Radiation + Chemotherapy for Small Cell Lung Cancer

Not currently recruiting at 950 trial locations
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: Alliance for Clinical Trials in Oncology
Must be taking: Carboplatin, Cisplatin, Etoposide
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests which combination of radiation and chemotherapy best treats limited-stage small cell lung cancer. Researchers compare two different radiation schedules, both paired with chemotherapy drugs: etoposide, carboplatin, or cisplatin. Suitable candidates for this trial have small cell lung cancer limited to one side of the chest and have not yet received radiation or extensive chemotherapy. As a Phase 3 trial, this study represents the final step before FDA approval, offering patients a chance to contribute to potentially groundbreaking treatment advancements.

Do I need to stop my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, it does mention that you should not have had prior radiotherapy or chemotherapy for small cell lung cancer, except for one cycle of specific chemotherapy drugs.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that the treatments studied in this trial have been used before and are generally well-tolerated. Here's a breakdown:

1. **High Radiation Dose Therapy**: Studies indicate that higher doses of radiation, like those tested, are usually well-tolerated by patients with small cell lung cancer. Some research suggests that high-dose radiation can improve outcomes for these patients. However, side effects such as tiredness or skin irritation can occur with any radiation treatment.

2. **Cisplatin and Carboplatin**: These common chemotherapy drugs have similar safety profiles and are often used to treat various cancers, including lung cancer. Patients may experience side effects like nausea or low blood cell counts, but these are expected and usually manageable.

3. **Etoposide**: Often used with the other chemotherapy drugs mentioned, etoposide is known to slow tumor growth. While it can cause side effects like hair loss or low blood counts, most patients tolerate it well.

In summary, the treatments in this trial have been used in other settings and are generally considered safe, though they may have side effects typical of cancer treatments. Always discuss any concerns with a healthcare provider.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for small cell lung cancer because they explore different radiation dose intensities combined with chemotherapy. Arm A combines standard-dose radiation with chemotherapy, which is a tried-and-true approach, while Arm B takes it up a notch with high-dose radiation over a longer period. This higher radiation dose could potentially improve the effectiveness of the treatment by delivering more radiation to the tumor, possibly shrinking it more effectively. By comparing these two approaches, researchers hope to discover whether the increased radiation dosage in Arm B offers a significant advantage in controlling the disease.

What evidence suggests that this trial's treatments could be effective for small cell lung cancer?

In this trial, participants will receive different combinations of treatments to evaluate their effectiveness in treating small cell lung cancer. Research has shown that chemotherapy drugs like cisplatin or carboplatin, when used with etoposide, can extend patient survival. In Arm A of this trial, participants will receive standard radiotherapy combined with chemotherapy, which includes either cisplatin or carboplatin with etoposide. Cisplatin is often recommended because it has improved overall survival, while carboplatin is also effective, with studies showing high success rates when used with etoposide. Etoposide alone has yielded good results, with many patients responding well to it. In Arm B, participants will receive high-dose radiotherapy combined with the same chemotherapy regimen. Higher doses of radiation therapy have not always improved survival compared to standard doses, but both are generally effective in treating small cell lung cancer. Overall, combining these treatments has been shown to fight cancer cells and improve patient outcomes.56789

Who Is on the Research Team?

JA

Jeffrey A. Bogart, MD

Principal Investigator

State University of New York - Upstate Medical University

Are You a Good Fit for This Trial?

This trial is for adults with limited-stage small cell lung cancer, who have measurable disease and haven't had complete surgical resection or prior chest radiotherapy. They can have received one cycle of specific chemotherapy. Key health metrics like blood counts and liver/kidney function must be within certain limits.

Inclusion Criteria

My cancer is confined to one side of my chest and has spread only to nearby lymph nodes.
I have had only one round of chemotherapy that included carboplatin or cisplatin and etoposide.
My lung cancer diagnosis was confirmed through lab tests.
See 8 more

Exclusion Criteria

I have not had surgery to completely remove my cancer.
I do not have fluid in my lungs or, if I do, it has been tested and is not cancerous.
I haven't had chemo or radiation for small cell lung cancer, except as noted before.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive thoracic radiotherapy and chemotherapy. Radiotherapy is administered either as standard-dose (45 Gy over 3 weeks), higher-dose (70 Gy over 7 weeks), or mid-dose (61.2 Gy over 5 weeks). Chemotherapy with cisplatin or carboplatin and etoposide is given every 21 days for 4 cycles.

12 weeks

Prophylactic Cranial Irradiotherapy (PCI)

Within 3-6 weeks after completion of chemotherapy, PCI is offered to patients with a complete or near complete tumor response.

3-6 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment. Follow-up occurs every 3 months for 2 years, every 6 months for 3 years, and then annually for 5 years or until disease progression.

10 years

What Are the Treatments Tested in This Trial?

Interventions

  • Carboplatin
  • Cisplatin
  • Etoposide
  • High Radiation Dose Therapy
  • Standard Radiation Dose Therapy
Trial Overview The study compares different doses of radiation therapy combined with chemotherapy drugs (cisplatin, etoposide, carboplatin) to see which regimen is more effective against limited-stage small cell lung cancer. It's a phase III trial where patients are randomly assigned to treatment groups.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Arm B - High Dose Radiotherapy + ChemotherapyExperimental Treatment4 Interventions
Group II: Arm A - Standard Radiotherapy + ChemotherapyActive Control4 Interventions

Carboplatin is already approved in United States, European Union, Canada for the following indications:

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Approved in United States as Paraplatin for:
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Approved in European Union as Carboplatin for:
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Approved in Canada as Carboplatin for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Alliance for Clinical Trials in Oncology

Lead Sponsor

Trials
521
Recruited
224,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Published Research Related to This Trial

In a study of 47 patients with limited disease small-cell lung carcinoma, the combination of carboplatin and etoposide followed by thoracic radiotherapy resulted in a 73% overall response rate, but the median survival time was only 13.7 months, indicating limited long-term efficacy.
The treatment was associated with significant adverse effects, including grade 3-4 neutropenia in 46% of patients and febrile neutropenia in 14%, highlighting safety concerns despite the initial response to therapy.
Carboplatin and etoposide followed by once-daily thoracic radiotherapy in limited disease small-cell lung cancer: unsatisfactory results.Yilmaz, U., Anar, C., Korkmaz, E., et al.[2022]
In a pilot study of 40 patients with limited-stage small-cell lung carcinoma, concurrent chemotherapy with cisplatin and etoposide alongside radiotherapy resulted in a high complete response rate, with 23 patients showing complete remission.
The median survival for all patients was 18 months, and five patients survived over 2 years without therapy, indicating promising long-term outcomes and acceptable toxicity levels, primarily neutropenia and mild to moderate radiation-related effects.
Concurrent chemotherapy and radiotherapy for limited small-cell carcinoma of the lung: a Southwest Oncology Group Study.McCracken, JD., Janaki, LM., Taylor, SB., et al.[2018]
A combination treatment of paclitaxel, carboplatin, and oral etoposide was found to be highly effective and well tolerated in 117 patients with small-cell lung cancer, showing promising results in both extensive and limited stages of the disease.
The regimen can be safely administered alongside thoracic radiation therapy, with only a few patients experiencing esophagitis, indicating a favorable safety profile compared to other treatments.
Paclitaxel, carboplatin, and extended-schedule oral etoposide for small-cell lung cancer.Hainsworth, JD., Hopkins, LG., Thomas, M., et al.[2015]

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/1846981/
Carboplatin in small cell lung cancerThe combination carboplatin/etoposide/vincristine (CEV) (phase II trial) led to an overall remission rate of 84% in patients with limited disease, with 52% CR.
Survival outcomes with carboplatin versus cisplatin and the ...During the pandemic, quarterly usage rates of carboplatin reached up to 81% and 90% in LS-SCLC and ES-SCLC, respectively. In LS-SCLC, ...
Survival outcomes of patients with extensive-stage small ...Combining atezolizumab with carboplatin plus etoposide (Carbo-E) improved overall survival (OS) in ES-SCLC pts and became a new standard for ...
Comparison of Carboplatin With Cisplatin in Small Cell ...For 2652 patients with extensive-stage SCLC, the median OS was 8.45 months for cisplatin and 8.51 months for carboplatin, and for 1756 patients ...
The Role of Carboplatin in the Treatment of Small-Cell ...The results of these clinical trials are encouraging, with total response rates ranging from 65% to 93% in patients with small-cell lung cancer.
Survival outcomes with carboplatin versus cisplatin and the ...Carboplatin use in SCLC increased during the COVID-19 pandemic. · Adjusting for confounders, OS was comparable with carboplatin and cisplatin in ...
Real-world safety of carboplatin in non-small cell lung cancerThis study aims to systematically assess carboplatin-related AEs and explore demographic factors that may influence risk.
Safety and efficacy of QL1706 plus carboplatin/etoposide ...QL1706 plus EC chemotherapy showed tolerable safety profile and promising efficacy as first-line treatment for pts with ES-SCLC.
Carboplatin, etoposide, atezolizumab, and bevacizumab in ...These findings demonstrate that combined VEGF and PD-L1 inhibition is a promising strategy to improve outcomes of patients with SCLC and that ...
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