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Pleurectomy/Decortication Followed by Intrathoracic/Intraperitoneal Heated Cisplatin for Malignant Pleural Mesothelioma

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ClinicalTrials.gov Identifier: NCT00165555
Recruitment Status : Completed
First Posted : September 14, 2005
Last Update Posted : March 27, 2014
Sponsor:
Collaborator:
Brigham and Women's Hospital
Information provided by (Responsible Party):
Dana-Farber Cancer Institute

Study Description
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Brief Summary:
The purpose of this study it to determine the safety and maximally tolerated dose (MTD) of cisplatin administered in the operating room and put into the chest and abdomen for one hour. We are also looking at the effects of heating the chemotherapy to a temperature of 42 degrees celsius.

Condition or disease Intervention/treatment Phase
Pleural Mesothelioma Malignant Pleural Mesothelioma Drug: Cisplatin Drug: Sodium Thiosulfate Phase 1

Detailed Description:
  • Patients will undergo surgery with pleurectomy/decortication which entails the removal of the inner and outer skin of the lung, including the pleura overlying the pericardium and diaphragm. Resection of the pericardium and diaphragm are occasionally necessary to debulk the tumor. This surgery is part of standard care for pleural mesothelioma.
  • After surgery, a one hour lavage with heated cisplatin will be administered to the hemithorax (and abdominal regions if the diaphragm is no longer present). The lung itself is not removed, only the diseased portion of the lung and surrounding areas with tumor.
  • Immediately following the one-hour lavage, a six hour infusion of sodium thiosulfate will begin to help reduce the side effects of the cisplatin.
  • Patients will remain hospitalized until they have recovered from surgery (usually 7-14 days).
  • Patients will return to the hospital three months after their surgery to have fluid drawn from their chest via an ultrasound guided thoracentesis. This is called a saline wash.
  • Patients will be in the study actively for three months. This includes a 2-week and 4-week post-operative follow-up in which blood work is performed. As well as a 3-month follow-up for the saline wash. Long-term follow-up includes computed tomography of the chest and abdomen every 6 months to assess recurrence.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 70 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Pleurectomy/Decortication Followed by Intrathoracic/Intraperitoneal Heated Cisplatin and Intravenous Sodium Thiosulfate in the Multimodality Treatment of Malignant Pleural Mesothelioma
Study Start Date : August 1999
Actual Primary Completion Date : April 2002
Actual Study Completion Date : November 2009

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Mesothelioma

Arms and Interventions
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Intervention Details:
  • Drug: Cisplatin
    Given as a heated one-hour lavage to the hemithorax after surgery.
  • Drug: Sodium Thiosulfate
    Given intravenously over 6 hours after the cisplatin lavage.

Outcome Measures
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Primary Outcome Measures :
  1. To determine the maximally tolerated dose of intracavitary cisplatin in patients with malignant pleural mesothelioma, [ Time Frame: 3 years ]

Secondary Outcome Measures :
  1. To quantitate the safety of intraoperative intrathoracic/intraperitoneal hyperthermic cisplatin [ Time Frame: 3 years ]
  2. to study the pharmacokinetics of cisplatin administered in this way. [ Time Frame: 3 years ]

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

Inclusion Criteria:

  • Histopathologic confirmation of malignant pleural mesothelioma
  • Patients who are able to tolerate surgical cytoreduction but unable to undergo extrapleural pneumonectomy due to poor cardiopulmonary reserve or tumor invasion
  • 18 years of age or older
  • Malignancy is confined to the affected hemithorax.
  • Grossly normal cardiac function with an EKG showing no cardiomyopathy or acute changes
  • Evidence of adequate renal and hepatic function
  • Karnofsky performance status of 70% or greater

Exclusion Criteria:

  • Extended disease outside the ipsilateral hemithorax as determined radiologically and intraoperatively
  • Distant metastases
  • Non-malignant systemic disease
  • Active concomitant malignancy
  • Psychiatric or addictive disorders which would preclude obtaining informed consent
  • Prior treatment within the last 2 months, other than surgical resection for their current malignancy
Contacts and Locations
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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): NCT00165555


Locations
United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115
Dana-Farber Cancer Institute
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Dana-Farber Cancer Institute
Brigham and Women's Hospital
Investigators
Principal Investigator: David J. Sugarbaker, MD Brigham and Women's Hospital
More Information
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Responsible Party: Dana-Farber Cancer Institute
ClinicalTrials.gov Identifier: NCT00165555     History of Changes
Other Study ID Numbers: 99-124
First Posted: September 14, 2005    Key Record Dates
Last Update Posted: March 27, 2014
Last Verified: March 2014

Keywords provided by Dana-Farber Cancer Institute:
cisplatin
pleurectomy
decortication
heated cisplatin

Additional relevant MeSH terms:
Mesothelioma
Adenoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Mesothelial
Cisplatin
Sodium thiosulfate
Antineoplastic Agents
Antidotes
 Protective Agents
Physiological Effects of Drugs
Antioxidants
Molecular Mechanisms of Pharmacological Action
Antitubercular Agents
Anti-Bacterial Agents
Anti-Infective Agents
Chelating Agents
Sequestering Agents