Difficulty in enrolling patients

This is a phase II, open-label clinical study prospectively enrolling 40 metastatic patients with non small cell lung cancer. The study will enroll patients at King Abdulaziz Medical City, Riyadh.

Sub-sites will be open for patient accrual in selected centers in the Kingdom.

The cisplatin/docetaxel is established standard in the first line management of metastatic non small cell lung cancer in the United States, Europe and Asia. However, the safety and efficacy of this regimen was not studied systematically in Middle Eastern population. The aim of this study is to study the efficacy and safety of this regimen in our patient population

Inclusion Criteria:

• Histologically or cytologically proven non-small cell lung carcinoma

• Stage IV metastatic non-small cell lung carcinoma or stage III with malignant pleural effusion.

• Patient should not be eligible for customization chemotherapy (if available at participating institutions).

• Having at least one measurable lesion

• Patient has life expectancy of 12 weeks or greater.

• Age > 18 years.

• No prior systemic treatment for metastatic lung cancer. Adjuvant treatment given more than 1 year ago is acceptable.

• WHO performance status 0-2 (See Appendix III )

• Adequate organ function:

  • Hematology: Neutrophils > 2 x 10 9 /L, platelets > 100 x 10 9 /L
  • Hepatic function: Total bilirubin < 1.25 times the upper normal limits, ASAT (SGOT) < 2 times the upper normal limits
  • Renal function: Creatinine < 1.5 mg/dL; if value is higher than upper normal limit but less than 2 mg/dL, the creatinine clearance should be > 60min/ml.

• Able to comply with scheduled follow-up and with management of toxicity

• Signed informed consent from patient or legal representative

• Negative urine pregnancy test (if indicated)

Exclusion Criteria:

• Pregnant or lactating women or women of childbearing potential using inadequate contraception.

• Uncontrolled brain metastatic disease. (CNS disease that is stable > 4 weeks after radiotherapy in lieu of steroids reduction is eligible).

• Symptomatic peripheral neuropathy > grade 1 according to the NCI Common Toxicity Criteria Version 3

• Other serious illness or medical condition:

  • Unstable cardiac disease requiring treatment
  • History of significant neurologic or psychiatric disorders including psychotic disorders, dementia or seizures
  • Active uncontrolled infection

• Concurrent treatment with other experimental drugs. Participation in another clinical trial with any investigational drug within 30 days prior to study screening

• Concurrent treatment with any other anti-cancer therapy

• Contraindication of steroid drug administration

• Past (up to 5 years) or concurrent history of other neoplasm except curatively treated non- melanoma skin cancer or in situ carcinoma of the cervix