Breast CancerPhase 3NCT00365105
Zoledronate, Vitamin D, and Calcium With or Without Strontium 89 or Samarium 153 in Preventing or Delaying Bone Problems in Patients With Bone Metastases From Prostate Cancer, Lung Cancer, or Breast Cancer
A Phase 3 study testing Calcium, Vitamin D and zoledronic acid in people with Breast Cancer and Lung Cancer, run by Radiation Therapy Oncology Group at 147 sites in United States.
Trial 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… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Breast Cancer, Lung Cancer, Metastatic Cancer
- What is being tested?
- Calcium, Vitamin D and zoledronic acid
- Type of treatment
- Pill or oral medicine, Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 261 participants
- Where
- 147 sitesUnited States
- Study dates
- 11 Jul 2006to 27 Feb 2017
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically or cytologically proven diagnosis of solid tumor malignancy of lung, breast, or prostate prior to registration;
- Appropriate diagnosis for protocol entry, based upon the following minimum diagnostic workup:
- 2.1 History/physical examination within 8 weeks prior to registration; 2.2 Bone scan within 4 weeks prior to registration; bone metastases must be visible on the scan. Other scanning modalities, such as magnetic resonance imaging (MRI), positron emission tomography (PET) 2.3 Dental evaluation according to the dental exam checklist (carried out by the investigator, the investigator's designee, or by a qualified dental professional [dental hygienist or dentist]), including history of dental surgery (e.g., extraction or implant) within 8 weeks prior to registration and recorded on the dental exam checklist; Note: If the patient has received prior oral bisphosphonate therapy and has had a prior dental evaluation within 8 weeks of registration, the evaluation should not be repeated.
- 2.4 Complete blood count (CBC)/differential within 2 weeks prior to registration, with adequate bone marrow function defined as follows:
- White blood cell count (WBC) ≥ 2400 cells/mm^3;
- Absolute neutrophil count (ANC) ≥ 1,800 cells/mm3;
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- Platelets ≥ 60,000 cells/mm3;
- Hemoglobin ≥ 8.0 g/dl (Note: The use of transfusion or other intervention to achieve the required hemoglobin is permitted).
- 2.5 Serum creatinine < 3 mg/dL (265 μmol/L) within 2 weeks prior to registration; 2.6 Total bilirubin < 2.5 mg/dL (43 μmol/L) within 2 weeks prior to registration; 2.7 Pregnancy test (urine dipstick or serum) for women of childbearing potential within 2 weeks prior to registration;
- ≥ 18 years of age;
- Zubrod performance status 0-2 for patients with breast or prostate primaries; Zubrod performance status 0-1 for patients with lung primaries;
- Patients receiving systemic chemotherapy or hormonal therapy are eligible for this study. See Sections 6.0 and 7.0 for further details. Note: All patients must complete external beam radiation therapy ≥ 14 days prior to registration. If patients have undergone CyberKnife treatment, treatment must be completed ≥ 14 days prior to registration.
- Patients may have received prior oral bisphosphonate therapy, such as Fosamax® or similar medications. Duration of bisphosphonate treatment prior to study entry must be documented, and all bisphosphonates other than the study drug must be discontinued prior to registration.
- Women of childbearing potential and male participants must agree to practice an adequate means of birth control throughout their participation in the study.
- Patient must sign study specific informed consent prior to study entry.
Who cannot join
- Patients with brain metastases and/or spinal cord compression are excluded. Note: Patients with no evidence of disease in the brain after treatment for brain metastases are eligible.
- Patients with painful bone metastases are not permitted until these bone metastases are successfully treated (for example by external beam irradiation) prior to registration, and the patient has stable pain for at least 2 weeks after that treatment (Stable pain is defined for this study as a patient response of 1, 2, or 3 on Questions 4 and 5 of The Brief Pain Inventory (BPI).
- Prior treatment with Strontium-89 or Samarium-153 for bone metastases.
- Treatment for more than 6 months with IV bisphosphonates prior to study entry;
- Treatment with calcitonin, mithramycin, or gallium nitrate within 2 weeks prior to registration
- Severe, active co-morbidity, defined as follows:
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- 6.1 Evidence in the six months prior to study entry of uncontrolled congestive heart failure, hypertension refractory to treatment, or symptomatic coronary artery disease; 6.2 Current, active dental problems within 4 weeks of registration, including infection of the teeth or jawbone (maxilla or mandible); dental or fixture trauma; current or prior diagnosis of osteonecrosis of the jaw (ONJ); exposed bone in the mouth; or slow healing after dental procedures; 6.3 Dental surgery (e.g., extractions, implants) within 6 weeks of study entry and while receiving study treatment; for patients who require dental surgery, there are no data to suggest whether discontinuation of bisphosphonate treatment reduces the risk of osteonecrosis of the jaw (ONJ) [see Section 7.2.4].
- 6.4 Acquired Immune Deficiency Syndrome (AIDS) based upon current Center for Disease Control (CDC) definition; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is necessary because the treatments involved in this protocol may be significantly immunosuppressive. Protocol-specific requirements may also exclude immuno-compromised patients.
- Pregnant or lactating patients are excluded, as treatment may be harmful to embryos and/or nursing infants.
Trial locations and contacts
147 sites in 1 country.
147 sites in 1 country
United States147 sites
Rosenfeld Cancer Center at Abington Memorial Hospital
Abington, Pennsylvania, 19001
McDowell Cancer Center at Akron General Medical Center
Akron, Ohio, 44307
Summa Center for Cancer Care at Akron City Hospital
Akron, Ohio, 44309-2090
New Mexico Cancer Center
Albuquerque, New Mexico, 87109
Tulane Cancer Center Office of Clinical Research
Alexandria, Louisiana, 71315-3198
Radiation Oncology Center
Alliance, Ohio, 44601
McFarland Clinic, PC
Ames, Iowa, 50010
Saint Joseph Mercy Cancer Center
Ann Arbor, Michigan, 48106-0995
Theda Care Cancer Institute
Appleton, Wisconsin, 54911
Northwest Community Hospital
Arlington Heights, Illinois, 60005
Mission Hospitals - Memorial Campus
Asheville, North Carolina, 28801
St. Agnes Hospital Cancer Center
Baltimore, Maryland, 21229
Barberton Citizens Hospital
Barberton, Ohio, 44203
UPMC Cancer Center at Beaver Medical Center
Beaver, Pennsylvania, 15009
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
Northern Rockies Radiation Oncology Center
Billings, Montana, 59101
Billings Clinic - Downtown
Billings, Montana, 59107-7000
New York Methodist Hospital
Brooklyn, New York, 11215
Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph Medical Center
Burbank, California, 91505
Sands Cancer Center
Canandaigua, New York, 14424
Mercy Cancer Center at Mercy Medical Center
Canton, Ohio, 44708
Mercy Cancer Center at Mercy San Juan Medical Center
Carmichael, California, 95608
Hollings Cancer Center at Medical University of South Carolina
Charleston, South Carolina, 29425
Presbyterian Cancer Center at Presbyterian Hospital
Charlotte, North Carolina, 28233-3549
Adena Regional Medical Center
Chillicothe, Ohio, 45601
UPMC Cancer Center at Jefferson Regional Medical Center
Clairton, Pennsylvania, 15025
John B. Amos Cancer Center
Columbus, Georgia, 31904
CCOP - Columbus
Columbus, Ohio, 43215
Grandview Hospital
Dayton, Ohio, 45405
Good Samaritan Hospital
Dayton, Ohio, 45406
David L. Rike Cancer Center at Miami Valley Hospital
Dayton, Ohio, 45409
Samaritan North Cancer Care Center
Dayton, Ohio, 45415
CCOP - Dayton
Dayton, Ohio, 45420
Oakwood Cancer Center at Oakwood Hospital and Medical Center
Dearborn, Michigan, 48123-2500
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, 50309
John Stoddard Cancer Center at Iowa Methodist Medical Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, 50314
Mercy Cancer Center at Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314
Josephine Ford Cancer Center at Henry Ford Hospital
Detroit, Michigan, 48202
Good Samaritan Cancer Care Center at Advocate Good Samaritan Hospital
Downers Grove, Illinois, 60515-1500
Northeast Radiation Oncology Center
Dunmore, Pennsylvania, 18512
Hudner Oncology Center at Saint Anne's Hospital - Fall River
Fall River, Massachusetts, 02721
St. Francis Hospital
Federal Way, Washington, 98003
Genesys Hurley Cancer Institute
Flint, Michigan, 48503
Hurley Medical Center
Flint, Michigan, 48503
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital
Fort Lauderdale, Florida, 33308
Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Northeast Georgia Medical Center
Gainesville, Georgia, 30501
Wayne Radiation Oncology
Goldsboro, North Carolina, 27534
Center for Cancer Care at Goshen General Hospital
Goshen, Indiana, 46526
Great Falls Clinic - Main Facility
Great Falls, Montana, 59405
Bellin Memorial Hospital
Green Bay, Wisconsin, 54301
UPMC Cancer Center - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601
CCOP - Greenville
Greenville, South Carolina, 29615
Van Elslander Cancer Center at St. John Hospital and Medical Center
Grosse Pointe Woods, Michigan, 48236
Ingalls Cancer Care Center at Ingalls Memorial Hospital
Harvey, Illinois, 60426
Veterans Affairs Medical Center - Hines
Hines, Illinois, 60141
Cape Cod Hospital
Hyannis, Massachusetts, 02601
Dickinson County Healthcare System
Iron Mountain, Michigan, 49801
Baptist Cancer Institute - Jacksonville
Jacksonville, Florida, 32207
Integrated Community Oncology Network at Southside Cancer Center
Jacksonville, Florida, 32207
Baptist Medical Center South
Jacksonville, Florida, 32258
Integrated Community Oncology Network
Jacksonville Beach, Florida, 32250
Princeton Radiation Oncology Center
Jamesburg, New Jersey, 08831
UPMC Cancer Center at the John P. Murtha Pavilion
Johnstown, Pennsylvania, 15901
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
Truman Medical Center - Hospital Hill
Kansas City, Missouri, 64108
CCOP - Kansas City
Kansas City, Missouri, 64131
Good Samaritan Cancer Center at Good Samaritan Hospital
Kearney, Nebraska, 68848-1990
Charles F. Kettering Memorial Hospital
Kettering, Ohio, 45429
Sparrow Regional Cancer Center
Lansing, Michigan, 48912-1811
Lawrence Memorial Hospital
Lawrence, Kansas, 66044
Central Maine Comprehensive Cancer Center at Central Maine Medical Center
Lewiston, Maine, 04240
Central Baptist Hospital
Lexington, Kentucky, 40503-9985
USC/Norris Comprehensive Cancer Center and Hospital
Los Angeles, California, 90089-9181
MedCentral - Mansfield Hospital
Mansfield, Ohio, 44903
Fox Chase Virtua Health Cancer Program at Virtua Memorial Hospital Marlton
Marlton, New Jersey, 08053
UPMC Cancer Center at UPMC McKeesport
McKeesport, Pennsylvania, 15132
Miami Cancer Center at Mercy Hospital
Miami, Florida, 33133
CCOP - Mount Sinai Medical Center
Miami Beach, Florida, 33140
Trinity CancerCare Center
Minot, North Dakota, 58701
Providence Cancer Center at Providence Hospital
Mobile, Alabama, 36608
UPMC - Moon
Moon Township, Pennsylvania, 15108
Cancer Center at Ball Memorial Hospital
Muncie, Indiana, 47303-3499
Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
Murray, Utah, 84157
UPMC Cancer Center - Natrona Heights
Natrona Heights, Pennsylvania, 15065
Jameson Memorial Hospital - North Campus
New Castle, Pennsylvania, 16105
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453-2699
Integrated Community Oncology Network - Orange Park
Orange Park, Florida, 32073
Florida Cancer Center - Palatka
Palatka, Florida, 32177
Bay Medical
Panama City, Florida, 32401
Advocate Lutheran General Cancer Care Center
Park Ridge, Illinois, 60068-1174
Regional Cancer Center at Singing River Hospital
Pascagoula, Mississippi, 39581
Oncology Hematology Associates of Central Illinois, PC - Peoria
Peoria, Illinois, 61615
UPMC - Shadyside
Pittsburgh, Pennsylvania, 15213-2582
UPMC Cancer Center at Magee-Womens Hospital
Pittsburgh, Pennsylvania, 15213
UPMC Cancer Center at UPMC Presbyterian
Pittsburgh, Pennsylvania, 15213
UPMC Cancer Center at UPMC St. Margaret
Pittsburgh, Pennsylvania, 15215
UPMC Cancer Center at UPMC Passavant
Pittsburgh, Pennsylvania, 15237
UPMC Cancer Center - Upper St. Clair
Pittsburgh, Pennsylvania, 15243
Fitzpatrick Cancer Center at Champlain Valley Physicians Hospital Medical Center
Plattsburgh, New York, 12901
Robert and Beverly Lewis Family Cancer Care Center at Pomona Valley Hospital Medical Center
Pomona, California, 91767
University Medical Center at Princeton
Princeton, New Jersey, 08540-3298
Good Samaritan Cancer Center
Puyallup, Washington, 98372
Highland Hospital of Rochester
Rochester, New York, 14620
Lipson Cancer and Blood Center at Rochester General Hospital
Rochester, New York, 14621
University Radiation Oncology at Parkridge Hospital
Rochester, New York, 14626
James P. Wilmot Cancer Center at University of Rochester Medical Center
Rochester, New York, 14642
Radiation Oncology Center - Roseville
Roseville, California, 95661
Radiological Associates of Sacramento Medical Group, Incorporated
Sacramento, California, 95815
Flagler Cancer Center
Saint Augustine, Florida, 32086
CentraCare Clinic - River Campus
Saint Cloud, Minnesota, 56303
Cancer Care Center, Incorporated
Salem, Ohio, 44460
Utah Cancer Specialists at UCS Cancer Center
Salt Lake City, Utah, 84106
LDS Hospital
Salt Lake City, Utah, 84143
CCOP - Virginia Mason Research Center
Seattle, Washington, 98101
UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania, 16346
Welch Cancer Center at Sheridan Memorial Hospital
Sheridan, Wyoming, 82801
Siouxland Hematology-Oncology Associates, LLP
Sioux City, Iowa, 51101
CCOP - Northern Indiana CR Consortium
South Bend, Indiana, 46601
Cancer Institute at St. John's Hospital
Springfield, Illinois, 62702
St. John's Regional Health Center
Springfield, Missouri, 65804
Hulston Cancer Center at Cox Medical Center South
Springfield, Missouri, 65807
Dixie Regional Medical Center - East Campus
St. George, Utah, 84770
Mount Nittany Medical Center
State College, Pennsylvania, 16803
Franciscan Cancer Center at St. Joseph Medical Center
Tacoma, Washington, 98405-3004
CCOP - Northwest
Tacoma, Washington, 98405
MultiCare Regional Cancer Center at Tacoma General Hospital
Tacoma, Washington, 98405
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida
Tampa, Florida, 33612-9497
General Robert Huyser Cancer Center at David Grant Medical Center
Travis Air Force Base, California, 94535-1800
UVMC Cancer Care Center at Upper Valley Medical Center
Troy, Ohio, 45373-1300
Natalie Warren Bryant Cancer Center at St. Francis Hospital
Tulsa, Oklahoma, 74136
UPMC Cancer Center - Uniontown
Uniontown, Pennsylvania, 15401
CCOP - Carle Cancer Center
Urbana, Illinois, 61801
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare
Vineland, New Jersey, 08360
Cancer Institute of New Jersey at Cooper - Voorhees
Voorhees Township, New Jersey, 08043
St. John Macomb Hospital
Warren, Michigan, 48093
Washington Hospital Cancer Center
Washington, Pennsylvania, 15301
CCOP - Wichita
Wichita, Kansas, 67214
Riverview UW Cancer Center at Riverview Hospital
Wisconsin Rapids, Wisconsin, 54494
Cancer Treatment Center
Wooster, Ohio, 44691
United States Air Force Medical Center - Wright-Patterson
Wright-Patterson Air Force Base, Ohio, 45433-5529
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
Xenia, Ohio, 45385
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, 98902
York Cancer Center at Apple Hill Medical Center
York, Pennsylvania, 17405
About this study
Official title: Randomized Phase III Trial to Evaluate Radiopharmaceuticals and Zoledronic Acid in the Palliation of Osteoblastic Metastases From Lung, Breast, and Prostate Cancer
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.
Read the detailed 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.
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.
- Conditions
- Breast Cancer, Lung Cancer, Metastatic Cancer, Pain, Prostate Cancer
- Being tested
- Calcium, Vitamin D, zoledronic acid, Sm-153, Sr-89
- Keywords
- pain, bone metastases, extensive stage small cell lung cancer, recurrent breast cancer, stage IV breast cancer, recurrent non-small cell lung cancer, stage IV non-small cell lung cancer, recurrent prostate cancer, stage IV prostate cancer
- Medical subject headings
- Breast Neoplasms, Lung Neoplasms, Neoplasm Metastasis, Pain, Prostatic Neoplasms, Carcinoma, Non-Small-Cell Lung
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CalciumDietary supplement
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 DDietary supplement
400 IU of vitamin D (1 pill) by mouth daily until the study doctor thinks it is in their best interest to stop.
zoledronic acidDrug
Also called Zometa
4 mg of Zoledronic acid intravenously once a month until the study doctor thinks it is in their best interest to stop.
Sm-153Drug
Also called Samarium-153
Single dose intravenously 1 mCi/kg body weight.
Sr-89Radiation
Also called Strontium-89
Single dose intravenously 4 mCi.
| Study group | Role | What they receive |
|---|---|---|
| Zoledronic acid | Active comparator | Zoledronic acid, vitamin D and calcium supplements. Receives: Dietary Supplement: Calcium; Dietary Supplement: Vitamin D; Drug: zoledronic acid |
| Zoledronic acid + Radiopharmaceuticals | Experimental | Zoledronic acid, vitamin D and calcium supplements, plus Sr-89 or Sm-153. Receives: Dietary Supplement: Calcium; Drug: zoledronic acid; Drug: Sm-153; Radiation: Sr-89 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to Development of a Malignant Skeletal-related Events (SRE)
Median time to development of a malignant skeletal related event (SRE), which is defined as a pathological bone fracture, spinal cord compression, surgery to bone or radiation to bone is estimated using Kaplan-Meier method. The time of failure was measured from date of randomization to the date of a documented SRE. The analysis was planned to occur after 257 SRE have been observed, unless the criteria for early stopping are met.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 80.1 months.
Secondary outcomes (5)
Number of Patients Experiencing a Skeletal-related Event (SRE) Within One Year
Skeletal-related events are defined as a pathological bone fracture, spinal cord compression, surgery to bone or radiation to bone.
Measured: From randomization to 1 year
Overall Survival
Overall survival time is defined as time from randomization to the date of death from any cause. Overall survival rates are estimated by the Kaplan-Meier method. Patients last known to be alive are censored at the date of last contact.
Measured: From randomization to last follow-up. Maximum follow-up at time of analysis was 101.7 months.
Change in Functional Assessment of Cancer Therapy - General (FACT-G) at One Year
The FACT-G is a validated 27-item measure in which a higher score represents higher quality of life (QOL). Physical, functional, social and emotional well-being subscale scores are added together to form the FACT-G total score. Responses range from 0=Not a lot to 4=Very much. Certain items must be reversed before being added, by subtracting the response from 4. Subscale items are added together, multiplied by the number of items in the subscale, then divided by the number of items answered to obtain subscale totals. Total score ranges from 0-108; physical, social and functional subscales from 0-28; emotional subscale from 0-24. Each subscale requires at least 50% of the items to be completed while the overall response rate must be greater than 80%. If items are missing the subscale scores can be prorated. Change score at one year is calculated as one year score - baseline score with a positive change score indicating improvement in QOL.
Measured: Baseline and 1 year
Change in Brief Pain Inventory (BPI) at One Year
The Brief Pain Inventory (BPI) is a measurement tool for assessing clinical pain. The BPI assesses severity (pain at its "worst," "least," "average," and "now"), and interference (how much pain has interfered with seven daily activities, including general activity, walking, work, mood, enjoyment of life, relations with others, and sleep). Patients rate the severity of their pain and the degree to which their pain interferes with common dimensions of feeling and function on a scale of 0 to 10, with 0=no pain/interference and 10=interferes completely/worst pain imaginable.
Measured: Baseline and 1 year
Change in EuroQol-5 Dimension 3-level (EQ-5D-3L) at One Year
The EQ-5D-3L is a 2-part self-assessment questionnaire. First part is 5 items (mobility, self care, usual activities, pain/discomfort, anxiety/depression) each with 3 problem levels (1-none, 2-moderate, 3-extreme). The 5-item index score is transformed into a utility score between 0 (worst health state) and 1 (best health state). The 2nd part is a visual analogue scale (VAS) valuing current health state, measured on a 20-cm 10-point interval scale. Worst imaginable health state is scored as 0 at the bottom of the scale, and best imaginable health state is scored as 100 at the top. Change at one year is calculated as one-year score - baseline score with positive change indicating improved quality of life.
Measured: Baseline and 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Aug 2006 (estimated)
- Study start11 Jul 2006
- Primary completionJan 2012
- Study completion27 Feb 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 261 participants (actual)
Sponsor and investigators
- Lead sponsor
- Radiation Therapy Oncology Group
- Sponsor type
- Research network
- Collaborators
- National Cancer Institute (NCI), NRG Oncology
- Responsible party
- Sponsor
- Investigators
- Michael J. Seider, MD, PhD, FACR, Study chair, Summa Center for Cancer Care at Akron City Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00365105
- Sponsor's protocol ID
- RTOG 0517
- Other IDs
- CDR0000491233, NCI-2009-00727
- Status last verified
- Sep 2024
- First submitted
- 16 Aug 2006
- Last updated
- 20 Sep 2024
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Seider MJ, Pugh SL, Langer C, Wyatt G, Demas W, Rashtian A, Clausen CL, Derdel JD, Cleary SF, Peters CA, Ramalingam A, Clarkson JE, Tomblyn M, Rabinovitch RA, Kachnic LA, Berk LB; NRG Oncology. Randomized phase III trial to evaluate radiopharmaceuticals and zoledronic acid in the palliation of osteoblastic metastases from lung, breast, and prostate cancer: report of the NRG Oncology RTOG 0517 trial. Ann Nucl Med. 2018 Oct;32(8):553-560. doi: 10.1007/s12149-018-1278-4. Epub 2018 Aug 9.
PubMed 30094545
Study at a glance
From the registry record, last updated by the sponsor on 20 Sep 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Randomized Phase III Trial to Evaluate Radiopharmaceuticals and Zoledronic Acid in the Palliation of Osteoblastic Metastases From Lung, Breast, and Prostate Cancer
- ClinicalTrials.gov ID
- NCT00365105
- Acronym / sponsor ID
- RTOG 0517
- Conditions
- Breast Cancer, Lung Cancer, Metastatic Cancer, Pain, Prostate Cancer
- Keywords
- pain, bone metastases, extensive stage small cell lung cancer, recurrent breast cancer, stage IV breast cancer, recurrent non-small cell lung cancer, stage IV non-small cell lung cancer, recurrent prostate cancer
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 261 participants (actual)
- Lead sponsor
- Radiation Therapy Oncology GroupResearch network
- Collaborators
- National Cancer Institute (NCI), NRG Oncology
- Study start
- 11 Jul 2006 (actual)
- Primary completion
- Jan 2012 (actual)
- Study completion
- 27 Feb 2017 (actual)
- First posted
- 17 Aug 2006 (estimated)
- Results
- Posted 10 Nov 2014
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed 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.
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.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Zoledronic acid | Active comparator | Dietary Supplement: Calcium, Dietary Supplement: Vitamin D, Drug: zoledronic acidZoledronic acid, vitamin D and calcium supplements. |
| Zoledronic acid + Radiopharmaceuticals | Experimental | Dietary Supplement: Calcium, Drug: zoledronic acid, Drug: Sm-153, Radiation: Sr-89Zoledronic acid, vitamin D and calcium supplements, plus Sr-89 or Sm-153. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (15 listed)
- Histologically or cytologically proven diagnosis of solid tumor malignancy of lung, breast, or prostate prior to registration;
- Appropriate diagnosis for protocol entry, based upon the following minimum diagnostic workup:
- 2.1 History/physical examination within 8 weeks prior to registration; 2.2 Bone scan within 4 weeks prior to registration; bone metastases must be visible on the scan. Other scanning modalities, such as magnetic resonance imaging (MRI), positron emission tomography (PET) 2.3 Dental evaluation according to the dental exam checklist (carried out by the investigator, the investigator's designee, or by a qualified dental professional [dental hygienist or dentist]), including history of dental surgery (e.g., extraction or implant) within 8 weeks prior to registration and recorded on the dental exam checklist; Note: If the patient has received prior oral bisphosphonate therapy and has had a prior dental evaluation within 8 weeks of registration, the evaluation should not be repeated.
- 2.4 Complete blood count (CBC)/differential within 2 weeks prior to registration, with adequate bone marrow function defined as follows:
- 2.5 Serum creatinine < 3 mg/dL (265 μmol/L) within 2 weeks prior to registration; 2.6 Total bilirubin < 2.5 mg/dL (43 μmol/L) within 2 weeks prior to registration; 2.7 Pregnancy test (urine dipstick or serum) for women of childbearing potential within 2 weeks prior to registration;
Key exclusion criteria (9 listed)
- Patients with brain metastases and/or spinal cord compression are excluded. Note: Patients with no evidence of disease in the brain after treatment for brain metastases are eligible.
- Patients with painful bone metastases are not permitted until these bone metastases are successfully treated (for example by external beam irradiation) prior to registration, and the patient has stable pain for at least 2 weeks after that treatment (Stable pain is defined for this study as a patient response of 1, 2, or 3 on Questions 4 and 5 of The Brief Pain Inventory (BPI).
- Prior treatment with Strontium-89 or Samarium-153 for bone metastases.
- Treatment for more than 6 months with IV bisphosphonates prior to study entry;
- Treatment with calcitonin, mithramycin, or gallium nitrate within 2 weeks prior to registration
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CalciumAt least 500 mg of calcium (1 pill) by mouth daily until the study doctor thinks it is in their best interest to stop. | Dietary supplement | Zoledronic acid, Zoledronic acid + Radiopharmaceuticals |
| Vitamin D400 IU of vitamin D (1 pill) by mouth daily until the study doctor thinks it is in their best interest to stop. | Dietary supplement | Zoledronic acid |
| zoledronic acidAlso: Zometa4 mg of Zoledronic acid intravenously once a month until the study doctor thinks it is in their best interest to stop. | Drug | Zoledronic acid, Zoledronic acid + Radiopharmaceuticals |
| Sm-153Also: Samarium-153Single dose intravenously 1 mCi/kg body weight. | Drug | Zoledronic acid + Radiopharmaceuticals |
| Sr-89Also: Strontium-89Single dose intravenously 4 mCi. | Radiation | Zoledronic acid + Radiopharmaceuticals |
Primary outcome
Time to Development of a Malignant Skeletal-related Events (SRE)
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 80.1 months.
Median time to development of a malignant skeletal related event (SRE), which is defined as a pathological bone fracture, spinal cord compression, surgery to bone or radiation to bone is estimated using Kaplan-Meier method. The time of failure was measured from date of randomization to the date of a documented SRE. The analysis was planned to occur after 257 SRE have been observed, unless the criteria for early stopping are met.
5 secondary outcomes
Number of Patients Experiencing a Skeletal-related Event (SRE) Within One Year
Time frame: From randomization to 1 year
Overall Survival
Time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 101.7 months.
Change in Functional Assessment of Cancer Therapy - General (FACT-G) at One Year
Time frame: Baseline and 1 year
Change in Brief Pain Inventory (BPI) at One Year
Time frame: Baseline and 1 year
Change in EuroQol-5 Dimension 3-level (EQ-5D-3L) at One Year
Time frame: Baseline and 1 year
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Sep 2024.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 30094545Seider MJ, Pugh SL, Langer C, Wyatt G, Demas W, Rashtian A, Clausen CL, Derdel JD, Cleary SF, Peters CA, Ramalingam A, Clarkson JE, Tomblyn M, Rabinovitch RA, Kachnic LA, Berk LB; NRG Oncology. Randomized phase III trial to evaluate radiopharmaceuticals and zoledronic acid in the palliation of osteoblastic metastases from lung, breast, and prostate cancer: report of the NRG Oncology RTOG 0517 trial. Ann Nucl Med. 2018 Oct;32(8):553-560. doi: 10.1007/s12149-018-1278-4. Epub 2018 Aug 9.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Michael J. Seider, MD, PhD, FACR study chair
Summa Center for Cancer Care at Akron City Hospital
147 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Calcium, Vitamin D and zoledronic acid in people with Breast Cancer and Lung Cancer, run by Radiation Therapy Oncology Group at 147 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 15 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 20 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 147 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 10 Nov 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to Development of a Malignant Skeletal-related Events (SRE) (time frame: From randomization to last follow-up. Maximum follow-up at time of analysis was 80.1 months.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00365105, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Sep 2024.