Cisplatin/Etoposide/Radiotherapy +/- Consolidation Docetaxel in Advanced Stage III Non-Small Cell Lung Cancer

NCT ID: NCT00216125

Last Updated: 2016-03-16

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

243 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-02-28

Study Completion Date

2008-03-31

Brief Summary

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In a previous phase II study, patients with pathological stage IIIb (without pleural effusion) NSCLC were treated with concurrent cisplatin and etoposide plus thoracic radiotherapy followed by 3 cycles of consolidation therapy with docetaxel. Docetaxel was selected based upon a survival benefit in patients with recurrent NSCLC.

This trial will evaluate the role of consolidation therapy with docetaxel in patients with unresectable stage III disease. The purpose of the trial is to evaluate survival and toxicities of the regimens employed.

Detailed Description

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OUTLINE: This is a multi-center study.

* Cisplatin 50 mg/m2 d1, 8, 29, 36
* Etoposide 50 mg/m2/day d1-5, 29-33
* Radiation 5940 cGy (180 cGy/day)

Patients with CR, PR, SD Randomized to either:Docetaxel75 mg/m2 q3wk X 3 cycles

or Observation Only

Performance Status: ECOG 0 or 1

Life Expectancy: Not specified

Hematopoietic:

* ANC \> 1,500/mm3
* Platelet count \> 100,000/mm3
* Hemoglobin \> 8 g/dl. PRBC transfusions will be allowed to increase hemoglobin to \>8 g/dl

Hepatic:

* Serum bilirubin \< institutional upper limit of normal (ULN)
* AST \< 2.5 X the upper limits of normal if alkaline phosphatase is \< ULN, or alkaline phosphatase may be up to 4 X ULN if AST are \< ULN

Renal:

* Serum creatinine of \< 2 mg/dl or calculated creatinine clearance \> 50 cc/min

Cardiovascular:

* No clinically significant history of cardiac disease, (i.e. uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the past year, or cardiac ventricular arrhythmias requiring medication).

Pulmonary:

* Pre-registration FEV1 \> 1 liters by spirometry within 42 days prior to study treatment.

Conditions

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Non-Small Cell Lung Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Pre-Randomization

Prior to randomization patients received Cisplatin 50 mg/m\^2 days 1,8,29,36 + Etoposide 50 mg/m\^2 days 1-5, 29-33 + Radiation 5940 cGy (180 cGy/day). Patients with CR, PR or SD with manageable toxicity were randomized to either Docetaxel arm or Observation only arm.

Group Type OTHER

Cisplatin

Intervention Type DRUG

Cisplatin 50 mg/m2 day 1, 8, 29, 36

Etoposide

Intervention Type DRUG

Etoposide 50 mg/m2, days 1-5, 29-33

Radiation

Intervention Type RADIATION

Radiation 5940 cGy (180 cGy/day)

Consolidation Docetaxel

Docetaxel 75 mg/m\^2 q3wk X 3 cycles.

Group Type ACTIVE_COMPARATOR

Docetaxel

Intervention Type DRUG

docetaxel 75mg/m2 q3wk x 3 cycles

Observation Only

Patients were followed for Observation.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Cisplatin

Cisplatin 50 mg/m2 day 1, 8, 29, 36

Intervention Type DRUG

Etoposide

Etoposide 50 mg/m2, days 1-5, 29-33

Intervention Type DRUG

Radiation

Radiation 5940 cGy (180 cGy/day)

Intervention Type RADIATION

Docetaxel

docetaxel 75mg/m2 q3wk x 3 cycles

Intervention Type DRUG

Other Intervention Names

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Platinol VP-16 Taxol

Eligibility Criteria

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Inclusion Criteria

* Histologic or cytologic evidence of NSCLCUnresectable Stage IIIA (N2) OR Stage IIIB NSCLC.
* Unresectable Stage IIIA will be defined by the following criteria:
* N2 mediastinal lymph nodes must be multiple and/or bulky on CT scan such that in the opinion of the treating investigator, the patient is not a candidate for surgical resection
* N2 disease must be documented by biopsy, FDG-PET scan imaging, or by CT if nodes are \> 2 cm on CT scan
* Stage IIIb patients must have N3 or T4 status. N3 status must be documented by one of the following criteria:
* Contralateral (to the primary tumor) mediastinal lymph node, supraclavicular or scalene lymph nodes proven by biopsy, FDG-PET scan imaging, or by CT if nodes are \> 2 cm on CT scan.
* Patients with positive supraclavicular or scalene lymph nodes must not have disease extending up into the cervical region.
* All patients must have measurable or evaluable disease documented by CT, MRI, X-ray or physical exam within 28 days prior to study treatment.
* Negative pregnancy test

Eligibility for Consolidation Therapy

* Following completion of induction chemoradiotherapy patients without local progression of disease or distant metastases will then be randomized to receive consolidation therapy with docetaxel or observation. Patients will be stratified and randomized based on stage IIIa vs IIIb disease at baseline, CR vs. non-CR following induction chemoradiation, and ECOG PS 0 or 1 vs. 2.
* Patients must have completed chemoradiotherapy per protocol and at least 4 weeks but no more than 8 weeks must have elapsed from the last day of induction therapy (the last day of radiation) to be eligible for randomization to consolidation with docetaxel or observation.
* Patients must have undergone re-staging tests according to the study calendar and determined to have no evidence of disease progression to be eligible for randomization to consolidation with docetaxel or observation.
* Patients must have an ANC \> 1,500/mm3, platelet count \> 100,000/ mm3, and hemoglobin \> 8 g/dl obtained within 14 days prior to registration for randomization to consolidation with docetaxel or observation.
* Patients must have adequate hepatic function as defined by a serum bilirubin \< institutional upper limit of normal (ULN) and an AST and/or ALT \< 2.5 X the upper limits of normal if alkaline phosphatase is \< ULN, or alkaline phosphatase may be up to 4 X ULN if transaminases are \< ULN within 14 days prior to registration for randomization to consolidation with docetaxel or observation.

Exclusion Criteria

* No prior chemotherapy or radiotherapy for lung cancer.
* No unintended weight loss \> 5% body weight in the preceding 3 months prior to study treatment will not be eligible for this trial.
* No symptomatic peripheral neuropathy prior to entry onto the study. Peripheral neuropathy must be \< Grade 1 to be eligible.
* No prior malignancy except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease-free for 5 years.
* No history of allergic reactions to drugs utilizing the vehicle polysorbate 80 (docetaxel) and polysorbate 80 + polyethylene glycol (etoposide).
* If the patient has hearing loss at pre-study, performance of an audiogram is recommended (not mandatory) to document baseline hearing status in the event of possible further hearing loss due to cisplatin administration.
* No current breastfeeding
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanofi

INDUSTRY

Sponsor Role collaborator

Walther Cancer Institute

OTHER

Sponsor Role collaborator

Nasser Hanna, M.D.

OTHER

Sponsor Role lead

Responsible Party

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Nasser Hanna, M.D.

Sponsor-Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Nasser Hanna, M.D.

Role: STUDY_CHAIR

Hoosier Oncology Group, LLC

Locations

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Medical & Surgical Specialists, LLC

Galesburg, Illinois, United States

Site Status

Elkhart Clinic

Elkhart, Indiana, United States

Site Status

Oncology Hematology Associates of SW Indiana

Evansville, Indiana, United States

Site Status

Fort Wayne Oncology & Hematology, Inc

Fort Wayne, Indiana, United States

Site Status

Center for Cancer Care at Goshen Health System

Goshen, Indiana, United States

Site Status

Indiana University Cancer Center

Indianapolis, Indiana, United States

Site Status

Quality Cancer Center (MCGOP)

Indianapolis, Indiana, United States

Site Status

Community Regional Cancer Center

Indianapolis, Indiana, United States

Site Status

Medical Consultants, P.C.

Muncie, Indiana, United States

Site Status

Center for Cancer Care, Inc., P.C.

New Albany, Indiana, United States

Site Status

Northern Indiana Cancer Research Consortium

South Bend, Indiana, United States

Site Status

AP&S Clinic

Terre Haute, Indiana, United States

Site Status

Siteman Cancer Center

St Louis, Missouri, United States

Site Status

Methodist Cancer Center

Omaha, Nebraska, United States

Site Status

US Oncology

Houston, Texas, United States

Site Status

Countries

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United States

References

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Hanna N, Neubauer M, Yiannoutsos C, McGarry R, Arseneau J, Ansari R, Reynolds C, Govindan R, Melnyk A, Fisher W, Richards D, Bruetman D, Anderson T, Chowhan N, Nattam S, Mantravadi P, Johnson C, Breen T, White A, Einhorn L; Hoosier Oncology Group; US Oncology. Phase III study of cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small-cell lung cancer: the Hoosier Oncology Group and U.S. Oncology. J Clin Oncol. 2008 Dec 10;26(35):5755-60. doi: 10.1200/JCO.2008.17.7840. Epub 2008 Nov 10.

Reference Type RESULT
PMID: 19001323 (View on PubMed)

Related Links

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http://www.hoosieroncologygroup.org

Hoosier Oncology Group Home Page

Other Identifiers

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HOG LUN01-24

Identifier Type: -

Identifier Source: org_study_id

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