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MnSOD (Esophageal Protectant) to Prevent Esophagitis During Radiation/Chemotherapy Treatment for Non-Small Cell Lung Cancer (NSCLC)
This study has been suspended.
( Suspended at the request of the U. Pitt IRB )
Sponsored by: University of Pittsburgh
Information provided by: University of Pittsburgh
ClinicalTrials.gov Identifier: NCT00618917
  Purpose

This is a Phase I-II study evaluating the feasibility, safety, and efficacy of swallowed MnSOD plasmid/liposome (PL) transgene given as protection against radiation-induced esophagitis during concurrent paclitaxel and carboplatin chemotherapy with thoracic radiation in subjects with locally advanced non-small cell lung cancer (NSCLC).


Condition Intervention Phase
Radiation-Induced Esophageal Toxicity
Genetic: MnSOD
Phase I
Phase II

MedlinePlus related topics: Cancer Esophagus Disorders Lung Cancer Radiation Therapy
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Chemotherapy (Paclitaxel and Carboplatin)and Thoracic Radiotherapy With Swallowed Manganese Superoxide Dismutase (MnSOD) Plasmid Liposome Protection in Patients With Locally Advanced Stage III Non-Small Cell Lung Cancer: A Phase I-II Study

Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:
  • feasibility and safety [ Time Frame: The endpoint will be the proportion of toxicities attributed to administration of MnSOD plasmid liposome. ] [ Designated as safety issue: Yes ]
  • Efficacy [ Time Frame: The clinical endpoint will be the proportion of radiation - induced grade III/IV esophageal toxicity. ] [ Designated as safety issue: No ]
  • Biologic endpoints [ Time Frame: Characterization of esophageal biopsy specimens by immunohistochemistry, RT-PCR for MnSOD mRNA as a measure of gene transfection and expression levels of inflammatory cytokines ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • clinical response to the combination of chemoradiotherapy with esophagus protection by MnSOD plasmid/liposome. [ Time Frame: dependent on subject response and survivial status ] [ Designated as safety issue: No ]

Estimated Enrollment: 45
Study Start Date: November 2005
Estimated Study Completion Date: November 2011
Estimated Primary Completion Date: November 2011 (Final data collection date for primary outcome measure)
Intervention Details:
    Genetic: MnSOD
    15 ml of a liquid that contains either 0.3 mg, 3.0 mg or 30.0 mg (depending on which cohort is open when the subject is entered) of MnSOD PL. This will be given on Day 1 and 3 of each week of the experimental treatment for a total of 14 doses.
Detailed Description:

This is a Phase I-II study evaluating the feasibility, safety, and efficacy of swallowed MnSOD plasmid/liposome (PL) transgene given as protection against radiation-induced esophagitis during concurrent paclitaxel and carboplatin chemotherapy with thoracic radiation in subjects with locally advanced non-small cell lung cancer (NSCLC). Phase I of the study will assess the feasibility and safety of MnSOD PL by dose escalation in 3 cohorts of 3 chemoradiotherapy subjects each (Cohort1 = 0.3 mg/dose, Cohort2 = 3 mg/dose, Cohort3 = 30 mg/dose). The highest dose completed (as determined by toxicity monitoring for 8 weeks from initial treatment) will be the starting dose for Phase II. Phase II will examine the efficacy of MnSOD PL by assessing the incidence of Grade 3 or 4 esophagitis in 27 additional chemoradiotherapy subjects. Incidence of esophageal toxicity, as well as clinical response to the combination of chemoradiotherapy with MnSOD PL are the outcomes of interest.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically or cytologically documented NSCLC including squamous cell carcinoma, adenocarcinoma (including bronchoalveolar cell), and large cell anaplastic carcinoma (including giant and clear cell carcinomas) and poorly differentiated non-small cell lung cancer. Totally resected tumors are excluded.
  • Subjects must be without evidence of M0.
  • Subjects with T1 or T2 disease with N2 or T3N1-2 disease (Stage IIIA) are eligible if they are medically inoperable. Subjects with T4 with any N or any T with N3 disease are eligible. Radiographic evidence of mediastinal lymph nodes >2.0 cm in the largest diameter is sufficient to stage N2 or N3 disease. If the largest mediastinal node is < 2.0 cm in diameter and this is the basis for stage III disease, then at least one of the nodes must be proven positive cytologically or histologically.
  • Subjects with tumors adjacent to a vertebral body are eligible as long as all gross disease can be encompassed in the radiation boost field. The boost volume must be limited to < 50% of the ipsilateral lung volume.
  • Subjects with a pleural effusion that is a transudate, cytologically negative and non-bloody are eligible if the radiation oncologists feel the tumor can still be encompassed within a reasonable field of radiotherapy. Exudative, bloody, or cytologically malignant effusions are ineligible. If a pleural effusion can be seen on the chest CT but not on CXR and is too small to tap, the subject will be eligible.
  • Subjects must be deemed a suitable candidate for protocol treatment by both Radiation Oncology and Medical Oncology
  • Subjects must have a Performance Status > 70 (Karnofsky Performance Scale).
  • Subjects Weight loss < 10% in 3 months prior to diagnosis.
  • Subjects must be male or female > 18 years.
  • Subjects must have had no prior systemic chemotherapy, radiation therapy to the thorax, or total surgical resection.
  • At least 3 weeks since formal exploratory thoracotomy and the subject has recovered from surgery, or 1 week from diagnostic thoracoscopy.
  • Laboratory values must be as follows: (See Section 6.1 of the full protocol for required timing): Granulocytes > 2,000/ml, Platelets > 100,000/ml, Hemoglobin* > 8 mg/dl, Bilirubin < 1.5 x normal, Creatinine clearance > 50 ml/n (24 hour or calculated, FEV1 > 800 cc. Note: *Physician can maintain a subject's hemoglobin with the use of Erythropoetin or transfusions prophylactic use of G-CSF is not permitted).
  • Subjects must have a MRI or CT brain scan within 4 weeks prior to study entry to rule out asymptomatic brain metastases.
  • Subjects must be informed of the investigational nature of the study and sign an informed consent form and have no serious medical or psychiatric illnesses that would prevent informed consent.
  • No history of serious cardiac disease that is not adequately controlled.
  • Female subjects must be non-pregnant and non-lactating. Female subjects of childbearing potential must implement an effective method of contraception during the study. All women of childbearing potential must have a pre-study negative serum or urine pregnancy test within 7 days prior to study entry.

Exclusion Criteria

  • Inability to meet any of the above eligibility requirements
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00618917

Locations
United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15232
Sponsors and Collaborators
University of Pittsburgh
Investigators
Principal Investigator: Joel Greenberger, MD University of Pittsburgh Cancer Institute/Univeristy of Pittsburgh Medical Center, Cancer Centers
  More Information

No publications provided

Responsible Party: Univeristy of Pittsburgh Cancer Institute ( Athanassios Argiris, MD )
Study ID Numbers: 01-054
Study First Received: February 6, 2008
Last Updated: October 3, 2008
ClinicalTrials.gov Identifier: NCT00618917  
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Pittsburgh:
NSCLC
lung cancer
chemotherapy
radiation therapy
radiation toxicity

Study placed in the following topic categories:
Thoracic Neoplasms
Non-small cell lung cancer
Esophageal disorder
Gastrointestinal Diseases
Carboplatin
Carcinoma
Esophagitis
Digestive System Diseases
Respiratory Tract Diseases
Paclitaxel
Lung Neoplasms
Lung Diseases
Esophageal Diseases
Manganese
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Respiratory Tract Neoplasms
Neoplasms
Neoplasms by Site
Neoplasms by Histologic Type

ClinicalTrials.gov processed this record on February 12, 2009