patient must have ECOG/Zubrod status \< 3.
3. Patient must have clinically resectable, NSCLC (squamous cell, adenocarcinoma, or large cell) and be clinical Stage I, IIa, IIb or IIIa, according to the 1998 staging system of the American Joint Commission on Cancer for lung cancer.
4. Patient must have N1 or N2 disease. NOTE: Patient must undergo mediastinoscopy if preoperative studies suggest N3 disease.
5. Patient must have a pathologic diagnosis (pre-operative or intra-operative) of NSCLC prior to registration.
6. Patient must be anticipated to have a thoracotomy with the intention of a curative resection for primary NSCLC. NOTE: The preoperative assessment of resectability should, at a minimum, include a CT scan of the chest and upper abdomen, including the adrenal glands, within 60 days prior to registration.
7. Patient must be medically fit for surgery.
8. Patient must be a candidate for complete resection of the carcinoma via pneumonectomy, bilobectomy, lobectomy, or anatomic segmentectomy with or without sleeve resection.
9. Patient or the patient's legally acceptable representative must provide a signed and dated written informed consent prior to registration and any study-related procedures.
10. Patient must be available for follow-up.
11. If the patient is a survivor of a prior cancer, all of the following criteria must apply:

1. Patient has undergone potentially curative therapy for all prior malignancies,
2. No evidence of any prior malignancies for at least 5 years with no evidence of recurrence (except for effectively treated basal cell or squamous carcinoma of the skin, carcinoma in-situ of the cervix that has been effectively treated by surgery alone, or lobular carcinoma in-situ of the ipsilateral or contralateral breast treated by surgery alone),
3. Patient is deemed by their treating physician to be at low risk for recurrence from prior malignancies.

Exclusion Criteria

1. Patient has evidence of pleural effusion by physical assessment, lateral chest x-ray, or by chest CT scan.
2. Patient has had ipsilateral thoracotomy or thoracoscopy within the past 5 years.
3. Patient has received prior chemotherapy or radiotherapy for this cancer.
4. Patient is considered a poor surgical risk due to non-malignant systemic disease (cardiovascular, renal, etc.) that would preclude the treatment options.
5. Patient for whom the surgeon plans to perform only a wedge resection for treatment.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Alliance for Clinical Trials in Oncology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robbin G. Cohen, MD

Role: STUDY_CHAIR

University of Southern California

Locations

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Providence Cancer Center

Mobile, Alabama, United States

Site Status

Mobile Infirmary Medical Center

Mobile, Alabama, United States

Site Status

USC/Norris Comprehensive Cancer Center and Hospital

Los Angeles, California, United States

Site Status

Huntington Cancer Center at Huntington Hospital

Pasadena, California, United States

Site Status

University of California Davis Cancer Center

Sacramento, California, United States

Site Status

UCSF Comprehensive Cancer Center

San Francisco, California, United States

Site Status

University of Colorado Health Sciences Center - Denver

Denver, Colorado, United States

Site Status

Michael & Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital

Fort Lauderdale, Florida, United States

Site Status

Bayfront Medical Center

St. Petersburg, Florida, United States

Site Status

University of Chicago Cancer Research Center

Chicago, Illinois, United States

Site Status

Alexian Brothers Medical Center

Elk Grove Village, Illinois, United States

Site Status

Cancer Institute at St. John's Hospital

Springfield, Illinois, United States

Site Status

Southern Illinois University School of Medicine

Springfield, Illinois, United States

Site Status

Holden Comprehensive Cancer Center at University of Iowa

Iowa City, Iowa, United States

Site Status

Jewish Hospital

Louisville, Kentucky, United States

Site Status

McLaren Regional Cancer Center

Flint, Michigan, United States

Site Status

Hurley Medical Center

Flint, Michigan, United States

Site Status

William Beaumont Hospital - Royal Oak

Royal Oak, Michigan, United States

Site Status

Siteman Cancer Center

St Louis, Missouri, United States

Site Status

Veterans Affairs Medical Center - Omaha

Omaha, Nebraska, United States

Site Status

Creighton University School of Medicine

Omaha, Nebraska, United States

Site Status

Roswell Park Cancer Institute

Buffalo, New York, United States

Site Status

Memorial Sloan-Kettering Cancer Center

New York, New York, United States

Site Status

James P. Wilmot Cancer Center at University of Rochester Medical Center

Rochester, New York, United States

Site Status

Long Island Cancer Center at Stony Brook University Hospital

Stony Brook, New York, United States

Site Status

University Hospital at State University of New York - Upstate Medical University

Syracuse, New York, United States

Site Status

Comprehensive Cancer Center at Wake Forest University

Winston-Salem, North Carolina, United States

Site Status

Charles M. Barrett Cancer Center at University Hospital

Cincinnati, Ohio, United States

Site Status

Ireland Cancer Center

Cleveland, Ohio, United States

Site Status

MetroHealth's Cancer Care Center at MetroHealth Medical Center

Cleveland, Ohio, United States

Site Status

Providence Cancer Center at Providence Portland Medical Center

Portland, Oregon, United States

Site Status

Cancer Institute at Oregon Health and Science University

Portland, Oregon, United States

Site Status

Westmoreland Regional Hospital

Greensburg, Pennsylvania, United States

Site Status

Jameson Memorial Hospital

New Castle, Pennsylvania, United States

Site Status

Abramson Cancer Center of the University of Pennsylvania Medical Center

Philadelphia, Pennsylvania, United States

Site Status

Kimmel Cancer Center at Thomas Jefferson University - Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Fox Chase Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Western Pennsylvania Hospital

Pittsburgh, Pennsylvania, United States

Site Status

St. Clair Memorial Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Lankenau Cancer Center at Lankenau Hospital

Wynnewood, Pennsylvania, United States

Site Status

Saint Thomas Hospital

Nashville, Tennessee, United States

Site Status

Veterans Affairs Medical Center - Tennessee Valley Healthcare System - Nashville Campus

Nashville, Tennessee, United States

Site Status

Vanderbilt-Ingram Cancer Center at Vanderbilt Medical Center

Nashville, Tennessee, United States

Site Status

University of Texas - MD Anderson Cancer Center

Houston, Texas, United States

Site Status

Cottonwood Hospital Medical Center

Murray, Utah, United States

Site Status

LDS Hospital

Salt Lake City, Utah, United States

Site Status

Cancer Center at the University of Virginia

Charlottesville, Virginia, United States

Site Status

Veterans Affairs Medical Center - Seattle

Seattle, Washington, United States

Site Status

Swedish Cancer Institute at Swedish Medical Center - First Hill Campus

Seattle, Washington, United States

Site Status

University Cancer Center at University of Washington Medical Center

Seattle, Washington, United States

Site Status

West Virginia University Hospitals

Morgantown, West Virginia, United States

Site Status

University of Wisconsin Comprehensive Cancer Center

Madison, Wisconsin, United States

Site Status

Medical College of Wisconsin Cancer Center

Milwaukee, Wisconsin, United States

Site Status

Veterans Affairs Medical Center - Milwaukee (Zablocki)

Milwaukee, Wisconsin, United States

Site Status

Cancer Care Ontario-London Regional Cancer Centre

London, Ontario, Canada

Site Status

Toronto General Hospital

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

References

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Rusch VW, Hawes D, Decker PA, Martin SE, Abati A, Landreneau RJ, Patterson GA, Inculet RI, Jones DR, Malthaner RA, Cohen RG, Ballman K, Putnam JB Jr, Cote RJ. Occult metastases in lymph nodes predict survival in resectable non-small-cell lung cancer: report of the ACOSOG Z0040 trial. J Clin Oncol. 2011 Nov 10;29(32):4313-9. doi: 10.1200/JCO.2011.35.2500. Epub 2011 Oct 11.

Reference Type RESULT
PMID: 21990404 (View on PubMed)

Other Identifiers

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CDR0000067072

Identifier Type: REGISTRY

Identifier Source: secondary_id

ACOSOG-Z0040

Identifier Type: -

Identifier Source: org_study_id

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