Study of Maintenance Temozolomide Versus Observation in Stable or Responding Stage III/IV Non-Small Cell Lung Cancer Patients (Study P05146)
Primary Purpose
Carcinoma, Non-Small-Cell Lung, Adenocarcinoma, Carcinoma, Large Cell
Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Temozolomide
Sponsored by
About this trial
This is an interventional treatment trial for Carcinoma, Non-Small-Cell Lung
Eligibility Criteria
Inclusion Criteria:
- Adult subjects (age >=18 years), of either sex, and of any race.
- Subjects must have stage IV or III with pleural and/or pericardial effusion
histologically confirmed NSCLC.
- Subjects must have completed 2-6 cycles of a standard systemic therapy, with or without radiation therapy, consisting of at least 2 anti-tumor agents as first-line treatment for Stage III/IV disease, and have documented complete response (CR), partial response (PR), or stable disease (SD) per Response Evaluation Criteria in Solid Tumors (RECIST).
- Response must be confirmed within 4-8 weeks of completing first-line chemotherapy. Study treatment must begin within 12 weeks of completing first-line chemotherapy.
- Female subjects of childbearing potential or male subjects with female partner of childbearing potential must agree to use a medically accepted method of contraception or be surgically sterilized prior to Screening, while receiving study drug, and for 30 days after stopping study drug. Female subjects of childbearing potential must have a negative pregnancy test confirmed prior to dosing with study drug.
- Subjects must be free of any clinically relevant disease (other than stage III/IV NSCLC) that would, in the principal investigator and/or Sponsor's opinion, interfere with the conduct of the study or study evaluations.
- Subjects must be able to adhere to the dosing and visit schedules, and agree to report medication taken, concomitant medications, and adverse events (AEs).
- Eastern Cooperative Oncology Group (ECOG) performance status <=2.
- Clinical laboratory tests (complete blood count [CBC], serum chemistries) must be obtained within 14 days prior to randomization and meet specified criteria.
Exclusion Criteria:
- Brain metastases documented on post-chemotherapy magnetic resonance imaging (MRI).
- Documented history of brain metastases.
- Subject has received more than one prior anti-tumor regimen for Stage III/IV disease. "Regimen" refers to single drug or planned combination of two or more anti-tumor therapies. Bevacizumab (Avastin®) as part of a planned sequence of therapy after first-line platinum-containing double regimen is not considered a second regimen. Neo-adjuvant treatment for resectable subjects is not considered a second regimen.
- Subject has used any investigational product within 4 weeks prior to enrollment.
- Subject is currently receiving immunotherapy or chemotherapy, cytotoxic or targeted therapy as treatment for active systemic disease. Bevacizumab (Avastin®) as part of the prescribed standard first-line regimen is allowed.
- Female who is pregnant, or intends to become pregnant, during the study.
- Subject is in a situation or condition that, in the opinion of the investigator, may interfere with optimal participation in the study.
- Subject is currently participating in any other clinical study, with the exception of observational long-term follow-up.
- Subject is allergic to, or has sensitivity to, the study drug or its excipients.
- Documented symptomatic, progressive or new bone metastases following the first-line chemotherapy with or without radiation therapy (biphosphonate use for prophylaxis or as a maintenance therapy is allowed).
- No prior malignancy except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the subject has been disease-free for 5 years.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Temozolomide treatment
Observation
Arm Description
Subjects will receive temozolomide at a dose of 75 mg/m^2 orally (PO) daily for 21 consecutive days, followed by a 7-day rest period, until progression or up to a maximum of 6 cycles, whichever occurs first.
Observation
Outcomes
Primary Outcome Measures
Number of Participants Who Had Brain Metastases
Brain Metastases were defined as radiological evidence of brain metastases on magnetic resonance imaging (MRI).
Secondary Outcome Measures
Time to Radiological Central Nervous System (CNS) Progression
Defined as CNS progression as measured by MRI.
Time to CNS progression was analyzed using the Kaplan-Meier method.
Time to Progression
The time to progression (per response evaluation criteria in solid tumors [RECIST]) was analyzed using the Kaplan-Meier method.
Definitions of response per RECIST:
Complete Response (CR): Disappearance of all target lesions.
Partial Response (PR): A decrease of at least 30% in the sum of the longest
diameter of target lesions.
Progressive Disease (PD): An increase of at least 20% in the sum of the longest
diameter of target lesions.
Stable Disease (SD): Neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease.
Overall Survival
The overall survival was analyzed using the Kaplan-Meier method.
Number of Participants With Brain Metastases at First Progression
Brain Metastases were defined as radiological evidence of brain metastases on MRI.
Cancer-related Quality of Life (QoL) as Assessed by The European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire C30 Version 3.0 (QLQ-C30), and the EORTC Lung Cancer Module (QLQ-LC13)
The EORTC QLQ-C30 is a 30-item questionnaire developed to assess the QoL of cancer patients. Scores range from 0 -100. For functional and global QoL scales, higher scores mean a better level of function. For symptom-oriented scales, a higher score means more severe symptoms and a decrease in QoL. The EORTC QLQ-LC13 is a 13-item questionnaire developed to supplement the EORTC QLQ-C30 in lung cancer patients. It has a score range 0-100 with higher scores representing an increase in symptoms.
Tolerability of Maintenance Temozolomide
Tolerability was defined as number of participants with any adverse event leading to study discontinuation and/or study drug discontinuation.
Full Information
NCT ID
NCT00632203
First Posted
February 29, 2008
Last Updated
May 15, 2017
Sponsor
Merck Sharp & Dohme LLC
1. Study Identification
Unique Protocol Identification Number
NCT00632203
Brief Title
Study of Maintenance Temozolomide Versus Observation in Stable or Responding Stage III/IV Non-Small Cell Lung Cancer Patients (Study P05146)
Official Title
A Randomized Phase 2 Study of Maintenance Temozolomide Versus Observation in Stable or Responding Stage III/IV Non-Small Cell Lung Cancer Patients
Study Type
Interventional
2. Study Status
Record Verification Date
May 2017
Overall Recruitment Status
Terminated
Study Start Date
March 4, 2008 (Actual)
Primary Completion Date
January 6, 2011 (Actual)
Study Completion Date
January 7, 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck Sharp & Dohme LLC
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The main objective of this study is to investigate whether administration of maintenance temozolomide following standard treatment could possibly prevent or delay the onset of brain metastases in patients with controlled non-small cell lung cancer (NSCLC).
Detailed Description
This is a Phase 2, open-label, randomized, multicenter study of maintenance temozolomide versus observation in subjects with stable or responding stage III/IV NSCLC to be conducted in conformance with Good Clinical Practices. Subjects will be randomly assigned to a study drug (temozolomide) or observation arm. The study drug will be administered at a dose of 75 mg/m^2 PO daily for 21 consecutive days, followed by a 7-day rest period, until progression or up to a maximum of 6 cycles, whichever occurs first. Subjects completing 6 cycles of treatment will be followed up for incidence of brain metastasis for up to 2 years, or until progression.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Non-Small-Cell Lung, Adenocarcinoma, Carcinoma, Large Cell, Carcinoma, Squamous Cell
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
53 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Temozolomide treatment
Arm Type
Experimental
Arm Description
Subjects will receive temozolomide at a dose of 75 mg/m^2 orally (PO) daily for 21 consecutive days, followed by a 7-day rest period, until progression or up to a maximum of 6 cycles, whichever occurs first.
Arm Title
Observation
Arm Type
No Intervention
Arm Description
Observation
Intervention Type
Drug
Intervention Name(s)
Temozolomide
Other Intervention Name(s)
Temodar®, SCH 52365
Intervention Description
5-mg, 20-mg, and 100-mg gel capsules, 75 mg/m^2 PO daily for 21 consecutive days, followed by a 7-day rest period, until progression or up to a maximum of 6 cycles, whichever occurs first.
Primary Outcome Measure Information:
Title
Number of Participants Who Had Brain Metastases
Description
Brain Metastases were defined as radiological evidence of brain metastases on magnetic resonance imaging (MRI).
Time Frame
Up to 12 months (as measured from day 1 of cycle 1 of standard first-line systemic chemotherapy)
Secondary Outcome Measure Information:
Title
Time to Radiological Central Nervous System (CNS) Progression
Description
Defined as CNS progression as measured by MRI.
Time to CNS progression was analyzed using the Kaplan-Meier method.
Time Frame
from Cycle 1 Day 1 of Standard First Line Systemic Therapy to radiological progression or the last known CNS progression-free date
Title
Time to Progression
Description
The time to progression (per response evaluation criteria in solid tumors [RECIST]) was analyzed using the Kaplan-Meier method.
Definitions of response per RECIST:
Complete Response (CR): Disappearance of all target lesions.
Partial Response (PR): A decrease of at least 30% in the sum of the longest
diameter of target lesions.
Progressive Disease (PD): An increase of at least 20% in the sum of the longest
diameter of target lesions.
Stable Disease (SD): Neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease.
Time Frame
from Cycle 1 Day 1 of Standard First Line Systemic Therapy to progression or up to 6 cycles (168 days) of study treatment
Title
Overall Survival
Description
The overall survival was analyzed using the Kaplan-Meier method.
Time Frame
from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up
Title
Number of Participants With Brain Metastases at First Progression
Description
Brain Metastases were defined as radiological evidence of brain metastases on MRI.
Time Frame
from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up (up to 6 cycles (168 days) of study treatment)
Title
Cancer-related Quality of Life (QoL) as Assessed by The European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire C30 Version 3.0 (QLQ-C30), and the EORTC Lung Cancer Module (QLQ-LC13)
Description
The EORTC QLQ-C30 is a 30-item questionnaire developed to assess the QoL of cancer patients. Scores range from 0 -100. For functional and global QoL scales, higher scores mean a better level of function. For symptom-oriented scales, a higher score means more severe symptoms and a decrease in QoL. The EORTC QLQ-LC13 is a 13-item questionnaire developed to supplement the EORTC QLQ-C30 in lung cancer patients. It has a score range 0-100 with higher scores representing an increase in symptoms.
Time Frame
from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up (up to 6 cycles (168 days) of study treatment)
Title
Tolerability of Maintenance Temozolomide
Description
Tolerability was defined as number of participants with any adverse event leading to study discontinuation and/or study drug discontinuation.
Time Frame
from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up (up to 6 cycles (168 days) of study treatment)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Adult subjects (age >=18 years), of either sex, and of any race.
Subjects must have stage IV or III with pleural and/or pericardial effusion
histologically confirmed NSCLC.
Subjects must have completed 2-6 cycles of a standard systemic therapy, with or without radiation therapy, consisting of at least 2 anti-tumor agents as first-line treatment for Stage III/IV disease, and have documented complete response (CR), partial response (PR), or stable disease (SD) per Response Evaluation Criteria in Solid Tumors (RECIST).
Response must be confirmed within 4-8 weeks of completing first-line chemotherapy. Study treatment must begin within 12 weeks of completing first-line chemotherapy.
Female subjects of childbearing potential or male subjects with female partner of childbearing potential must agree to use a medically accepted method of contraception or be surgically sterilized prior to Screening, while receiving study drug, and for 30 days after stopping study drug. Female subjects of childbearing potential must have a negative pregnancy test confirmed prior to dosing with study drug.
Subjects must be free of any clinically relevant disease (other than stage III/IV NSCLC) that would, in the principal investigator and/or Sponsor's opinion, interfere with the conduct of the study or study evaluations.
Subjects must be able to adhere to the dosing and visit schedules, and agree to report medication taken, concomitant medications, and adverse events (AEs).
Eastern Cooperative Oncology Group (ECOG) performance status <=2.
Clinical laboratory tests (complete blood count [CBC], serum chemistries) must be obtained within 14 days prior to randomization and meet specified criteria.
Exclusion Criteria:
Brain metastases documented on post-chemotherapy magnetic resonance imaging (MRI).
Documented history of brain metastases.
Subject has received more than one prior anti-tumor regimen for Stage III/IV disease. "Regimen" refers to single drug or planned combination of two or more anti-tumor therapies. Bevacizumab (Avastin®) as part of a planned sequence of therapy after first-line platinum-containing double regimen is not considered a second regimen. Neo-adjuvant treatment for resectable subjects is not considered a second regimen.
Subject has used any investigational product within 4 weeks prior to enrollment.
Subject is currently receiving immunotherapy or chemotherapy, cytotoxic or targeted therapy as treatment for active systemic disease. Bevacizumab (Avastin®) as part of the prescribed standard first-line regimen is allowed.
Female who is pregnant, or intends to become pregnant, during the study.
Subject is in a situation or condition that, in the opinion of the investigator, may interfere with optimal participation in the study.
Subject is currently participating in any other clinical study, with the exception of observational long-term follow-up.
Subject is allergic to, or has sensitivity to, the study drug or its excipients.
Documented symptomatic, progressive or new bone metastases following the first-line chemotherapy with or without radiation therapy (biphosphonate use for prophylaxis or as a maintenance therapy is allowed).
No prior malignancy except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the subject has been disease-free for 5 years.
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf
http://engagezone.msd.com/ds_documentation.php
Citations:
PubMed Identifier
25069747
Citation
Boggs DH, Robins HI, Langer CJ, Traynor AM, Berkowitz MJ, Mehta MP. Strategies to prevent brain metastasis in high-risk non-small-cell lung cancer: lessons learned from a randomized study of maintenance temozolomide versus observation. Clin Lung Cancer. 2014 Nov;15(6):433-40. doi: 10.1016/j.cllc.2014.06.008. Epub 2014 Jun 24.
Results Reference
result
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Study of Maintenance Temozolomide Versus Observation in Stable or Responding Stage III/IV Non-Small Cell Lung Cancer Patients (Study P05146)
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