Lung Cancer Clinical Trial
Official title:
A Randomized Phase II Study of Radiation Therapy, Pemetrexed and Carboplatin With or Without Cetuximab in Stage III Non-Small Cell Lung Cancer
RATIONALE: Pemetrexed disodium may stop the growth of tumor cells by blocking some of the
enzymes needed for cell growth. Drugs used in chemotherapy, such as carboplatin, 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.
Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some
block the ability of tumor cells to grow and spread. Others find tumor cells and help kill
them or carry tumor-killing substances to them. Cetuximab may also make tumor cells more
sensitive to radiation therapy. Giving pemetrexed disodium, carboplatin, and radiation
therapy together with cetuximab may kill more tumor cells.
PURPOSE: This randomized phase II trial is studying how well giving pemetrexed disodium and
carboplatin together with radiation therapy with or without cetuximab works in treating
patients with stage III non-small cell lung cancer that cannot be removed by surgery.
OBJECTIVES:
Primary
- Determine the overall survival of patients with unresectable stage III non-small cell
lung cancer treated with pemetrexed disodium, carboplatin, and thoracic radiotherapy
with or without cetuximab.
Secondary
- Determine the failure-free survival and response rates in patients treated with these
regimens.
- Correlate epidermal growth factor receptor, erbB2, and K-ras mutations with survival
and tumor response in patients treated with these regimens.
OUTLINE: This is a randomized, multicenter study.
- Chemoradiotherapy (courses 1-4): Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive pemetrexed disodium IV over 10 minutes followed by
carboplatin IV over 30 minutes on days 1, 22, 43, and 64. Patients also undergo
thoracic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, 36-40,
and 43-47.
- Arm II: Patients receive pemetrexed disodium, carboplatin, and thoracic
radiotherapy as in arm I. Patients also receive cetuximab IV over 2 hours on day 1
and then IV over 1 hour on days 8, 15, 22, 29, 36, and 43.
- Consolidation chemotherapy (courses 5-8): Beginning 3-5 weeks after completion of
chemoradiotherapy, all patients receive consolidation chemotherapy comprising
pemetrexed disodium alone IV over 10 minutes on day 1. Treatment repeats every 21 days
for 4 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed periodically for up to 3 years.
PROJECTED ACCRUAL: A total of 100 patients (50 per treatment arm) will be accrued for this
study within 10-13 months.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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