RECRUITING

JoLT-Ca Sublobar Resection (SR) Versus Stereotactic Ablative Radiotherapy (SAbR) for Lung Cancer

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

To Determine if SAbR improves survival over SR in High Risk Operable Stage I NSCLC

Official Title

JoLT-Ca a Randomized Phase III Study of Sublobar Resection (SR) Versus Stereotactic Ablative Radiotherapy (SAbR) in High Risk Patients with Stage I Non-Small Cell Lung Cancer (NSCLC), the STABLE-MATES Trial

Quick Facts

Study Start:2015-07

Study Completion:2028-12

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT02468024

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Age \> 18 years. * ECOG performance status (PS) 0, 1, or 2. * Radiographic findings consistent with non-small cell lung cancer, including lesions with ground glass opacities with a solid component of 50% or greater. Those with ground glass opacities and \<50% solid component will be excluded. * The primary tumor in the lung must be biopsy confirmed non-small cell lung cancer within 180 days prior to randomization. * Tumor ≤ 4 cm maximum diameter, including clinical stage IA and selected IB by PET/CT scan of the chest and upper abdomen performed within 180 days prior to randomization. Repeat imaging within 90 days prior to randomization is recommended for re-staging but is not required based on institutional norms. * All clinically suspicious mediastinal N1, N2, or N3 lymph nodes (\> 1 cm short-axis dimension on CT scan and/or positive on PET scan) confirmed negative for involvement with NSCLC by one of the following methods: mediastinoscopy, anterior mediastinotomy, EUS/EBUS guided needle aspiration, CT-guided, video-assisted thoracoscopic or open lymph node biopsy within 180 days of randomization. * Tumor verified by a thoracic surgeon to be in a location that will permit sublobar resection. * Tumor located peripherally within the lung. NOTE: Peripheral is defined as not touching any surface within 2 cm of the proximal bronchial tree in all directions. See below. Patients with non-peripheral (central) tumors are NOT eligible. * No evidence of distant metastases. * Availability of pulmonary function tests (PFTs - spirometry, DLCO, +/- arterial blood gases) within 180 days prior to registration. Patients with tracheotomy, etc, who are physically unable to perform PFTs (and therefore cannot be tested for the Major criteria in 3.1.11 below) are potentially still eligible if a study credentialed thoracic surgeon documents that the patient's health characteristics would otherwise have been acceptable for eligibility as a high risk but nonetheless operable patient (in particular be eligible for sublobar resection). * Patient at high-risk for surgery by meeting a minimum of one major criteria or two minor criteria * Major Criteria * FEV1 ≤ 50% predicted (pre-bronchodilator value) * DLCO ≤ 50% predicted (pre-bronchodilator value) * Minor Criteria * Age ≥75 * FEV1 51-60% predicted (pre-bronchodilator value) * DLCO 51-60% predicted (pre-bronchodilator value) * Pulmonary hypertension (defined as a pulmonary artery systolic pressure greater than 40mm Hg) as estimated by echocardiography or right heart catheterization * Study credentialed thoracic surgeon believes the patient is potentially operable but that a lobectomy or pneumonectomy would be poorly tolerated by the patient for tangible or intangible reasons. The belief must be declared and documented in the medical record prior to randomization. * Poor left ventricular function (defined as an ejection fraction of 40% or less) * Resting or Exercise Arterial pO2 ≤ 55 mm Hg or SpO2 ≤ 88% * pCO2 \> 45 mm Hg * Modified Medical Research Council (MMRC) Dyspnea Scale ≥ 3. * No prior intra-thoracic radiation therapy for previously identified intra-thoracic primary tumor (e.g. previous lung cancer) on the ipsilateral side. NOTE: Previous radiotherapy as part of treatment for head and neck, breast, or other non-thoracic cancer is permitted so long as possible radiation fields would not overlap. Previous chemotherapy or surgical resection specifically for the lung cancer being treated on this protocol is NOT permitted. * No prior lung resection on the ipsilateral side. * Non-pregnant and non-lactating. Women of child-bearing potential must have a negative urine or serum pregnancy test prior to registration. Peri-menopausal women must be amenorrheic \> 12 months prior to registration to be considered not of childbearing potential. * No prior invasive malignancy, unless disease-free for ≥ 3 years prior to registration (exceptions: non-melanoma skin cancer, in-situ cancers). * Ability to understand and the willingness to sign a written informed consent.	* evidence of distant metastases * prior intra-thoracic radiation therapy. NOTE: Previous radiotherapy as part of treatment for head and neck, breast, or other non-thoracic cancer is permitted so long as possible radiation fields would not overlap. Previous chemotherapy or surgical resection specifically for the lung cancer being treated on this protocol is NOT permitted. No prior lung resection on the ipsilateral side. * pregnant and lactating women * prior invasive malignancy, unless disease-free for ≥ 3 years prior to registration (exceptions: non-melanoma skin cancer, in-situ cancers).

Inclusion Criteria

Exclusion Criteria

* Age \> 18 years.
* ECOG performance status (PS) 0, 1, or 2.
* Radiographic findings consistent with non-small cell lung cancer, including lesions with ground glass opacities with a solid component of 50% or greater. Those with ground glass opacities and \<50% solid component will be excluded.
* The primary tumor in the lung must be biopsy confirmed non-small cell lung cancer within 180 days prior to randomization.
* Tumor ≤ 4 cm maximum diameter, including clinical stage IA and selected IB by PET/CT scan of the chest and upper abdomen performed within 180 days prior to randomization. Repeat imaging within 90 days prior to randomization is recommended for re-staging but is not required based on institutional norms.
* All clinically suspicious mediastinal N1, N2, or N3 lymph nodes (\> 1 cm short-axis dimension on CT scan and/or positive on PET scan) confirmed negative for involvement with NSCLC by one of the following methods: mediastinoscopy, anterior mediastinotomy, EUS/EBUS guided needle aspiration, CT-guided, video-assisted thoracoscopic or open lymph node biopsy within 180 days of randomization.
* Tumor verified by a thoracic surgeon to be in a location that will permit sublobar resection.
* Tumor located peripherally within the lung. NOTE: Peripheral is defined as not touching any surface within 2 cm of the proximal bronchial tree in all directions. See below. Patients with non-peripheral (central) tumors are NOT eligible.
* No evidence of distant metastases.
* Availability of pulmonary function tests (PFTs - spirometry, DLCO, +/- arterial blood gases) within 180 days prior to registration. Patients with tracheotomy, etc, who are physically unable to perform PFTs (and therefore cannot be tested for the Major criteria in 3.1.11 below) are potentially still eligible if a study credentialed thoracic surgeon documents that the patient's health characteristics would otherwise have been acceptable for eligibility as a high risk but nonetheless operable patient (in particular be eligible for sublobar resection).
* Patient at high-risk for surgery by meeting a minimum of one major criteria or two minor criteria
* Major Criteria
* FEV1 ≤ 50% predicted (pre-bronchodilator value)
* DLCO ≤ 50% predicted (pre-bronchodilator value)
* Minor Criteria
* Age ≥75
* FEV1 51-60% predicted (pre-bronchodilator value)
* DLCO 51-60% predicted (pre-bronchodilator value)
* Pulmonary hypertension (defined as a pulmonary artery systolic pressure greater than 40mm Hg) as estimated by echocardiography or right heart catheterization
* Study credentialed thoracic surgeon believes the patient is potentially operable but that a lobectomy or pneumonectomy would be poorly tolerated by the patient for tangible or intangible reasons. The belief must be declared and documented in the medical record prior to randomization.
* Poor left ventricular function (defined as an ejection fraction of 40% or less)
* Resting or Exercise Arterial pO2 ≤ 55 mm Hg or SpO2 ≤ 88%
* pCO2 \> 45 mm Hg
* Modified Medical Research Council (MMRC) Dyspnea Scale ≥ 3.
* No prior intra-thoracic radiation therapy for previously identified intra-thoracic primary tumor (e.g. previous lung cancer) on the ipsilateral side. NOTE: Previous radiotherapy as part of treatment for head and neck, breast, or other non-thoracic cancer is permitted so long as possible radiation fields would not overlap. Previous chemotherapy or surgical resection specifically for the lung cancer being treated on this protocol is NOT permitted.
* No prior lung resection on the ipsilateral side.
* Non-pregnant and non-lactating. Women of child-bearing potential must have a negative urine or serum pregnancy test prior to registration. Peri-menopausal women must be amenorrheic \> 12 months prior to registration to be considered not of childbearing potential.
* No prior invasive malignancy, unless disease-free for ≥ 3 years prior to registration (exceptions: non-melanoma skin cancer, in-situ cancers).
* Ability to understand and the willingness to sign a written informed consent.

* evidence of distant metastases
* prior intra-thoracic radiation therapy. NOTE: Previous radiotherapy as part of treatment for head and neck, breast, or other non-thoracic cancer is permitted so long as possible radiation fields would not overlap. Previous chemotherapy or surgical resection specifically for the lung cancer being treated on this protocol is NOT permitted. No prior lung resection on the ipsilateral side.
* pregnant and lactating women
* prior invasive malignancy, unless disease-free for ≥ 3 years prior to registration (exceptions: non-melanoma skin cancer, in-situ cancers).

Contacts and Locations

Study Contact

Sarah Neufeld, MBA

CONTACT

214-645-8525

sarah.hardee@UTSouthwestern.edu

Principal Investigator

Robert Timmerman, MD

PRINCIPAL_INVESTIGATOR

UTSW Medical Center

Study Locations (Sites)

UCSD

La Jolla, California, 92023

United States

University of Colorado/Memorial

Aurora, Colorado, 80045

United States

Penrose Cancer Center

Colorado Springs, Colorado, 80907

United States

Boca Raton Regional Hospital

Boca Raton, Florida, 33486

United States

Curtis and Elizabeth Anderson Cancer

Savannah, Georgia, 31404

United States

University of Iowa

Iowa City, Iowa, 52242

United States

University of Kansas Medical Center

Kansas City, Kansas, 66160

United States

University of Kentucky Health Care

Lexington, Kentucky, 40536-0093

United States

University of Louisville Physicians

Louisville, Kentucky, 40202

United States

Ochsner Medical Center

New Orleans, Louisiana, 70121

United States

Luminis Health Research Institute

Annapolis, Maryland, 21401

United States

University of Maryland Medical Center

Baltimore, Maryland, 21201

United States

Boston Medical Center

Boston, Massachusetts, 02118

United States

Henry Ford Health System

Detroit, Michigan, 48202-2689

United States

Beaumont

Royal Oak, Michigan, 48073

United States

Mayo Clinic Rochester

Rochester, Minnesota, 55905

United States

Meridian Health System

Neptune, New Jersey, 07753

United States

New York University Langone Medical Center

New York, New York, 10016

United States

SUNY - Upsate Medical Centre

Syracuse, New York, 13210

United States

University of North Carolina

Chapel Hill, North Carolina, 27599

United States

Wake Forest Baptist Health

Winston-Salem, North Carolina, 27157

United States

University of Cincinnati

Cincinnati, Ohio, 45267

United States

Case Western (University Hospitals Case Medical Center)

Cleveland, Ohio, 44106

United States

Cleveland Clinic

Cleveland, Ohio, 44195

United States

Ohio State University Wexner Medical Center

Columbus, Ohio, 43210

United States

Providence Health & Services/Oregon Clinic

Portland, Oregon, 97213

United States

Thomas Jefferson University

Philadelphia, Pennsylvania, 19107

United States

UPMC Health System

Pittsburgh, Pennsylvania, 15234

United States

Allegheny

Pittsburg, Pennsylvania, 15212

United States

Mount Nittany

State College, Pennsylvania, 16803

United States

Lifespan Oncology Clinical Research

Providence, Rhode Island, 02903

United States

University of Tennessee Health Science Center

Memphis, Tennessee, 38163

United States

Cardiothoracic and Vascular Surgeons

Austin, Texas, 78756

United States

University of Texas Southwestern Medical Center

Dallas, Texas, 75390

United States

Intermountain Medical Center

Salt Lake City, Utah, 84107

United States

University of Virginia Health System

Charlottesville, Virginia, 22901

United States

Inova Fairfax Medical Campus

Falls Church, Virginia, 22042

United States

Swedish Cancer Institute

Seattle, Washington, 98104

United States

Medical College of Wisconsin

Milwaukee, Wisconsin, 53226

United States

Clement Zablocki VA Medical Center

Milwaukee, Wisconsin, 53295

United States

Collaborators and Investigators

Sponsor: University of Texas Southwestern Medical Center

Robert Timmerman, MD, PRINCIPAL_INVESTIGATOR, UTSW Medical Center

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2015-07

Study Completion Date2028-12

Study Record Updates

Study Start Date2015-07

Study Completion Date2028-12

Terms related to this study

Additional Relevant MeSH Terms

Non-Small Cell Lung Cancer