Lung Cancer Clinical Trial
Official title:
A Phase I Study of Gemcitabine, Carboplatin or Gemcitabine, Paclitaxel and Radiation Therapy Followed by Adjuvant Chemotherapy for Patients With Favorable Prognosis Inoperable Stage IIIA/B Non-Small Cell Lung Cancer (NSCLC)
RATIONALE: Drugs used in chemotherapy, such as gemcitabine, carboplatin, and paclitaxel,
work in different ways to stop tumor cells from dividing so they stop growing or die.
Radiation therapy uses high-energy x-rays to damage tumor cells. Combining radiation therapy
with chemotherapy may kill more tumor cells.
PURPOSE: Phase I trial to study the effectiveness of combining combination chemotherapy with
radiation therapy in treating patients who have stage IIIA or stage IIIB non-small cell lung
cancer.
OBJECTIVES:
- Determine the maximum tolerated dose (MTD) of gemcitabine when administered with
carboplatin and thoracic radiotherapy followed by adjuvant gemcitabine and carboplatin
in patients with stage IIIA or IIIB non-small cell lung cancer.
- Determine the MTD of gemcitabine and paclitaxel when administered with thoracic
radiotherapy followed by adjuvant gemcitabine and carboplatin in these patients.
OUTLINE: This is a multicenter, dose-escalation study of gemcitabine and paclitaxel.
Patients are sequentially assigned to 1 of 3 treatment regimens.
- Regimen A: Patients receive gemcitabine IV over 30-60 minutes on days 1, 8, 22, 29, and
43 and thoracic radiotherapy daily 5 days a week for 7 weeks beginning on day 1.
- Regimen B (closed to accrual as of 5/13/03): Patients receive gemcitabine and thoracic
radiotherapy as in regimen A and carboplatin IV over 30 minutes on days 1, 8, 22, 29,
and 43.
- Regimen C: Patients receive gemcitabine and thoracic radiotherapy as in regimen A and
paclitaxel IV over 1 hour on days 1, 8, 22, 29, and 43.
At 3 weeks after completion of chemoradiotherapy, all patients receive adjuvant gemcitabine
IV over 30-60 minutes on days 71, 78, 92, and 99 and carboplatin IV over 30 minutes on days
71 and 92.
The first 6 patients enrolled receive regimen A to determine the safety of the initial dose
of gemcitabine. After completion of regimen A, cohorts of 3-6 patients receive escalating
doses of gemcitabine in regimen B (closed to accrual as of 5/13/03) until the maximum
tolerated dose (MTD) is determined. In a separate sequence, cohorts of 3-6 patients receive
alternating escalating doses of gemcitabine and paclitaxel in regimen C until the MTD is
determined. The MTD is defined as the dose preceding that at which at least 3 of 6 patients
experience dose-limiting toxicity.
Patients are followed at 3 months, 6 months, every 3 months for 1 year, every 6 months for 2
years, and then annually thereafter.
PROJECTED ACCRUAL: A maximum of 78 patients will be accrued for this study within 29 months.
;
Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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