Lung Cancer Clinical Trial
Official title:
Parallel Phase II Trials of ZD1839 (Iressa) Alone or Weekly Carboplatin and Paclitaxel Followed by ZD1839 (Iressa) (Oncologists Must Choose) for Metastatic Non-Small Cell Lung Cancer in Patients > or = 65 Years of Age
RATIONALE: Biological therapies such as gefitinib may interfere with the growth of cancer
cells and slow the growth of the tumor. Drugs used in chemotherapy such as carboplatin and
paclitaxel use different ways to stop tumor cells from dividing so they stop growing or die.
Combining gefitinib with carboplatin and paclitaxel may kill more tumor cells.
PURPOSE: This phase II trial is studying how well giving gefitinib alone or together with
carboplatin and paclitaxel works in treating older patients with unresectable or metastatic
non-small cell lung cancer.
OBJECTIVES:
Primary
- Determine the 6-month progression status of older patients with unresectable or
metastatic non-small cell lung cancer treated with gefitinib alone or with carboplatin
and paclitaxel.
Secondary
- Determine the response rate in patients treated with these regimens.
- Determine the quality of life of patients treated with these regimens.
- Determine whether serum-secreted or soluble epidermal growth factor receptor (EGFR)
concentrations predict response in patients treated with these regimens.
- Correlate the presence of social support for these patients with toxicity and efficacy
of these regimens.
- Determine whether social support for these patients differs according to gender.
- Determine the reasons an oncologist would choose a chemotherapy vs a nonchemotherapy
regimen for these patients.
Tertiary
- Correlate EGFR signaling pathway markers, RNA expression profile, gene polymorphisms of
prespecified germline and tumor genes, and plasma and urine proteomic patterns with
response rate and time to progression of patients receiving treatment in group I.
OUTLINE: This is a nonrandomized, multicenter study. Patients are assigned to 1 of 2
treatment groups as determined by their treating physician.
- Group I: Patients receive oral gefitinib on days 1-28. Courses repeat every 28 days in
the absence of disease progression or unacceptable toxicity.
- Group II: Patients receive paclitaxel IV over 1 hour and carboplatin IV over 30 minutes
on days 1, 8, and 15. Treatment repeats every 28 days for up to 4 courses in the
absence of disease progression or unacceptable toxicity. After completion of
chemotherapy and in the absence of disease progression, patients receive oral gefitinib
as in group I.
Quality of life is assessed at baseline and after the completion of course 2.
Patients are followed every 3 months for 5 years.
PROJECTED ACCRUAL: A total of 107 patients (51 for group I and 56 for group II) will be
accrued for this study within 1.7 years.
;
Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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