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Pemetrexed Disodium and Gemcitabine in Treating Patients With Stage IIIB or Stage IV Non-Small Cell Lung Cancer

This study has been completed.
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Mayo Clinic Identifier:
First received: December 4, 2006
Last updated: March 21, 2017
Last verified: April 2016

RATIONALE: Pemetrexed disodium may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as gemcitabine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving pemetrexed disodium together with gemcitabine may kill more tumor cells.

PURPOSE: This randomized phase II trial is studying two different schedules of pemetrexed disodium and gemcitabine to compare how well they work in treating patients with stage IIIB or stage IV non-small cell lung cancer.

Condition Intervention Phase
Lung Cancer
Drug: gemcitabine HCL
Drug: pemetrexed disodium
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: No masking
Primary Purpose: Treatment
Official Title: A Randomized Phase II Study of ALIMTA® (Pemetrexed) and GEMZAR® (Gemcitabine) Every 14 Days Versus Pemetrexed and Gemcitabine Every 21 Days in Advanced Non-Small Cell Lung Cancer

Resource links provided by NLM:

Further study details as provided by Mayo Clinic:

Primary Outcome Measures:
  • Number of Patients With Confirmed Responses [ Time Frame: Two consecutive evaluations at least 6 weeks apart (up to 2 years) ]

    Confirmed tumor response (complete and partial) as measured by RECIST(Response Evaluation Criteria In Solid Tumors) criteria on 2 consecutive evaluations at least 6 weeks apart.


    > Confirmed tumor response is at least a 30% decrease in the sum of the longest diameter of target lesions and no new lesions.

Secondary Outcome Measures:
  • Progression-free Survival [ Time Frame: Time from registration to progression or death (up to 2 years) ]
    Progression-free survival was defined as the number of months from registration to the date of disease progression or death, with patients who are alive and progression free being censored on the date of their last evaluation.

  • Overall Survival [ Time Frame: Death or last follow-up (up to 2 years) ]
    Overall survival time was defined as the number of months from registration to the date of death or last follow-up

  • Adverse Event [ Time Frame: Gemzar x2 Arm every 21 days, Gemzar x1 Arm every 14 days (up to 2 years) ]
    Number of patients that experienced adverse events (grade 4 or more) as measured by NCI CTCAE (Common Terminology Criteria for Adverse Events) v3.0

Enrollment: 19
Actual Study Start Date: November 2006
Study Completion Date: May 12, 2010
Primary Completion Date: January 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Gemzar x2
Treat subjects with 2 dosings/cycle of Gemzar x6 cycles.
Drug: gemcitabine HCL
1250 mg/m^2 administered through 250 cc NS (normal saline) IV (intravenous) infusion over 30 minutes at days 1 & 8 of each cycle (21 days) x6 cycles.
Other Name: GEMZAR
Drug: pemetrexed disodium
500 mg/m^2 administered through 100 mL NS IV infusion over 10 minutes at day 1 of each cycle.
Other Name: ALIMTA
Experimental: Gemzar x1
Treat subjects with 1 dosing/cycle of Gemzar x9 cycles.
Drug: pemetrexed disodium
500 mg/m^2 administered through 100 mL NS IV infusion over 10 minutes at day 1 of each cycle.
Other Name: ALIMTA
Drug: gemcitabine HCL
1500 mg/m^2 administered through 250 cc NS IV infusion over 30 minutes at days 1 of each cycle (14 days) x9 cycles.
Other Name: GEMZAR

Detailed Description:



  • Compare response rates in patients with stage IIIB or IV non-small cell lung cancer treated with two different treatment schedules of pemetrexed disodium and gemcitabine hydrochloride.


  • Compare time-to-event efficacy variables in patients treated with these regimens.
  • Compare progression-free and overall survival of patients treated with these regimens.
  • Determine the overall toxicity of these regimens in these patients.

OUTLINE: This is a multicenter, open-label, randomized study. Patients are stratified according to disease stage (IIIB vs IV) and ECOG performance status (0 vs 1). Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive pemetrexed disodium IV over 10 minutes and gemcitabine hydrochloride IV over 30 minutes on days 1 and 8. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity.
  • Arm II: Patients receive pemetrexed disodium IV over 10 minutes and gemcitabine hydrochloride IV over 30 minutes on day 1. Treatment repeats every 14 days for up to 9 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed periodically for up to 2 years.

PROJECTED ACCRUAL: A total of 80 patients will be accrued for this study.


Ages Eligible for Study:   18 Years to 120 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)

    • Stage IIIB (with controlled pleural effusion) OR stage IV disease
  • At least 1 measurable lesion whose longest diameter is ≥ 20 mm by conventional techniques OR ≥ 10 mm by spiral CT scan
  • No medically significant third-space fluid collection (e.g., ascites or pleural effusions) that cannot be controlled by drainage or other procedures
  • No documented brain metastases unless all of the following criteria are met:

    • Successful local therapy has been completed
    • At least 2 weeks since prior corticosteroids
    • Brain imaging required for symptomatic patients only (to rule out brain metastases)
  • Concurrent enrollment in clinical trial MCCRC-RC0527 required


  • Life expectancy ≥ 12 weeks
  • ECOG performance status 0-1
  • Absolute neutrophil count ≥ 1,500/mm³
  • Platelet count ≥ 100,000/mm³
  • Hemoglobin ≥ 9.0 g/dL
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • Alkaline phosphatase ≤ 3 times ULN
  • AST and ALT ≤ 3 times ULN (5 times ULN for liver involvement)
  • Creatinine clearance ≥ 45 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Able to take folic acid, cyanocobalamin (vitamin B12) supplementation, or dexamethasone and corticosteroids
  • Able to interrupt intake of aspirin and nonsteroidal anti-inflammatory agents for a total of 5 days
  • No severe and/or uncontrolled medical conditions, including any of the following:

    • Hypertension, labile hypertension, or history of poor compliance with antihypertensive medication
    • Angina pectoris
    • Congestive heart failure within the past 3 months, unless ejection fraction > 40%
    • Myocardial infarction within the past 6 months
    • Cardiac arrhythmia
    • Diabetes
    • Interstitial pneumonia or extensive and symptomatic interstitial fibrosis of the lung
    • New York Heart Association class III or IV heart disease
    • Clinically significant infection
  • No other serious medical condition or illness that would preclude study participation
  • No peripheral neuropathy ≥ grade 2
  • No other malignancy within the past 5 years except nonmelanomatous skin cancer, carcinoma in situ of the cervix, or low-grade (Gleason score ≤ 6) localized prostate cancer
  • No significant weight loss (≥ 10%) within the past 6 weeks
  • No investigator site personnel directly affiliated with the study, or immediate family (i.e., spouse, parent, child, or sibling, whether biological or legally adopted)
  • No employees of Eli Lilly (i.e., employees, temporary contract workers, or designees responsible for conducting the study)

    • Immediate family of Eli Lilly employees may participate in Eli Lilly-sponsored clinical trials, but are not permitted to participate at an Eli Lilly facility


  • See Disease Characteristics
  • At least 2 weeks since prior corticosteroids
  • At least 4 weeks since prior radiation therapy involving > 25% of the bone marrow and recovered
  • At least 30 days since prior investigational therapy
  • No prior radiation therapy to the whole pelvis
  • No prior systemic chemotherapy for advanced non-small cell lung cancer
  • No prior pemetrexed disodium and/or gemcitabine hydrochloride
  • No prior or concurrent sorafenib tosylate and/or temsirolimus
  • No concurrent Hypericum perforatum (St. John's wort)
  • No other concurrent antitumor therapy
  • No concurrent agents that stimulate thrombopoiesis
  • Concurrent palliative radiation therapy allowed
  • Concurrent corticosteroids allowed for adrenal insufficiency or severe nausea and vomiting
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00407550

United States, Minnesota
Mayo Clinic Cancer Center
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
National Cancer Institute (NCI)
Principal Investigator: Julian Molina, MD, PhD Mayo Clinic
  More Information

Responsible Party: Mayo Clinic Identifier: NCT00407550     History of Changes
Other Study ID Numbers: CDR0000516012
P30CA015083 ( US NIH Grant/Contract Award Number )
RC0524 ( Other Identifier: Mayo Clinic Cancer Center & MCCRC )
06-002282 ( Other Identifier: Mayo Clinic IRB )
H3E-US-S061 ( Other Identifier: Lilly Protocol )
Study First Received: December 4, 2006
Results First Received: February 17, 2012
Last Updated: March 21, 2017

Keywords provided by Mayo Clinic:
stage IIIB non-small cell lung cancer
stage IV non-small cell lung cancer
recurrent non-small cell lung cancer

Additional relevant MeSH terms:
Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Antiviral Agents
Anti-Infective Agents
Enzyme Inhibitors
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors processed this record on May 25, 2017