Preoperative Chemoradiotherapy Versus Chemotherapy Alone in Nonsmall Cell Lung Cancer (NSCLC) Patients With Mediastinal Lymph Node Metastases

Shanghai Jiao Tong University School of Medicine

Status and phase: Unknown; Phase 2

Conditions: Non-small Cell Lung Cancer

Treatments: Radiation: neoadjuvant chemoradiotherapy

Study type: Interventional

Funder types: Other

Identifiers

NCT01187290

chest1001

Details and patient eligibility

About

The main objective of this trial is to compare feasibility and efficacy of sequential neoadjuvant chemoradiotherapy with 44Gy concomitant boost to neoadjuvant chemotherapy alone. Secondary objectives are to assess the value of position emission tomography (PET）in predicting pathological response and event-free survival（EFS）in stage IIIA non-small cell lung cancer (NSCLC). Further to compare the amount of serum DNA in patients with stage IIIa NSCLC before, during and after chemotherapy, before and after radiotherapy (in arm A) and during follow-up in patients randomized into the trial and to correlate the Deoxyribonucleic acid (DNA) variation with tumor response, remission duration and overall survival.

Enrollment: 80 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Histologically proven NSCLC with nodal metastases: T1-3N2M0
• Performance status 0-1
• Patient medically fit enough for protocol therapy, including operability
• Age 18-75
• Written informed consent
• No previous chemo- or radiotherapy

Exclusion criteria

• Patients with prior or concomitant malignancies Allowed are: non-melanomatous skin cancer, adequately treated in situ cervical cancer or any other neoplastic diseases with disease-free interval ³ 5 years.
• Presence or history of any distant metastasis
• Unstable cardiac disease requiring treatment, congestive heart failure or angina pectoris even if medically controlled, significant arrhythmia, or prior history of myocardial infarction in the last 3 months
• History of significant neurologic or psychiatric disorders including psychotic disorders, dementia or seizures that would prohibit the understanding and giving of informed consent
• Active uncontrolled infection
• Uncontrolled diabetes mellitus
• Gastric ulcers
• Preexisting peripheral neuropathy (> grade 1)
• Other serious underlying medical condition which could impair the ability of the patient to participate in the trial
• Concurrent treatment with other experimental drugs
• Pretreatment with any other cytostatic therapy
• Previous radiotherapy to the chest
• Concurrent treatment with prednisone (or equivalent) except: for the prophylactic medication regimen before treatment, treatment of acute hypersensitivity reactions or chronic treatment (initiated > 6 months prior to trial entry) at low dose (£ 20 mg methylprednisolone or equivalent)
• Definite contraindications for the use of corticosteroids as premedication
• Treatment within a clinical trial within 30 days prior to trial entry
• Socioeconomic or geographic circumstances that may prohibit proper staging, treatment or follow-up procedures
• Pregnancy, lactation period

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 2 patient groups

neoadjuvant chemotherapy

No Intervention group

Description:

Chemotherapy Docetaxel 75 mg/m2 1 hour iv infusion d1 Cisplatin 100 mg/m2 1 hour iv infusion d1 Schedule: 3 cycles repeated every 21 days

Treatment:

Radiation: neoadjuvant chemoradiotherapy

neoadjuvant chemoradiotherapy

Experimental group

Description:

Docetaxel 75 mg/m2 1 hour iv infusion d1 Cisplatin 100 mg/m2 1 hour iv infusion d1 Schedule: 3 cycles repeated every 21 days

Treatment:

Radiation: neoadjuvant chemoradiotherapy