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Carboplatin and Paclitaxel Albumin-Stabilized Nanoparticle Formulation Followed by Radiation Therapy and Erlotinib in Treating Patients With Stage III Non-Small Cell Lung Cancer That Cannot Be Removed By Surgery

Phase 2
Completed
Conditions
Lung Cancer
Interventions
Registration Number
NCT00553462
Lead Sponsor
Alliance for Clinical Trials in Oncology
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as carboplatin and paclitaxel albumin-stabilized nanoparticle formulation, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. Erlotinib may make tumor cells more sensitive to radiation therapy. Giving carboplatin and paclitaxel albumin-stabilized nanoparticle formulation together with radiation therapy and erlotinib may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving carboplatin and paclitaxel albumin-stabilized nanoparticle formulation together with radiation therapy and erlotinib works in treating patients with stage III non-small cell lung cancer that cannot be removed by surgery.

Detailed Description

OBJECTIVES:

Primary

* To determine the activity of induction chemotherapy comprising carboplatin and paclitaxel albumin-stabilized nanoparticle formulation followed by concurrent thoracic radiotherapy and erlotinib hydrochloride in patients with poor-risk, unresectable stage IIIA or IIIB non-small cell lung cancer.

Secondary

* To determine the response rate and progression-free survival of these patients.

OUTLINE: Patients receive induction chemotherapy comprising paclitaxel albumin-stabilized nanoparticle formulation IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 2 courses. Patient with rapid disease progression outside of the chest after induction therapy are removed from study. Patients with intrathoracic disease progression within the potential radiation field may continue protocol therapy at the discretion of the Study Chair. Patients with no disease progression outside the planned radiation field (either regional or distant) proceed to concurrent erlotinib hydrochloride and radiotherapy.

Beginning on day 43 (week 7), patients receive oral erlotinib hydrochloride once daily. Patients also undergo concurrent radiotherapy 5 days a week for up to 7 weeks (33 fractions) in the absence of rapid disease progression outside of the chest or unacceptable toxicity.

After completion of study therapy, patients are followed every 3 months for 1 year, and then every 6 months for up to 2 years

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
78
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
paclitaxel + carboplatin + radiation + erlotinibcarboplatinPatients receive paclitaxel IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 2 courses. Patient with rapid disease progression outside of the chest after induction therapy are removed from study. Patients with intrathoracic disease progression within the potential radiation field may continue protocol therapy at the discretion of the Study Chair. Patients with no disease progression outside the planned radiation field (either regional or distant) proceed to concurrent erlotinib hydrochloride and radiotherapy. Beginning on day 43 (week 7), patients receive oral erlotinib hydrochloride once daily. Patients also undergo concurrent radiotherapy 5 days a week for up to 7 weeks (33 fractions) in the absence of rapid disease progression outside of the chest or unacceptable toxicity. After completion of study therapy, patients are followed every 3 months for 1 year, and then every 6 months for up to 2 years
paclitaxel + carboplatin + radiation + erlotinibpaclitaxel albumin-stabilized nanoparticle formulationPatients receive paclitaxel IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 2 courses. Patient with rapid disease progression outside of the chest after induction therapy are removed from study. Patients with intrathoracic disease progression within the potential radiation field may continue protocol therapy at the discretion of the Study Chair. Patients with no disease progression outside the planned radiation field (either regional or distant) proceed to concurrent erlotinib hydrochloride and radiotherapy. Beginning on day 43 (week 7), patients receive oral erlotinib hydrochloride once daily. Patients also undergo concurrent radiotherapy 5 days a week for up to 7 weeks (33 fractions) in the absence of rapid disease progression outside of the chest or unacceptable toxicity. After completion of study therapy, patients are followed every 3 months for 1 year, and then every 6 months for up to 2 years
paclitaxel + carboplatin + radiation + erlotinibradiation therapyPatients receive paclitaxel IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 2 courses. Patient with rapid disease progression outside of the chest after induction therapy are removed from study. Patients with intrathoracic disease progression within the potential radiation field may continue protocol therapy at the discretion of the Study Chair. Patients with no disease progression outside the planned radiation field (either regional or distant) proceed to concurrent erlotinib hydrochloride and radiotherapy. Beginning on day 43 (week 7), patients receive oral erlotinib hydrochloride once daily. Patients also undergo concurrent radiotherapy 5 days a week for up to 7 weeks (33 fractions) in the absence of rapid disease progression outside of the chest or unacceptable toxicity. After completion of study therapy, patients are followed every 3 months for 1 year, and then every 6 months for up to 2 years
paclitaxel + carboplatin + radiation + erlotiniberlotinib hydrochloridePatients receive paclitaxel IV over 30 minutes on days 1 and 8 and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for 2 courses. Patient with rapid disease progression outside of the chest after induction therapy are removed from study. Patients with intrathoracic disease progression within the potential radiation field may continue protocol therapy at the discretion of the Study Chair. Patients with no disease progression outside the planned radiation field (either regional or distant) proceed to concurrent erlotinib hydrochloride and radiotherapy. Beginning on day 43 (week 7), patients receive oral erlotinib hydrochloride once daily. Patients also undergo concurrent radiotherapy 5 days a week for up to 7 weeks (33 fractions) in the absence of rapid disease progression outside of the chest or unacceptable toxicity. After completion of study therapy, patients are followed every 3 months for 1 year, and then every 6 months for up to 2 years
Primary Outcome Measures
NameTimeMethod
Overall Survival at 12 MonthsAt 12 months

Percentage of participants who were alive at 12 months.

Secondary Outcome Measures
NameTimeMethod
Progression-free SurvivalDuration of study (up to 2 years)

Progression free survival (PFS) is defined as the time from registration to disease progression or death of any cause, which ever comes first. The median PFS with 95% CI was estimated using the Kaplan-Meier method.

Response RateDuration of study (up to 2 years)

Response was defined using Response Evaluation Criteria In Solid Tumors (RECIST) criteria:

* Complete Response (CR): disappearance of all target lesions;

* Partial Response (PR) 30% decrease in sum of longest diameter of target lesions;

* Progressive Disease (PD): 20% increase in sum of longest diameter of target lesions;

* Stable Disease (SD): small changes that do not meet above criteria.

Response rate is reported as the percentage of participants who achieved each response.

Trial Locations

Locations (99)

Saint Francis/Mount Sinai Regional Cancer Center at Saint Francis Hospital and Medical Center

🇺🇸

Hartford, Connecticut, United States

Greenebaum Cancer Center at University of Maryland Medical Center

🇺🇸

Baltimore, Maryland, United States

Heartland Regional Medical Center

🇺🇸

Saint Joseph, Missouri, United States

CCOP - Upstate Carolina

🇺🇸

Spartanburg, South Carolina, United States

Menorah Medical Center

🇺🇸

Overland Park, Kansas, United States

Sparrow Regional Cancer Center

🇺🇸

Lansing, Michigan, United States

CancerCare of Maine at Eastern Maine Medical Center

🇺🇸

Bangor, Maine, United States

Gibbs Regional Cancer Center at Spartanburg Regional Medical Center

🇺🇸

Spartanburg, South Carolina, United States

Iredell Memorial Hospital

🇺🇸

Statesville, North Carolina, United States

Summa Center for Cancer Care at Akron City Hospital

🇺🇸

Akron, Ohio, United States

Southeastern Regional Medical Center

🇺🇸

Lumberton, North Carolina, United States

AnMed Cancer Center

🇺🇸

Anderson, South Carolina, United States

Christine LaGuardia Phillips Cancer Center at Wellmont Holston Valley Medical Center

🇺🇸

Kingsport, Tennessee, United States

Union Hospital of Cecil County

🇺🇸

Elkton, Maryland, United States

University Medical Center of Southern Nevada

🇺🇸

Las Vegas, Nevada, United States

CCOP - Nevada Cancer Research Foundation

🇺🇸

Las Vegas, Nevada, United States

Duke Comprehensive Cancer Center

🇺🇸

Durham, North Carolina, United States

Saint Luke's Hospital - South

🇺🇸

Overland Park, Kansas, United States

CCOP - Kansas City

🇺🇸

Prairie Village, Kansas, United States

East Bay Radiation Oncology Center

🇺🇸

Castro Valley, California, United States

Contra Costa Regional Medical Center

🇺🇸

Martinez, California, United States

Bay Area Breast Surgeons, Incorporated

🇺🇸

Oakland, California, United States

Doctors Medical Center - San Pablo Campus

🇺🇸

San Pablo, California, United States

Camino Medical Group - Treatment Center

🇺🇸

Mountain View, California, United States

Larry G Strieff MD Medical Corporation

🇺🇸

Oakland, California, United States

St. Joseph Mercy Oakland

🇺🇸

Pontiac, Michigan, United States

SUNY Upstate Medical University Hospital

🇺🇸

Syracuse, New York, United States

National Naval Medical Center

🇺🇸

Bethesda, Maryland, United States

CCOP - Missouri Valley Cancer Consortium

🇺🇸

Omaha, Nebraska, United States

Immanuel Medical Center

🇺🇸

Omaha, Nebraska, United States

Alegant Health Cancer Center at Bergan Mercy Medical Center

🇺🇸

Omaha, Nebraska, United States

Veterans Affairs Medical Center - Milwaukee

🇺🇸

Milwaukee, Wisconsin, United States

Creighton University Medical Center

🇺🇸

Omaha, Nebraska, United States

Medical College of Wisconsin Cancer Center

🇺🇸

Milwaukee, Wisconsin, United States

Genesys Regional Medical Center

🇺🇸

Grand Blanc, Michigan, United States

Valley Medical Oncology Consultants - Castro Valley

🇺🇸

Castro Valley, California, United States

Highland General Hospital

🇺🇸

Oakland, California, United States

Alta Bates Summit Medical Center - Summit Campus

🇺🇸

Oakland, California, United States

El Camino Hospital Cancer Center

🇺🇸

Mountain View, California, United States

Tom K Lee, Incorporated

🇺🇸

Oakland, California, United States

CCOP - Bay Area Tumor Institute

🇺🇸

Oakland, California, United States

Tunnell Cancer Center at Beebe Medical Center

🇺🇸

Lewes, Delaware, United States

Poudre Valley Radiation Oncology

🇺🇸

Fort Collins, Colorado, United States

CCOP - Christiana Care Health Services

🇺🇸

Newark, Delaware, United States

Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital

🇺🇸

Fort Lauderdale, Florida, United States

Ella Milbank Foshay Cancer Center at Jupiter Medical Center

🇺🇸

Jupiter, Florida, United States

University of Chicago Cancer Research Center

🇺🇸

Chicago, Illinois, United States

CCOP - Mount Sinai Medical Center

🇺🇸

Miami Beach, Florida, United States

Harold Alfond Center for Cancer Care

🇺🇸

Augusta, Maine, United States

Boston University Cancer Research Center

🇺🇸

Boston, Massachusetts, United States

Veterans Affairs Medical Center - Baltimore

🇺🇸

Baltimore, Maryland, United States

Oakwood Cancer Center at Oakwood Hospital and Medical Center

🇺🇸

Dearborn, Michigan, United States

Genesys Hurley Cancer Institute

🇺🇸

Flint, Michigan, United States

Hurley Medical Center

🇺🇸

Flint, Michigan, United States

Van Elslander Cancer Center at St. John Hospital and Medical Center

🇺🇸

Grosse Pointe Woods, Michigan, United States

Foote Memorial Hospital

🇺🇸

Jackson, Michigan, United States

St. Mary Mercy Hospital

🇺🇸

Livonia, Michigan, United States

Mercy Regional Cancer Center at Mercy Hospital

🇺🇸

Port Huron, Michigan, United States

St. John Macomb Hospital

🇺🇸

Warren, Michigan, United States

Ellis Fischel Cancer Center at University of Missouri - Columbia

🇺🇸

Columbia, Missouri, United States

Seton Cancer Institute at Saint Mary's - Saginaw

🇺🇸

Saginaw, Michigan, United States

Regional Cancer Center at Singing River Hospital

🇺🇸

Pascagoula, Mississippi, United States

Saint Luke's East - Lee's Summit

🇺🇸

Lee's Summit, Missouri, United States

Liberty Hospital

🇺🇸

Liberty, Missouri, United States

Saint Joseph Oncology, Incorporated

🇺🇸

Saint Joseph, Missouri, United States

New Hampshire Oncology - Hematology, PA at Payson Center for Cancer Care

🇺🇸

Concord, New Hampshire, United States

Lakes Region General Hospital

🇺🇸

Laconia, New Hampshire, United States

Elliot Regional Cancer Center at Elliot Hospital

🇺🇸

Manchester, New Hampshire, United States

New Hampshire Oncology - Hematology, PA - Hooksett

🇺🇸

Hooksett, New Hampshire, United States

Cancer Institute of New Jersey at Cooper - Voorhees

🇺🇸

Voorhees, New Jersey, United States

Veterans Affairs Medical Center - Buffalo

🇺🇸

Buffalo, New York, United States

Charles R. Wood Cancer Center at Glens Falls Hospital

🇺🇸

Glens Falls, New York, United States

CCOP - Hematology-Oncology Associates of Central New York

🇺🇸

East Syracuse, New York, United States

Presbyterian Cancer Center at Presbyterian Hospital

🇺🇸

Charlotte, North Carolina, United States

Kinston Medical Specialists

🇺🇸

Kinston, North Carolina, United States

Granville Medical Center

🇺🇸

Oxford, North Carolina, United States

Duke Health Raleigh Hospital

🇺🇸

Raleigh, North Carolina, United States

Person Memorial Hospital

🇺🇸

Roxboro, North Carolina, United States

Rex Cancer Center at Rex Hospital

🇺🇸

Raleigh, North Carolina, United States

Rutherford Hospital

🇺🇸

Rutherfordton, North Carolina, United States

Barberton Citizens Hospital

🇺🇸

Barberton, Ohio, United States

Aultman Cancer Center at Aultman Hospital

🇺🇸

Canton, Ohio, United States

Delaware County Regional Cancer Center at Delaware County Memorial Hospital

🇺🇸

Drexel Hill, Pennsylvania, United States

Danville Regional Medical Center

🇺🇸

Danville, Virginia, United States

North Star Lodge Cancer Center at Yakima Valley Memorial Hospital

🇺🇸

Yakima, Washington, United States

Southwest Virginia Regional Cancer Center at Wellmonth Health

🇺🇸

Norton, Virginia, United States

Palo Alto Medical Foundation

🇺🇸

Palo Alto, California, United States

University of Florida Shands Cancer Center

🇺🇸

Gainesville, Florida, United States

Saint Joseph Mercy Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

CCOP - Michigan Cancer Research Consortium

🇺🇸

Ann Arbor, Michigan, United States

Saint Luke's Cancer Institute at Saint Luke's Hospital

🇺🇸

Kansas City, Missouri, United States

St. Joseph Medical Center

🇺🇸

Kansas City, Missouri, United States

North Kansas City Hospital

🇺🇸

Kansas City, Missouri, United States

Parvin Radiation Oncology

🇺🇸

Kansas City, Missouri, United States

Heartland Hematology Oncology Associates, Incorporated

🇺🇸

Kansas City, Missouri, United States

Research Medical Center

🇺🇸

Kansas City, Missouri, United States

Wake Forest University Comprehensive Cancer Center

🇺🇸

Winston-Salem, North Carolina, United States

Hematology Oncology Associates of the Quad Cities

🇺🇸

Bettendorf, Iowa, United States

Valley Medical Oncology

🇺🇸

Fremont, California, United States

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