Fludeoxyglucose F 18 PET/CT Scans in Predicting Therapy Response in Patients With Stage IIIA Non-Small Cell Lung Cancer Undergoing Chemoradiation

Study Description

Go to 

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Brief Summary:

This clinical trial studies fludeoxyglucose F 18 (FDG) positron emission tomography (PET)/computed tomography (CT) in predicting chemoradiation therapy (CRT) failure in patients with stage IIIA non-small cell lung cancer (NSCLC). Diagnostic procedures, such as FDG PET/CT, may help predict CRT failure. Comparing diagnostic results during CRT may help doctors predict a patient's response to treatment and help plan the best treatment

Condition or disease	Intervention/treatment	Phase
Stage IIIA Non-small Cell Lung Cancer	Procedure: positron emission tomography/computed tomography (PET/CT); Radiation: fludeoxyglucose F 18	Not Applicable

Detailed Description:

PRIMARY OBJECTIVES:

I. To determine whether early response of the research positron emission tomography (PET)-computed tomography(CT) scan measured by change in Standard Uptake Value (SUV)max relative to baseline scan can predict induction chemoradiation therapy (CRT) failures sooner than post-treatment PET-CT scan.

II. To determine the optimal timing for 18FDG PET-CT that best predicts for induction CRT failure.

SECONDARY OBJECTIVES:

I. To correlate early 18 fludeoxyglucose (FDG) PET-CT response metrics with pathologic response, progression-free survival separately for: induction CRT failures vs. non-failures, or overall survival separately for induction CRT failures vs. non-failures.

OUTLINE: Patients are randomized to 1 of 3 groups.

Patients undergo a baseline FDG PET/CT scan and receive standard radiotherapy (RT) for 28 fractions with concurrent chemotherapy.

GROUP A: Patients undergo a FDG PET/CT scan between RT fractions 5-6 (before course 2 of chemotherapy).

GROUP B: Patients undergo a FDG PET/CT scan between RT fractions 10-11 (before course 3 of chemotherapy).

GROUP C: Patients undergo a FDG PET/CT scan between RT fractions 15-16 (before course 4 of chemotherapy).

Approximately 6 weeks after completion of CRT, patients undergo a FDG PET/CT scan and undergo standard tumor resection.

After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months thereafter.

Study Design

Go to 

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	0 participants
Allocation:	Randomized
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Diagnostic
Official Title:	Open Label Randomized Trial of Early Assessment of Therapy Response Using 18FDG-PET/CT in Patients With Marginally Resectable Stage IIIA (N2) Non-Small Cell Lung Cancer (NSCLC) Treated With Induction Concurrent Chemoradiation Followed by Resection and Adjuvant Chemotherapy
Study Start Date :	April 2011
Actual Primary Completion Date :	June 2012
Actual Study Completion Date :	June 2012

Arms and Interventions

Go to 

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Arm	Intervention/treatment
Experimental: Group A (FDG PET/CT between RT fractions 5-6); Patients undergo a baseline FDG PET/CT scan and receive standard radiotherapy (RT) for 28 fractions with concurrent chemotherapy. Patients undergo a FDG PET/CT scan between RT fractions 5-6 (before course 2 of chemotherapy). Approximately 6 weeks after completion of CRT, patients undergo a FDG PET/CT scan and undergo standard tumor resection.	Procedure: positron emission tomography/computed tomography (PET/CT); Undergo FDG PET/CT Radiation: fludeoxyglucose F 18; Undergo FDG PET/CT; Other Names: 18FDG; FDG
Experimental: Group B (FDG PET/CT between RT fractions 10-11); Patients undergo a baseline FDG PET/CT scan and receive standard radiotherapy (RT) for 28 fractions with concurrent chemotherapy. Patients undergo a FDG PET/CT scan between RT fractions 10-11 (before course 3 of chemotherapy). Approximately 6 weeks after completion of CRT, patients undergo a FDG PET/CT scan and undergo standard tumor resection.	Procedure: positron emission tomography/computed tomography (PET/CT); Undergo FDG PET/CT Radiation: fludeoxyglucose F 18; Undergo FDG PET/CT; Other Names: 18FDG; FDG
Experimental: Group C (FDG PET/CT between RT fractions 15-16); Patients undergo a baseline FDG PET/CT scan and receive standard radiotherapy (RT) for 28 fractions with concurrent chemotherapy. Patients undergo a FDG PET/CT scan between RT fractions 15-16 (before course 4 of chemotherapy). Approximately 6 weeks after completion of CRT, patients undergo a FDG PET/CT scan and undergo standard tumor resection.	Procedure: positron emission tomography/computed tomography (PET/CT); Undergo FDG PET/CT Radiation: fludeoxyglucose F 18; Undergo FDG PET/CT; Other Names: 18FDG; FDG

Outcome Measures

Go to 

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Primary Outcome Measures :

1. Induction therapy failure [ Time Frame: 6 weeks after completion of chemoradiation therapy (CRT) ]
   Defined as any evidence by clinically unresectable disease based on tumor board consensus and review of restaging scans demonstrating locoregional progression or distant metastasis, surgically unresectable disease based on surgical exploration, or suboptimal resection disease still requiring pneumonectomy and still having R1 resection.
2. Early positron emission tomography (PET) response of group A [ Time Frame: Baseline and between standard radiotherapy (RT) fractions 5-6 ]
   Measured by the change in Standard Uptake Value (SUV)max from baseline at the research PET scan in 1 of 3 scheduled time point.
3. Early positron emission tomography (PET) response of group B [ Time Frame: Baseline and between standard radiotherapy (RT) fractions 10-11 ]
   Measured by the change in Standard Uptake Value (SUV)max from baseline at the research PET scan in 1 of 3 scheduled time point.
4. Early positron emission tomography (PET) response of group C [ Time Frame: Baseline and between standard radiotherapy (RT) fractions 15-16 ]
   Measured by the change in Standard Uptake Value (SUV)max from baseline at the research PET scan in 1 of 3 scheduled time point.

Secondary Outcome Measures :

1. Pathologic response [ Time Frame: 6 weeks after completion of chemoradiation therapy (CRT) ]
2. Progression-free survival [ Time Frame: Every 3 months for 2 years and every 6 months thereafter ]
3. Overall survival [ Time Frame: Every 3 months for 2 years and every 6 months thereafter ]

Eligibility Criteria

Go to 

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Ages Eligible for Study:	Child, Adult, Senior
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• All patients with marginally resectable IIIA (N2) NSCLC undergoing induction CRT will be eligible for this imaging trial; patients will be screened by the chest tumor board for entry
• Undergoing or plan to undergo induction chemoradiation

Exclusion Criteria:

• Poorly controlled or uncontrolled diabetes mellitus, with blood glucose > 200 mg/dl
• Have allergies or medical contra-indications to FDG or intravenous (IV) contrast
• Medical contra-indications to obtaining CT or PET scans
• Pre-authorization denial of coverage by insurance providers of clinical staging and restaging PET-CT scans

Contacts and Locations

Go to 

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Sponsors and Collaborators

City of Hope Medical Center

National Cancer Institute (NCI)

Investigators

Principal Investigator:	Khanh Nguyen	City of Hope Medical Center

More Information

Go to 

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Responsible Party:	City of Hope Medical Center
ClinicalTrials.gov Identifier:	NCT01314677 History of Changes
Other Study ID Numbers:	10012; NCI-2011-00337 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
First Posted:	March 14, 2011
Last Update Posted:	June 29, 2012
Last Verified:	June 2012

Additional relevant MeSH terms:

Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases	Respiratory Tract Diseases; Carcinoma, Bronchogenic; Bronchial Neoplasms; Fluorodeoxyglucose F18; Radiopharmaceuticals; Molecular Mechanisms of Pharmacological Action