Paclitaxel Micelles for Injection / Paclitaxel Injection in Combination With Cisplatin for First-line Therapy of Advanced NSCLC
Non-Small Cell Lung Cancer(NSCLC)
About this trial
This is an interventional treatment trial for Non-Small Cell Lung Cancer(NSCLC) focused on measuring NSCLC, Paclitaxel Micelles for Injection
Eligibility Criteria
Inclusion Criteria:
First-line patients with locally advanced or metastatic NSCLC (Clinical Stage of ⅢB/Ⅳ, TNM (primary tumor, regional nodes, metastasis) Staging Edition 7) confirmed by histological or cytological diagnosis or of postoperative recurrence;
First-line patients include:
- Patients who are newly diagnosed as ⅢB/Ⅳ and have undergone no radiotherapy or chemotherapy or molecular targeting treatment;
- Patients with postoperative reoccurrence and metastasis and receiving no adjuvant radiotherapy or chemotherapy or molecular targeting treatment;
- Patients with postoperative reoccurrence and metastasis and receiving adjuvant radiotherapy or chemotherapy or molecular targeting treatment, but it has been more than one year since the end of such therapies or treatment.
- Patients who have received prior radiotherapy can be enrolled. However, the radiation area must be <25% of bone marrow area, the prior radiotherapy has been completed at least 4 weeks before the enrollment, and the acute radiation toxicity must have been restored. Local lesions that have undergone radiotherapy are not allowed to be included in the measurable lesions save as such lesions with significant progress recorded after the last radiotherapy.
- Patients with available measurable lesions in line with the requirements of "measurable lesions" in the response evaluation criteria "RECIST Version 1.1". Lesions with at least one accurately measurable diameter (serve as the maximum diameter): the maximum diameter of target lesions with CT scan ≥20 mm or the maximum diameter with spiral CT or MRI scan ≥10 mm;
- ECOG (Eastern Cooperative Oncology Group) score ≤ 1 points and expected survival of at least 3 months;
- 18 to 70 years old, male or female;
- Blood picture and functions of major organs such as heart, lung, liver, kidneys are basically normal.
Blood routine test must meet the following criteria:
- ANC≥1.5×109/L;
- PLT≥100×109/L;
- Hb≥90g/L。
Blood biochemical test must meet the following criteria:
- Plasma total bilirubin ≤1.5 × upper limit of normal (ULN);
- ALT (Alanine aminotransferase), AST (Aspartate transaminase) or AKP≤2.5 × ULN (for patients with hepatic metastases, ALT, AST or AKP≤5 × ULN; for patients with bone metastases, AKP≤10 × ULN);
- Cr ≤1.5 × ULN;
- Patients have no cardiac insufficiency symptoms at baseline; no serious abnormal signs in ECG
- Efficacy of cancer-related imaging examinations are completed within 2 weeks before enrollment and clinical condition assessment, the three routine tests of blood, urea, and stool, blood biochemical examination, ECG, CEA (carcinoembryonic antigen) and other examinations completed within 1 week before enrollment;
- Patients can understand the purpose of the clinical trial, participate out of their own will, and sign the informed consent;
- Patients have good compliance, accept the doctor's follow-up evaluations, and voluntarily follow treatment protocol during the study;
- Male or female patients with childbearing potential voluntarily take contraceptive measures during the trial.
Exclusion Criteria:
In case of any of the following circumstances, the patient is not allowed to participate in this study:
- Patients known to have mutant EGFR (epidermal growth factor receptor), ALK (anaplastic lymphoma kinase) in genetic examinations;
- Patients with primary brain or central nervous metastases (including leptomeningeal metastasis), excluding patients with asymptomatic single brain metastasis under strict control; and patients with central nervous tumors accompanied by cerebral hypertension or neuropsychiatric symptoms;
- Patients with non-eliminated acute and chronic infections or patients also suffer from other serious diseases simultaneously;
- Patients who cannot complete the entire trial process as the investigator may deem fit;
- Patients with peripheral neuropathy above grade I;
- Patients with an allergic history to Paclitaxel;
- The existence of a third space effusion that cannot be controlled by drainage or other means (such as middle - large pleural effusion, middle - large pericardial effusion and ascites); patients with asymptomatic small pleural effusion requiring no clinical intervention may be enrolled subject to strict control;
- Patients with mental illness or mental disorders, poor compliance, or cannot account treatment responses;
- Patients with poor tolerability due to serious organic diseases or major organ failure, such as decompensated heart and lung failure;
- Patients with bleeding tendency diseases;
- Organ transplant recipients;
- Patients with drug abuse and other adverse drug addicts, long-term alcoholics and patients with AIDS and other infectious diseases;
- Long-term users of adrenal corticosteroids or immunosuppressive agents;
- Patients have suffered from other malignant cancers within 5 years (except for cured basal cell carcinoma and cervical carcinoma in situ);
- Patients with active hepatitis and liver metastasis exceeding three-quarters of the whole liver.
Sites / Locations
- Guangdong General Hospital
- Shanghai Chest Hospital
- Jiangsu Cancer Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Paclitaxel Micelles for Injection + Cisplatin
Paclitaxel Injection + Cisplatin
In the First Period, 230 mg/m2 of Paclitaxel Micelles for Injection was intravenously administrated for three hours without special infusion device, then 70 mg/m2 of Cisplatin was intravenously administrated for two hours. Three weeks constituted one course of treatment. In the Second Period, 300 mg/㎡ of Paclitaxel Micelles for Injection was intravenously administrated for three hours without special infusion device to patients whose minimum neutrophil ≥1.0 × 109 /L and minimum platelet count ≥80 × 109 /L and with no hematologic toxicity of grade II to IV occurred in the First Period. Then 70 mg/m2 of Cisplatin was intravenously administrated for two hours. Three weeks constituted one course of treatment.
175 mg/m2 of conventional Paclitaxel Injection was intravenously administrated for three hours, then 70 mg/m2 of Cisplatin was intravenously administrated for two hours. Three weeks constituted one course of treatment.