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临床试验/NCT01326767
NCT01326767已完成3 期

An Open-Label, Randomized, Parallel Group Study of Patients Treated With Paclitaxel With Standard Dosing Versus Pharmacokinetic Guided Dose Adjustment in Patients With Advanced Non Small Cell Lung Cancer (NSCLC)

Central European Society for Anticancer Drug Research3 个研究点 分布在 2 个国家目标入组 366 人开始时间: 2011年3月最近更新:
适应症
干预措施
相关药物

试验速览

阶段
3 期
状态
已完成
发起方
入组人数
366
试验地点
3
主要终点
Grad 4 Neutropenia

研究概览

简要总结

This study will be performed on grade IIIb and grade IV Non Small Cell Lung Cancer (NSCLC) chemotherapy naive patients with good performance status. In course of this study, patients will be treated with Paclitaxel in combination with either Cisplatin or Carboplatin in a maximum of six therapy cycles. The goal of this study is to determine, if a pharmakokinetic driven dose adaptation of paclitaxel leads to a reduction of of grade 4 neutropenia, compared to conventional Paclitaxel dosing, without affecting progression free survival and overall survival.

This study includes a biomarker analysis and an optional genetic substudy.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 75 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Capable of understanding the protocol requirements and risks, and providing written informed consent.
  • Patients with histologically confirmed NSCLC (stage IIIB-IV).
  • Patients considered for first-line palliative chemotherapy with paclitaxel in combination with either cisplatin or carboplatin. Patients having received prior adjuvant non taxane-containing adjuvant chemotherapy are eligible.
  • At least one bidimensionally measurable lesion according to RECIST 1.
  • ECOG Performance Status (ECOG-PS) status ≤
  • Female or male patients of 18 to 75 years of age at randomization
  • Women of child-bearing potential (i.e., women who are pre-menopausal or not surgically sterile) must use acceptable contraceptive methods (intrauterine device [IUD], oral contraceptive or double barrier device), and must have a negative serum pregnancy test within 1 week prior to beginning treatment on this trial. Nursing patients are excluded. Sexually active men must also use acceptable contraceptive methods (condom).
  • An absolute neutrophil count >1,500 cells/ mm3 (= 1.5 G/l).
  • Platelet count > 100,000/mm
  • Total bilirubin ≤ 2 x upper limit of normal.
  • AST and ALT ≤ 2.5 x upper limit of normal, or ≤ 5 x upper limit of normal in case of liver metastases.
  • Creatinine clearance (according to the Cockcroft-Gault formula) ≥30ml/min. For patients planned to receive Cisplatin: Creatinine clearance ≥60ml/min.
  • Patients suffering from asymptomatic brain metastases can be enrolled in case corticosteroid therapy is not indicated. Prior irradiation must be completed at least 4 weeks prior to first cycle of treatment.

排除标准

  • Serious concomitant systemic disorders (e.g., active infection, severe heart disease, uncontrolled hypertension or diabetes mellitus) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the patient's ability to complete the study.
  • A history of hypersensitivity reactions to drugs formulated in polyoxyethylated castor oil.
  • Having received prior treatment with paclitaxel or cisplatin or carboplatin (other drugs/drug combinations are allowed).
  • Concomitant treatment with any targeted drug (licensed or experimental) like bevacizumab or cetuximab.
  • Any condition / concomitant disease not allowing chemotherapy with paclitaxel, the platinum compound (carboplatin or cisplatin) or required premedication for the treatment regimen.
  • Pregnant/nursing women.
  • Individuals known to be seropositive for human immunodeficiency virus, hepatitis C virus, hepatitis B surface antigen or syphilis.
  • Treatment with cytotoxic or biologic agents or any experimental drug within the 4 weeks prior to beginning treatment on this study.
  • Secondary malignancy within the last five years, with the exception of adequately treated carcinoma-in-situ of the uterine cervix, basal-cell carcinoma of the skin and pTa or pTis urothelial cancer.
  • Medical or psychological conditions that would not permit the patient to complete the study or sign informed consent.
  • Preexisting neuropathy > grade I NCI-CTC.

研究组 & 干预措施

Paclitaxel dosing according to SmPC

Active Comparator

干预措施: Paclitaxel dosing according to SmPC (Drug)

Individualized pharmacokinetically driven paclitaxel dosing

Experimental

In the first treatment cycle, the Paclitaxel dose is adapted depending on the age and the gender of the patient. In the treatment cycles 2-6 the Paclitaxel dose is adapted based on individual PK data and toxicities.

干预措施: Individualized pharmacokinetically driven paclitaxel dosing (Drug)

结局指标

主要结局

Grad 4 Neutropenia

时间窗: up to 6 weeks on treatment

The rate of grade 4 Neutropenia during the second treatment cycle between the conventional Paclitaxel dosing arm and pharmacokinetically driven Paclitaxel dosing arm is compared. At the same time progression free survival and overall survival must not be affected.

次要结局

  • Objective tumor response according to Response Evaluation Criteria in Solid Tumors 1.1 (RECIST v1.1)(24 months)
  • Progression free survival(24 month)
  • Overall survival(24 month)
  • Overall neutropenia(24 month)
  • Hematological / non-hematological toxicites(24 months)
  • Cumulative dose and dose intensity of paclitaxel and platinum drug(24 months)
  • Incidence of changes from cisplatin to carboplatin and reasons thereof(24 months)
  • Overall rate of febrile neutropenia and hospitalization due to chemotherapy-associated adverse events(24 months)
  • Health economic analysis using QoL Questionnaires(24 months)

研究者

发起方
Central European Society for Anticancer Drug Research
申办方类型
Other
责任方
Sponsor

研究点 (3)

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