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NCT Number: NCT00136864

Positron Emission Tomography (PET) Imaging in Stage III Non-small Cell Lung Cancer (PET START Trial)

Locally advanced non-small cell lung cancer, NSCLC, (Stage III) is potentially curable with aggressive combined modality therapy (chemotherapy and radiation). Conventional imaging can only evaluate gross anatomic abnormalities but functional imaging with positron emission tomography (PET) may more accurately identify patients who will benefit from aggressive combined modality therapy.

This prospective randomized clinical trial will enroll 400 patients that have undergone conventional staging for lung cancer and have been found to have Stage III NSCLC. The patients will then be randomized to either standard combined modality therapy for Stage III NSCLC or to PET imaging prior to combined modality therapy with curative intent. Based on the PET findings, patients will either be suitable for combined modality therapy with curative intent or not.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Juravinski Cancer Centre, Hamilton, Ontario, Canada

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Histological or cytological evidence of NSCLC. Must have documented pathology report with histology indicated (e.g. squamous, adenocarcinoma, large cell, NSCLC not otherwise specified).
  • Stage III (mediastinal node positive) NSCLC based on conventional staging (e.g. computed tomography [CT] scan of chest and upper abdomen, CT or magnetic resonance imaging [MRI] of brain, bone scan).
  • Suitable for combined modality (chemotherapy and radiation) therapy or radical radiation therapy or trimodality therapy (chemotherapy, radiation and surgery).

Exclusion criteria

  • Stage IV NSCLC (by conventional staging).
  • Small cell lung cancer.
  • Poor performance status Eastern Cooperative Oncology Group (ECOG) 3-4.
  • Poor pulmonary function precluding radical radiation therapy (Adequate pulmonary reserve for radical radiation therapy. Pulmonary function tests should have forced expiratory volume in 1 second (FEV1) > 1.0 liter or > 40% predicted, diffusing capacity of the lung for carbon monoxide (DLCO) > 45% and/or predicted contralateral FEV1 > 800 cc based on quantitative ventilation perfusion lung scan).
  • Significant concurrent medical problems (e.g. uncontrolled diabetes, active cardiac problems, significant chronic obstructive pulmonary disease).
  • Insulin dependent diabetic where requirements for PET imaging may be problematic.
  • Unable to lie supine for at least 30 minutes in radiation treatment position for imaging with PET.
  • Failure to provide informed consent.
  • Previous PET scan relating to recent cancer diagnosis prior to entry into study.
  • Pregnant or lactating females.
  • Prior thoracic radiation.
  • Prior malignancy within 3 years from randomization (except nonmelanotic skin cancer or carcinoma in situ of the cervix).
  • Administered more than two cycles of chemotherapy prior to radical radiation therapy or concurrent chemoradiation (as part of induction or sequential chemotherapy prior to randomization) for the current malignancy.

Treatment and study plan

PET Diagnostic Imaging

Procedure

Patients in the PET group will undergo the standard diagnostic tests plus PET to determine those suitable for combined modality therapy

Primary outcomes

  1. Stage III NSCLC patients upstaged by PET

    Time frame: 2 years

Secondary outcomes

  1. Overall survival

    Time frame: 2 years

  2. Impact of PET on radiation treatment planning

    Time frame: 2 years

  3. Prognostic ability of PET standard uptake value

    Time frame: 2 years

  4. Number of patients downstaged by PET

    Time frame: 2 years

Sponsors and collaborators

Lead sponsor

Ontario Clinical Oncology Group (OCOG)

Other

Collaborators

  • Ontario Ministry of Health and Long Term Care

Registry information

Official study title

The Impact of Positron Emission Tomography (PET) Imaging in Stage III Non-small Cell Lung Cancer: A Prospective Randomized Clinical Trial (PET START Trial)

Important dates

Study start
2004
Primary completion
2009
Study completion
2011
First posted
Aug 29, 2005
Registry last updated
Nov 18, 2011

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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