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Brief Title: Study of Patient Preference for Oral or Intravenous Vinorelbine in the Treatment of Advanced NSCLC
Official Title: Randomized Cross-over Study of Patient Preference for Oral or Intravenous Vinorelbine in the Treatment of Advanced NSCLC. A Phase IV Study.
Study ID: NCT01848613
Brief Summary: Title: Randomized cross-over study of patient preference for oral or intravenous vinorelbine in the treatment of advanced NSCLC. A phase IV study. ShortTitle/ Acronym: VIVOS Protocol Code :IRST162.05 Study Design: Randomized, open label cross-over study Study Duration: Two years Study Center(s): Multicenter study Objectives: Primary: Patient preference for oral or intravenous vinorelbine Secondary: Overall Response Rate, Time to Progression, Toxicity, Survival, Subjective reasons for treatment choice. Number of Subjects: 120 Diagnosis and Main Inclusion Criteria: Patients affected by stage IIIB or stage IV NSCLC candidates to receive a first line chemotherapy with vinorelbine due to age ≥ 70 and Eastern Cooperative Oncology Group (ECOG) Performance status ≤2 or age ≤ 70 but ECOG PS ≥ 2 Study Product, Dose, Route, Regimen and duration of administration : * Arm A: first cycle of IV vinorelbine (30 mg/m2) and second cycle of PO vinorelbine (60mg/m2) * Arm B: first cycle with PO vinorelbine (60mg/m2) followed by a second cycle of IV vinorelbine (30mg/m2) In both arms vinorelbine will be given at day 1 and day 8 every 3 weeks. From the third cycle onwards patients will have to choose to receive oral or intravenous vinorelbine. Vinorelbine capsules will be administered at the dosage of 60 mg/m2 for the first course and then may be increased to 80 mg/m² at physician's choice. Treatment will be repeated every 21 days and continued until disease progression, intolerable toxicity or patient refusal. Reference therapy: Vinorelbine 30 mg/m2 intravenous day 1 and 8 every 21 days Statistical Methodology: The sample size is calculated based on 75% of patients preferring "oral" vinorelbine and 25% preferring "intravenous" vinorelbine. Therefore, the investigators would compare patients preferring "oral" vinorelbine as 75% compared to a null hypothesis of 50% (no difference in proportion of patients preferring "oral" to "intravenous"). With 80% power and a total alpha of 0.05, the estimated sample size is 60 for group (120 total). During recruitment period, a formal interim analysis was planned when 60 patients (30 for group) have been enrolled, with a p-value \<0.0001. To claim statistical significance in the final analysis, the overall p-value is still 5% (referred to Peto-Haybittle rule).
Detailed Description:
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Irccs Irst, Meldola (FC), FC, Italy
U.O. Oncologia Ospedale Civile degli Infermi, Faenza, RA, Italy
U.O. Oncologia Ospedale Civile Umberto I, Lugo, RA, Italy
UO Oncologia Medica, Ospedale S.Maria delle Croci, Ravenna, RA, Italy
U.O. Oncologia Ospedale Cervesi, Cattolica, RN, Italy
U.O. Oncologia ed Ematologia Oncologica ULSS 13 MIRANO, Mirano, VE, Italy
U.O. Oncologia Medica ULSS 1 Belluno, Belluno, , Italy
U.O. Oncologia Ospedale degli Infermi, Rimini, , Italy
Name: Claudio Dazzi, MD
Affiliation: UO Oncologia Medica, Ospedale S.Maria delle Croci, RAVENNA - ITALY
Role: STUDY_CHAIR