Non Small Cell Lung Cancer
Conditions
Keywords
NSCLC, Induction chemotherapy, Concurrent chemoradiotherapy, Consolidation therapy, Docetaxel, Gemcitabine, Carboplatin
Brief summary
The combination of chemotherapy with radiotherapy remains the standard of therapy for patients with stage III NSCLC. A recent phase II study has presented encouraging data regarding the administration of docetaxel as consolidation treatment after definitive concurrent chemo-radiotherapy.
Detailed description
To evaluate whether the administration of consolidation therapy with docetaxel/carboplatin after induction chemotherapy followed by concurrent chemoradiotherapy, offers any advantage regarding time to tumor progression
Interventions
Docetaxel 75 mg/m2 IV on day 8 every 3 weeks for 2 cycles
Gemcitabine 1100 mg/m2 on days 1 and 8 every 3 weeks for 2 cycles
Carboplatin 6AUC IV on day 1 every 3 weeks for 3 cycles
After 21 days from the 2nd chemotherapy cycle definitive concurrent chemoradiotherapy will be started: daily fractions of 1.8 Gy for 5 days/week, for a total dose of 45 Gy. During the radiotherapy docetaxel 25 mg/m2, IV, will be administered on days 1, 8, 15, 22, 29 and carboplatin 2AUC, IV , on days 4, 11, 18, 25, 32
Sponsors
Study design
Eligibility
Inclusion criteria
* histologically or cytologically confirmed, unresectable locally advanced (stage IIIA/IIIB) NSCLC * no previous therapy for NSCLC is allowed * age \>18 years * bidimensionally measurable disease * performance status (WHO) 0-2 * absence of pleural effusion * adequate liver (serum bilirubin \< 1.5 times the upper normal limit (UNL); AST and ALT \< 2.5 times the UNL in the absence of demonstrable liver metastases, or \< 5 times the UNL in the presence of liver metastases); adequate renal function (serum creatinine \< 1.5 times the UNL); and bone marrow (neutrophils ≥ 1.5x 109 /L, and platelets ≥ 100x 109 /L) function * life expectancy of more than 3 months * written informed consent
Exclusion criteria
* active infection * history of significant cardiac disease (unstable angina, congestive heart failure, myocardial infarction within the previous 6 months, ventricular arrhythmias) * malnutrition (loss of ≥ 20% of the original body weight) * performance status: 3-4 * sensor or motor neuropathy \> grade I * second primary malignancy, except for non-melanoma skin cancer * psychiatric illness or social situation that would preclude study compliance * pregnant or lactating women
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time to tumor progression (TTP) | 1 year |
Secondary
| Measure | Time frame |
|---|---|
| Response rate | Objective responses confirmed by CT or MRI (on 3rd and 6th cycle) |
| Overall survival | Probability of 1-year survival (%) |
| Toxicity | Toxicity assessment on each chemotherapy cycle |
| Quality of life | Assessment every two cycles |
| Symptom improvement | Assessment every two cycles |
Countries
Greece