Locally Advanced NSCLC Hyperfractionated RT
This is a prospective phase II study designed to evaluate an accelerated and adaptive RT approach for locally-advanced non-small cell lung cancer (NSCLC). All eligible subjects will have an interim PET-CT during radiation therapy to determine the metabolic complete response rate. Radiation therapy will be given in an accelerated fashion (2 Gy/fraction, 6 fractions/week) with concurrent chemotherapy. Interim responses will be assessed using PERCIST criteria. Despite concurrent chemotherapy and radiation therapy, local/regional failure occurs in \~50% of patients with locally-advanced NSCLC. Clinical studies have demonstrated that accelerated fractionation (giving the same total dose in a shorter period of time) improves outcomes in several malignancies, including lung cancer. Administering higher than conventional doses of RT to all sites of original disease leads to inferior outcomes. Adapting the RT approach, giving a higher dose to slowly responding disease as assessed with interim PET has been shown to be feasible. PERCIST (Positron Emission Tomography Response Criteria in Solid Tumors) provides guidelines on how to report responses to therapy based on PET-CT. PET-CT response has been shown to be prognostic in a variety of clinical scenarios in lung cancer including after induction therapy. In one study, PET was performed after neoadjuvant chemoradiotherapy (40-50.4 Gy). Complete or partial metabolic response using PERCIST criteria was predictive of loco-regional, distant, and overall progression-free survival.
Checked against the public recordLast updated May 28, 2021 · Source: ClinicalTrials.gov
What this study is about
- Purpose
- Treatment
- Study type
- Interventional
- Phase
- Phase 2
- Sponsor
- Duke University
- Interventions being studied
- Drug: Carboplatin; Drug: Paclitaxel; Radiation: Daily hyperfractionated radiation therapy
How this study is categorized
These labels come from structured fields and exact terms in the public record.
Who may be able to participate
Inclusion Criteria: 1. Histologic/cytologic documentation of non-small cell lung cancer (NSCLC) 2. Unresectable stage II, IIIA, or IIIB disease 3. Zubrod/ECOG performance status 0-1 4. Weight loss \< 10% in preceding 3 months prior to diagnosis 5. Adequate organ function defined as the following 6. Absolute neutrophil count of ≥ 1,500 and platelet count ≥ 100,000 7. Cockcroft calculated creatinine clearance of ≥ 45 ml/min or 1.5 x the upper limit of normal (ULN) 8. A total bilirubin ≤ 1.5 ULN, aspartate aminotransferase (AST) ≤ 2.0 x ULN 9. ≥ 18 years of age. 10. Negative pregnancy test in women of child-bearing potential 11. Signed study-specific informed consent. 12. No prior chemotherapy or radiotherapy for NSCLC 13. No prior mediastinal or thoracic radiation Exclusion Criteria: 1. Prior thoracic irradiation. 2. Medical contraindications to thoracic irradiation. 3. Pre-existing sensory neuropathy of grade ≥ 2 4. Pleural effusion: when pleural fluid is visible on both CT scan and on a chest x-ray, a pleuracentesis is required to confirm that the pleural fluid is cytologically negative. Patients with effusions that are minimal (i.e. not visible on chest x-ray) or that are too small to safely tap are eligible 5. Patients with contralateral hilar involvement
Important: This is the sponsor’s public criteria, not a determination of eligibility. The study team must review your individual situation.
U.S. locations
- Duke University Medical CenterDurham, North Carolina
Source and freshness
Processed from ClinicalTrials.gov. Last public update: May 28, 2021. Always confirm current availability with the study team.