Lung Cancer Clinical Trial
Carboplatin, Paclitaxel, Selenomethionine, and Radiation Therapy in Treating Patients With Stage III Non-Small Cell Lung Cancer That Cannot Be Removed by Surgery
Summary
RATIONALE: Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Selenomethionine may slow the growth of tumor cells. Radiation therapy uses high-energy x-rays to kill tumor cells. Giving combination chemotherapy together with selenomethionine and radiation therapy may kill more tumor cells.
PURPOSE: This phase II trial is studying the side effects and how well selenomethionine works when given together with carboplatin, paclitaxel, and radiation therapy in treating patients with stage III non-small cell lung cancer that cannot be removed by surgery.
Full Description
OBJECTIVES:
Primary
Determine the safety and tolerability of selenomethionine in combination with chemotherapy and radiotherapy in patients with unresectable stage IIIA or IIIB non-small cell lung cancer.
Determine if the incidence of excessive adverse events, in the form of esophagitis, pneumonitis, and myelosuppression, can be reduced with this regimen.
Secondary
Estimate response rate, failure-free survival, and overall survival of these patients.
Correlate selenium levels with degree of observed adverse events.
OUTLINE: This is a multicenter study.
Patients receive oral selenomethionine twice daily for 1 week and then once daily for 6 weeks. Patients also receive paclitaxel IV over 1 hour once weekly and carboplatin IV over 30 minutes once weekly for 6 weeks and undergo radiotherapy 5 days a week for 6 weeks. Treatment continues in the absence of disease progression or unacceptable toxicity.
Blood samples are collected at baseline and weekly during treatment and analyzed by absorption spectrophotometry for selenium measurement of drug concentration
After the completion of study treatment, patients are followed periodically.
Eligibility Criteria
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed non-small cell lung cancer (NSCLC), including any of the following histologic subtypes:
Squamous cell carcinoma
Adenocarcinoma (including bronchoalveolar cell carcinoma)
Large cell anaplastic carcinoma (including giant and clear cell carcinoma)
Stage IIIA disease OR selected stage IIIB disease
T1-2, N2 disease OR T3, N2 or T4, N0-N2 disease (if based on tumor closeness to the carina, invasion of the mediastinum, or invasion of the chest wall)
Contralateral mediastinal disease (N3) allowed if all gross disease can be encompassed in the radiation boost field
Tumors adjacent to a vertebral body allowed unless there is demonstrable bone invasion
All gross disease must be able to be encompassed in the radiation boost field
No direct invasion of a vertebrae body
Unresectable or inoperable disease
Measurable disease
Suitable for radiotherapy, as deemed by the radiation oncologist
No scalene, supraclavicular, or contralateral hilar node involvement
Pleural effusion allowed provided it is transudate, cytologically negative, and non-bloody, and, according to the radiation oncologist, the tumor can be encompassed within a reasonable radiation field
Pleural effusion seen on chest CT scan, but not on chest x-ray, that is too small to tap is allowed
No exudative, bloody, or cytologically malignant effusions
No known brain metastases
PATIENT CHARACTERISTICS:
ECOG performance status 0-1
ANC ≥ 1,500/mm³
Platelet count ≥ 75,000/mm³
Total bilirubin ≤ 1.5 mg/dL
Creatinine normal
Alkaline phosphatase AND AST or ALT meeting 1 of the following criteria:
Alkaline phosphatase normal AND AST or ALT ≤ 5 times upper limit of normal (ULN)
Alkaline phosphatase ≤ 2.5 times ULN AND AST or ALT ≤ 1.5 times ULN
Alkaline phosphatase ≤ 5 times ULN AND AST or ALT normal
Able to swallow oral medications
No peripheral neuropathy > grade 1
No history of allergic reactions attributed to compounds of similar chemical or biologic composition to selenomethionine or agents formulated with Cremophor EL
No concurrent uncontrolled illness including, but not limited to, any of the following:
Ongoing or active infection
Symptomatic congestive heart failure
Unstable angina pectoris
Clinically significant cardiac arrhythmia
Psychiatric illness or social situations that would limit compliance with study requirements
No currently "active" second malignancy other than non-melanoma skin cancer
Patients are considered not to have an "active" malignancy if they have completed therapy and are considered by their physician to be at less than 30% risk of relapse
Not pregnant
Negative pregnancy test
Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY:
At least 2 weeks since prior formal exploratory thoracotomy (N2 node identified making patient ineligible for surgery)
No prior chemotherapy or radiotherapy for NSCLC
No prior taxanes or platinum drugs
No other concurrent investigational agents or anticancer therapy
No concurrent combination antiretroviral therapy for HIV-positive patients
No other concurrent chemotherapy or hormonal therapy, except for the following:
Steroids administered for adrenal failure or septic shock
Hormones administered for non-disease-related conditions (e.g., insulin for diabetes)
Glucocorticosteroids administered as antiemetics
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There is 1 Location for this study
Buffalo New York, 14263, United States
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