Temozolomide as Maintenance Therapy Following Induction Chemotherapy in Extensive Stage Small Cell Lung Cancer

Chinese PLA General Hospital (301 Hospital)

Status and phase: Unknown; Phase 3; Phase 2

Conditions: Extensive-stage Small Cell Lung Cancer

Treatments: Drug: first-line chemotherapy; Radiation: Prophylactic cranial irradiation; Drug: Temozolomide; Radiation: thoracic radiotherapy

Study type: Interventional

Funder types: Other

Identifiers

NCT02772107

301PLAGH

Details and patient eligibility

About

Temozolomide may delay progression in sequence with chemotherapy. This open-label, randomized,multicenter phase II trial was designed to evaluate the role of Temozolomide following 4 or 6 cycles of platinum-based first-line chemotherapy in patients with newly diagnosed estensive-stage SCLC.

Enrollment: 132 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Cytologically and/or histologically confirmed small-cell lung cancer with extensive-stage disease
• Patients must have measurable disease, this can include brain metastases
• Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1
• Adequate bone marrow function, as defined by: absolute neutrophil count (ANC) >1,500/µL; platelets >100,000/µL; hemoglobin >=9.0 g/dL
• Normal organ function, defined as follows: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) <=2.5 × the upper limit of normal (ULN), or AST and ALT <=5 × the ULN if liver function abnormalities are due to underlying malignancy; total serum bilirubin <=1.5 × the ULN; serum creatinine <=1.5 × the ULN
• the time interval from the data of the last chemotherapy to random must be between 3 and 7 weeks
• Women of childbearing potential and men with partners of childbearing potential must agree to use a form of birth control that is acceptable to their physician to prevent pregnancy during treatment
• Patients must be informed of the investigational nature of this study and sign an informed consent form

Exclusion criteria

• Patients who are pregnant or breastfeeding
• Patients receiving other investigational agents
• Patients with leptomeningeal involvement
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or psychiatric illness/social situations that would limit compliance with study requirements
• Acquired Immune Deficiency Syndrome (AIDS) based upon current CDC definition or HIV-positive patients on combination antiretroviral therapy. However, HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because these patients are at increased risk of lethal infections when treated with marrow- suppressive therapy. Excluding patients on HAART is necessary due to the potential for pharmacokinetic interactions with temozolomide.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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132 participants in 2 patient groups

BSC group

Experimental group

Description:

Patients in the study will receive the following for the duration of the study:First-line chemotherapy according to the NCCN guidelines. The study will consist of 21-day cycles, to a maximum of 6 cycles of therapy for the first-line chemotherapy. Radiotherapy was allowed. Follow-up until disease progression.

Treatment:

Drug: first-line chemotherapy

Radiation: Prophylactic cranial irradiation

Radiation: thoracic radiotherapy

TMZ group

Experimental group

Description:

Patients will receive platinum-based first-line chemotherapy according to the NCCN guidelines. The study will consist of 21-day cycles, to a maximum of 6 cyclesfor the first-line chemotherapy. After first-line treatment, temozolomide will be given alone as maintenance therapy in all patients who have achieved study entry hematologic criteria and who do not have progressive disease or severe toxicity. During temozolomide maintenance therapy, patients will receive temozolomide at 150mg/m2/d for 5 days of a 28-day cycle orally daily. Temozolomide maintenance therapy will continue until progressive disease or irreversible toxicity occurs. Re-staging will be performed every 2 cycles (every 8 weeks) during the study, radiotherapy was allowed.

Treatment:

Drug: first-line chemotherapy

Radiation: Prophylactic cranial irradiation

Radiation: thoracic radiotherapy

Drug: Temozolomide