Stage IV Non-small Cell Lung Cancer Clinical Trial
Official title:
A Phase II Study of Prophylactic Radiation Therapy for the Prevention of Hemoptysis in Advanced Non Small Cell Lung Cancer in Combination With Bevacizumab, Paclitaxel, and Carboplatin in Patients at High Risk for Bevacizumab-Associated Hemoptysis
This phase II trial is studying the side effects and how well giving radiation therapy together with bevacizumab, paclitaxel, and carboplatin works in treating patients with unresectable stage IIIB or stage IV non-small cell lung cancer at high risk for hemoptysis caused by bevacizumab. Radiation therapy uses high-energy x-rays to kill tumor cells. It may also prevent hemoptysis caused by bevacizumab. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of non-small cell lung cancer by blocking blood flow to the tumor. Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving radiation therapy together with bevacizumab and chemotherapy may kill more tumor cells
PRIMARY OBJECTIVES:
I. Evaluate the safety of prophylactic chest radiotherapy, bevacizumab, paclitaxel, and
carboplatin in patients with unresectable stage IIIB or IV non-small cell lung cancer at
high risk for bevacizumab-associated hemoptysis.
SECONDARY OBJECTIVES:
I. Assess progression-free survival of patients treated with this regimen. II. Assess the
rate of objective response, overall survival, time to response, and response duration in
irradiated lesions and non-irradiated lesions in these patients.
OUTLINE: This is an open-label, pilot, multicenter study. Patients are assigned sequentially
to 1 of 2 treatment strata.
Stratum I: Patients undergo prophylactic radiotherapy on days 1-5 and 8-12. Patients receive
paclitaxel IV over 3 hours and carboplatin IV over 30-60 minutes on day 15. Patients also
receive paclitaxel IV over 3 hours or carboplatin IV over 30-60 minutes and bevacizumab IV
over 30-90 minutes on day 36 (course 2).
Stratum II: Patients undergo prophylactic radiotherapy and receive paclitaxel and
carboplatin as in stratum I. Patients also receive bevacizumab IV over 30-90 minutes on day
15 (course 1). In both strata, treatment with paclitaxel, carboplatin, and bevacizumab
repeats every 21 days for 5-6 courses in the absence of disease progression or unacceptable
toxicity. Patients with complete or partial response or stable disease may continue to
receive single-agent bevacizumab every 21 days in the absence of disease progression or
unacceptable toxicity.
After completion of study treatment, patients are followed periodically for 12 months.
PROJECTED ACCRUAL: A total of 72 patients will be accrued for this study.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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