The main objective of this study is to investigate whether administration of maintenance temozolomide following standard treatment could possibly prevent or delay the onset of brain metastases in patients with controlled non-small cell lung cancer (NSCLC).
This is a Phase 2, open-label, randomized, multicenter study of maintenance temozolomide versus observation in subjects with stable or responding stage III/IV NSCLC to be conducted in conformance with Good Clinical Practices. Subjects will be randomly assigned to a study drug (temozolomide) or observation arm. The study drug will be administered at a dose of 75 mg/m\^2 PO daily for 21 consecutive days, followed by a 7-day rest period, until progression or up to a maximum of 6 cycles, whichever occurs first. Subjects completing 6 cycles of treatment will be followed up for incidence of brain metastasis for up to 2 years, or until progression.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
53
5-mg, 20-mg, and 100-mg gel capsules, 75 mg/m\^2 PO daily for 21 consecutive days, followed by a 7-day rest period, until progression or up to a maximum of 6 cycles, whichever occurs first.
Number of Participants Who Had Brain Metastases
Brain Metastases were defined as radiological evidence of brain metastases on magnetic resonance imaging (MRI).
Time frame: Up to 12 months (as measured from day 1 of cycle 1 of standard first-line systemic chemotherapy)
Time to Radiological Central Nervous System (CNS) Progression
Defined as CNS progression as measured by MRI. Time to CNS progression was analyzed using the Kaplan-Meier method.
Time frame: from Cycle 1 Day 1 of Standard First Line Systemic Therapy to radiological progression or the last known CNS progression-free date
Time to Progression
The time to progression (per response evaluation criteria in solid tumors \[RECIST\]) was analyzed using the Kaplan-Meier method. Definitions of response per RECIST: Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): A decrease of at least 30% in the sum of the longest diameter of target lesions. Progressive Disease (PD): An increase of at least 20% in the sum of the longest diameter of target lesions. Stable Disease (SD): Neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease.
Time frame: from Cycle 1 Day 1 of Standard First Line Systemic Therapy to progression or up to 6 cycles (168 days) of study treatment
Overall Survival
The overall survival was analyzed using the Kaplan-Meier method.
Time frame: from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up
Number of Participants With Brain Metastases at First Progression
Brain Metastases were defined as radiological evidence of brain metastases on MRI.
Time frame: from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up (up to 6 cycles (168 days) of study treatment)
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Cancer-related Quality of Life (QoL) as Assessed by The European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire C30 Version 3.0 (QLQ-C30), and the EORTC Lung Cancer Module (QLQ-LC13)
The EORTC QLQ-C30 is a 30-item questionnaire developed to assess the QoL of cancer patients. Scores range from 0 -100. For functional and global QoL scales, higher scores mean a better level of function. For symptom-oriented scales, a higher score means more severe symptoms and a decrease in QoL. The EORTC QLQ-LC13 is a 13-item questionnaire developed to supplement the EORTC QLQ-C30 in lung cancer patients. It has a score range 0-100 with higher scores representing an increase in symptoms.
Time frame: from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up (up to 6 cycles (168 days) of study treatment)
Tolerability of Maintenance Temozolomide
Tolerability was defined as number of participants with any adverse event leading to study discontinuation and/or study drug discontinuation.
Time frame: from Cycle 1 Day 1 of Standard First Line Systemic Therapy to the last time of follow-up (up to 6 cycles (168 days) of study treatment)