Comparison of Postoperative Adjuvant Chemotherapy With/Without Rh-endostatin on Non-small Cell Lung Cancer in PhaseⅠB

Non-small Cell Lung Cancer Clinical Trial

Official title: Comparison of Postoperative Adjuvant Chemotherapy With/Without Rh-endostatin: a Randomized, PhaseⅢ and Open Clinical Study of Non-small Cell Lung Cancer in PhaseⅠB

Status Active, not recruiting

Clinical Trial Summary

• Lung cancer is one of causes of the malignant tumor-associated death on a global scale, in which the surgery is the only effective approach in patients with non-small cell lung cancer (NSCLC). As present, the total postoperative 5-year survival rate of NSCLC is 40%, while only 4%～15% patients can benefit from adjuvant chemotherapy[1]. American National Comprehensive Cancer Network (NCCN) manual recommends that adjuvant chemotherapy can be performed on NSCLC patients in phase Ⅱ～ⅢA.

• In order to assure the necessity of adjuvant chemotherapy on NSCLC patients in phase ⅠB or which kind of patients would benefit from it after the establishment of new staging, a multi-subject group of lung cancer set up a perspective, randomized, open clinical trial to explore whether adjuvant chemotherapy was effective on NSCLC patients in phase ⅠB under new staging policy, and to collect the characteristics of patients who could benefit from the treatment and the better adjuvant drugs after operation.

Clinical Trial Description

• In postoperative adjuvant chemotherapy, navelbine plus platinum (NP), the most commonly used therapeutic protocol, had more advantages than other 3 generations of new drugs plus platinum. With the continuous implementation of individual therapies for lung cancer, some new drugs became selective to pathological patterns and gene types, and it was unclear whether these drugs would be more effective than conventional drugs in postoperative adjuvant chemotherapy. The first- and second-generation of drugs were not observed with survival advantages except the third generation, so what conclusion would be made in selecting individual chemotherapeutic drugs according to pathological patterns? In this study, Pemetrexed plus Platinum were adopted in postoperative adjuvant chemotherapy on patients with adeno-carcinoma, while Docetaxel plus Platinum were performed on those with non-adeno-carcinoma.

• Apart from individual chemotherapy on the basis of different pathological patterns, anti-angiogenesis therapy has been quickly developed in recent years, becoming the most effective approach to improve chemotherapeutic efficacy. The main mechanism of anti-angiogenesis drugs includes inhabiting tumor angiogenesis to postpone or inhabit the recurrence of residual tumor through reconstructing the balance of anti-angiogenesis and preventing the growth of micro-metastasis to keep it in resting stage. The effect of adjuvant chemotherapy can be promoted by increasing the drug sensitivity, and survival time can be prolonged though further delaying the time and decreasing the rate of postoperative recurrence and metastasis of tumor by anti-angiogenesis therapy combined with adjuvant chemotherapy. As more attentions are increasingly given to anti-angiogenesis drugs in postoperative adjuvant chemotherapy at present, Endostar, an anti-angiogenesis drug studied independently in China, had favorable effect in treating advanced lung cancer when combined with chemotherapy. Therefore, this study protocol to gather the effect of Endostar on improving the survival of early lung cancer patients by observing its effect on partial NSCLC patients in treatment group when combined with other therapies.

• A total of 392 NSCLC patients in phase ⅠB were selected in this perspective, randomized, open and control clinical trial, in which 262 and 130 patients served as research and control groups respectively by 2:1. Patients 4-8 weeks after operation were divided according to different high risk factors. A total of 4-week different chemotherapies (21 d as a course) were given to patients with different pathological patterns in research group, in which adeno-carcinoma group and non-adeno-carcinoma group were treated by Pemetrexed plus Cis-platinum and Docetaxel plus Cis-platinum, respectively. Then, above two groups were randomly divided into two subgroups respectively by 1:1, with subgroup 1 being treated with original chemotherapies while subgroup 2 being added with rh-Endostatin therapy.

• High risk factors included poor differentiation (including neuro-endocrine carcinoma), blood vessel invasion, wedge incision, tumor diameter ＞4 cm, visceral pleura involvement, ambiguous N staging and incisal edge ＜1 cm. ;

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung
• Lung Neoplasms
• Non-small Cell Lung Cancer

• NCT number: NCT02001168
• Study type: Interventional
• Source: Xinjiang Medical University
• Status: Active, not recruiting
• Phase: Phase 3
• Start date: October 2013
• Completion date: October 2022