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Concurrent Once Daily Versus Twice Daily Radiotherapy for Limited Stage Small Cell Lung Cancer (CONVERT)

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ClinicalTrials.gov Identifier: NCT00433563
Recruitment Status : Completed
First Posted : February 12, 2007
Last Update Posted : March 17, 2020
Sponsor:
Collaborators:
Cancer Research UK
NCIC Clinical Trials Group
European Organisation for Research and Treatment of Cancer - EORTC
Spanish Lung Cancer Group
Groupe Francais De Pneumo-Cancerologie
Intergroupe Francophone de Cancerologie Thoracique
Information provided by (Responsible Party):
The Christie NHS Foundation Trust

Tracking Information
First Submitted Date  ICMJE February 8, 2007
First Posted Date  ICMJE February 12, 2007
Last Update Posted Date March 17, 2020
Study Start Date  ICMJE April 2008
Actual Primary Completion Date February 2016   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: April 8, 2013)
Overall survival [ Time Frame: August 2015 ]
Original Primary Outcome Measures  ICMJE
 (submitted: February 8, 2007)
Overall survival
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: April 8, 2013)
  • Local progression-free survival [ Time Frame: August 2015 ]
  • Metastasis-free survival [ Time Frame: August 2015 ]
  • Toxicity [ Time Frame: August 2015 ]
  • Cytotoxic dose intensity [ Time Frame: August 2015 ]
  • Radiotherapy dose intensity [ Time Frame: August 2015 ]
Original Secondary Outcome Measures  ICMJE
 (submitted: February 8, 2007)
  • Local progression-free survival
  • Metastasis-free survival
  • Toxicity
  • Response rate
  • Cytotoxic dose intensity
  • Radiotherapy dose intensity
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Concurrent Once Daily Versus Twice Daily Radiotherapy for Limited Stage Small Cell Lung Cancer
Official Title  ICMJE A 2-Arm Randomized Controlled Trial of Concurrent Chemo-Radiotherapy Comparing Twice-Daily and Once-Daily Radiotherapy Schedules in Patients With Limited Stage Small Cell Lung Cancer (SCLC) and Good Performance Status [CONVERT]
Brief Summary

RATIONALE: Drugs used in chemotherapy, such as cisplatin and etoposide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Radiation therapy uses high-energy x-rays to kill tumor cells. It is not yet known which schedule of radiation therapy is more effective when given together with chemotherapy in treating small cell lung cancer.

PURPOSE: This randomized phase III trial is studying two different schedules of radiation therapy to compare how well they work when given together with cisplatin and etoposide in treating patients with limited stage small cell lung cancer.

Detailed Description

OBJECTIVES:

Primary

  • Compare overall survival of patients with limited stage small cell lung cancer treated with chemoradiotherapy comprising cisplatin, etoposide, and once vs twice daily radiotherapy.

Secondary

  • Compare local progression-free survival of patients treated with these regimens.
  • Compare metastasis-free survival of patients treated with these regimens.
  • Compare the toxicity of these regimens in these patients.
  • Compare response rates in patients treated with these regimens.
  • Compare the cytotoxic dose intensity of these regimens in these patients.
  • Compare the dose intensity of two different schedules of radiotherapy in these patients.

OUTLINE: This is a multicenter, randomized, controlled study. Patients are stratified according to participating center, ECOG performance status (0-1 vs 2), and lactic dehydrogenase, sodium, and alkaline phosphatase levels. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive cisplatin IV over 2 hours on days 1-3 OR on day 1 only and etoposide IV over 45-90 minutes on days 1-3. Treatment repeats every 21 days for up to 6 courses. During course 2, patients undergo concurrent radiotherapy once daily 5 days a week for 6½ weeks (total of 33 fractions).
  • Arm II: Patients receive cisplatin and etoposide as in arm I. During courses 2 and 3, patients undergo concurrent radiotherapy twice daily 5 days a week for 3 weeks (total of 30 fractions).

In both arms, treatment continues in the absence of disease progression or unacceptable toxicity.

Beginning 3-4 weeks after completion of chemoradiotherapy, patients in both arms achieving a complete or partial response with no evidence of brain metastasis undergo prophylactic cranial irradiation once daily 5 days a week for 2 weeks (total of 10 fractions).

After completion of study treatment, patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 532 patients will be accrued for this study.

Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Lung Cancer
Intervention  ICMJE
  • Radiation: Once daily radiotherapy
    Standard of care chemotherapy (cisplatin/etoposide) + once daily radiotherapy
  • Radiation: Twice daily radiotherapy
    Standard of care chemotherapy (cisplatin/etoposide) + twice daily radiotherapy
Study Arms  ICMJE
  • Experimental: Once daily radiotherapy
    Once daily radiotherapy
    Interventions:
    • Radiation: Once daily radiotherapy
    • Radiation: Twice daily radiotherapy
  • Active Comparator: Twice daily radiotherapy
    Twice daily radiotherapy
    Interventions:
    • Radiation: Once daily radiotherapy
    • Radiation: Twice daily radiotherapy
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: February 19, 2014)
547
Original Enrollment  ICMJE
 (submitted: February 8, 2007)
532
Actual Study Completion Date  ICMJE January 2019
Actual Primary Completion Date February 2016   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion/exclusion criteria:

  • Either sex, age ≥18 years
  • Performance status ECOG grade 0-1. Patients with PS 2 whose general condition is explained by obstructive/bulky disease likely to improve after the first cycle of chemotherapy can be included at the discretion of the local investigator. Patients with PS 2 as a result of comorbid conditions will be excluded.
  • Histologically or cytologically confirmed SCLC
  • No patients with mixed small-cell and non-small-cell histologic features
  • No history of previous malignancy in the last 5 years (except non melanomatous skin or in-situ cervix carcinoma). Patients with previous malignancies (except breast cancer) and in remission for at least 5 years can be included.
  • Limited stage disease (Veterans Administration Lung Cancer Study Group) ie patients whose disease can be encompassed within a radical radiation portal.
  • No pleural or pericardial effusions proven to be malignant
  • RT target volume acceptable by the local radiotherapist
  • Pulmonary function

    1. FEV1 >1 litre or 40% predicted value
    2. KCO (DLCO/VA) >40%predicted
  • Maximum of one of the following adverse biochemical factors:

    1. Serum alkaline phosphatase more than >1.5 times the upper limit of normal (ULN)
    2. Serum sodium < Lower limit of Normal
    3. Serum LDH > ULN
  • Normal serum creatinine and calculated creatinine clearance >50 ml/min. If calculated creatinine clearance is <50 ml/mn according to the Cockroft and Gault formula, an EDTA clearance should be performed
  • Adequate haematological function

    1. Neutrophils >1.5 x 109/l
    2. Platelets >100 x 109/l
  • Adequate liver function: ALT & AST <= 2.5 x ULN
  • No other previous or concomitant illness or treatment which in the opinion of the clinician will interfere with the trial treatments or comparisons
  • No prior surgical resection of the primary tumour, no prior radiotherapy for lung cancer
  • Considered fit to receive any of the trial regimens
  • Female patients must satisfy the investigator that they are not pregnant, or are not of child-bearing potential, or are using adequate contraception. Men must also use adequate contraception, as etoposide is clastogenic.
  • Patients must not be breastfeeding
  • Patient has read the patient information sheet and has signed the consent form.
  • Patients available for follow-up
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United Kingdom
Removed Location Countries Belgium,   Canada,   France,   Spain
 
Administrative Information
NCT Number  ICMJE NCT00433563
Other Study ID Numbers  ICMJE CDR0000531709
CHNT-CONVERT ( Other Identifier: Christie Hospital NHS Foundation Trust )
CHNT-CTAAC-CONVERT-C17052/A815 ( Other Grant/Funding Number: Cancer Research UK )
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement  ICMJE Not Provided
Responsible Party The Christie NHS Foundation Trust
Study Sponsor  ICMJE The Christie NHS Foundation Trust
Collaborators  ICMJE
  • Cancer Research UK
  • NCIC Clinical Trials Group
  • European Organisation for Research and Treatment of Cancer - EORTC
  • Spanish Lung Cancer Group
  • Groupe Francais De Pneumo-Cancerologie
  • Intergroupe Francophone de Cancerologie Thoracique
Investigators  ICMJE
Study Chair: Corinne Faivre-Finn, MD The Christie NHS Foundation Trust
PRS Account The Christie NHS Foundation Trust
Verification Date March 2020

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP