S0222: Tirapazamine Combined With Chemo and RT in Limited-Stage Small Cell Lung Cancer
This phase II trial is studying how well giving tirapazamine together with cisplatin, etoposide, and radiation therapy works in treating patients with limited-stage small cell lung cancer. Drugs used in chemotherapy, such as cisplatin and etoposide, work in different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Tirapazamine may make the tumor cells more sensitive to chemotherapy and radiation therapy. Combining chemotherapy and radiation therapy with tirapazamine may kill more tumor cells.
Radiation: radiation therapy
|Study Design:||Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Phase II Study Of Tirapazamine (NSC-130181)/Cisplatin/Etoposide And Concurrent Thoracic Radiotherapy For Limited Stage Small Cell Lung Cancer|
- Overall Survival [ Time Frame: Weekly during protocol treatment, then every 3 months for first year, then every 6 months for up to 3 years after enrollment. ] [ Designated as safety issue: No ]Overall survival was defined as the time from date of enrollment until the date of death due to any cause. Patients last known to be alive were censored at the date of last conatct. Patients were followed for a maximum of 3 years from the date of enrollment.
- Response Rate (Confirmed and Unconfirmed Complete and Partial Responses Per RECIST) in the Subset of Patients With Measurable Disease at Baseline. [ Time Frame: After completeion of concurrent chemotherapy+radiation (Week 8); then after completion of consolidation chemotherapy (Week15); once off treatment, every 3 months until disease progression for a maximum of 3 years after enrollment. ] [ Designated as safety issue: No ]A complete response (CR) was defined as a complete disappearance of all disease with no new lesions. A partial response (PR) was defined as at least a 30% decrease under baseline of the sum of longest diameters of all target measurable lesions with no unequivocal progression of non-measurable disease and no new lesions. Both CR and PR had to be confirmed by a second determination at least 4 weeks apart. All disease had to be assessed using same method as baseline. Only patients with measurable disease at baseline were included in this analysis.
- Progression-Free Survival [ Time Frame: At end of concurrent chemoradiotherapy (Week 8), then at end of consolidation chemotherapy (Week 15). After off treatment, every 3 months for the first 2 years then every 6 months for up to 3 years after enrollment. ] [ Designated as safety issue: No ]Progression was defined as a >= 20% increase in the sum of longest diameters of measurable lesions over the smallest sum observed or unequivocal progression of non-measurable disease or the appearance of any new lesion/site. Symptomatic deterioration was defined as a global deterioration of health status requiring discontinuation of treatment. Progression-free survival was defined as the time from the date of enrollment until the date of progression, symptomatic deterioration, or death due to any cause. Patients last known to be alive and progression-free were censored at last contact date.
|Study Start Date:||September 2003|
|Study Completion Date:||August 2009|
|Primary Completion Date:||August 2009 (Final data collection date for primary outcome measure)|
Experimental: tirapazamine/cisplatin/etoposide and RT
tirapazamine/cisplatin/etoposide and RT
During Induction: 50 mg/m2/day, IV on Days 1, 8, 29, 36. 1 hour infusion
During Consolidation: 60 mg/m2 IV Day 1 only at the beginning of each cycle. 1 hour infusion.
Other Name: platinolDrug: etoposide
During Induction: 50 mg/m2/day IV on Days 1 - 5, 29 - 33. 1 hour infusion.
During Consolidation: 120 mg/m2 IV Days 1, 2 and 3 at the beginning of each cycle. 1 hour infusion.
Other Name: VP-16Drug: tirapazamine
Radiation: radiation therapy
260 mg/m2/day IV on days 1 and 29. 1 hour infusion
160 mg/m2/day IV on Days 8, 10, 12, 36, 38, 40. 1 hour infusion
RT given to a total dose of 4500 cGy in 25 fractions. 180 cGy per day for 5 days a week for 5 weeks. Radiotherapy Boost: There will be no break (other than the weekend) between induction radiation and the boost radiation. RT will be continued for an additional 1,600 cGy with 200 cGy fractions, daily except weekends. Dose will be prescribed to the central axis at isocenter.
Patients achieving a complete response after consolidation chemotherapy will receive PCI. PCI is to be delivered at 200 cGy daily to a total dose of 3,000 cGy in 15 fractions over three weeks.
Other Name: RT
I. Determine the overall survival of patients with limited stage small cell lung cancer treated with tirapazamine, cisplatin, and etoposide with concurrent thoracic radiotherapy followed by consolidation cisplatin and etoposide.
II. Determine the time to treatment failure and response (confirmed and unconfirmed, complete and partial) in patients with measurable disease treated with this regimen.
III. Determine the toxicity of this regimen in these patients. IV. Correlate baseline PAI-1, VEGF, OPN, and NDRG1 plasma markers with response and survival of patients treated with this regimen.
OUTLINE: This is a multicenter study.
Chemoradiotherapy: Patients receive tirapazamine IV over 1 hour on days 1, 8, 10, 12, 29, 36, 38, and 40; cisplatin IV over 1 hour on days 1, 8, 29, and 36; and etoposide IV over 1 hour on days 1-5 and 29-33. Beginning on day 1 of chemotherapy, patients undergo thoracic radiotherapy once daily 5 days a week for 7 weeks.
Consolidation chemotherapy: Within 28 days after completion of radiotherapy, patients with stable or responding disease receive cisplatin IV over 1 hour on days 1 and 22 and etoposide IV over 1 hour on days 1-3 and 22-24.
Treatment continues in the absence of disease progression or unacceptable toxicity.
Patients are followed every 2-3 months for 2 years and then every 6 months for 1 year.
PROJECTED ACCRUAL: A total of 30-85 patients will be accrued for this study within 17 months.
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|Study Chair:||Quynh-Thu X. Le, MD||Stanford University|
|Study Chair:||Stephen K. Williamson, MD||University of Kansas|
|Study Chair:||Primo N. Lara, MD||University of California, Davis|
|Study Chair:||Zelanna Goldberg, MD||University of California, Davis|