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Combination Chemotherapy Plus Radiation Therapy With or Without AE-941 in Treating Patients With Stage III Non-small Cell Lung Cancer That Cannot Be Removed By Surgery

Primary Purpose

Adenocarcinoma of the Lung, Adenosquamous Cell Lung Cancer, Large Cell Lung Cancer

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
shark cartilage extract AE-941
placebo
cisplatin
vinorelbine tartrate
carboplatin
paclitaxel
radiation therapy
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adenocarcinoma of the Lung

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically or cytologically confirmed newly diagnosed, untreated, unresectable stage IIIA or stage IIIB non-small cell lung cancer Squamous cell carcinoma, adenocarcinoma, or large cell carcinoma of the lung Mixed tumors allowed if non-small cell elements identified Contralateral supraclavicular and/or scalene lymph node involvement allowed No disease extending into the cervical region At least 1 bidimensionally or unidimensionally measurable lesion No pleural effusion unless cytologically negative or too small to safely aspirate Not scheduled for curative cancer surgery Performance status - ECOG 0-1 Absolute neutrophil count greater than 1,500/mm^3 Platelet count greater than 100,000/mm^3 Hematocrit greater than 30% SGOT or SGPT less than 1.5 times upper limit of normal Bilirubin normal Creatinine less than 1.5 mg/dL Creatinine clearance greater than 60 mL/min No other major medical or psychiatric illness that would preclude study participation or consent No medical condition that interferes with oral medication intake and/or absorption (gastrectomy or major intestinal resection) No grade 2 or greater peripheral neuropathy unless secondary to mechanical etiology No hypersensitivity to fish products No more than 10% weight loss within past 3 months No other malignancy within past 3 years except inactive carcinoma in situ of the cervix or nonmelanoma skin cancer Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception At least 30 days since prior chemotherapy See Disease Characteristics Recovered from prior major surgery At least 30 days since prior shark cartilage products No other concurrent investigational anticancer agents No other concurrent cartilage products No other concurrent investigational agents No concurrent amifostine or other radioprotectants No concurrent enrollment in other clinical trials

Sites / Locations

  • M D Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arm I (shark cartilage extract AE-941)

Arm II (placebo)

Arm Description

Patients receive oral AE-941 (Neovastat) twice daily beginning on day 1 or within 10 days of initiation of chemotherapy. All patients receive induction chemotherapy with 1 of the following platinum-based regimens: cisplatin IV on days 1, 22, 50, and 71 and vinorelbine IV on days 1, 8, 22, 29, 50, 57, 71, and 78 carboplatin IV over 30 minutes and paclitaxel IV over 3 hours on days 1, 22, 50, 57, 64, 71, 78, and 85. All patients receive radiotherapy beginning on day 50 for 6 weeks. Treatment in both arms continues in the absence of unacceptable toxicity.

Patients receive oral placebo twice daily beginning on day 1 or within 10 days of initiation of chemotherapy. All patients receive induction chemotherapy with 1 of the following platinum-based regimens: cisplatin IV on days 1, 22, 50, and 71 and vinorelbine IV on days 1, 8, 22, 29, 50, 57, 71, and 78 carboplatin IV over 30 minutes and paclitaxel IV over 3 hours on days 1, 22, 50, 57, 64, 71, 78, and 85. All patients receive radiotherapy beginning on day 50 for 6 weeks. Treatment in both arms continues in the absence of unacceptable toxicity.

Outcomes

Primary Outcome Measures

Overall survival
Survival distributions will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted to illustrate the comparative survival experience of both groups over the entire study period.

Secondary Outcome Measures

Progression-free survival every 3 months
Will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted.
Tumor response rate
Will be compared by chi-square test.
Tumor response duration
Will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted.
Metastasis-free survival
Will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted.

Full Information

First Posted
June 2, 2000
Last Updated
January 22, 2013
Sponsor
National Cancer Institute (NCI)
Collaborators
Radiation Therapy Oncology Group, National Center for Complementary and Integrative Health (NCCIH)
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1. Study Identification

Unique Protocol Identification Number
NCT00005838
Brief Title
Combination Chemotherapy Plus Radiation Therapy With or Without AE-941 in Treating Patients With Stage III Non-small Cell Lung Cancer That Cannot Be Removed By Surgery
Official Title
Multicenter, Open-Ended, Double-Blind, Placebo-Controlled, Phase III Study of AE-941 in Addition to Combined Modality Treatment (Chemotherapy/Radiotherapy) for Locally Advanced Unresectable Non-Small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
March 2000 (undefined)
Primary Completion Date
February 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)
Collaborators
Radiation Therapy Oncology Group, National Center for Complementary and Integrative Health (NCCIH)

4. Oversight

5. Study Description

Brief Summary
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. Radiation therapy uses high-energy x-rays to damage tumor cells. AE-941 may help shrink or slow the growth of non-small cell lung cancer cells. It is not yet known if combination chemotherapy plus radiation therapy is more effective with or without AE-941 for non-small cell lung cancer. This randomized phase III trial is studying combination chemotherapy and radiation therapy given with AE-941 to see how well they work compared to combination chemotherapy and radiation therapy alone in treating patients with stage III non-small cell lung cancer that cannot be removed by surgery
Detailed Description
PRIMARY OBJECTIVES: I. Determine the overall survival of patients with unresectable stage IIIA or IIIB non-small cell lung cancer treated with induction platinum-based chemotherapy and radiotherapy with or without AE-941 (Neovastat). II. Determine the progression-free survival, tumor response, tumor response duration, and metastasis-free survival of patients treated with these regimens. III. Determine the tolerability of this regimen in these patients. OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to stage (IIIA vs IIIB), type of platinum-based induction chemotherapy to be received (cisplatin and vinorelbine vs carboplatin and paclitaxel), and gender. Patients are randomized to 1 of 2 treatment arms. Arm I: Patients receive oral AE-941 (Neovastat) twice daily beginning on day 1 or within 10 days of initiation of chemotherapy. Arm II: Patients receive oral placebo twice daily beginning on day 1 or within 10 days of initiation of chemotherapy. All patients receive induction chemotherapy with 1 of the following platinum-based regimens: cisplatin IV on days 1, 22, 50, and 71 and vinorelbine IV on days 1, 8, 22, 29, 50, 57, 71, and 78 carboplatin IV over 30 minutes and paclitaxel IV over 3 hours on days 1, 22, 50, 57, 64, 71, 78, and 85. All patients receive radiotherapy beginning on day 50 for 6 weeks. Treatment in both arms continues in the absence of unacceptable toxicity. Patients are followed every 3 months. PROJECTED ACCRUAL: A total of 756 patients (378 per treatment arm) will be accrued for this study within 36 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenocarcinoma of the Lung, Adenosquamous Cell Lung Cancer, Large Cell Lung Cancer, Squamous Cell Lung Cancer, Stage IIIA Non-small Cell Lung Cancer, Stage IIIB Non-small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
756 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I (shark cartilage extract AE-941)
Arm Type
Experimental
Arm Description
Patients receive oral AE-941 (Neovastat) twice daily beginning on day 1 or within 10 days of initiation of chemotherapy. All patients receive induction chemotherapy with 1 of the following platinum-based regimens: cisplatin IV on days 1, 22, 50, and 71 and vinorelbine IV on days 1, 8, 22, 29, 50, 57, 71, and 78 carboplatin IV over 30 minutes and paclitaxel IV over 3 hours on days 1, 22, 50, 57, 64, 71, 78, and 85. All patients receive radiotherapy beginning on day 50 for 6 weeks. Treatment in both arms continues in the absence of unacceptable toxicity.
Arm Title
Arm II (placebo)
Arm Type
Placebo Comparator
Arm Description
Patients receive oral placebo twice daily beginning on day 1 or within 10 days of initiation of chemotherapy. All patients receive induction chemotherapy with 1 of the following platinum-based regimens: cisplatin IV on days 1, 22, 50, and 71 and vinorelbine IV on days 1, 8, 22, 29, 50, 57, 71, and 78 carboplatin IV over 30 minutes and paclitaxel IV over 3 hours on days 1, 22, 50, 57, 64, 71, 78, and 85. All patients receive radiotherapy beginning on day 50 for 6 weeks. Treatment in both arms continues in the absence of unacceptable toxicity.
Intervention Type
Drug
Intervention Name(s)
shark cartilage extract AE-941
Other Intervention Name(s)
AE-941, Neovastat, Neovastat/AE-941
Intervention Description
Given orally
Intervention Type
Other
Intervention Name(s)
placebo
Other Intervention Name(s)
PLCB
Intervention Description
Given orally
Intervention Type
Drug
Intervention Name(s)
cisplatin
Other Intervention Name(s)
CACP, CDDP, CPDD, DDP
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
vinorelbine tartrate
Other Intervention Name(s)
Eunades, navelbine ditartrate, NVB, VNB
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
carboplatin
Other Intervention Name(s)
Carboplat, CBDCA, JM-8, Paraplat, Paraplatin
Intervention Description
Given IV
Intervention Type
Drug
Intervention Name(s)
paclitaxel
Other Intervention Name(s)
Anzatax, Asotax, TAX, Taxol
Intervention Description
Given IV
Intervention Type
Radiation
Intervention Name(s)
radiation therapy
Other Intervention Name(s)
irradiation, radiotherapy, therapy, radiation
Intervention Description
Undergo radiotherapy
Primary Outcome Measure Information:
Title
Overall survival
Description
Survival distributions will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted to illustrate the comparative survival experience of both groups over the entire study period.
Time Frame
From randomization until date of death or last follow-up, assessed up to 7 years
Secondary Outcome Measure Information:
Title
Progression-free survival every 3 months
Description
Will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted.
Time Frame
From randomization until disease progression, assessed up to 7 years
Title
Tumor response rate
Description
Will be compared by chi-square test.
Time Frame
Up to 7 years
Title
Tumor response duration
Description
Will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted.
Time Frame
From first observation of at least a partial response to detection of disease progression or death due to any cause, assessed up to 7 years
Title
Metastasis-free survival
Description
Will be compared by use of the log-rank test. The stratified log-rank test (nominal or categorical covariates) may be used to simultaneously control for important prognostic factors. Kaplan-Meier curves will also be plotted.
Time Frame
From randomization until metastasis documented by imaging procedures, assessed up to 7 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed newly diagnosed, untreated, unresectable stage IIIA or stage IIIB non-small cell lung cancer Squamous cell carcinoma, adenocarcinoma, or large cell carcinoma of the lung Mixed tumors allowed if non-small cell elements identified Contralateral supraclavicular and/or scalene lymph node involvement allowed No disease extending into the cervical region At least 1 bidimensionally or unidimensionally measurable lesion No pleural effusion unless cytologically negative or too small to safely aspirate Not scheduled for curative cancer surgery Performance status - ECOG 0-1 Absolute neutrophil count greater than 1,500/mm^3 Platelet count greater than 100,000/mm^3 Hematocrit greater than 30% SGOT or SGPT less than 1.5 times upper limit of normal Bilirubin normal Creatinine less than 1.5 mg/dL Creatinine clearance greater than 60 mL/min No other major medical or psychiatric illness that would preclude study participation or consent No medical condition that interferes with oral medication intake and/or absorption (gastrectomy or major intestinal resection) No grade 2 or greater peripheral neuropathy unless secondary to mechanical etiology No hypersensitivity to fish products No more than 10% weight loss within past 3 months No other malignancy within past 3 years except inactive carcinoma in situ of the cervix or nonmelanoma skin cancer Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception At least 30 days since prior chemotherapy See Disease Characteristics Recovered from prior major surgery At least 30 days since prior shark cartilage products No other concurrent investigational anticancer agents No other concurrent cartilage products No other concurrent investigational agents No concurrent amifostine or other radioprotectants No concurrent enrollment in other clinical trials
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Charles Lu
Organizational Affiliation
M.D. Anderson Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
M D Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Combination Chemotherapy Plus Radiation Therapy With or Without AE-941 in Treating Patients With Stage III Non-small Cell Lung Cancer That Cannot Be Removed By Surgery

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