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Radiation Therapy With or Without RSR13 in Treating Patients With Brain Metastases

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ClinicalTrials.gov Identifier: NCT00005887
Recruitment Status : Completed
First Posted : August 29, 2003
Last Update Posted : May 10, 2013
Sponsor:
Information provided by (Responsible Party):

Study Description
Brief Summary:

RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs such as RSR13 may make tumor cells more sensitive to radiation therapy.

PURPOSE: Randomized phase III trial to compare the effectiveness of radiation therapy to the brain with or without RSR13 in treating patients who have brain metastases.


Condition or disease Intervention/treatment Phase
Metastatic Cancer Drug: efaproxiral Radiation: radiation therapy Phase 3

Detailed Description:

OBJECTIVES:

  • Compare the median survival time in patients with brain metastases after receiving treatment with whole brain radiotherapy with or without RSR13.
  • Compare the response rate to these treatment regimens in these patients.
  • Compare the time to progression after receiving these treatment regimens in these patients.
  • Compare quality of life in these patients receiving these treatment regimens.
  • Compare cause of death (neurologic vs nonneurologic death) in these patients after receiving these treatment regimens.
  • Determine the safety of RSR13 in these patients.
  • Assess the pharmacokinetics of RSR13 in these patients.

OUTLINE: This is a randomized, open label, comparative, multicenter study. Patients are stratified according to the Radiation Therapy Oncology Group RPA Class (I vs II). Patients are further stratified within the RPA class II stratum according to site of primary cancer (non-small cell lung cancer vs breast vs other). Patients are randomized to one of two treatment arms.

  • Arm I: Patients receive whole brain radiotherapy 5 days a week for two weeks in conjunction with supplemental oxygen breathing.
  • Arm II: Patients receive RSR13 IV over 30 minutes followed by whole brain radiotherapy and supplemental oxygen breathing as in arm I.

Quality of life is assessed at the first and last day of radiotherapy, at 1 month, 3 months, and then every 3 months until disease progression.

Patients are followed at 1 month, 3 months, every 3 months until disease progression, and then for survival.

PROJECTED ACCRUAL: A maximum of 408 (204 per treatment arm) patients will be accrued for this study.


Study Design

Study Type : Interventional  (Clinical Trial)
Allocation: Randomized
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase III, Randomized, Open-Label, Comparative Study of Standard Whole Brain Radiation Therapy With or Without RSR13 in Patients With Brain Metastases
Study Start Date : February 2000
Arms and Interventions


Outcome Measures

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Radiographically, histologically, or cytologically confirmed brain metastases with histologically or cytologically confirmed primary malignancy except the following:

    • Small cell lung cancer, germ cell tumors, and lymphomas
  • No leptomeningeal metastases

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • Karnofsky 70-100%

Life expectancy:

  • Not specified

Hematopoietic:

  • Hemoglobin at least 10 g/dL
  • WBC at least 2,000/mm3
  • Platelet count at least 75,000/mm3

Hepatic:

  • Bilirubin no greater than 2.0 mg/dL
  • ALT and AST no greater than 3 times upper limit of normal

Renal:

  • Creatinine no greater than 2.0 mg/dL

Pulmonary:

  • Forced vital capacity and forced expiratory volume at least 50% of normal in patients with significant intrathoracic tumor involvement, chronic obstructive pulmonary disease, interstitial lung disease, or pulmonary embolism
  • Resting and exercise oxygen saturation at least 90% on room air

Other:

  • No other concurrent active malignancy from a second histologic site
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • No prior biologic therapy or immunotherapy for brain metastases
  • At least 28 days since prior investigational biologic therapy

Chemotherapy:

  • No prior chemotherapy for brain metastases
  • No chemotherapy for brain metastases for at least one month following radiation therapy
  • At least 7 days since prior chemotherapy for primary tumor or extracranial metastases
  • No planned chemotherapy during radiation therapy

Endocrine therapy:

  • No prior hormonal therapy for brain metastases
  • Prior or concurrent corticosteroid therapy allowed

Radiotherapy:

  • No prior whole brain radiotherapy for brain metastases
  • No prior stereotactic radiosurgery for brain metastases

Surgery:

  • Prior surgery allowed for brain metastases if at least one measurable lesion remains

Other:

  • At least 28 days since prior investigational drug or device
  • No prior RSR13
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00005887


  Show 73 Study Locations
Sponsors and Collaborators
Spectrum Pharmaceuticals, Inc
Investigators
Study Chair: Edward G. Shaw, MD Wake Forest University Health Sciences
More Information

Publications:
Nabid A, Kresl J, Stea B, et al.: Standard whole brain radiation (WBRT) with supplemental oxygen (O2) with or without RSR13 (efaproxiral) in patients with brain metastases originating from NSCLC: results of a subgroup analysis. [Abstract] J Clin Oncol 22 (Suppl 14): A-7115, 645s, 2004.
Shaw E, Stea B, Pinter T, et al.: Pharmacokinetics (PK) of RSR13 (efaproxiral) predict survival in patients with brain metastases randomized to receive whole brain radiation therapy (WBRT) with or without RSR13 (REACH RT-009). [Abstract] J Clin Oncol 22 (Suppl 14): A-1561, 122s, 2004.
Stea B, Suh J, Shaw E, et al.: Efaproxiral (EFAPROXYN) as an adjunct to whole brain radiation therapy for the treatment of brain metastases originating from breast cancer: updated survival results of the randomized REACH (RT-009) study. [Abstract] Breast Cancer Res Treat 88 (1): A-4064, 2004.
Suh J, Stea BD, Nabid A, et al.: Prognostic factors for survival in patients with brain metastases enrolled on a worldwide phase 3 randomized trial of 538 patients (study RSR13 RT-009). [Abstract] Int J Radiat Oncol Biol Phys 60 (1 Suppl 1): A-60, S165, 2004.
Suh J, Stea B, Nabid A, et al.: Standard whole brain radiation therapy (WBRT) with supplemental oxygen (O2), with or without RSR13 (efaproxiral) in patients with brain metastases: results of the randomized REACH (RT-009) study. [Abstract] J Clin Oncol 22 (Suppl 14): A-1534, 115s, 2004.

Responsible Party: Spectrum Pharmaceuticals, Inc
ClinicalTrials.gov Identifier: NCT00005887     History of Changes
Other Study ID Numbers: CDR0000067957
ALLOS-RSR13RT-009
First Posted: August 29, 2003    Key Record Dates
Last Update Posted: May 10, 2013
Last Verified: May 2013

Keywords provided by Spectrum Pharmaceuticals, Inc:
tumors metastatic to brain

Additional relevant MeSH terms:
Neoplasm Metastasis
Neoplastic Processes
Neoplasms
Pathologic Processes
Efaproxiral
Antisickling Agents