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Phase III Randomized Study of Marimastat in Patients with Small Cell Lung Cancer Following a Response to First Line Chemotherapy
Alternate Title Marimastat Following Chemotherapy in Treating Patients With Small Cell Lung Cancer
Objectives I. Determine whether treatment with the oral matrix metalloproteinase inhibitor (MMPI) marimastat prolongs overall survival and time to progression in patients with small cell lung cancer who have achieved complete or partial remission after first line chemotherapy, with or without radiotherapy. II. Determine the tolerability and toxicity of prolonged administration of marimastat in patients with small cell lung cancer. III. Determine the effect of prolonged administration of marimastat on the quality of life of patients with small cell lung cancer. Entry Criteria Disease Characteristics: Histologically or cytologically proven small cell lung cancer Complete response (CR) or partial response (PR) following first line chemotherapy required Chest x-ray showing CR or PR required. No documented prior brain metastases Prior/Concurrent Therapy:
Biologic therapy:
Not specified
Chemotherapy:
One prior induction combination chemotherapy regimen required
Must be completed prior to randomization
Hematologically recovered before randomization
Minimum of 4 cycles required
No change in regimen due to progression
No chemotherapy within 28 days prior to randomization if thoracic radiation
is given prior to or concurrent with chemotherapy
No prior marimastat
Endocrine therapy:
Not specified
Radiotherapy:
Prior radiotherapy allowed
Must be completed prior to randomization
Last dose of radiation treatment must be within 7-14 days prior to
randomization if thoracic radiation and/or prophylactic cranial irradiation
is given after completion of chemotherapy
If severe esophagitis precludes administration of oral medication,
randomization may be within 21 days after radiation therapy
Surgery:
No surgery within 2 weeks prior to randomization
Prior complete resection of tumor allowed
Other:
No other investigational agents within 4 weeks prior to study, and none
planned
No concurrent coumarin anticoagulants and no coumarin anticoagulants within 4
weeks prior to randomization
No concurrent antitumor treatment
Patient Characteristics: Age: 16 and over Performance status: ECOG 0-2 Life expectancy: At least 12 weeks Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified Other: Not pregnant or nursing Effective contraception use by men or women of reproductive potential No prior malignancies within 5 years except: Adequately treated nonmelanomatous skin cancer Adequately treated carcinoma in situ of the cervix No other concurrent malignancies No prior diagnosis of breast cancer, melanoma, or hypernephroma No major medical illness that would preclude prolonged administration of marimastat or required follow up No active peptic ulceration or symptoms suggestive of this diagnosis No grade 3 or 4 musculoskeletal disorders Expected Enrollment The planned sample size is 360, with an equal number of patients in both arms, accrued at a rate of 240 responders per year (resulting in an accrual period of approximately 1.5 years). The total duration of the study is estimated as 2.3 years. Outline This is a randomized, double blind, multicenter, placebo controlled study. Patients are stratified by stage of disease at diagnosis, response to prior chemotherapy/radiotherapy, type of thoracic radiotherapy, and cooperative group. Patients are randomized into two groups. Half of the patients take marimastat orally twice a day (breakfast and evening meal); the other half take placebo orally twice a day (breakfast and evening meal). Treatment continues for 2 years or until documented disease recurrence or progression and institution of further anticancer treatment, occurrence of unacceptable toxicity, initiation of anticoagulant treatment, or development of intercurrent illness. All patients are followed every 6 months until death.Published Results Shepherd FA, Giaccone G, Seymour L, et al.: Prospective, randomized, double-blind, placebo-controlled trial of marimastat after response to first-line chemotherapy in patients with small-cell lung cancer: a trial of the National Cancer Institute of Canada-Clinical Trials Group and the European Organization for Research and Treatment of Cancer. J Clin Oncol 20 (22): 4434-9, 2002.[PUBMED Abstract] Shepherd FA, Giaccone G, Debruyne C, et al.: Randomizd double-blind placebo-controlled trial of marimastat in patients with small cell lung cancer (SCLC) following response to first-line chemotherapy: an NCIC-CTG and EORTC study. [Abstract] Proceedings of the American Society of Clinical Oncology 20: A-11, 4a, 2001. Related PublicationsHuisman C, Postmus PE, Giaccone G, et al.: Second-line chemotherapy and its evaluation in small cell lung cancer. Cancer Treat Rev 25 (4): 199-206, 1999.[PUBMED Abstract] Trial Lead Organizations European Organization for Research and Treatment of Cancer
NCIC-Clinical Trials Group
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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