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Pemetrexed Plus Cisplatin for Brain Metastasis of Advanced Non - Small Cell Lung Cancer (NSCLC) (GFPC 07-01)

Primary Purpose

Lung Cancer

Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Pemetrexed, cisplatin
Sponsored by
University Hospital, Brest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Cancer focused on measuring Pemetrexed, Non-Small Cell Lung Cancer, brain metastasis

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with cytologically or histologically confirmed NSCLC.
  • Patient with brain metastasis not amenable to surgery or radiosurgery with curative intent
  • At least one brain measurable lesion using RECIST criteria
  • ECOG Performance Status ≤2
  • No prior chemotherapy for this cancer
  • Prior surgery is allowed provided there is a relapse or progression after the procedure.
  • Adequate organ function including the following: Adequate bone marrow reserve: absolute neutrophil count (ANC) superior or equal to 1.5 X109/L, platelets superior or equal to 100 X 109/L, and hemoglobin superior or equal to 9 g/dL; Hepatic: bilirubin <1.5 times the upper limit of normal (ULN), alkaline phosphatase (AP), aspartate transaminase (AST) and alanine transaminase (ALT) <3xULN (or <5xULN with liver metastases); Renal: Calculated creatinine clearance (CrCl) superior or equal to 45mL/min based on the standard Cockroft and Gault formula
  • Signed informed consent document from the patient
  • Patient must be at least 18 years of age.
  • Estimated life expectancy of at least 12 weeks.
  • Effective contraception (men and women) for and during the 6 months following the end of treatment

Exclusion Criteria:

  • Symptomatic brain metastasis
  • Have received prior radiotherapy for brain metastasis
  • Unable or unwilling to take folic acid, vitamin B12 supplementation or dexamethasone (or equivalent corticosteroid); or any other inability to comply with protocol or study related procedures.
  • A prior malignancy other than NSCLC, except carcinoma in situ of the cervix or non-melanoma skin cancer, adequately treated low grade [Gleason score <6] localized prostate cancer, unless that prior malignancy was diagnosed and definitively treated at least 5 years previously with no subsequent evidence of recurrence
  • Serious concomitant systemic disorders (for example, active infection or abnormal electrocardiogram (ECG) indicative of cardiac disease) that, in the opinion of the investigator, would compromise the safety of the patient and his/her ability to complete study.
  • Inability to discontinue administration of aspirin at a dose >1.3g/day or other non-steroidal anti-inflammatory agents for 2 days before, the day of, and 2 days after the dose of pemetrexed (5 days prior for long-acting agents such as piroxicam).
  • Presence of fluid accumulations in third spaces, e.g., ascite or pleural effusion, which can be detected clinically (during physical examination), and which cannot be adequately controlled by drainage or other procedures prior to inclusion in the study.
  • Peripheral neuropathy > CTC Grade 2
  • Patient compliance or geographic distance precluding adequate follow up.

Sites / Locations

  • Centre Hôspitalier du Pays d'Aix, Service des Maladies Respiratoires
  • CHU d'Angers, Service de Pneumologie
  • Médecine 4, C.H.G. de la Fontonne Antibes
  • CHU brest, institut de cancérologie et d'hématologie
  • Centre François Baclesse
  • Centre Hospitalier René Dubos - Pontoise, Service d'Oncologie - Hématologie Clinique
  • Centre Hospitalier, Service de Pneumologie
  • CHI, Service de Pneumologie
  • Pneumologie, Centre hôspitalier, DRAGUIGNAN
  • CH GAP
  • Centre Hospitalier Départemental, Service de Pneumologie,
  • Hôpital A. Mignot, Service de Pneumologie
  • Hopital de la Croix Rousse
  • Centre Hôspitalier, Service de Pneumo-Neuro
  • Hôpital Sainte Margueritte
  • Serv. de Pneumo-Allergo, CH de Martigues
  • Serv. de Pneumo - Hôpital St Antoine
  • Service Pneumologie, Pavillon 1A, CH de Lyon-Sud
  • Hôpital Pontchailloux, Service de Pneumologie.
  • CHG, Service de Pneumologie
  • Luc THIBERVILLE
  • CHU de ROUEN, Hôpital Bois Guillaume, Serv. de Pneumo.
  • Institut de Cancérologie de la Loire
  • CHU, Service du Pr. Carles
  • Pneumologie, Centre Hospitalier

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

A

Arm Description

Outcomes

Primary Outcome Measures

Objective of this study is overall response rate on brain metastasis according to RECIST criteria.

Secondary Outcome Measures

Overall response rate, PFS after first-line CDDP plus pemetrexed, safety profile, quality of life, neurological symptoms and overall survival.

Full Information

First Posted
August 29, 2008
Last Updated
July 24, 2009
Sponsor
University Hospital, Brest
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1. Study Identification

Unique Protocol Identification Number
NCT00744900
Brief Title
Pemetrexed Plus Cisplatin for Brain Metastasis of Advanced Non - Small Cell Lung Cancer (NSCLC)
Acronym
GFPC 07-01
Official Title
A Phase II Trial With Pemetrexed Plus Cisplatin as First Line Chemotherapy for Advanced Non - Small Cell Lung Cancer (NSCLC) Patients With Measurable Asymptomatic Brain Metastasis (GFPC 07-01/METAL).
Study Type
Interventional

2. Study Status

Record Verification Date
July 2009
Overall Recruitment Status
Completed
Study Start Date
September 2008 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
University Hospital, Brest

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
NSCLC patients often have cerebral metastasis : 10% at diagnosis and 40% during disease management. Neurosurgery is not indicated in the majority of cases because of presence of several lesions in the brain, failure of primary tumor control or presence of extra-cerebral metastasis. Cerebral metastasis lead to death in 30 to 50% of these cases. Management of these patients in this situation is based on supportive care and whole-brain radiotherapy. The place of chemotherapy for patients with good performance status was discussed for a long time and it is now admitted. However, the place of new drugs such as pemetrexed, which is currently used as a second line treatment for NSCLC, needs to be further studied. It is known that pemetrexed when added to cisplatin for treatment of NSCLC provides a similar effectiveness when compared to other drugs associations commonly used in this indication. In addition, Cisplatin with Pemetrexed probably present a better safety profile. The present study is based upon the hypothesis stipulating that the association cisplatin-pemetrexed will be at least as efficient as the others association currently used for treatment of NSCLC and will present a better safety profile. The primary objective of this study is overall response rate on brain metastasis according to RECIST criteria. Secondary judgment criterias are : Overall response rate, PFS after first-line CDDP plus pemetrexed, safety profile, quality of life, neurological symptoms, overall survival. The trial will enroll up to 45 patients in this single-arm two-stage sequential phase II study with the possibility of stopping the study early because of lack of efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Cancer
Keywords
Pemetrexed, Non-Small Cell Lung Cancer, brain metastasis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Pemetrexed, cisplatin
Intervention Description
Alimta 500mg/m² IV 10 min infusion and Cisplatin 75mg/m² IV 60 min on day 1. Cycle will be repeated each 21 days.Folic acid orally 400µg should begin 5-7days prior to the first dose of pemetrexed and continuing daily until 3 weeks after the last dose of pemetrexed. Vitamin B12 will be administered as a 1000 mg intramuscular injection, approximately one week before Day 1 of cycle 1 and should repeat approximately every 9 weeks Dexamethasone, 4 mg or equivalent, should be taken orally twice per day on the day before, the day of, and the day after each dose of pemetrexed.WBRT will be administered with high energy photons systematically after cycle 6 or in case of stable disease (SD) after cycle 4 or progressive disease (PD) at any time. The dose will be 3Gy by fraction, 1 fraction per day, for 10 days.
Primary Outcome Measure Information:
Title
Objective of this study is overall response rate on brain metastasis according to RECIST criteria.
Time Frame
After cycles 2, 4 and 6 and every 6 weeks after study drug completion in absence of disease progression.
Secondary Outcome Measure Information:
Title
Overall response rate, PFS after first-line CDDP plus pemetrexed, safety profile, quality of life, neurological symptoms and overall survival.
Time Frame
After cycles 2, 4 and 6 and every 6 weeks after study drug completion.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with cytologically or histologically confirmed NSCLC. Patient with brain metastasis not amenable to surgery or radiosurgery with curative intent At least one brain measurable lesion using RECIST criteria ECOG Performance Status ≤2 No prior chemotherapy for this cancer Prior surgery is allowed provided there is a relapse or progression after the procedure. Adequate organ function including the following: Adequate bone marrow reserve: absolute neutrophil count (ANC) superior or equal to 1.5 X109/L, platelets superior or equal to 100 X 109/L, and hemoglobin superior or equal to 9 g/dL; Hepatic: bilirubin <1.5 times the upper limit of normal (ULN), alkaline phosphatase (AP), aspartate transaminase (AST) and alanine transaminase (ALT) <3xULN (or <5xULN with liver metastases); Renal: Calculated creatinine clearance (CrCl) superior or equal to 45mL/min based on the standard Cockroft and Gault formula Signed informed consent document from the patient Patient must be at least 18 years of age. Estimated life expectancy of at least 12 weeks. Effective contraception (men and women) for and during the 6 months following the end of treatment Exclusion Criteria: Symptomatic brain metastasis Have received prior radiotherapy for brain metastasis Unable or unwilling to take folic acid, vitamin B12 supplementation or dexamethasone (or equivalent corticosteroid); or any other inability to comply with protocol or study related procedures. A prior malignancy other than NSCLC, except carcinoma in situ of the cervix or non-melanoma skin cancer, adequately treated low grade [Gleason score <6] localized prostate cancer, unless that prior malignancy was diagnosed and definitively treated at least 5 years previously with no subsequent evidence of recurrence Serious concomitant systemic disorders (for example, active infection or abnormal electrocardiogram (ECG) indicative of cardiac disease) that, in the opinion of the investigator, would compromise the safety of the patient and his/her ability to complete study. Inability to discontinue administration of aspirin at a dose >1.3g/day or other non-steroidal anti-inflammatory agents for 2 days before, the day of, and 2 days after the dose of pemetrexed (5 days prior for long-acting agents such as piroxicam). Presence of fluid accumulations in third spaces, e.g., ascite or pleural effusion, which can be detected clinically (during physical examination), and which cannot be adequately controlled by drainage or other procedures prior to inclusion in the study. Peripheral neuropathy > CTC Grade 2 Patient compliance or geographic distance precluding adequate follow up.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gilles Robinet, MD
Organizational Affiliation
CHU Brest
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Barlesi Barlesi, MD, Ph.D
Organizational Affiliation
Assistance Publique Hôpitaux de Marseille
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Isabelle Monet, MD
Organizational Affiliation
Centre Hospitalier, Créteil
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centre Hôspitalier du Pays d'Aix, Service des Maladies Respiratoires
City
Aix En Provence
ZIP/Postal Code
13616
Country
France
Facility Name
CHU d'Angers, Service de Pneumologie
City
Angers
ZIP/Postal Code
49033
Country
France
Facility Name
Médecine 4, C.H.G. de la Fontonne Antibes
City
Antibes
ZIP/Postal Code
06606
Country
France
Facility Name
CHU brest, institut de cancérologie et d'hématologie
City
Brest
ZIP/Postal Code
29200
Country
France
Facility Name
Centre François Baclesse
City
Caen
ZIP/Postal Code
14000
Country
France
Facility Name
Centre Hospitalier René Dubos - Pontoise, Service d'Oncologie - Hématologie Clinique
City
Cergy Pontoise
ZIP/Postal Code
95303
Country
France
Facility Name
Centre Hospitalier, Service de Pneumologie
City
Charleville
ZIP/Postal Code
08 000
Country
France
Facility Name
CHI, Service de Pneumologie
City
Creteil
ZIP/Postal Code
94010
Country
France
Facility Name
Pneumologie, Centre hôspitalier, DRAGUIGNAN
City
Draguignan
ZIP/Postal Code
83300
Country
France
Facility Name
CH GAP
City
GAP
ZIP/Postal Code
05000
Country
France
Facility Name
Centre Hospitalier Départemental, Service de Pneumologie,
City
La Roche Sur Yon
ZIP/Postal Code
85000
Country
France
Facility Name
Hôpital A. Mignot, Service de Pneumologie
City
Le Chesnay
ZIP/Postal Code
78157
Country
France
Facility Name
Hopital de la Croix Rousse
City
Lyon
ZIP/Postal Code
69317
Country
France
Facility Name
Centre Hôspitalier, Service de Pneumo-Neuro
City
Mantes La Jolie
ZIP/Postal Code
78200
Country
France
Facility Name
Hôpital Sainte Margueritte
City
Marseilles
ZIP/Postal Code
13274
Country
France
Facility Name
Serv. de Pneumo-Allergo, CH de Martigues
City
Martigues
ZIP/Postal Code
13695
Country
France
Facility Name
Serv. de Pneumo - Hôpital St Antoine
City
Paris
ZIP/Postal Code
75571
Country
France
Facility Name
Service Pneumologie, Pavillon 1A, CH de Lyon-Sud
City
Pierre-benite
ZIP/Postal Code
69495
Country
France
Facility Name
Hôpital Pontchailloux, Service de Pneumologie.
City
Rennes
ZIP/Postal Code
35033
Country
France
Facility Name
CHG, Service de Pneumologie
City
Roanne
ZIP/Postal Code
42300
Country
France
Facility Name
Luc THIBERVILLE
City
Rouen
ZIP/Postal Code
76031
Country
France
Facility Name
CHU de ROUEN, Hôpital Bois Guillaume, Serv. de Pneumo.
City
Rouen
ZIP/Postal Code
76233
Country
France
Facility Name
Institut de Cancérologie de la Loire
City
Saint-Priest en Jarez Cedex
ZIP/Postal Code
42271
Country
France
Facility Name
CHU, Service du Pr. Carles
City
Toulouse
ZIP/Postal Code
31059
Country
France
Facility Name
Pneumologie, Centre Hospitalier
City
VILLEFRANCHE sur SAONE
ZIP/Postal Code
69655
Country
France

12. IPD Sharing Statement

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Pemetrexed Plus Cisplatin for Brain Metastasis of Advanced Non - Small Cell Lung Cancer (NSCLC)

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