Stage III Lung Cancer AJCC v8 Clinical Trial
Official title:
Phase III Prospective Randomized Trial of Primary Lung Tumor Stereotactic Body Radiation Therapy Followed by Concurrent Mediastinal Chemoradiation for Locally Advanced Non-Small Cell Lung Cancer
Verified date | February 2024 |
Source | NRG Oncology |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This phase III trial compares the effect of adding stereotactic body radiation therapy (SBRT) to standard treatment (image guided radiation therapy [IGRT] and chemotherapy followed by immunotherapy with durvalumab) versus standard treatment alone in treating patients with non-small cell lung cancer that cannot be treated by surgery (inoperable). SBRT uses special equipment to position a patient and deliver radiation to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. IGRT is a type of radiation that uses a computer to create picture of the tumor, to help guide the radiation beam during therapy, making it more accurate and causing less damage to healthy tissue. Standard chemotherapy used in this trial consists of combinations of the following drugs: cisplatin, carboplatin, paclitaxel, pemetrexed, and etoposide. Cisplatin is in a class of medications known as platinum-containing compounds. It works by killing, stopping or slowing the growth of tumor cells. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of tumor cells. Paclitaxel is in a class of medications called antimicrotubule agents. It works by stopping the growth and spread of tumor cells. Pemetrexed is in a class of medications called antifolate antineoplastic agents. It works by blocking the action of a certain substance in the body that may help tumor cells multiply. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and DNA repair and may kill tumor cells. Immunotherapy with durvalumab, may induce changes in body's immune system and may interfere with the ability of tumor cells to grow and spread. Adding SBRT to the standard treatment of IGRT with chemotherapy and immunotherapy may be more effective at treating patients with inoperable non-small cell lung cancer than giving the standard treatment alone.
Status | Recruiting |
Enrollment | 474 |
Est. completion date | October 15, 2036 |
Est. primary completion date | October 15, 2031 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Pathologically (histologically or cytologically) proven diagnosis of stage II or III (American Joint Committee on Cancer [AJCC] eighth edition) non-small cell lung cancer (NSCLC) with known PD-L1 status prior to registration - Patients must have an identified primary tumor and at least one nodal metastasis (peribronchial/hilar/intrapulmonary, mediastinal/subcarinal, supraclavicular/scalene) - Up to 4 cycles of systemic therapy received prior to registration for the current study cancer is allowable; any prior chemotherapy for a different cancer is also permissible - The patient must be deemed clinically appropriate for curative intent definitive combined modality therapy, based on the following staging assessments: - History/physical examination prior to registration; - Magnetic resonance imaging (MRI) scan of the brain (preferred) or CT scan of the brain (if available, contrast is preferred for all neuroimaging) prior to registration; - CT chest with IV contrast (if contrast is available and unless contraindicated, such as for abnormal kidney function) prior to registration. PET/CT may be used if the CT portion is of identical diagnostic quality as achieved in a stand-alone CT - No evidence of distant metastases based on FDG PET/CT scan obtain within 60 days of registration - Primary tumor =< 7 cm - Age >= 18 - Eastern Cooperative Oncology Group (ECOG) performance status 0-2 - Hematologic function (e.g. platelets, leukocytes, hemoglobin) amenable, at the discretion of the treating physician, to allow for treatment with chemotherapy and concurrent radiation therapy - Creatinine clearance >= 25 mL/min by the Cockcroft-Gault (C-G) equation - Subjects with non-malignant pleural effusion are eligible provided the effusion is not known or demonstrated to be an exudative effusion - If a pleural effusion is present, the following criteria must be met to exclude malignant involvement: - When pleural fluid is visible on both the CT scan and on a chest x-ray, a pleuracentesis is required to confirm that the pleural fluid is cytologically negative; - Effusions that are minimal (i.e., not visible on chest x-ray) that are too small to safely tap are eligible - Medical history consistent with the patient being amenable, at the discretion of the treating physician, to allow for treating with consolidation immunotherapy. Patients with known EGFR/ALK mutation at the time of registration are eligible, and these patients can be treated with consolidation durvalumab or chemotherapy at the discretion of the treating physician - Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen - Negative pregnancy test =< 14 days prior to registration for participants of childbearing potential - The patient or a legally authorized representative must provide study-specific informed consent prior to study entry and, for patients treated in the United States (U.S.), authorization permitting release of personal health information Exclusion Criteria: - Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields that is determined by the treating physician to impede the treatment of the study malignancy - Patients without identifiable primary tumor and at least 1 pathologically enlarged lymph node are not eligible (T3-4N0 or T0N1-3 patients are not eligible). At least 1 radiographically-involved lymph node is required, but pathologic confirmation of involvement is not mandated - Centrally located primary tumor < 2 cm from involved nodal disease which would result in significant overlap of the primary SBRT and nodal radiation fields. Centrally located is defined as within or touching the zone of the proximal bronchial tree, which is a volume 2 cm in all directions around the proximal bronchial tree (carina, right and left main bronchi, right and left upper lobe bronchi, intermedius bronchus, right middle lobe bronchus, lingular bronchus right and left lower lobe bronchi) - Participants who are pregnant or unwilling to discontinue nursing - Participants of childbearing potential (participants who may become pregnant or who may impregnate a partner) unwilling to use highly effective contraceptives during therapy and for the Food and Drug Administration (FDA)-labeled contraception timeframe required after the final dose of the selected chemotherapy regimen, because the treatment in this study may be significantly teratogenic |
Country | Name | City | State |
---|---|---|---|
United States | Hawaii Cancer Care - Westridge | 'Aiea | Hawaii |
United States | Pali Momi Medical Center | 'Aiea | Hawaii |
United States | Cleveland Clinic Akron General | Akron | Ohio |
United States | Atrium Health Stanly/LCI-Albemarle | Albemarle | North Carolina |
United States | Mary Greeley Medical Center | Ames | Iowa |
United States | McFarland Clinic - Ames | Ames | Iowa |
United States | Mission Cancer and Blood - Ankeny | Ankeny | Iowa |
United States | Saint Joseph Mercy Hospital | Ann Arbor | Michigan |
United States | Anne Arundel Medical Center | Annapolis | Maryland |
United States | Langlade Hospital and Cancer Center | Antigo | Wisconsin |
United States | Emory Proton Therapy Center | Atlanta | Georgia |
United States | Emory Saint Joseph's Hospital | Atlanta | Georgia |
United States | Emory University Hospital Midtown | Atlanta | Georgia |
United States | Emory University Hospital/Winship Cancer Institute | Atlanta | Georgia |
United States | Grady Health System | Atlanta | Georgia |
United States | Rush - Copley Medical Center | Aurora | Illinois |
United States | UCHealth University of Colorado Hospital | Aurora | Colorado |
United States | AIS Cancer Center at San Joaquin Community Hospital | Bakersfield | California |
United States | Advocate Good Shepherd Hospital | Barrington | Illinois |
United States | Memorial Sloan Kettering Basking Ridge | Basking Ridge | New Jersey |
United States | Wilmot Cancer Center at Batavia | Batavia | New York |
United States | McLaren Cancer Institute-Bay City | Bay City | Michigan |
United States | Sanford Bismarck Medical Center | Bismarck | North Dakota |
United States | Illinois CancerCare-Bloomington | Bloomington | Illinois |
United States | Saint Joseph Medical Center | Bloomington | Illinois |
United States | Saint Joseph Mercy Brighton | Brighton | Michigan |
United States | Trinity Health IHA Medical Group Hematology Oncology - Brighton | Brighton | Michigan |
United States | Montefiore Medical Center - Moses Campus | Bronx | New York |
United States | Montefiore Medical Center-Einstein Campus | Bronx | New York |
United States | Montefiore Medical Center-Weiler Hospital | Bronx | New York |
United States | Mills-Peninsula Medical Center | Burlingame | California |
United States | Aurora Cancer Care-Southern Lakes VLCC | Burlington | Wisconsin |
United States | University of Vermont and State Agricultural College | Burlington | Vermont |
United States | University of Vermont Medical Center | Burlington | Vermont |
United States | Sands Cancer Center | Canandaigua | New York |
United States | Cleveland Clinic Mercy Hospital | Canton | Ohio |
United States | Illinois CancerCare-Canton | Canton | Illinois |
United States | Saint Francis Medical Center | Cape Girardeau | Missouri |
United States | Illinois CancerCare-Carthage | Carthage | Illinois |
United States | Miami Valley Hospital South | Centerville | Ohio |
United States | Centralia Oncology Clinic | Centralia | Illinois |
United States | Christiana Care Health System-Concord Health Center | Chadds Ford | Pennsylvania |
United States | Chambersburg Hospital | Chambersburg | Pennsylvania |
United States | Atrium Health Pineville/LCI-Pineville | Charlotte | North Carolina |
United States | Atrium Health University City/LCI-University | Charlotte | North Carolina |
United States | Carolinas Medical Center/Levine Cancer Institute | Charlotte | North Carolina |
United States | Novant Health Presbyterian Medical Center | Charlotte | North Carolina |
United States | Saint Joseph Mercy Chelsea | Chelsea | Michigan |
United States | Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital | Chelsea | Michigan |
United States | Advocate Illinois Masonic Medical Center | Chicago | Illinois |
United States | Northwestern University | Chicago | Illinois |
United States | McLaren Cancer Institute-Clarkston | Clarkston | Michigan |
United States | Morton Plant Hospital | Clearwater | Florida |
United States | Wake Forest University at Clemmons | Clemmons | North Carolina |
United States | Medical Oncology and Hematology Associates-West Des Moines | Clive | Iowa |
United States | Memorial Hospital North | Colorado Springs | Colorado |
United States | Rocky Mountain Cancer Centers-Penrose | Colorado Springs | Colorado |
United States | UCHealth Memorial Hospital Central | Colorado Springs | Colorado |
United States | Memorial Sloan Kettering Commack | Commack | New York |
United States | Atrium Health Cabarrus/LCI-Concord | Concord | North Carolina |
United States | MD Anderson in The Woodlands | Conroe | Texas |
United States | AMG Crystal Lake - Oncology | Crystal Lake | Illinois |
United States | Carle at The Riverfront | Danville | Illinois |
United States | Geisinger Medical Center | Danville | Pennsylvania |
United States | Dayton Blood and Cancer Center | Dayton | Ohio |
United States | Dayton Physician LLC-Miami Valley Hospital North | Dayton | Ohio |
United States | Miami Valley Hospital | Dayton | Ohio |
United States | Miami Valley Hospital North | Dayton | Ohio |
United States | Cancer Care Specialists of Illinois - Decatur | Decatur | Illinois |
United States | Decatur Memorial Hospital | Decatur | Illinois |
United States | Northwestern Medicine Cancer Center Kishwaukee | DeKalb | Illinois |
United States | UCHealth - Cherry Creek | Denver | Colorado |
United States | Iowa Methodist Medical Center | Des Moines | Iowa |
United States | Medical Oncology and Hematology Associates-Des Moines | Des Moines | Iowa |
United States | Mission Cancer and Blood - Laurel | Des Moines | Iowa |
United States | Wayne State University/Karmanos Cancer Institute | Detroit | Michigan |
United States | HSHS Sacred Heart Hospital | Eau Claire | Wisconsin |
United States | Carle Physician Group-Effingham | Effingham | Illinois |
United States | Crossroads Cancer Center | Effingham | Illinois |
United States | Advocate Sherman Hospital | Elgin | Illinois |
United States | Ephrata Cancer Center | Ephrata | Pennsylvania |
United States | Illinois CancerCare-Eureka | Eureka | Illinois |
United States | Sanford Broadway Medical Center | Fargo | North Dakota |
United States | Sanford Roger Maris Cancer Center | Fargo | North Dakota |
United States | Parkland Health Center - Farmington | Farmington | Missouri |
United States | Weisberg Cancer Treatment Center | Farmington Hills | Michigan |
United States | McLaren Cancer Institute-Flint | Flint | Michigan |
United States | Cancer Care and Hematology-Fort Collins | Fort Collins | Colorado |
United States | Poudre Valley Hospital | Fort Collins | Colorado |
United States | Atrium Medical Center-Middletown Regional Hospital | Franklin | Ohio |
United States | Illinois CancerCare-Galesburg | Galesburg | Illinois |
United States | CaroMont Regional Medical Center | Gastonia | North Carolina |
United States | Northwestern Medicine Cancer Center Delnor | Geneva | Illinois |
United States | Aurora Health Care Germantown Health Center | Germantown | Wisconsin |
United States | Adams Cancer Center | Gettysburg | Pennsylvania |
United States | Aurora Cancer Care-Grafton | Grafton | Wisconsin |
United States | Altru Cancer Center | Grand Forks | North Dakota |
United States | UCHealth Greeley Hospital | Greeley | Colorado |
United States | Aurora BayCare Medical Center | Green Bay | Wisconsin |
United States | Saint Vincent Hospital Cancer Center Green Bay | Green Bay | Wisconsin |
United States | Miami Valley Cancer Care and Infusion | Greenville | Ohio |
United States | Legacy Mount Hood Medical Center | Gresham | Oregon |
United States | Memorial Sloan Kettering Westchester | Harrison | New York |
United States | Advocate South Suburban Hospital | Hazel Crest | Illinois |
United States | UCHealth Highlands Ranch Hospital | Highlands Ranch | Colorado |
United States | Hawaii Cancer Care Inc - Waterfront Plaza | Honolulu | Hawaii |
United States | Kuakini Medical Center | Honolulu | Hawaii |
United States | Queen's Cancer Cenrer - POB I | Honolulu | Hawaii |
United States | Queen's Cancer Center - Kuakini | Honolulu | Hawaii |
United States | Queen's Medical Center | Honolulu | Hawaii |
United States | Straub Clinic and Hospital | Honolulu | Hawaii |
United States | The Cancer Center of Hawaii-Liliha | Honolulu | Hawaii |
United States | University of Hawaii Cancer Center | Honolulu | Hawaii |
United States | M D Anderson Cancer Center | Houston | Texas |
United States | MD Anderson West Houston | Houston | Texas |
United States | Novant Health Cancer Institute - Huntersville | Huntersville | North Carolina |
United States | Novant Health Presbyterian Medical Center Huntersville | Huntersville | North Carolina |
United States | UW Cancer Center Johnson Creek | Johnson Creek | Wisconsin |
United States | Aurora Cancer Care-Kenosha South | Kenosha | Wisconsin |
United States | Novant Health Cancer Institute - Kernersville | Kernersville | North Carolina |
United States | Illinois CancerCare-Kewanee Clinic | Kewanee | Illinois |
United States | Karmanos Cancer Institute at McLaren Greater Lansing | Lansing | Michigan |
United States | Sparrow Hospital | Lansing | Michigan |
United States | McLaren Cancer Institute-Lapeer Region | Lapeer | Michigan |
United States | MD Anderson League City | League City | Texas |
United States | Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center | Lebanon | New Hampshire |
United States | Sechler Family Cancer Center | Lebanon | Pennsylvania |
United States | Geisinger Medical Oncology-Lewisburg | Lewisburg | Pennsylvania |
United States | University of Kentucky/Markey Cancer Center | Lexington | Kentucky |
United States | AMG Libertyville - Oncology | Libertyville | Illinois |
United States | Condell Memorial Hospital | Libertyville | Illinois |
United States | Trinity Health Saint Mary Mercy Livonia Hospital | Livonia | Michigan |
United States | UCHealth Lone Tree Health Center | Lone Tree | Colorado |
United States | Los Angeles General Medical Center | Los Angeles | California |
United States | USC / Norris Comprehensive Cancer Center | Los Angeles | California |
United States | Medical Center of the Rockies | Loveland | Colorado |
United States | Illinois CancerCare-Macomb | Macomb | Illinois |
United States | University of Wisconsin Carbone Cancer Center | Madison | Wisconsin |
United States | Aurora Bay Area Medical Group-Marinette | Marinette | Wisconsin |
United States | Fremont - Rideout Cancer Center | Marysville | California |
United States | Levine Cancer Institute - Union West | Matthews | North Carolina |
United States | Matthews Radiation Oncology Center | Matthews | North Carolina |
United States | Novant Health Cancer Institute - Matthews | Matthews | North Carolina |
United States | Carle Physician Group-Mattoon/Charleston | Mattoon | Illinois |
United States | Froedtert Menomonee Falls Hospital | Menomonee Falls | Wisconsin |
United States | Memorial Sloan Kettering Monmouth | Middletown | New Jersey |
United States | Aurora Cancer Care-Milwaukee | Milwaukee | Wisconsin |
United States | Aurora Saint Luke's Medical Center | Milwaukee | Wisconsin |
United States | Aurora Sinai Medical Center | Milwaukee | Wisconsin |
United States | Medical College of Wisconsin | Milwaukee | Wisconsin |
United States | Zablocki Veterans Administration Medical Center | Milwaukee | Wisconsin |
United States | Atrium Health Union/LCI-Union | Monroe | North Carolina |
United States | Memorial Sloan Kettering Bergen | Montvale | New Jersey |
United States | Novant Health Cancer Institute - Mooresville | Mooresville | North Carolina |
United States | Novant Health Cancer Institute - Mount Airy | Mount Airy | North Carolina |
United States | McLaren Cancer Institute-Macomb | Mount Clemens | Michigan |
United States | ProHealth D N Greenwald Center | Mukwonago | Wisconsin |
United States | Memorial Sloan Kettering Cancer Center | New York | New York |
United States | New York Proton Center | New York | New York |
United States | Christiana Care Health System-Christiana Hospital | Newark | Delaware |
United States | Helen F Graham Cancer Center | Newark | Delaware |
United States | Medical Oncology Hematology Consultants PA | Newark | Delaware |
United States | Cancer Care Center of O'Fallon | O'Fallon | Illinois |
United States | Drexel Town Square Health Center | Oak Creek | Wisconsin |
United States | Advocate Christ Medical Center | Oak Lawn | Illinois |
United States | ProHealth Oconomowoc Memorial Hospital | Oconomowoc | Wisconsin |
United States | University of Oklahoma Health Sciences Center | Oklahoma City | Oklahoma |
United States | Vince Lombardi Cancer Clinic - Oshkosh | Oshkosh | Wisconsin |
United States | Illinois CancerCare-Ottawa Clinic | Ottawa | Illinois |
United States | Advocate Lutheran General Hospital | Park Ridge | Illinois |
United States | Illinois CancerCare-Pekin | Pekin | Illinois |
United States | Illinois CancerCare-Peoria | Peoria | Illinois |
United States | Methodist Medical Center of Illinois | Peoria | Illinois |
United States | Mercy Health Perrysburg Cancer Center | Perrysburg | Ohio |
United States | Illinois CancerCare-Peru | Peru | Illinois |
United States | McLaren Cancer Institute-Northern Michigan | Petoskey | Michigan |
United States | Thomas Jefferson University Hospital | Philadelphia | Pennsylvania |
United States | University of Pennsylvania/Abramson Cancer Center | Philadelphia | Pennsylvania |
United States | Cancer Center at Saint Joseph's | Phoenix | Arizona |
United States | 21st Century Oncology-Pontiac | Pontiac | Michigan |
United States | Saint Joseph Mercy Oakland | Pontiac | Michigan |
United States | McLaren-Port Huron | Port Huron | Michigan |
United States | Legacy Good Samaritan Hospital and Medical Center | Portland | Oregon |
United States | Illinois CancerCare-Princeton | Princeton | Illinois |
United States | Aurora Cancer Care-Racine | Racine | Wisconsin |
United States | Renown Regional Medical Center | Reno | Nevada |
United States | Ascension Saint Mary's Hospital | Rhinelander | Wisconsin |
United States | Highland Hospital | Rochester | New York |
United States | University of Rochester | Rochester | New York |
United States | Wilmot Cancer Institute Radiation Oncology at Greece | Rochester | New York |
United States | Levine Cancer Institute-Rock Hill | Rock Hill | South Carolina |
United States | Rock Hill Radiation Therapy Center | Rock Hill | South Carolina |
United States | Sutter Cancer Centers Radiation Oncology Services-Roseville | Roseville | California |
United States | Sutter Roseville Medical Center | Roseville | California |
United States | William Beaumont Hospital-Royal Oak | Royal Oak | Michigan |
United States | Sutter Medical Center Sacramento | Sacramento | California |
United States | Coborn Cancer Center at Saint Cloud Hospital | Saint Cloud | Minnesota |
United States | Norris Cotton Cancer Center-North | Saint Johnsbury | Vermont |
United States | Mercy Hospital Saint Louis | Saint Louis | Missouri |
United States | Mercy Hospital South | Saint Louis | Missouri |
United States | Missouri Baptist Medical Center | Saint Louis | Missouri |
United States | Sainte Genevieve County Memorial Hospital | Sainte Genevieve | Missouri |
United States | Novant Health Cancer Institute - Rowan | Salisbury | North Carolina |
United States | Rowan Regional Medical Center | Salisbury | North Carolina |
United States | California Pacific Medical Center-Pacific Campus | San Francisco | California |
United States | Mills Health Center | San Mateo | California |
United States | Saint Vincent Hospital Cancer Center at Sheboygan | Sheboygan | Wisconsin |
United States | Vince Lombardi Cancer Clinic-Sheboygan | Sheboygan | Wisconsin |
United States | Atrium Health Cleveland/LCI-Cleveland | Shelby | North Carolina |
United States | Sanford Cancer Center Oncology Clinic | Sioux Falls | South Dakota |
United States | Sanford USD Medical Center - Sioux Falls | Sioux Falls | South Dakota |
United States | Memorial Medical Center | Springfield | Illinois |
United States | Southern Illinois University School of Medicine | Springfield | Illinois |
United States | Springfield Clinic | Springfield | Illinois |
United States | Novant Health Cancer Institute - Statesville | Statesville | North Carolina |
United States | Wake Forest Baptist Health - Hematology Oncology - Statesville | Statesville | North Carolina |
United States | Ascension Saint Michael's Hospital | Stevens Point | Wisconsin |
United States | Saint Vincent Hospital Cancer Center at Sturgeon Bay | Sturgeon Bay | Wisconsin |
United States | MD Anderson in Sugar Land | Sugar Land | Texas |
United States | Missouri Baptist Sullivan Hospital | Sullivan | Missouri |
United States | Aurora Medical Center in Summit | Summit | Wisconsin |
United States | BJC Outpatient Center at Sunset Hills | Sunset Hills | Missouri |
United States | Novant Cancer Institute Radiation Oncology - Supply | Supply | North Carolina |
United States | Novant Health Cancer Institute - Thomasville | Thomasville | North Carolina |
United States | Munson Medical Center | Traverse City | Michigan |
United States | Upper Valley Medical Center | Troy | Ohio |
United States | William Beaumont Hospital - Troy | Troy | Michigan |
United States | Legacy Meridian Park Hospital | Tualatin | Oregon |
United States | Banner University Medical Center - Tucson | Tucson | Arizona |
United States | University of Arizona Cancer Center-North Campus | Tucson | Arizona |
United States | Memorial Sloan Kettering Nassau | Uniondale | New York |
United States | Carle Cancer Center | Urbana | Illinois |
United States | Westchester Medical Center | Valhalla | New York |
United States | Legacy Cancer Institute Medical Oncology and Day Treatment | Vancouver | Washington |
United States | Legacy Salmon Creek Hospital | Vancouver | Washington |
United States | Northwestern Medicine Cancer Center Warrenville | Warrenville | Illinois |
United States | Illinois CancerCare - Washington | Washington | Illinois |
United States | UW Cancer Center at ProHealth Care | Waukesha | Wisconsin |
United States | Aspirus Regional Cancer Center | Wausau | Wisconsin |
United States | Aurora Cancer Care-Milwaukee West | Wauwatosa | Wisconsin |
United States | Wilmot Cancer Institute at Webster | Webster | New York |
United States | Aurora West Allis Medical Center | West Allis | Wisconsin |
United States | Froedtert West Bend Hospital/Kraemer Cancer Center | West Bend | Wisconsin |
United States | Reading Hospital | West Reading | Pennsylvania |
United States | Ascension Via Christi Hospitals Wichita | Wichita | Kansas |
United States | Geisinger Wyoming Valley/Henry Cancer Center | Wilkes-Barre | Pennsylvania |
United States | Novant Health Cancer Institute - Wilkesboro | Wilkesboro | North Carolina |
United States | Wake Forest Baptist Health - Wilkes Medical Center | Wilkesboro | North Carolina |
United States | Asplundh Cancer Pavilion | Willow Grove | Pennsylvania |
United States | Novant Health Cancer Institute Radiation Oncology - Wilmington | Wilmington | North Carolina |
United States | Novant Health New Hanover Regional Medical Center | Wilmington | North Carolina |
United States | Novant Health Forsyth Medical Center | Winston-Salem | North Carolina |
United States | Wake Forest University Health Sciences | Winston-Salem | North Carolina |
United States | Aspirus Cancer Care - Wisconsin Rapids | Wisconsin Rapids | Wisconsin |
United States | WellSpan Health-York Cancer Center | York | Pennsylvania |
United States | WellSpan Health-York Hospital | York | Pennsylvania |
United States | Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus | Ypsilanti | Michigan |
Lead Sponsor | Collaborator |
---|---|
NRG Oncology | National Cancer Institute (NCI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Functional mean lung dose | Collection of 4 dimensional (4D) CT planning CTs and calculation of radiation dose to regional lung ventilation will be performed among randomized patients with 4D CT planning CTs. To evaluate functional dose metrics, ventilation maps will be registered to the average 4DCT reference frame. Functional dose metrics and standard dose metrics will be calculated and evaluated. Functional mean lung dose will be defined as the mean dose delivered to functional lung. Dose to total lung and dose to functional lung will then be correlated with pulmonary toxicity including grade 2 or higher radiation pneumonitis or any grade 3 or higher cough, dyspnea, hypoxia or respiratory failure. Logistic regression models will be used to explore the correlation between pulmonary toxicity and functional mean lung dose. | Up to 8 years | |
Other | Incidence of toxicities | Descriptive analyses will be reported, based on corresponding analysis plans within patients who actually receive proton and photon radiotherapy (e.g., per-protocol population), respectively. | Up to 8 years | |
Primary | Overall Survival (OS) | Non-inferiority (NI) between arm 2 and arm 1 (reference level) will be evaluated by comparing the upper bound of the 95% confidence interval for the hazard ratio to the pre-specified NI margin. NI of arm 2 will be concluded if the upper bound of the confidence interval is equal to, or falls below, the pre-specified margin at the final analysis. When evaluating the NI of arm 2 in OS, a Cox proportional hazards (PH) model stratified by stratification factors will be used to compute the hazard ratio and associated 95% confidence interval (CI). OS rates will be estimated using the Kaplan-Meier method. If the NI of arm 2 in OS is demonstrated, the superiority of arm 1 in OS will be tested at 1-sided significance level of 0.025 using a stratified log-rank test by adjusting for stratification factors. | Between date of randomization and date of death due to any cause, assessed up to 8 years | |
Primary | Progression-Free Survival (PFS) | The PFS analysis will be conducted using the same methods and stratification factors as the OS analysis. The superiority of arm 2 in PFS will be tested at 1-sided significance level of 0.025 using a stratified log-rank test by adjusting for stratification factors. In the event that the NI of OS is not established, statistical inference of PFS will be considered exploratory in nature only. A Cox PH model stratified by stratification factors will be used to compute the hazard ratio and associated 95% CI. | Between date of randomization and first date of documented progression or death due to any cause, assessed up to 8 years | |
Secondary | Objective Response Rate (ORR) | ORR (per Response Evaluation Criteria in Solid Tumors [RECIST] 1.1) is defined as the number (%) of patients with at least 1 visit response of complete response (CR) or partial response (PR) and will be based on all randomized patients who have measurable disease. Therefore, data obtained up until progression, or the last evaluable assessment in the absence of progression, will be included in the assessment of ORR. The ORR will be compared between arm 2 versus arm 1 using a Fisher's exact test. A binary response variable for ORR will be used for the analysis with the categories of CR and PR versus stable disease (SD), progressive disease (PD) and inevaluable (NE). | Up to 8 years | |
Secondary | Time to progression | Local control will be defined as freedom from local progression, in which a failure is defined as intrathoracic tumor progression (failure in the lobe of the primary tumor or mediastinal lymph nodes) by RECIST 1.1 criteria. Local control will be analyzed as competing risks data based on cause-specific hazards approaches, where deaths without local failure will be considered as a competing event and analyzed as "censoring" of local failure. The rates at various timepoints (e.g., every 6 months after randomization) and medians of PFS for each arm will be estimated using the Kaplan-Meier method. The associated 95% CI will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function. Results from an unstratified analysis will also be provided. | Up to 8 years | |
Secondary | Time to primary, locoregional, or distant failure | Competing risks analysis will be used to analyze times to primary failure, locoregional failure and distant failure as the first failure. Competing events include primary failure, locoregional failure, distant failure and deaths without any failures. Rates at various timepoints (i.e., every 6 months after randomization) for each arm will be estimated using the cumulative incidence function. The associated 95% CI will be calculated using the Delta method and based on a log-log transformation applied on the estimated cumulative incidence functions. Statistical inferences of the development of each failure between arms will be based on cause-specific hazards using the log-rank test and Cox proportional hazard model. In addition, Gray's test and the Fine-Gray model will also be used to provide statistical inferences between arms based on cumulative incidence functions and subdistribution hazards. | Up to 8 years | |
Secondary | Changes in pulmonary function | Includes forced expiratory volume in 1 second (FEV1) and diffusion capacity of the lung for carbon monoxide (DLCO). Changes in pulmonary function (FEV1 and DLCO) will be summarized with descriptive statistics, and compared with Wilcoxon rank-sum test. The descriptive statistics of changes in FEV1 and diffusion capacity before and after treatment will be reported by treatment arm and by response categories (complete response; partial response; stable disease; progressive disease). Linear regression will be used to model changes with adjustment for treatment arms and possibly other baseline covariates, if applicable. The grade 3-5 NRG Oncology Pulmonary Toxicity Scale for changes will be reported with the frequency and grade by arm. Logistic regression will be used to model the distribution of the NRG Oncology Pulmonary Toxicity Scale by arms with and without adjustment for covariates. | From randomization to 6 months or 12 months | |
Secondary | Patient Reported Outcomes | Functional Assessment of Cancer Therapy Lung Questionnaire trial outcome index deterioration rates at 3 months and associated 95% confidence interval will be calculated for each treatment group, based on all randomized subjects. Clopper-Pearson method will be used for calculating 95% CI. The deterioration rates of each arm will also be compared using Cochran-Mantel-Haenszel Test, stratified by PD-L1 expression and T-stage. | At 3, 12, and 24 months | |
Secondary | Incidence of adverse events | For each patient, the maximum severity reported will be used in the summaries. Adverse events will be summarized regardless of relationship to protocol treatment as assessed by the investigator. Treatment-related adverse events using National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) will be presented in statistical analysis reports/publications in CTCAE version 5. Adverse event rates will be reported with the frequency and severity (e.g., type, grade, and attribution) by arm. | Up to 8 years |
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Single Fraction Stereotactic Body Radiation Therapy After Surgery in Treating Patients With Non-small Cell Lung Cancer
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Phase 1 | |
Withdrawn |
NCT04186988 -
[18F]-AraG for the Detection of T-Cell Activation in Advanced Non-small Cell Lung Cancer Patients Undergoing PD-1/PD-L1-Directed Therapy
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Early Phase 1 | |
Active, not recruiting |
NCT03637816 -
Anamorelin Hydrochloride in Reducing Anorexia in Patients With Advanced Non-small Cell Lung Cancer
|
Phase 2/Phase 3 | |
Active, not recruiting |
NCT04514484 -
Testing the Combination of the Anti-cancer Drugs XL184 (Cabozantinib) and Nivolumab in Patients With Advanced Cancer and HIV
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Phase 1 | |
Recruiting |
NCT06122064 -
A Tool for Improving the Shared Decision-making Process in Patients With Non-small Cell Lung Cancer
|
N/A | |
Active, not recruiting |
NCT03776253 -
Conquer Fear SUPPORT Intervention in Supporting Patients With Stage III-IV Lung or Gynecologic Cancer
|
N/A | |
Active, not recruiting |
NCT03731585 -
Online Psychosocial Intervention in Improving Social Well-Being and Support in Women With Stage I-IV Non-small Cell Lung Cancer Undergoing Treatment
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N/A | |
Recruiting |
NCT04314401 -
National Cancer Institute "Cancer Moonshot Biobank"
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Terminated |
NCT04862195 -
Registrational Trial to Compare Effectiveness of Two Digital Software Medical Devices as Adjunctive Oncology Treatment
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N/A | |
Active, not recruiting |
NCT03939481 -
Treatment Effects on Development of Chemotherapy-Induced Peripheral Neuropathy in Patients With Cancer
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Active, not recruiting |
NCT04227028 -
Brigatinib and Bevacizumab for the Treatment of ALK-Rearranged Locally Advanced, Metastatic, or Recurrent NSCLC
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Phase 1 | |
Recruiting |
NCT05733000 -
CPI-613 (Devimistat) in Combination With Hydroxychloroquine and 5-fluorouracil or Gemcitabine in Treating Patients With Advanced Chemorefractory Solid Tumors
|
Phase 2 | |
Active, not recruiting |
NCT04819997 -
A Nurse-Led Intervention for Fear of Progression in Advanced Cancer
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N/A | |
Completed |
NCT03902535 -
Geriatric and Quality of Life Assessments in Older Patients With Non-metastatic or Metastatic Head and Neck or Lung Cancer Undergoing Surgery or Chemoradiation and Their Caregivers
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