Active Symptom Control With or Without Chemotherapy in Treating Patients With Malignant Pleural Mesothelioma
Recruitment status was Active, not recruiting
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Purpose
RATIONALE: Active symptom control may decrease chest pain, breathlessness, sweating, and general discomfort in patients with malignant pleural mesothelioma. It is not yet known if active symptom control is more effective with or without chemotherapy.
PURPOSE: This randomized phase III trial is studying active symptom control and chemotherapy to see how well they work compared to active symptom control alone in treating patients with malignant pleural mesothelioma.
| Condition | Intervention | Phase |
|---|---|---|
|
Malignant Mesothelioma |
Drug: cisplatin Drug: mitomycin C Drug: vincristine sulfate Drug: vinorelbine tartrate Procedure: pain therapy Procedure: psychosocial assessment and care Procedure: quality-of-life assessment |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Primary Purpose: Treatment |
| Official Title: | A Randomized Controlled Trial of Active Symptom Control With or Without Chemotherapy in the Treatment of Patients With Malignant Pleural Mesothelioma |
- Overall survival [ Designated as safety issue: No ]
- Palliation of chest pain, breathlessness, malaise (e.g., feeling weak, tiredness, anorexia), and sweating attacks [ Designated as safety issue: No ]
- Performance status as measured by WHO grade [ Designated as safety issue: No ]
- Analgesic usage [ Designated as safety issue: No ]
- Toxicity as measured by the NCIC CTC [ Designated as safety issue: Yes ]
- Quality of life as assessed by the European Organization for Research and Treatment of Cancer [ Designated as safety issue: No ]
- Tumor response as measured by the RECIST criteria [ Designated as safety issue: No ]
- Progression-free survival as measured by CT scan [ Designated as safety issue: No ]
| Estimated Enrollment: | 840 |
| Study Start Date: | September 2003 |
OBJECTIVES:
Primary
- Compare the overall survival of patients with malignant pleural mesothelioma treated with active symptom control (ASC) alone vs ASC and mitomycin, vinblastine, and cisplatin vs ASC and vinorelbine.
Secondary
- Compare the toxic effects of these regimens in these patients.
- Compare symptom palliation (chest pain, breathlessness, malaise, and sweating attacks) in patients treated with these regimens.
- Compare the performance status of patients treated with these regimens.
- Compare analgesic usage in patients treated with these regimens.
- Compare the tumor response and progression-free survival of patients treated with these regimens.
- Compare the quality of life of patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive active symptom control (ASC) through regular visits at a specialist clinic. ASC may include steroids, analgesics, appetite stimulants, bronchodilators, and/or palliative radiotherapy, when required.
- Arm II: Patients receive ASC and chemotherapy comprising mitomycin IV, vincristine IV, and cisplatin IV on day 1. Chemotherapy repeats every 21 days for a total of 4 courses.
- Arm III: Patients receive ASC and vinorelbine IV over 5 minutes weekly for 6 weeks. Vinorelbine repeats every 55 days for a total of 2 courses.
Quality of life is assessed at baseline, every 3 weeks for 21 weeks, and then every 8 weeks thereafter.
Patients are followed at 15, 18, and 21 weeks, and then every 8 weeks thereafter.
Peer Reviewed and Funded or Endorsed by Cancer Research UK
PROJECTED ACCRUAL: A total of 840 patients (280 per treatment arm) will be accrued for this study within 4 years.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Histologically and immunohistochemically confirmed malignant pleural mesothelioma
- Epithelial and other histological types are allowed
- No more than 3 months since diagnosis
- Symptomatic pleural effusion must have been treated and brought under control by drainage, pleurodesis, or pleurectomy
- Prior surgical resection of mesothelioma allowed provided 2 CT scans at least 6 weeks apart show stable or progressive disease
PATIENT CHARACTERISTICS:
Age
- 18 and over
Performance status
- WHO 0-2
Life expectancy
- Not specified
Hematopoietic
- WBC > 3,000/mm^3
- Absolute neutrophil count > 1,500/mm^3
- Platelet count > 100,000/mm^3
Hepatic
- Not specified
Renal
- Creatinine clearance > 50 mL/min
Pulmonary
- See Disease Characteristics
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- Considered medically fit to receive chemotherapy
- No other disease or prior malignancy likely to interfere with protocol treatments or comparisons
- No clinical evidence of infection
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- No prior chemotherapy for mesothelioma
Endocrine therapy
- Not specified
Radiotherapy
- Prior local radiotherapy to a wound site after exploratory thoracotomy allowed
Surgery
- See Disease Characteristics
- See Radiotherapy
Contacts and Locations| United Kingdom | |
| Leeds General Infirmary at Leeds Teaching Hospital NHS Trust | |
| Leeds, England, United Kingdom, LS1 3EX | |
| Saint Bartholomew's Hospital | |
| London, England, United Kingdom, EC1A 7BE | |
| Royal Marsden NHS Foundation Trust - Surrey | |
| Sutton, England, United Kingdom, SM2 5PT | |
| Principal Investigator: | Martin F. Muers, MD | Leeds General Infirmary |
More Information
Additional Information:
Publications:
| ClinicalTrials.gov Identifier: | NCT00075699 History of Changes |
| Other Study ID Numbers: | CDR0000347461, BTS-MRC-MS01, ISRCTN54469112, EU-20349 |
| Study First Received: | January 9, 2004 |
| Last Updated: | February 26, 2011 |
| Health Authority: | United States: Federal Government |
Keywords provided by National Cancer Institute (NCI):
|
epithelial mesothelioma localized malignant mesothelioma advanced malignant mesothelioma |
Additional relevant MeSH terms:
|
Mesothelioma Adenoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neoplasms, Mesothelial Mitomycins Mitomycin Vinorelbine Cisplatin Vincristine Vinblastine Antibiotics, Antineoplastic |
Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Alkylating Agents Radiation-Sensitizing Agents Physiological Effects of Drugs Tubulin Modulators Antimitotic Agents Mitosis Modulators Antineoplastic Agents, Phytogenic |
ClinicalTrials.gov processed this record on June 18, 2013