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Brief Title: Survival imProvement in Lung cancEr iNduced by DenOsUmab theRapy
Official Title: A Randomised, Open-label Phase III Trial Evaluating the Addition of Denosumab to Standard First-line Anticancer Treatment in Advanced NSCLC
Study ID: NCT02129699
Brief Summary: The purpose of this study is to investigate how well the standard treatment (platinum-based doublet chemotherapy) in combination with denosumab works compared with the standard treatment alone in patients with a type of lung cancer called "non small cell lung cancer" (NSCLC) that has spread to other parts of the body.
Detailed Description: The investigational medicinal product denosumab is a protein (monoclonal antibody) that works to slow down bone destruction caused by cancer spreading to the bone (bone metastasis). Denosumab is used in adults with cancer to prevent serious complications caused by bone metastasis (e.g., fracture, pressure on the spinal cord or the need to receive radiation therapy or surgery). Results from one study in lung cancer patients with bone metastasis suggested that adding denosumab to the standard chemotherapy may lead to a possible survival benefit. All patients will receive standard chemotherapy consisting of a combination of platinum-based doublet agents plus gemcitabine or pemetrexed, depending on the nature of the lung cancer, every 3 weeks for about 3-4 months: Patients will be assigned to one of two groups, known as 'arms'. The treatment for each arm will be as follows: Arm A: 4 - 6 cycles of chemotherapy and best supportive care (including any bone protective agent except denosumab) Arm B: 4 - 6 cycles of chemotherapy + denosumab 120 mg, administered subcutaneously every 3-4 weeks until unacceptable toxicity, patient refusal or patient's death. After stop of first-line chemotherapy, denosumab must be continued every 3-4 weeks lifelong, regardless of tumour progression and concomitantly with subsequent lines of systemic treatment, as long as tolerable for the patient. Beyond primary analysis, all subjects randomised to ARM B and still benefitting from the drug will be offered denosumab at a dose of 120 mg s.c. until patient or physician elect to discontinue denosumab for any reason, and for a maximum of 2 years after the required number of events for the final analysis has been reached. A total of 1000 patients from centers in Europe, Switzerland and Israel are expected to be enrolled in this study over a period of 37 months. The study will take approximately 56 months to be completed.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Univ. Klinik für Innere Medizin V, Innsbruck, , Austria
KH der Elisabethinen Linz, Linz, , Austria
AKH Wien, Wien, , Austria
Otto-Wagner-Spital Department 1, Wien, , Austria
Otto-Wagner-Spital Department 2, Wien, , Austria
Onze Lieve Vrouw Ziekenhuis, Aalst, , Belgium
University Hosptial Ghent, Ghent, , Belgium
Centre Hospitalier Regional De La Citadelle, Liege, , Belgium
Clinique et Maternite Sainte Elisabeth, Namur, , Belgium
Centre hospitalier universitaire d'Angers, Angers, , France
Centre Hospitalier Annecy, Annecy, , France
Centre Hospitalier De Beauvais, Beauvais Cedex, , France
Hôpitale de la Cavale Blanche - CHRU de BREST, Brest, , France
GHPSO (Sie de Creil), Creil, , France
Centre Hospitalier Intercommunal Creteil, Creteil, , France
Hospital Center Le Mans, Le Mans, , France
Hôpital du Cluzeau, Limoges, , France
CHBS Lorient, Lorient, , France
Hôpital Louis Pradel, Lyon, , France
Assistance Publique-Hôitaux de Marseille, Marseille, , France
Institut Paoli-Calmettes, Marseille, , France
Centre Hospitalier de Meaux, Meaux, , France
Centre Hospitalier Universitaire Rennes, Rennes, , France
Clinique Mutualiste de l'Estuaire, Saint-Nazaire, , France
CHICAS, Sisteron, , France
Hôpital de Villefranche-sur-Saône, Villefranche-sur-saône, , France
ASKLEPIOS - Fachkliniken München - Gauting, München, , Germany
Pius Hospital, Oldenburg, , Germany
Cork University Hospital, Cork, , Ireland
Beaumont Hospital, Dublin, , Ireland
Mater Miscordia University Hospital, Dublin, , Ireland
Mater Private Hospital, Dublin, , Ireland
St James's Hospital, Dublin, , Ireland
The Adelaide and Meath Hospital, Dublin, , Ireland
University Hospital Galway, Galway, , Ireland
University Hospital Limerick, Limerick, , Ireland
Hospital Waterford, Waterford, , Ireland
S.G Moscati Hospital, Aversa, , Italy
IRCCS Azienda Ospedaliera Universitaria San Martino, Genova, , Italy
San Paolo Hospital, Milan, , Italy
Ospedale San Gerardo, Monza, , Italy
Maria Sklodowska-Curie Memorial Car, Gliwice, , Poland
University Clinic Golnik, Golnik, , Slovenia
Institute of Oncology Ljubljana, Ljubljana, , Slovenia
Hospital General de Alicante, Alicante, , Spain
Hospital De La Santa Creu I Sant Pau, Barcelona, , Spain
Institut Català d'Oncologia - L'Hospitalet, Barcelona, , Spain
Hospital General Castellón, Castelló, , Spain
Hospital Universitario Reina Sofia, Córdoba, , Spain
Complejo Hospitalario de Jaén, Jaén, , Spain
H. U. Insular Gran Canaria, Las Palmas, , Spain
Regional Universitario Carlos Haya, Malaga, , Spain
H Morales Meseguer, Murcia, , Spain
Hospital Son Espases, Palma de Mallorca, , Spain
Hospital Arnau Vilanova Valencia, Valencia, , Spain
Hospital Universitario Miguel Servet, Zaragoza, , Spain
Kantonsspital Graubünden, Chur, , Switzerland
HFR Fribourg, Fribourg, , Switzerland
Centre Hospitalier Universitaire Vaudois, Lausanne, , Switzerland
Kantonsspital Luzern, Luzern, , Switzerland
Onkologiezentrum Berner Oberland, Thun, , Switzerland
Kantonsspital Winterthur, Winterthur, , Switzerland
Universitätsspital Zürich, Zürich, , Switzerland
Aberdeen Royal Infirmary, Aberdeen, , United Kingdom
Oxford University Hospitals Trust, Oxford, , United Kingdom
Weston Park Hospital, Sheffield, , United Kingdom
Name: Solange Peters, MD, PhD
Affiliation: Trial Chair, CHUV Lausanne, Switzerland
Role: STUDY_CHAIR
Name: Mary O'Brien, MD
Affiliation: EORTC Trial Co-Chair, Royal Marden Hospital, Sutton, UK
Role: STUDY_CHAIR
Name: Sarah Danson, PhD
Affiliation: EORTC Trial Co-Chair, University of Sheffield, Sheffield, UK
Role: STUDY_CHAIR
Name: Rolf Stahel, MD
Affiliation: Trial Co-Chair, University Hospital of Zuerich, Switzerland
Role: STUDY_CHAIR