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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)

Primary Purpose

Carcinoma, Non-Small-Cell Lung, Adenocarcinoma, Carcinoma, Large Cell

Status
Terminated
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Temozolomide
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Non-Small-Cell Lung

Eligibility Criteria

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

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

    First Posted
    February 29, 2008
    Last Updated
    May 15, 2017
    Sponsor
    Merck Sharp & Dohme LLC
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    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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