Small Cell Lung Cancer Clinical Trial
Official title:
Randomized Study Comparing Two Strategies Carboplatin and Etoposide Topotecan in Patients With SCLC on the Second Row With Relapsed at Least Three Months After Initial Response to Chemotherapy With Platinum-etoposide 6 Cycles
The purpose of this study was to determine prospectively in all patients with SCLC in second line therapy that progression-free survival with the expected reintroduction of platinum / etoposide is greater progression-free survival in the standard arm (topotecan ) in patients who have relapsed at least three months after initial chemotherapy with platinum-etoposide
Topotecan is currently the only drug approved in Europe and the United States for the
treatment of second line of SCLC when the recovery first line of treatment is considered
inappropriate. This raises the problem of knowing when the recovery first line of treatment
should be considered appropriate. Secondly, the effectiveness of response to chemotherapy
can be predicted based on the response to initial chemotherapy and the time interval after
stopping first line treatment. A complete response after initial treatment and a long
disease-free interval are predictors of better response to a second-line treatment. There
are two groups: the said patients 'sensitive', which correspond to the first-line
chemotherapy and who have relapsed at least 90 days after the first-line treatment and a
group of so-called patients "Refractory" refers patients who progress in 90 days or patients
who have not responded or progressed during first-line treatment. Median survival is very
different depending on whether patients with so-called "sensitive" or "refractory".
When relapse occurs six months after the end of the first line chemotherapy, the usual
practice is to reintroduce the first-line treatment. This is based on old studies where the
number of patients included was low. If the interval of time after the first line of
treatment is ≥ three months, two second-line treatment strategies are possible resumption of
initial chemotherapy or topotecan. The combination of cisplatin with etoposide have shown
high response rate, whatever the time of relapse. There are, however, no randomized study in
the literature comparing topotecan to the reintroduction of a platinum salt associated
etoposide.
This study is Randomized, multicenter, controlled, open-label, second line, 2 arms.
Arm A : Carboplatin Auc 5 J1 Etoposide 100 mg / m² / J J1 to J3 IV Arm B : topotecan 2.3 mg
/ m²J1 to J5 po
1 line by Etoposide Cisplatin or carboplatin etoposide Time interval between the first-line
chemotherapy and relapse ≥ 90 days (the date is set at J1 of the last cycle) J-28: TDM
thoracoabdominal, brain CT or MRI brain, J 7: Biology, quality of life questionnaire (Lung
Cancer Symptom Scale). Assessment of tumor response every 6 weeks during chemotherapy
post-chemotherapy followed 2nd line: TDM every 8 weeks until progression or death.
The duration of the participation of each patient included in the trial will be from
inclusion through 12 months.
The planned total duration of the trial will be 5 years including 4 years of patient
inclusion
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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