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A Study to Evaluate the Safety and Efficacy of Zoledronic Acid in the Prevention or Delaying of Bone Metastasis in Patients With Stage IIIA and IIIB Non-small Cell Lung Cancer (NSCLC)

A Study to Evaluate the Safety and Efficacy of Zoledronic Acid in the Prevention or Delaying of Bone Metastasis in Patients With Stage IIIA and IIIB Non-small Cell Lung Cancer

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00172042
Enrollment
437
Registered
2005-09-15
Start date
2005-03-31
Completion date
2010-06-30
Last updated
2015-05-04

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Non-Small-Cell Lung Cancer

Keywords

Non-Small-Cell Lung Cancer, Bisphosphonates, Zoledronic acid, Bone metastases, Prevention of bone metastases

Brief summary

30-40% of patients with lung cancer will develop bone metastases during the course of their disease, which can lead to pain, decreased mobility and skeletal complications. This study will investigate the effect of zoledronic acid on preventing or delaying the development of bone metastases and the impact on disease progression/survival in patients with stage IIIA and IIIB Non-small Cell Lung Cancer (NSCLC).

Interventions

Zoledronic acid 4 mg in 5 mL concentrated solution prepared with 100 mL calcium free infusion solution (0.9 % sodium chloride or 5% glucose solution).

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Histologically or cytologically confirmed Non-small Cell Lung Cancer (NSCLC) * Newly Diagnosed, Stage IIIA and Stage IIIB excluding patients with pleural effusion * Patients must have received primary treatment for their disease and had no progression

Exclusion criteria

* Diagnosed with NSCLC longer than 6 months ago * Treatment with other bisphosphonates in past 12 months * Presence of metastases Other protocol-defined inclusion and

Design outcomes

Primary

MeasureTime frameDescription
Progression-Free SurvivalUp to 24 monthsProgression-free survival is defined as the time from randomization to the date of the first documented progression or recurrence of disease or death from any cause. Time to disease progression (TTP) was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines with evaluations every 3 months.
Kaplan-Meier Estimates for Progression-free SurvivalMonths 6, 12, 18, and 24Progression-free survival is defined as the time from randomization to the date of the first documented progression or recurrence of disease or death from any cause. Time to disease progression (TTP) was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines with evaluations every 3 months.
Percentage of Participants With Progression-Free Survival EventsUp to 24 monthsPercentage of Participants with the Progression-free survival events: disease progression and death. Time to disease progression (TTP) was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines with evaluations every 3 months.

Secondary

MeasureTime frameDescription
Kaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)Months 6,12, 18, and 24Time to the first skeletal related event defined as the time from randomization to the date of occurrence of the first SRE. Skeletal Related Events were defined as radiation therapy or surgery to bone, spinal cord compression event or a pathologic bone fracture event
Percentage of Participants With Bone Metastases at 6, 12, 18, and 24 MonthsMonths 6, 12, 18 and 24Percentage of participants developing at least 1 bone metastasis, whether or not symptomatic. Bone scans were scheduled at screening and at 6-monthly intervals after study entry, or when symptoms suggested the presence of bone metastases. Positive bone scans required confirmation by x-ray, magnetic resonance imaging (MRI), or computed tomography (CT).
Kaplan-Meier Estimates for Overall SurvivalMonths 6, 12, 18, and 24
Kaplan-Meier Estimate of the Time to Occurrence of Bone MetastasesMonths 6, 12, 18, and 24Time to occurrence of bone metastases was defined as the time from randomization to the date of the first documented bone metastases which could be asymptomatic or symptomatic at the time of detection. Bone scans were scheduled at screening and at 6-monthly intervals after study entry, or when symptoms suggested the presence of bone metastases. Positive bone scans required confirmation by x-ray, magnetic resonance imaging (MRI), or computed tomography (CT).
Percentage of Participants With Skeletal Related Events (SREs) at 12 and 24 Months From Study EntryMonths 12 and 24Skeletal Related Events were defined as radiation therapy or surgery to bone, spinal cord compression event or a pathologic bone fracture event.

Countries

Belgium, China, France, Germany, Greece, Hungary, Italy, Netherlands, Poland, Portugal, South Korea, Spain, Taiwan, Thailand, United Kingdom

Participant flow

Participants by arm

ArmCount
Zoledronic Acid
Zoledronic acid 4 mg intravenous infusion over at least 15 minutes every 3 to 4 weeks for 24 months. Dosage was adjusted for participants with mild or moderate renal impairment.
226
Control
No investigational treatment. If a participant developed bone metastases, treatment was started with Zoledronic acid 4 mg intravenous infusion over at least 15 minutes every 3 to 4 weeks until 24 months from the date of study entry had elapsed.
211
Total437

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAbnormal laboratory value(s)51
Overall StudyAbnormal test procedure(s)03
Overall StudyAdministrative problems1310
Overall StudyAdverse Event2713
Overall StudyDeath4242
Overall StudyLost to Follow-up35
Overall StudyPatient no longer requires study drug108
Overall StudyProtocol Violation87
Overall StudyUnsatisfactory therapeutic effect1311
Overall StudyWithdrawal by Subject3725

Baseline characteristics

CharacteristicZoledronic AcidControlTotal
Age, Continuous59.2 years
STANDARD_DEVIATION 9.19
60.0 years
STANDARD_DEVIATION 9.27
59.6 years
STANDARD_DEVIATION 9.23
Sex: Female, Male
Female
65 Participants65 Participants130 Participants
Sex: Female, Male
Male
161 Participants146 Participants307 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
166 / 224139 / 213
serious
Total, serious adverse events
71 / 22484 / 213

Outcome results

Primary

Kaplan-Meier Estimates for Progression-free Survival

Progression-free survival is defined as the time from randomization to the date of the first documented progression or recurrence of disease or death from any cause. Time to disease progression (TTP) was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines with evaluations every 3 months.

Time frame: Months 6, 12, 18, and 24

Population: Intent-to-Treat Population consisting of all randomized participants.

ArmMeasureGroupValue (NUMBER)
Zoledronic AcidKaplan-Meier Estimates for Progression-free Survival6 months63.0 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates for Progression-free Survival12 months44.4 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates for Progression-free Survival18 months30.7 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates for Progression-free Survival24 months25.7 Percentage of participants
ControlKaplan-Meier Estimates for Progression-free Survival24 months36.0 Percentage of participants
ControlKaplan-Meier Estimates for Progression-free Survival6 months67.9 Percentage of participants
ControlKaplan-Meier Estimates for Progression-free Survival18 months40.6 Percentage of participants
ControlKaplan-Meier Estimates for Progression-free Survival12 months48.8 Percentage of participants
Primary

Percentage of Participants With Progression-Free Survival Events

Percentage of Participants with the Progression-free survival events: disease progression and death. Time to disease progression (TTP) was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines with evaluations every 3 months.

Time frame: Up to 24 months

Population: Intent-to-Treat Population consisting of all randomized participants.

ArmMeasureGroupValue (NUMBER)
Zoledronic AcidPercentage of Participants With Progression-Free Survival EventsDisease Progression60.2 Percentage of participants
Zoledronic AcidPercentage of Participants With Progression-Free Survival EventsDeath8.4 Percentage of participants
ControlPercentage of Participants With Progression-Free Survival EventsDisease Progression55.5 Percentage of participants
ControlPercentage of Participants With Progression-Free Survival EventsDeath5.7 Percentage of participants
Primary

Progression-Free Survival

Progression-free survival is defined as the time from randomization to the date of the first documented progression or recurrence of disease or death from any cause. Time to disease progression (TTP) was assessed by the Response Evaluation Criteria in Solid Tumors (RECIST) guidelines with evaluations every 3 months.

Time frame: Up to 24 months

Population: Intent-to-Treat Population consisting of all randomized participants.

ArmMeasureValue (MEDIAN)
Zoledronic AcidProgression-Free Survival9.0 Months
ControlProgression-Free Survival11.3 Months
Secondary

Kaplan-Meier Estimate of the Time to Occurrence of Bone Metastases

Time to occurrence of bone metastases was defined as the time from randomization to the date of the first documented bone metastases which could be asymptomatic or symptomatic at the time of detection. Bone scans were scheduled at screening and at 6-monthly intervals after study entry, or when symptoms suggested the presence of bone metastases. Positive bone scans required confirmation by x-ray, magnetic resonance imaging (MRI), or computed tomography (CT).

Time frame: Months 6, 12, 18, and 24

Population: Intent-to-Treat Population consisting of all randomized participants. Any participant without documented bone metastases at the date of analysis was to be censored at the date of the last bone scan.

ArmMeasureGroupValue (NUMBER)
Zoledronic AcidKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases6 months2.7 Percentage of participants
Zoledronic AcidKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases12 months4.2 Percentage of participants
Zoledronic AcidKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases18 months11.1 Percentage of participants
Zoledronic AcidKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases24 months12.4 Percentage of participants
ControlKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases24 months13.7 Percentage of participants
ControlKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases6 months1.9 Percentage of participants
ControlKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases18 months12.6 Percentage of participants
ControlKaplan-Meier Estimate of the Time to Occurrence of Bone Metastases12 months9.0 Percentage of participants
Secondary

Kaplan-Meier Estimates for Overall Survival

Time frame: Months 6, 12, 18, and 24

Population: Intent-to-Treat Population consisting of all randomized participants.

ArmMeasureGroupValue (NUMBER)
Zoledronic AcidKaplan-Meier Estimates for Overall Survival12 months81.8 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates for Overall Survival24 months59.5 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates for Overall Survival18 months72.4 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates for Overall Survival6 months92.8 Percentage of participants
ControlKaplan-Meier Estimates for Overall Survival18 months71.0 Percentage of participants
ControlKaplan-Meier Estimates for Overall Survival12 months81.8 Percentage of participants
ControlKaplan-Meier Estimates for Overall Survival6 months93.6 Percentage of participants
ControlKaplan-Meier Estimates for Overall Survival24 months63.6 Percentage of participants
Secondary

Kaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)

Time to the first skeletal related event defined as the time from randomization to the date of occurrence of the first SRE. Skeletal Related Events were defined as radiation therapy or surgery to bone, spinal cord compression event or a pathologic bone fracture event

Time frame: Months 6,12, 18, and 24

Population: Intent-to-Treat Population consisting of all randomized participants. Any participant in whom no SRE had been observed during the study was to be censored at the date of the last visit or the date of death whichever was the earlier.

ArmMeasureGroupValue (NUMBER)
Zoledronic AcidKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)6 month1.0 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)12 month2.7 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)18 month2.7 Percentage of participants
Zoledronic AcidKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)24 month2.7 Percentage of participants
ControlKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)24 month1.8 Percentage of participants
ControlKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)6 month0.0 Percentage of participants
ControlKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)18 month1.8 Percentage of participants
ControlKaplan-Meier Estimates of the Time to the First Skeletal Related Event (SRE)12 month1.8 Percentage of participants
Secondary

Percentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months

Percentage of participants developing at least 1 bone metastasis, whether or not symptomatic. Bone scans were scheduled at screening and at 6-monthly intervals after study entry, or when symptoms suggested the presence of bone metastases. Positive bone scans required confirmation by x-ray, magnetic resonance imaging (MRI), or computed tomography (CT).

Time frame: Months 6, 12, 18 and 24

Population: Intent-to-Treat Population consisting of all randomized participants.

ArmMeasureGroupValue (NUMBER)
Zoledronic AcidPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months6 months2.2 Percentage of participants
Zoledronic AcidPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months12 months4.0 Percentage of participants
Zoledronic AcidPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months18 months6.2 Percentage of participants
Zoledronic AcidPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months24 months6.6 Percentage of participants
ControlPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months24 months9.0 Percentage of participants
ControlPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months6 months4.3 Percentage of participants
ControlPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months18 months8.1 Percentage of participants
ControlPercentage of Participants With Bone Metastases at 6, 12, 18, and 24 Months12 months7.1 Percentage of participants
Secondary

Percentage of Participants With Skeletal Related Events (SREs) at 12 and 24 Months From Study Entry

Skeletal Related Events were defined as radiation therapy or surgery to bone, spinal cord compression event or a pathologic bone fracture event.

Time frame: Months 12 and 24

Population: Intent-to-Treat Population consisting of all randomized participants.

ArmMeasureGroupValue (NUMBER)
Zoledronic AcidPercentage of Participants With Skeletal Related Events (SREs) at 12 and 24 Months From Study Entry24 months2.2 Percentage of participants
Zoledronic AcidPercentage of Participants With Skeletal Related Events (SREs) at 12 and 24 Months From Study Entry12 months2.2 Percentage of participants
ControlPercentage of Participants With Skeletal Related Events (SREs) at 12 and 24 Months From Study Entry12 months1.4 Percentage of participants
ControlPercentage of Participants With Skeletal Related Events (SREs) at 12 and 24 Months From Study Entry24 months1.4 Percentage of participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026