The main objective of this study is to demonstrate superiority in progression-free survival (PFS) when NGR-hTNF is added to standard chemotherapy regimen (cisplatin/gemcitabine or cisplatin/pemetrexed) in locally advanced (stage IIIb with supraclavicular lymph node metastases or malignant pleural or pericardial effusion), metastatic (stage IV) or recurrent non-small cell lung cancer (NSCLC).
Eligible patients will be randomly assigned to a standard chemotherapy regimen plus low-dose (0.8 mcg/m\^2) NGR-hTNF or standard chemotherapy alone, through a centralized randomization process using the following stratification factors: performance status (0 vs 1) and histology (squamous vs non-squamous). In both arms the choice between the two chemotherapy regimens will be based on the histologic subtype: in patients with squamous histology (including also generic diagnosis of NSCLC without further subtype classification) is recommended cisplatin/gemcitabine regimen, in patients with nonsquamous histology (including adenocarcinoma and large-cell carcinoma) is recommended cisplatin/pemetrexed regimen.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
121
NGR-hTNF: 0.8 mcg/m² as 60-minute intravenous infusion every 3 weeks until confirmed evidence of disease progression or unacceptable toxicity occurs
Cisplatin: 80 mg/m² intravenous infusion on day 1 every 3 weeks for a maximum of 6 cycles
Gemcitabine: 1,250 mg/m² intravenous infusion on days 1 and 8 every 3 weeks for a maximum of 6 cycles
Istituto Nazionale per la ricerca sul cancro
Genoa, Italy
Fondazione San Raffaele del Monte Tabor
Milan, Italy
Istituto Nazionale dei Tumori
Milan, Italy
Istituto Europeo Oncologico
Milan, Italy
Progression-free survival (PFS)
PFS evaluated according to Response evaluation criteria in solid tumors (RECIST)
Time frame: Every 6 weeks during study treatment and every 6 weeks during the follow-up before PD
Safety according to NCI-CTCAE criteria (version 3)
To evaluate safety profile related to NGR-hTNF in combination with standard chemotherapy
Time frame: from the date of randomization until 28 days after last treatment
Objective response rate
Antitumor activity defined as response rate evaluated according to Response evaluation criteria in solid tumors (RECIST)
Time frame: Every 6 weeks during study treatment and every 6 weeks during the follow-up before PD
Duration of response (DR)
defined as the time that measurement criteria are met for complete response or partial response (whichever status is recorded first) until the progressive disease is objectively documented.
Time frame: from the time of first recorded evidence of complete response or partial response until the progressive disease objectively documented
Overall survival (OS)
Defined as the time from the date of randomization until the date of death due to any cause or the last date the patient was known to be alive
Time frame: from the randomization until to the date of patient death or discontinuation from the study
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Pemetrexed: 500 mg/m² intravenous infusion on day 1 every 3 weeks for a maximum of 6 cycles