Carboplatin and Paclitaxel Albumin-Stabilized Nanoparticle Formulation Followed by Radiation Therapy and Erlotinib in Treating Patients With Stage III Non-Small Cell Lung Cancer That Cannot Be Removed By Surgery
Condition: Lung Cancer
MeSH terms: Lung Neoplasms; Carcinoma, Non-Small-Cell Lung
Intervention: carboplatin; erlotinib hydrochloride; paclitaxel albumin-stabilized nanoparticle formulation; radiation therapy
Intervention MeSH terms: Paclitaxel; Carboplatin; Erlotinib Hydrochloride; Albumin-Bound Paclitaxel
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 78.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: stage IIIA non-small cell lung cancer; stage IIIB non-small cell lung cancer; adenocarcinoma of the lung; bronchoalveolar cell lung cancer; large cell lung cancer; squamous cell lung cancer

Summary:

      RATIONALE: Drugs used in chemotherapy, such as carboplatin and paclitaxel albumin-stabilized
      nanoparticle formulation, work in different ways to stop the growth of tumor cells, either by
      killing the cells or by stopping them from dividing. Radiation therapy uses high-energy
      x-rays to kill tumor cells. Erlotinib may make tumor cells more sensitive to radiation
      therapy. Giving carboplatin and paclitaxel albumin-stabilized nanoparticle formulation
      together with radiation therapy and erlotinib may kill more tumor cells.

      PURPOSE: This phase II trial is studying how well giving carboplatin and paclitaxel
      albumin-stabilized nanoparticle formulation together with radiation therapy and erlotinib
      works in treating patients with stage III non-small cell lung cancer that cannot be removed
      by surgery.
    

Eligibility criteria:

        DISEASE CHARACTERISTICS:

          -  Histologically or cytologically confirmed non-small cell lung cancer (NSCLC),
             including any of the following histologies:

               -  Squamous cell carcinoma

               -  Adenocarcinoma (including bronchoalveolar cell)

               -  Large cell anaplastic carcinoma (including giant and clear cell carcinomas)

          -  Must meet the following criteria:

               -  T1-3 with N2 and selected N3*

               -  T4 with N0, N1, N2 and selected N3*

               -  M0 (no M1 patients) NOTE: *Patients with contralateral mediastinal disease (i.e.,
                  N3) are eligible, provided all gross disease can be encompassed within the
                  radiation boost field in accordance with the homogeneity criteria. Patients with
                  ipsilateral scalene or supraclavicular disease are also eligible. Patients with
                  contralateral hilar or supraclavicular node involvement are not eligible.

          -  Must have measurable disease, defined as ≥ 1 unidimensionally measurable lesion ≥ 20
             mm by conventional techniques or ≥ 10 mm by spiral CT scan

               -  Nonmeasurable lesions include the following:

                    -  Bone lesions

                    -  Leptomeningeal disease

                    -  Ascites

                    -  Pleural or pericardial effusion

                    -  Abdominal masses that are not confirmed and followed by imaging techniques

                    -  Cystic lesions

                    -  Tumor lesions situated in a previously irradiated area

          -  Patients must be considered unresectable or inoperable AND be deemed candidates for
             combined modality therapy by a medical oncologist and a radiation oncologist

          -  Considered to be poor-risk with NCI CTC performance status (PS) 2 OR PS 0-1 and ≥ 10%
             weight loss within the past 3 months

          -  Patients with tumors adjacent to a vertebral body are eligible, provided all gross
             disease can be encompassed within the radiation boost field in accordance with the
             homogeneity criteria

          -  Pleural effusions meeting the following criteria allowed:

               -  Effusion is transudate, cytologically negative, and non-bloody

               -  Effusion can be seen on the chest CT scan but not on the chest x-ray AND is too
                  small to tap

               -  Effusion appears only after a thoracotomy or other invasive thoracic procedure
                  was attempted

        PATIENT CHARACTERISTICS:

          -  See Disease Characteristics

          -  Granulocytes ≥ 1,500/μL

          -  Platelet count ≥ 100,000/μL

          -  Creatinine ≤ 1.5 x upper limit of normal (ULN)

          -  AST < 2 x ULN

          -  Bilirubin ≤ ULN

          -  Not pregnant or nursing

          -  Negative pregnancy test

          -  Fertile patients must use effective contraception

        PRIOR CONCURRENT THERAPY:

          -  No prior chemotherapy or radiotherapy for NSCLC

          -  At least 2 weeks since formal exploratory thoracotomy

          -  No concurrent administration of sucralfate suspension and erlotinib hydrochloride

          -  No concurrent intensity-modulated radiotherapy

          -  No concurrent hormones or other chemotherapeutic agents except steroids given for
             adrenal failure, hormones administered for non-disease-related conditions (e.g.,
             insulin for diabetes), and intermittent use of dexamethasone as an antiemetic

          -  No concurrent palliative radiotherapy