Overview

This trial is active, not recruiting.

Conditions breast cancer, lung cancer, metastatic cancer, pain, prostate cancer
Treatments calcium, vitamin d, zoledronic acid, sm-153, sr-89
Phase phase 3
Sponsor Radiation Therapy Oncology Group
Collaborator National Cancer Institute (NCI)
Start date July 2006
End date January 2012
Trial size 261 participants
Trial identifier NCT00365105, CDR0000491233, NCI-2009-00727, RTOG 0517

Summary

RATIONALE: Zoledronate, vitamin D and calcium may prevent or delay bone pain and other symptoms caused by bone metastases. It is not yet known whether giving zoledronate together with vitamin D and calcium is more effective with or without strontium 89 or samarium 153 in treating patients with bone metastases from prostate cancer, lung cancer, or breast cancer.

PURPOSE: This randomized phase III trial is studying zoledronate, vitamin D, and calcium to see how well they work compared to zoledronate, vitamin D, calcium, and either strontium 89 or samarium 153 in preventing or delaying bone problems in patients with bone metastases from prostate cancer, lung cancer, or breast cancer.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Intervention model parallel assignment
Masking open label
Primary purpose supportive care
Arm
(Active Comparator)
Zoledronic acid, vitamin D and calcium supplements.
calcium
At least 500 mg of calcium (1 pill) by mouth daily until the study doctor thinks it is in their best interest to stop.
vitamin d
400 IU of vitamin D (1 pill) by mouth daily until the study doctor thinks it is in their best interest to stop.
zoledronic acid Zometa
4 mg of Zoledronic acid intravenously once a month until the study doctor thinks it is in their best interest to stop.
(Experimental)
Zoledronic acid, vitamin D and calcium supplements, plus Sr-89 or Sm-153.
calcium
At least 500 mg of calcium (1 pill) by mouth daily until the study doctor thinks it is in their best interest to stop.
zoledronic acid Zometa
4 mg of Zoledronic acid intravenously once a month until the study doctor thinks it is in their best interest to stop.
sm-153 Samarium-153
Single dose intravenously 1 mCi/kg body weight.
sr-89 Strontium-89
Single dose intravenously 4 mCi.

Primary Outcomes

Measure
Time to Development of a Malignant Skeletal-related Events (SRE)
time frame: From randomization to date of SRE development

Secondary Outcomes

Measure
SRE Rate at 1 Year
time frame: From randomization to 1 year
Overall Survival
time frame: From randomization to date of death or last follow-up. Analysis occurs at the same time as the primary outcome.
Changes in Quality of Life as Measured by FACT-G
time frame: From pre-treatment to 1 year
Changes in Pain Control as Measured by Brief Pain Inventory (BPI)
time frame: From pre-treatment to 1 year
Utility and Cost Effectiveness of the Use of Radiopharmaceuticals and Bisphosphonates as Measured by the EuroQol-5 Dimension (EQ-5D)
time frame: From pre-treatment to 1 year

Eligibility Criteria

Male or female participants at least 18 years old.

DISEASE CHARACTERISTICS: - Histologically or cytologically confirmed lung, breast, or prostate cancer - Bone metastases, meeting both of the following criteria: - Must be visible on bone scan performed within the past 4 weeks - No painful bone metastases unless successfully treated (i.e., by external-beam irradiation) prior to study entry AND the patient has stable pain* for at least 2 weeks after that treatment NOTE: *Stable pain is defined as a patient response of 1, 2, or 3 on Questions 4 and 5 of The Brief Pain Inventory (BPI) - No untreated or symptomatic brain metastases - No spinal cord compression - Hormone receptor status not specified PATIENT CHARACTERISTICS: - Zubrod performance status (PS) 0-2 (for patients with primary breast or prostate cancer) OR Zubrod PS 0-1 (for patients with primary lung cancer) - White blood cell count (WBC) ≥ 2,400/mm³ - Absolute neutrophil count ≥ 1,800/mm³ - Platelet count ≥ 60,000/mm³ - Hemoglobin ≥ 8.0 g/dL (transfusion allowed) - Creatinine < 3.0 mg/dL - Bilirubin < 2.5 mg/dL - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception - No uncontrolled congestive heart failure within the past 6 months - No hypertension refractory to treatment within the past 6 months - No symptomatic coronary artery disease within the past 6 months - No current, active dental problems within the past 4 weeks, including any of the following: - Infection of the teeth or jawbone (maxilla or mandible) - Dental or fixture trauma - Prior or current diagnosis of osteonecrosis of the jaw - Exposed bone in the mouth - Slow healing after dental procedures - No known AIDS - HIV testing is not required PRIOR CONCURRENT THERAPY: - See Disease Characteristics - Prior oral bisphosphonate therapy (i.e. alendronate sodium or similar) allowed - No prior IV bisphosphonates for a treatment duration of > 6 months - At least 2 weeks since prior calcitonin, mithramycin, or gallium nitrate - At least 2 weeks since prior external-beam radiotherapy - At least 6 weeks since prior and no concurrent dental surgery (e.g., extractions or implants) - No prior radioisotope therapy for bone metastasis - Concurrent systemic chemotherapy* or hormonal therapy allowed - Chemotherapy and/or hormonal therapy should not be changed within 14 days prior to start of protocol treatment (arm I) - No other concurrent bisphosphonate NOTE: *Chemotherapy must be held 2 weeks before and for at least 2 weeks after radiopharmaceutical administration (arm II)

Additional Information

Official title Randomized Phase III Trial to Evaluate Radiopharmaceuticals and Zoledronic Acid in the Palliation of Osteoblastic Metastases From Lung, Breast, and Prostate Cancer
Description OBJECTIVES: Primary - Compare the efficacy of zoledronate, vitamin D, and calcium with or without strontium chloride Sr 89 or samarium Sm 153 lexidronam pentasodium, in terms of preventing or delaying the time to development of malignant skeletal-related events (SREs) (defined as a pathological bone fracture, spinal cord compression, surgery to bone, or radiation to bone) in patients with bone metastases secondary to prostate, lung, or breast cancer. Secondary - Compare the rate of SREs at 1 year in patients treated with these regimens. - Compare overall survival of patients treated with these regimens. - Compare quality of life of patients treated with these regimens. - Compare the effect of these regimens on pain control in these patients. - Evaluate resource utilization and cost effectiveness of these regimens. OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to primary disease site (prostate vs breast vs lung) and number of bone metastases (≤ 2 vs > 2). Patients are randomized to 1 of 2 treatment arms. - Arm I: Patients receive zoledronate IV over 15 minutes once a month. Patients also receive oral vitamin D and oral calcium once daily. Treatment continues in the absence of disease progression or unacceptable toxicity. - Arm II: Patients receive zoledronate, vitamin D, and calcium as in arm I. Within 6 weeks of beginning study treatment, patients also receive a single dose of either strontium chloride Sr 89 IV or samarium Sm 153 lexidronam pentasodium IV. Quality of life and pain are assessed at baseline and then at 1, 3, 6, and 12 months from start of protocol treatment. After completion of study treatment, patients are followed every 6 months. PROJECTED ACCRUAL: A total of 352 patients will be accrued for this study.
Trial information was received from ClinicalTrials.gov and was last updated in March 2015.
Information provided to ClinicalTrials.gov by Radiation Therapy Oncology Group.