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Chemotherapy in Treating Patients With Non-Small Cell Lung Cancer

A Randomized Phase 3 Study Comparing Pemetrexed-Carboplatin With Docetaxel-Carboplatin as First-Line Treatment for Patients With Locally Advanced or Metastatic Non-Small Cell Lung Cancer

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00520676
Enrollment
260
Registered
2007-08-24
Start date
2007-10-31
Completion date
2010-07-31
Last updated
2011-08-10

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

Brief summary

The purpose of this study is to compare the combination of pemetrexed and carboplatin with the combination of docetaxel and carboplatin in terms of survival without Grade 3 or 4 toxicity in previously untreated patients with locally advanced or metastatic non-small cell lung cancer (NSCLC).

Interventions

DRUGpemetrexed

500 mg/m\^2, IV, q 21 days x 6 cycles maximum

DRUGdocetaxel

75 mg/m\^2, IV, q 21 days x 6 cycles maximum

DRUGcarboplatin

AUC 5 mg\*min/mL, IV, q 21 days x 6 cycles maximum

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* Patient with locally advanced or metastatic (Stage IIIB/IV) NCSLC with no prior chemotherapy for advanced disease or molecular target treatment * Easter Cooperative Oncology Group (ECOG) performance status 0 to 2 * Estimated life expectancy of at least 8 weeks

Exclusion criteria

* Known or suspected brain metastases * Concurrent administration of any other tumor therapy * Serious concomitant disorders * Pregnancy or breast feeding * Inability or unwillingness to take folic acid or vitamin B12 supplementation

Design outcomes

Primary

MeasureTime frameDescription
Survival Without Grade 3 or 4 ToxicityBaseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).Defined as the time from date of randomization to first date of a Grade 3 or 4 treatment-emergent adverse event (TEAE; as graded by the National Cancer Institute Common Terminology Criteria for Adverse Events \[CTCAE\], version 3.0) or death due to any cause. Grade 3 TEAE: Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated. Grade 4 TEAE: Life-threatening consequences; urgent intervention indicated. Participants who were alive without experiencing Grade 3 or 4 toxicity were censored at the date of last contact.

Secondary

MeasureTime frameDescription
Overall Survival (OS)Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).OS is the duration from enrollment to death. For participants who are alive, OS is censored at the last contact.
Progression-free Survival (PFS)Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).Defined as the time from date of first dose to the first observation of disease progression (PD), or death due to any cause.
Percentage of Participants With Tumor Response (Response Rate)Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).Response using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Complete Response (CR)=disappearance of all target lesions; Partial Response (PR)=at least a 30% decrease in sum of longest diameter of target lesions; Progressive Disease (PD)=at least a 20% increase in sum of longest diameter of target lesions; Stable Disease (SD)=small changes not meeting above criteria. Response rate (%)=Number of participants with CR+PR/Number of participants analyzed \*100. Disease Control rate=Number of participants with SD+PR+CR/Number of participants analyzed \*100.
Survival Without Grade 4 ToxicityBaseline to until 218 events (defined as death or Grade 4 toxicity) have been observed (up to 33.3 months).Survival without Grade 4 toxicity is the time from the date of randomization to the first date of a Grade 4 TEAE or death due to any cause. Participants who are alive without experiencing Grade 4 toxicity will be censored for this analysis at the date of last contact.
Number of Participants With Adverse Events (AEs)Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).Summaries of serious AEs (SAEs) and all other non-serious AEs are located in the Reported Adverse Event Module.
Survival Without Clinically Important Grade 3 or 4 ToxicityBaseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).Survival without Grade 3 or 4 toxicity is the time from date of randomization to the first date of the following clinically important Grade 3 or 4 TEAEs graded by the Common Terminology Criteria for Adverse Events \[CTCAE\], version 3.0: neutropenia (lasting \>5 days), febrile neutropenia, documented infections related to neutropenia, anemia, thrombocytopenia, fatigue, nausea, vomiting, diarrhea, stomatitis, and neurosensory events; or death due to any cause. Participants who were alive without experiencing Grade 3 or 4 toxicity were censored for this analysis at the date of last contact.

Other

MeasureTime frameDescription
Duration of ResponseBaseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).The duration of a complete response (CR) or partial response (PR) was defined as the time from first objective status assessment of CR or PR to the first time of progression or death as a result of any cause. Response using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. CR=disappearance of all target lesions; PR=at least a 30% decrease in sum of longest diameter of target lesions.

Countries

Australia, Brazil, China, Mexico, South Korea, Taiwan

Participant flow

Pre-assignment details

Analyses were conducted on the qualified intent-to-treat population (Q-ITT) unless otherwise specified. This population includes all data from all randomized participants, with nonsquamous histology, receiving at least 1 dose of the study drug according to the treatment the participants were assigned.

Participants by arm

ArmCount
Pemetrexed Plus Carboplatin
pemetrexed 500 mg/m\^2 plus carboplatin AUC 5 mg\*min/mL on Day 1 every 21 days
106
Docetaxel Plus Carboplatin
docetaxel 75 mg/m\^2 plus carboplatin AUC 5 mg\*min/mL on Day 1 every 21 days
105
Total211

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath8481
Overall StudyLost to Follow-up610
Overall StudyPhysician Decision41
Overall StudyWithdrawal by Subject711

Baseline characteristics

CharacteristicPemetrexed Plus CarboplatinTotalDocetaxel Plus Carboplatin
Age Continuous59.6 years
STANDARD_DEVIATION 10
59.4 years
STANDARD_DEVIATION 10.3
59.2 years
STANDARD_DEVIATION 10.7
Histology
Adenocarcinoma, lung
10 participants21 participants11 participants
Histology
Adenocarcinoma, not otherwise specified
80 participants160 participants80 participants
Histology
Carcinoma, lung
6 participants11 participants5 participants
Histology
Large cell carcinoma, lung
10 participants19 participants9 participants
Region of Enrollment
Australia
10 participants24 participants14 participants
Region of Enrollment
Brazil
35 participants60 participants25 participants
Region of Enrollment
China
20 participants37 participants17 participants
Region of Enrollment
Korea, Republic of
21 participants39 participants18 participants
Region of Enrollment
Mexico
17 participants39 participants22 participants
Region of Enrollment
Taiwan
3 participants12 participants9 participants
Sex: Female, Male
Female
42 Participants97 Participants55 Participants
Sex: Female, Male
Male
64 Participants114 Participants50 Participants
Smoking Status
Currently Smoking
11 participants22 participants11 participants
Smoking Status
Ever Smoking but Quit
61 participants114 participants53 participants
Smoking Status
Never Smoking
34 participants75 participants41 participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
94 / 106100 / 105
serious
Total, serious adverse events
28 / 10635 / 105

Outcome results

Primary

Survival Without Grade 3 or 4 Toxicity

Defined as the time from date of randomization to first date of a Grade 3 or 4 treatment-emergent adverse event (TEAE; as graded by the National Cancer Institute Common Terminology Criteria for Adverse Events \[CTCAE\], version 3.0) or death due to any cause. Grade 3 TEAE: Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated. Grade 4 TEAE: Life-threatening consequences; urgent intervention indicated. Participants who were alive without experiencing Grade 3 or 4 toxicity were censored at the date of last contact.

Time frame: Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on protocol-qualified, intent-to-treat (Q-ITT) population. This population includes all data from all randomized participants, with nonsquamous histology, receiving at least 1 dose of the study drug according to the treatment the participants were assigned.

ArmMeasureValue (MEDIAN)
Pemetrexed Plus CarboplatinSurvival Without Grade 3 or 4 Toxicity3.2 months
Docetaxel Plus CarboplatinSurvival Without Grade 3 or 4 Toxicity0.7 months
p-value: <0.00195% CI: [0.34, 0.6]Log Rank
Secondary

Number of Participants With Adverse Events (AEs)

Summaries of serious AEs (SAEs) and all other non-serious AEs are located in the Reported Adverse Event Module.

Time frame: Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on safety population. This population includes all participants with non-squamous histology who received at least one dose of study drug. Participants were analysed according to treatments they actually received.

ArmMeasureGroupValue (NUMBER)
Pemetrexed Plus CarboplatinNumber of Participants With Adverse Events (AEs)Non-Serious Adverse Events (AEs)94 participants
Pemetrexed Plus CarboplatinNumber of Participants With Adverse Events (AEs)Serious Adverse Events (SAEs)28 participants
Docetaxel Plus CarboplatinNumber of Participants With Adverse Events (AEs)Non-Serious Adverse Events (AEs)100 participants
Docetaxel Plus CarboplatinNumber of Participants With Adverse Events (AEs)Serious Adverse Events (SAEs)35 participants
Secondary

Overall Survival (OS)

OS is the duration from enrollment to death. For participants who are alive, OS is censored at the last contact.

Time frame: Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on protocol-qualified, intent-to-treat (Q-ITT) population. This population includes all data from all randomized participants, with nonsquamous histology, receiving at least 1 dose of the study drug according to the treatment the participants were assigned.

ArmMeasureValue (MEDIAN)
Pemetrexed Plus CarboplatinOverall Survival (OS)14.9 months
Docetaxel Plus CarboplatinOverall Survival (OS)14.7 months
p-value: 0.93495% CI: [0.72, 1.42]Log Rank
Secondary

Percentage of Participants With Tumor Response (Response Rate)

Response using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Complete Response (CR)=disappearance of all target lesions; Partial Response (PR)=at least a 30% decrease in sum of longest diameter of target lesions; Progressive Disease (PD)=at least a 20% increase in sum of longest diameter of target lesions; Stable Disease (SD)=small changes not meeting above criteria. Response rate (%)=Number of participants with CR+PR/Number of participants analyzed \*100. Disease Control rate=Number of participants with SD+PR+CR/Number of participants analyzed \*100.

Time frame: Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on tumour response-qualified population. This population includes all participants with locally advanced or metastatic non-small cell lung cancer (NSCLC), non-squamous histology with measurable disease as defined by RECIST (Version 1.0), who received at least 1 dose of pemetrexed, docetaxel, or carboplatin.

ArmMeasureGroupValue (NUMBER)
Pemetrexed Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Complete Response0.9 percentage of participants
Pemetrexed Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Tumor Response Rate34.0 percentage of participants
Pemetrexed Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Disease Control Rate74.5 percentage of participants
Pemetrexed Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Partial Response33.0 percentage of participants
Pemetrexed Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Stable Disease40.6 percentage of participants
Pemetrexed Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Progressive Disease16.0 percentage of participants
Pemetrexed Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Unknown9.4 percentage of participants
Docetaxel Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Unknown18.3 percentage of participants
Docetaxel Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Complete Response0 percentage of participants
Docetaxel Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Stable Disease41.3 percentage of participants
Docetaxel Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Partial Response23.1 percentage of participants
Docetaxel Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Tumor Response Rate23.1 percentage of participants
Docetaxel Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Progressive Disease17.3 percentage of participants
Docetaxel Plus CarboplatinPercentage of Participants With Tumor Response (Response Rate)Disease Control Rate64.4 percentage of participants
p-value: 0.08195% CI: [0.93, 3.15]Fisher Exact
Secondary

Progression-free Survival (PFS)

Defined as the time from date of first dose to the first observation of disease progression (PD), or death due to any cause.

Time frame: Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on protocol-qualified, intent-to-treat (Q-ITT) population. This set includes all data from all randomized participants, with nonsquamous histology, receiving at least 1 dose of the study drug according to the treatment the participants were assigned.

ArmMeasureValue (MEDIAN)
Pemetrexed Plus CarboplatinProgression-free Survival (PFS)5.8 months
Docetaxel Plus CarboplatinProgression-free Survival (PFS)6.0 months
p-value: 0.895% CI: [0.72, 1.29]Log Rank
Secondary

Survival Without Clinically Important Grade 3 or 4 Toxicity

Survival without Grade 3 or 4 toxicity is the time from date of randomization to the first date of the following clinically important Grade 3 or 4 TEAEs graded by the Common Terminology Criteria for Adverse Events \[CTCAE\], version 3.0: neutropenia (lasting \>5 days), febrile neutropenia, documented infections related to neutropenia, anemia, thrombocytopenia, fatigue, nausea, vomiting, diarrhea, stomatitis, and neurosensory events; or death due to any cause. Participants who were alive without experiencing Grade 3 or 4 toxicity were censored for this analysis at the date of last contact.

Time frame: Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on protocol-qualified, intent-to-treat (Q-ITT) population. This population includes all data from all randomized participants, with nonsquamous histology, receiving at least one dose of the study drug according to the treatment the participants were assigned.

ArmMeasureValue (MEDIAN)
Pemetrexed Plus CarboplatinSurvival Without Clinically Important Grade 3 or 4 Toxicity3.6 months
Docetaxel Plus CarboplatinSurvival Without Clinically Important Grade 3 or 4 Toxicity1.3 months
p-value: <0.00195% CI: [0.4, 0.71]Log Rank
Secondary

Survival Without Grade 4 Toxicity

Survival without Grade 4 toxicity is the time from the date of randomization to the first date of a Grade 4 TEAE or death due to any cause. Participants who are alive without experiencing Grade 4 toxicity will be censored for this analysis at the date of last contact.

Time frame: Baseline to until 218 events (defined as death or Grade 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on protocol-qualified, intent-to-treat (Q-ITT) population. This population includes all data from all randomized participants, with nonsquamous histology, receiving at least 1 dose of the study drug according to the treatment the participants were assigned.

ArmMeasureValue (MEDIAN)
Pemetrexed Plus CarboplatinSurvival Without Grade 4 Toxicity12.2 participants
Docetaxel Plus CarboplatinSurvival Without Grade 4 Toxicity2.0 participants
p-value: <0.00195% CI: [0.35, 0.66]Log Rank
Other Pre-specified

Duration of Response

The duration of a complete response (CR) or partial response (PR) was defined as the time from first objective status assessment of CR or PR to the first time of progression or death as a result of any cause. Response using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. CR=disappearance of all target lesions; PR=at least a 30% decrease in sum of longest diameter of target lesions.

Time frame: Baseline to until 218 events (defined as death or Grade 3 or 4 toxicity) have been observed (up to 33.3 months).

Population: Analysis was performed on tumour response qualified population. This population includes all participants with locally advanced or metastatic non-small cell lung cancer (NSCLC), non-squamous histology with measurable disease as defined by RECIST (Version 1.0), who received at least 1 dose of pemetrexed, docetaxel, or carboplatin.

ArmMeasureValue (MEDIAN)
Pemetrexed Plus CarboplatinDuration of Response5.5 months
Docetaxel Plus CarboplatinDuration of Response5.4 months
p-value: 0.64195% CI: [0.49, 1.55]Log Rank

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