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Last Modified: 10/30/2007     First Published: 4/23/2004  
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Phase II Study of Fludeoxyglucose F18 Positron Emission Tomography for Pre- and Post-treatment Assessment in Patients With Locally Advanced Non-Small Cell Lung Cancer

Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Trial Contact Information
Registry Information

Alternate Title

Fludeoxyglucose F18 Positron Emission Tomography Imaging In Assessing Patients Before and After Treatment for Locally Advanced Non-Small Cell Lung Cancer

Basic Trial Information

Phase
Type
Status
Age
Sponsor
Protocol IDs

Phase II


Biomarker/Laboratory analysis, Diagnostic, Treatment


Active


18 and over


NCI


ACRIN-6668
ACRIN-6668, RTOG-0235, NCT00083083

Objectives

Primary

  1. Determine whether peak standardized uptake value (SUV) for fludeoxyglucose F 18 positron emission tomography (FDG-PET) shortly after definitive chemoradiotherapy is predictive of long-term survival of patients with inoperable stage IIB or III non-small cell lung cancer.

Secondary

  1. Determine whether max SUV for FDG-PET shortly after definitive chemoradiotherapy is predictive of long-term survival in these patients.
  2. Determine whether post-treatment imaging using peak and max SUV for FDG-PET shortly after definitive chemoradiotherapy is predictive of local disease control in these patients.
  3. Determine whether pre-treatment imaging using these techniques is predictive of long-term survival and local disease control in these patients.
  4. Correlate, if possible, Ki-67 expression with overall survival of patients assessed with these imaging techniques.

Entry Criteria

Disease Characteristics:

  • Histologically confirmed non-small cell lung cancer (NSCLC)
    • Clinical stage IIB or III disease
    • No small cell carcinoma
    • No stage IV disease*
    • No diffuse bronchoalveolar subtype
    • No planned definitive surgical resection

     [Note: *Patients with evidence of stage IV disease by positron emission tomography are eligible if the evidence cannot be confirmed by other means AND the physician still plans to proceed with definitive chemoradiation]



  • Planning treatment with definitive chemoradiotherapy
    • May be treated on another Radiation Therapy Oncology Group protocol (except phase I studies) OR with conventional concurrent NSCLC chemoradiotherapy
    • Radiotherapy ≥ 60 Gy AND chemotherapy to include concurrent platinum-based therapy


  • No brain metastases by head CT scan or MRI


Prior/Concurrent Therapy:

Biologic therapy

  • No anticipated use of adjuvant biologic therapy beyond 14 weeks after the completion of radiotherapy

Chemotherapy

  • See Disease Characteristics
  • No anticipated use of adjuvant chemotherapy beyond 14 weeks after the completion of radiotherapy

Endocrine therapy

  • Not specified

Radiotherapy

  • See Disease Characteristics
  • No prior thoracic radiotherapy
  • No concurrent intensity-modulated radiotherapy

Surgery

  • See Disease Characteristics

Patient Characteristics:

Age

  • 18 and over

Performance status

  • Zubrod 0-1

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Not specified

Renal

  • Not specified

Other

  • Medically suitable for early concurrent chemoradiotherapy (radiotherapy dose ≥ 60 Gy)
  • Able to tolerate positron emission tomography imaging
  • No poorly controlled diabetes (defined as fasting glucose level > 200 mg/dL)
  • No other malignancy within the past 3 years except basal cell or squamous cell skin cancer or carcinoma in situ
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 3 months after study participation

Expected Enrollment

250

A total of 250 patients (including at least 75 with stage IIB/IIIA disease and at least 75 with stage IIIB disease) will be accrued for this study within 2 years.

Outcomes

Primary Outcome(s)

Relationship of survival to post-treatment peak standardized uptake value (SUV) as determined by the imaging institution

Secondary Outcome(s)

Relationship of survival to post-treatment max SUV as determined by the imaging institute
Relationship of local control to post-treatment peak and max SUV as determined by the imaging institution
Relationship of survival and of local control to pre-treatment peak and max SUV as determined by the imaging institution
Reliability between peak and max SUV measurements both pre- and post-treatment
Proportion of participants who are either upstaged or downstaged by positron emission tomography scan
Reliability between PET scan-defined response to therapy measurements
Correlation of Ki-67 expression with peak and max pre-treatment SUV
Association between Ki-67 expression and overall survival at 2 years

Outline

This is a diagnostic, multicenter study.

Before starting chemoradiotherapy, patients undergo baseline whole-body positron emission tomography (PET) imaging. Patients receive fludeoxyglucose F 18 (18FDG) IV followed 50-70 minutes later by PET imaging. Patients then receive concurrent definitive radiotherapy and chemotherapy. Patients enrolled in other treatment-oriented clinical trials receive therapy as per that trial. Other patients receive standard thoracic radiotherapy (dose ≥ 60 Gy) and standard chemotherapy comprising a platin (cisplatin or carboplatin) and a second non-platin, non-gemcitabine drug (etoposide, vinblastine, vinorelbine, paclitaxel, or docetaxel). Approximately 14 weeks after completion of chemoradiotherapy and adjuvant chemotherapy (if given), patients undergo post-treatment 18FDG-PET imaging.

Patients are followed every 3 months for 2 years and then every 6 months for at least 1 year.

Trial Contact Information

Trial Lead Organizations

American College of Radiology Imaging Network

Mitchell Machtay, MD, Protocol chair
Ph: 215-955-6706; 800-533-3669
Email: mitchell.machtay@mail.tju.edu

Radiation Therapy Oncology Group

Mitchell Machtay, MD, Protocol chair
Ph: 215-955-6706; 800-533-3669
Email: mitchell.machtay@mail.tju.edu

Trial Sites

U.S.A.
Alabama
  Birmingham
 Lurleen Wallace Comprehensive Cancer at University of Alabama - Birmingham
 Clinical Trials Office - Lurleen Wallace Comprehensive Cancer
Ph: 205-934-0309
Arizona
  Scottsdale
 Scottsdale Medical Imaging, Limited
 Allison Irving
Ph: 480-425-5000 ext. 5044
California
  Los Angeles
 USC/Norris Comprehensive Cancer Center and Hospital
 Clinical Trials Office - USC/Norris Comprehensive Cancer Center and Hospital
Ph: 323-865-0451
  Sacramento
 Radiological Associates of Sacramento Medical Group at Sutter Cancer Center
 Kim Vagharfard
Ph: 916-454-6699 ext. 80383
 Email: vagharfardk@radiological.com
Connecticut
  New Haven
 Hospital of Saint Raphael
 Clinical Trials Office - Hospital of Saint Raphael
Ph: 203-789-3545
Florida
  Boynton Beach
 Bethesda Comprehensive Cancer Care Center at Bethesda Memorial Hospital
 Clinical Trials Office - Bethesda Comprehensive Cancer Care Center
Ph: 561-374-5020
  Dearfield Beach
 North Broward Medical Center
 Clinical Trials Office - North Broward Medical Center
Ph: 954-941-8300
  Jacksonville
 Integrated Community Oncology Network at Baptist Cancer Institute
 Jan Peer
Ph: 904-202-7027
  Tallahassee
 Tallahassee Memorial Hospital
 Rowena Dimayuga
Ph: 850-431-5262
Illinois
  Chicago
 Rush Cancer Institute at Rush University Medical Center
 Clinical Trials Office - Rush Cancer Institute at Rush University Medical Center
Ph: 312-942-5498
 Email: clinical_trials@rush.edu
Indiana
  Anderson
 Saint John's Cancer Center at Saint John's Medical Center
 Patricia Farran, RN, OCN, CTR RA
Ph: 765-646-8459
 Email: pafarran@sjhsnet.org
  Goshen
 Center for Cancer Care at Goshen General Hospital
 Clinical Trials Office - Center for Cancer Care at Goshen General Hospital
Ph: 574-535-2858
  South Bend
 CCOP - Northern Indiana CR Consortium
 Virginia Bolin
Ph: 800-284-7370
Maryland
  Baltimore
 Greenebaum Cancer Center at University of Maryland Medical Center
 Clinical Trials Office - Greenebaum Cancer Center at University of Maryladn Medical Center
Ph: 800-888-8823
Massachusetts
  Boston
 Beth Israel Deaconess Medical Center
 Clinical Trials Office - Beth Israel Deaconess Medical Center
Ph: 617-667-9925
 Dana-Farber Partners Cancer Care
 Jennifer Curry
Ph: 617-726-3694
  South Weymouth
 South Shore Hospital
 Kelly O'Neil
Ph: 617-376-6400
 Email: koneil@shcpo.shields.com
Michigan
  Detroit
 Josephine Ford Cancer Center at Henry Ford Hospital
 Karen Dziubek
Ph: 313-916-9462
888-734-5322
  Kalamazoo
 West Michigan Cancer Center
 Clinical Trials Office - West Michigan Cancer Center
Ph: 269-373-7458
  Royal Oak
 William Beaumont Hospital - Royal Oak Campus
 Clinical Trials Office - William Beaumont Hospital - Royal Oak Campus
Ph: 248-551-7695
Missouri
  St. Louis
 Mallinckrodt Institute of Radiology at Washington University Medical Center
 Clinical Trials Office - Mallinckrodt Institute of Radiology at Washington University Medical Center
Ph: 314-362-1000
Nevada
  Reno
 Renown Institute for Cancer at Renown Regional Medical Center
 Lynn Jarvis
Ph: 775-982-5842
866-559-0558
 Email: ljarvis@washoehealth.com
New Hampshire
  Lebanon
 Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
 Clinical Trials Office - Norris Cotton Cancer Center
Ph: 603-650-7609
 Email: cancerhelp@dartmouth.edu
New Jersey
  Teaneck
 Sister Patricia Lynch Regional Cancer Center at Holy Name Hospital
 Clinical Trials Office - Sister Patricia Lynch Regional Cancer Center at Holy Name Hospital
Ph: 201-833-6312
  Toms River
 J. Phillip Citta Regional Cancer Center at Community Medical Center
 Clinical Trials Office - J. Phillip Citta Regional Cancer Center at Community Medical Center
Ph: 732-818-3882
Ohio
  Akron
 McDowell Cancer Center at Akron General Medical Center
 Kim Surface
Ph: 330-344-6348
  Cleveland
 Cleveland Clinic Cancer Center at Fairview Hospital
 Clinical Trials Office - Cleveland Clinic Cancer Center at Fairview Hospital
Ph: 216-476-9362
 Cleveland Clinic Taussig Cancer Center
 Clinical Trials Office - Cleveland Clinic Taussig Cancer Center
Ph: 866-223-8100
Oklahoma
  Oklahoma City
 Oklahoma University Cancer Institute
 Faraz Masood
Ph: 405-271-5125
Oregon
  Portland
 Oregon Health and Science University Cancer Institute
 Clinical Trials Office - Oregon Health and Science University Cancer Institute
Ph: 503-494-1080
 Email: trials@ohsu.edu
Pennsylvania
  Philadelphia
 Albert Einstein Cancer Center
 Sharon Byrne
Ph: 215-456-6280
 Fox Chase Cancer Center - Philadelphia
 Clinical Trials Office - Fox Chase Cancer Center - Philadelphia
Ph: 215-728-4790
 Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
 Clinical Trials Office - Kimmel Cancer Center at Thomas Jefferson University - Philadelphia
Ph: 215-955-6084
  Pittsburgh
 UPMC Cancer Centers
 Clinical Trials Office - UPMC Cancer Centers
Ph: 412-647-8073
  Wynnewood
 Lankenau Cancer Center at Lankenau Hospital
 Judith Fanelli
Ph: 610-645-2395
 Email: fanellij@mlhs.org
Rhode Island
  Providence
 Brown University School of Medicine
 Cindy Cobb
Ph: 401-444-4344
 Roger Williams Medical Center
 Cindy Cobb
Ph: 401-444-4344
 Email: ccobb@lifespan.org
South Carolina
  Charleston
 Hollings Cancer Center at Medical University of South Carolina
 Clinical Trials Office - Hollings Cancer Center at Medical University of South Carolina
Ph: 843-792-9321
  Spartanburg
 Gibbs Regional Cancer Center at Spartanburg Regional Medical Center
 Clinical Trials Office - Gibbs Regional Cancer Center
Ph: 800-486-5941
Tennessee
  Nashville
 Vanderbilt-Ingram Cancer Center
 Clinical Trials Office - Vanderbilt-Ingram Cancer Center
Ph: 1-800-811-8480;
Texas
  Dallas
 Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
 Clinical Trials Office - Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
Ph: 866-460-4673; 214-648-7097
  Houston
 M. D. Anderson Cancer Center at University of Texas
 Clinical Trials Office - M. D. Anderson Cancer Center at the University of Texas
Ph: 713-792-3245
Utah
  Salt Lake City
 Huntsman Cancer Institute at University of Utah
 Clinical Trials Office - Huntsman Cancer Institute at University of Utah
Ph: 801-581-4477
 Email: clinical.trials@hci.utah.edu
Virginia
  Richmond
 Bon Secours Cancer Institute at St. Mary's Hospital
 Ann Kaplan
Ph: 804-287-7418
 Email: ann_kaplan@bshsi.com
Wisconsin
  Madison
 University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
 Clinical Trials Office - University of Wisconsin Paul P. Carbone Comprehensive Cancer Center
Ph: 608-262-5223
  Waukesha
 Waukesha Memorial Hospital Regional Cancer Center
 Clinical Trials Office - Waukesha Memorial Hospital Regional Cancer Center
Ph: 262-928-7632
Canada
Alberta
  Calgary
 Tom Baker Cancer Centre - Calgary
 Pina Sjoblom
Ph: 403-944-8018
Ontario
  Kitchner
 Grand River Regional Cancer Centre at Grand River Hospital
 Carla Girolametto
Ph: 519-749-4370
Republic of Korea
  Goyang
 National Cancer Center - Korea
 Hyang Kang
Ph: 82-31-920-0146
 Email: nccrtog@ncc.re.kr

Registry Information
Official Title Positron Emission Tomography Pre- and Post-treatment Assessment For Locally Advanced Non-Small Cell Lung Carcinoma
Trial Start Date 2005-03-01
Registered in ClinicalTrials.gov NCT00083083
Date Submitted to PDQ 2004-03-17
Information Last Verified 2007-10-29
NCI Grant/Contract Number CA080098

Note: The purpose of some clinical studies is to help researchers learn more about how cancer cells grow and how drugs are used in the body. Cells and tissues collected from cancer patients may be used to detect new biomarkers that may be important in diagnosing and treating cancer in the future. The procedure or lab test described in this clinical study is intended to be carried out by clinical oncologists and researchers in carefully structured settings. Individual results obtained from these studies may not be made available to patients.

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