Non Small Cell Lung Cancer
Conditions
Keywords
elderly, chemotherapy, quality of life, ADL, toxicity
Brief summary
The main purpose of this study is to describe activity and toxicity of single-agent gemcitabine given as prolonged infusion, and of two 2-drug combinations containing cisplatin (cisplatin + vinorelbine, and cisplatin + gemcitabine) in the treatment of elderly patients with advanced non small cell lung cancer
Detailed description
The study design includes three parallel phase II studies, all with the same rules for patient selection and outcome assessment. In the two studies of cisplatin-based doublets, a dose-finding phase is planned, with subsequent cohorts of 6 patients treated with increasing doses of cisplatin (50-60-70 mg/m²). Following this phase, patients will be assigned to the three studies through a randomization procedure, to reduce selection biases. Arm A: gemcitabine: Gemcitabine 1200 mg/m2 intravenously in 2 hours (10 mg/m²/minute) on days 1 & 8 of each cycle, every 21 days, for a maximum of 6 cycles. Arm B: cisplatin + vinorelbine: Vinorelbine 25 mg/m² on days 1 & 8, followed by Cisplatin (50 or 60 or 70 mg/m²) on day 1 of each cycle, every 21 days, for a maximum of 6 cycles. Arm C: cisplatin + gemcitabine: Gemcitabine 1000 mg/m2,, on days 1 & 8, followed by Cisplatin (50 or 60 or 70 mg/m²) on day 1 of each cycle, every 21 days, for a maximum of 6 cycles.
Interventions
DRUGgemcitabine prolonged continuous infusion
DRUGcisplatin
DRUGvinorelbine
Sponsors
National Cancer Institute, Naples
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologic or cytologic diagnosis of NSCLC * Stage IV or IIIB with pleural effusion or metastatic supraclavicular lymphoadenopathy * Age \> o = 70 years. * Written informed consent.
Exclusion criteria
* Performance status (ECOG) ³2 * Previous chemotherapy. * Symptomatic brain metastases requiring synchronous radiotherapy * Previous radiotherapy (completed less than 4 weeks before enrollment) * Previous or synchronous malignant disease (except adequately treated non melanomatous skin cancer or carcinoma in situ of the cervix) if diagnosed in the last five years before enrollment. * Neutrophils \< 2.000/mm³ or platelets \< 100.000/mm³ or hemoglobin \< 10 g/dl. * Serum creatinine \> 1.5 times the UNL. * GOT and/or GPT \>1.25 times the UNL or serum total bilirubin \>1.25 times the UNL without hepatic metastases. * GOT and/or GPT \>2.5 times the UNL or serum total bilirubin \>1.5 times the UNL with hepatic metastases. * Other concomitant diseases contraindicating the study treatments. * Refusal of written informed consent. * Follow-up impossible.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Activity and toxicity of monochemotherapy with gemcitabine as prolonged infusion | — |
| Toxicity and activity of 2 standard polychemotherapy cisplatin based treatments (cisplatin and vinorelbine , and cisplatin and gemcitabine | — |
Secondary
| Measure | Time frame |
|---|---|
| patient quality of life | — |
| the prognostic significance of the ADL and IADL scales for time to progression and survival | — |
| exploratory predictive clinical variables for chemotherapy related toxicity | — |
| exploratory predictive clinical variables for response to chemotherapy | — |
Outcome results
None listed