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This study will help researchers test the safety of hypofractionated dose of radiotherapy (HySBst) at different dose levels before or after chemo-radiation for Non Small Cell Lung Cancer.
Patients are assigned to Sub-group 1 or 2 based on the primary lesion size and location. This protocol will utilize a standard 3 + 3 phase I design with three patients enrolled per cohort.
Patients will be offered the opportunity to participate in the blood specimen component of the study.
Patients will be followed up to 2 years post radiation therapy.
Sub-group 1 will receive HySBst for 1 week. Weeks 2-7 will be standard chemo-radiation therapy. Patients have the option of consolidative chemotherapy at week 12.
Sub-group 2 will receive standard chemo-radiation therapy for weeks 1-6 then receive HySBst during week 7. Patients have the option of consolidative chemotherapy at week 12.
HySBst dose escalation for each sub-group is listed below:
Optional: 4 Gy x 4 daily fractions Level 1: 5 Gy x 4 daily fractions Level 2: 5.5 Gy x 4 daily fractions Level 3: 6 Gy x 4 daily fractions
DLTs will be based on events occurring during the course of HySBst.
Chemo-Radiation Therapy is defined as:
Standard Carboplatin & Paclitaxel Doublelet Regimen with weekly Carboplatin AUC 2/week and Paclitaxel 45 mg/ m2/ week during conventionally fractionated IMRT
Image-guided IMRT to 60 Gy, 5 x per week for 6 weeks
Consolidative chemotherapy is defined as Carboplatin AUC 6 and Paclitaxel 200 mg/m2 every 21 days x 2 cycles will be given after ALL radiotherapy is delivered.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sub-group 1 | Experimental | HySBst to be delivered during week 1 with Chemo-radiation to be delivered weeks 2-7 |
|
| Sub-group 2 | Experimental | Chemo-radiation to be delivered weeks 1-6 and HySBst to be delivered week 7 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hypofractionated Stereotactic Boost | Radiation | An ablative dose of radiation is delivered to the primary tumor target over a week through Stereotactic Ablative Radiotherapy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Maximum Tolerated Dose of HySBst | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Dose Limiting Toxicity | 1 week | |
| Blood Sample Collection | Biomarker analysis | 2 years |
| Local Control |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Malcolm Mattes, MD | West Virginia University - Mary Babb Randolph Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| West Virginia University Hospitals Mary Babb Randolph Cancer Center | Morgantown | West Virginia | 26506 | United States |
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| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
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| ID | Term |
|---|---|
| D016190 | Carboplatin |
| D017239 | Paclitaxel |
| ID | Term |
|---|---|
| D056831 | Coordination Complexes |
| D009930 | Organic Chemicals |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
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|
| Carboplatin | Drug | Given during chemo-radiation phase and optional consolidative phase. |
|
| Paclitaxel | Drug | Given during chemo-radiation phase and optional consolidative phase. |
|
| Image-guided IMRT | Radiation | Given during chemo-radiation phase |
|
To determine the 2-year regional, and distant metastasis rates, progression-free survival (PFS), local progression free survival (L-PFS), overall survival (OS) |
| 2 years |
| Quality of Life | To determine the quality of life before and after treatment using the European Organisation of Research and Treatment of Cancer Quality of Life Questionnaire, Core 30 and Lung Cancer 13 (EORTC QLQ-C30, and the LC 13) scales | 2 years |
| D013899 |
| Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D003516 |
| Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D004224 | Diterpenes |
| D013729 | Terpenes |