STUDY 15 - Comparing Gemcitabine/Carboplatin and Hydroxychloroquine Versus Carboplatin/Etoposide Therapy Alone in Small Cell Lung Cancer (SCLC)
- Conditions
- Small Cell Lung Cancer
- Interventions
- Registration Number
- NCT02722369
- Lead Sponsor
- University College, London
- Brief Summary
To determine whether the combination of gemcitabine/carboplatin with hydroxychloroquine (HCQ) is associated with an improved clinical outcome (progression free and overall survival) compared with chemotherapy alone in patients with small cell lung cancer (SCLC)
- Detailed Description
This is a multicentre, randomised, phase II trial which aims to compare the combination of hydroxychloroquine and gemcitabine/carboplatin versus standard carboplatin/etoposide chemotherapy, as first line treat in patients with stage IV disease.
The standard first line chemotherapy treatment remains a platinum-based chemotherapy and this has been unchanged for 20 years. Novel active treatment approaches are urgently needed to improve survival in SCLC.
Patients are randomised to one of two treatment arms; carboplatin/etoposide or gemcitabine/carboplatin/hydroxychloroquine.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 72
- Histologically or cytologically confirmed SCLC
- Stage IV disease
- Performance status ECOG 0-2
- Life expectancy >8 weeks
- Age 18 or over
- Willing and able to give informed consent
- Patient considered able to tolerate chemotherapy
- Adequate renal function - defined by GFR ≥50mL/min as measured by EDTA or C&G
- Adequate bone marrow reserve: Absolute neutrophil count ≥1.5 x 109/L, haemoglobin ≥90 g/L, platelet count ≥100 x 109/L
- Negative pregnancy test for WCBP
- Highly effective contraception is mandatory for all patients of reproductive potential
- At least one site of measurable disease (target lesion) for RECIST 1.1 evaluation
- Hypersensitivity or history of severe allergic reaction to any of the IMPs
- Able to swallow medication
-
Mixed cell histology (i.e. NSCLC and SCLC)
-
Prior macular degeneration or diabetic retinopathy
-
History of glaucoma
-
Patients with abnormal LFTs (ALP, ALT/AST*) that are ≥3 x ULN (≥5 x ULN for patients with liver metastases)
-
Patients with abnormal bilirubin levels that are ≥1.5 x ULN
-
Prior treatment for this disease e.g. chemotherapy, surgery, radiotherapy (except palliative radiotherapy to bone metastases)
-
Documented side effects to chloroquine or related agents
-
Treatment with chloroquine or related agents within the last year prior to randomisation
-
Evidence of significant medical condition or laboratory finding which, in the opinion of the investigator, makes it undesirable for the patient to participate in the trial
-
Previous medical history of prolonged QT interval
-
A history of prior malignant tumour, unless the patient has been without evidence of disease for at least 3 years or the tumour was a non-melanoma skin tumour or early cervical cancer
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Patients with symptomatic brain metastases
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Women who are breastfeeding
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Concurrent cytochrome P450 enzyme-inducing anticonvulsant drugs e.g. phenytoin, carbamazepine, phenobarbital, primidone or oxcarbazepine
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Patients who are unable to have their digoxin levels regularly monitored
- if both ALT and AST performed then both need to be recorded
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Investigational Arm Gemcitabine * IV gemcitabine 1200mg/m2 on Day 1 and Day 8 * IV carboplatin AUC5 on Day 1 * Oral HCQ will be taken at a dose of 400mg BD from day 1 of cycle 1 (maximum of 30 months) Control Arm Carboplatin * IV carboplatin AUC5 (area under curve) on Day1 * IV etoposide 120mg/m2 Day 1, followed by oral etoposide 100mg BD (twice daily) on Day 2 and Day 3 Control Arm Etoposide * IV carboplatin AUC5 (area under curve) on Day1 * IV etoposide 120mg/m2 Day 1, followed by oral etoposide 100mg BD (twice daily) on Day 2 and Day 3 Investigational Arm Carboplatin * IV gemcitabine 1200mg/m2 on Day 1 and Day 8 * IV carboplatin AUC5 on Day 1 * Oral HCQ will be taken at a dose of 400mg BD from day 1 of cycle 1 (maximum of 30 months) Investigational Arm Hydroxychloroquine * IV gemcitabine 1200mg/m2 on Day 1 and Day 8 * IV carboplatin AUC5 on Day 1 * Oral HCQ will be taken at a dose of 400mg BD from day 1 of cycle 1 (maximum of 30 months)
- Primary Outcome Measures
Name Time Method Progression free survival Defined as the time from randomisation to first progression/death (whichever came first), assessed up to 41 months
- Secondary Outcome Measures
Name Time Method Adverse events From date of consent to 30 days after final trial treatment Including ophthalmologic and treatment specific toxicities
Overall survival From date of randomisation to death due to any cause, assessed up to 41 months Quality of life as measured by QLQ-LC-13 From baseline to progression/trial end (whicenver is first), assessed up to 41 months The questionnaire is a standardised questionnaire
Compliance measured by dose intensity From first date of trial treatment to progression/trial end (whichever is first), assessed up to 41 months Capturing dose delays, modifications and omissions
Quality of life as measured by EQ-5D From baseline to progression/trial end (whichever is first), assessed up to 41 months The questionnaire is a standardised questionnaire
Quality of life as measured by QLQC-30 From baseline to progression/trial end (whichever is first), assessed up to 41 months The questionnaire is a standardised questionnaire
Objective response as measured by Response Evaluation Criteria in Solid Tumours (RECIST) v.1.1 From first tumour assessment to progression/trial end (whichever is first), assessed up to 41 months Complete Response (CR)/ Partial Response (PR)/ Progressive Disease (PD)/ Stable Disease (SD)
Compliance measured by dose exposure From first date of trial treatment to progression/trial end (whichever is first), assessed up to 41 months Capturing dose delays, modifications and omissions
Trial Locations
- Locations (13)
UCLH
🇬🇧London, United Kingdom
The Christie
🇬🇧Manchester, United Kingdom
East and North Herts NHS Foundation Trust
🇬🇧Northwood, United Kingdom
North West Anglia NHS Trust
🇬🇧Peterborough, United Kingdom
Royal Surrey County Hospital
🇬🇧Guildford, United Kingdom
Dorset County Hospital NHS Foundation Trust
🇬🇧Dorchester, United Kingdom
University Hospitals of Morecambe Bay NHS Foundation Trust
🇬🇧Lancaster, United Kingdom
Guy's and St Thomas' Hospitals NHS Foundation Trust
🇬🇧London, United Kingdom
University Hospital Leicester NHS Trust
🇬🇧Leicester, United Kingdom
Betsi Cadwaladr University Health Board
🇬🇧Rhyl, United Kingdom
Nottingham University Hospitals NHS Trust
🇬🇧Nottingham, United Kingdom
Airedale NHS Foundation Trust
🇬🇧Steeton, United Kingdom
The Princess Alexandra Hospital NHS Trust
🇬🇧Harlow, United Kingdom