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S0124: Cisplatin Combined With Irinotecan or Etoposide For Extensive-Stage Small Cell Lung Cancer

Phase 3
Completed
Conditions
Lung Cancer
Interventions
Registration Number
NCT00045162
Lead Sponsor
SWOG Cancer Research Network
Brief Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells. It is not yet known whether cisplatin combined with irinotecan is more effective than cisplatin combined with etoposide in treating extensive-stage small cell lung cancer.

PURPOSE: Randomized phase III trial to compare the effectiveness of cisplatin combined with either irinotecan or etoposide in treating patients who have extensive-stage small cell lung cancer.

Detailed Description

OBJECTIVES:

* Compare the survival of patients with extensive stage small cell lung cancer treated with cisplatin and irinotecan vs cisplatin and etoposide.

* Compare the objective response rate and progression-free survival of patients treated with these regimens.

* Compare the toxic effects of these regimens in these patients.

* Determine the association between UGT1A1 polymorphisms and irinotecan-associated toxic effects in these patients.

* Determine the association between ERCC-1 and XRCC-1 polymorphisms and non-response of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to number of metastatic sites (single vs multiple), lactic dehydrogenase (no greater than upper limit of normal (ULN) vs greater than ULN), and weight loss in the past 6 months (5% or less vs more than 5%). Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive irinotecan IV over 90 minutes on days 1, 8, and 15 and cisplatin IV over 30-60 minutes on day 1. Courses repeat every 4 weeks.

* Arm II: Patients receive etoposide IV over 30-60 minutes on days 1-3 and cisplatin IV over 30-60 minutes on day 1. Courses repeat every 3 weeks.

Treatment in both arms continues for 4 courses in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 1 year and then every 6 months for 2 years.

PROJECTED ACCRUAL: A total of 620 patients (310 per treatment arm) will be accrued for this study within 4 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
671
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1cisplatin-
2cisplatin-
1irinotecan hydrochloride-
2etoposide-
Primary Outcome Measures
NameTimeMethod
Overall SurvivalWeekly while on treatment, then every 3 months for first year, then every 6 months unitl a maximum of 3 years from enrollment.

Overall survival was defined as the duration between the date of randomization( enrollment) and the date of death due to any cause. Patients last known to be alive were censored at the date of last contact.

Secondary Outcome Measures
NameTimeMethod
Confirmed and Unconfirmed Complete and Partial Responses.Every 6 weeks while on protocol treatment for a maximum of 12 weeks

Patients underwent chest CT/MRI every 6 weeks while on treatment and tumor response was evaluated by RECIST in the subset of patients with at least one target lesion at baseline. A target lesion was defined as a lesion with a longest diameter of at least 2 cm ( or at least 1 cm if by spiral CT). A complete response (CR) was defined as the disappearance of all disease, including non-target lesions. A partial response (PR) was defined as a 30% or greater decrease in the sum of the longest diameters. Confirmation of a CR or PR was defined as a second determination of CR or PR at least 4 weeks after the first determination.

Progression-free SurvivalEvery 6 weeks until disease progression or a maximum of 3 years from the date of enrollment.

Progression-Free Survival was defined as the duration from the date of randomization (enrollment) until the date of documentation of progression as defined by RECIST (a 20% increase over nadir in the sum of longest diameters of target lesions, clear progression of a non-target lesion in the opinion of the treating investigator, appearance of new lesions, or symptomatic deterioration) or death due to any cause. Patients last known to be alive and without evidence of progression were censored at the date of last contact.

Number of Patients With a Given Type and Grade of Adverse Event.Every 4 weeks while subject on protocol treatment for a maximum of 12 weeks.

Only adverse events that are possibly, probably or definitely related to study drug are reported. Only patients who received protocol treatment and were assessed for adverse events are included.

Trial Locations

Locations (402)

Northeast Alabama Regional Medical Center

🇺🇸

Anniston, Alabama, United States

Huntsville Hospital

🇺🇸

Huntsville, Alabama, United States

Mobile Infirmary Medical Center

🇺🇸

Mobile, Alabama, United States

East Alabama Medical Center

🇺🇸

Opelika, Alabama, United States

Alaska Regional Hospital Cancer Center

🇺🇸

Anchorage, Alaska, United States

Mayo Clinic Scottsdale

🇺🇸

Scottsdale, Arizona, United States

Arizona Cancer Center at University of Arizona Health Sciences Center

🇺🇸

Tucson, Arizona, United States

Hembree Mercy Cancer Center at St. Edward Mercy Medical Center

🇺🇸

Fort Smith, Arkansas, United States

Arkansas Cancer Research Center at University of Arkansas for Medical Sciences

🇺🇸

Little Rock, Arkansas, United States

Providence Saint Joseph Medical Center - Burbank

🇺🇸

Burbank, California, United States

Scroll for more (392 remaining)
Northeast Alabama Regional Medical Center
🇺🇸Anniston, Alabama, United States

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