Paclitaxel and Carboplatin With or Without Nitroglycerin in Treating Patients With Previously Untreated Stage III or Stage IV Non-Small Cell Lung Cancer
Lung Cancer
Conditions: official terms
Carcinoma, Non-Small-Cell Lung - Lung Neoplasms
Conditions: Keywords
stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer
Study Type
Study Phase
Phase 2
Study Design
Allocation: Randomized, Primary Purpose: Treatment
Name: carboplatin Type: Drug
Name: nitroglycerin Type: Drug
Name: paclitaxel Type: Drug
Overall Status
RATIONALE: Drugs used in chemotherapy, such as paclitaxel and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Nitroglycerin may help carboplatin and paclitaxel work better by making tumor cells more sensitive to the drugs.

PURPOSE: This phase II randomized trial is studying how well giving nitroglycerin together with paclitaxel and carboplatin works and compares it to giving paclitaxel and carboplatin alone in treating patients with previously untreated stage III or stage IV non-small cell lung cancer.
Detailed Description

- To evaluate tumor response rate and safety of nitroglycerin as a potentiator of anticancer combination therapy comprising paclitaxel and carboplatin in patients with previously untreated stage IIIB or IV non-small cell lung cancer.

OUTLINE: This is a multicenter, randomized, controlled study. Patients are randomized to 1 of 2 treatment arms.

- Arm I: Patients receive nitroglycerin, paclitaxel, and carboplatin.

- Arm II: Patients receive paclitaxel and carboplatin. In both arms, treatment continues for 6 courses in the absence of disease progression or unacceptable toxicity.
Criteria for eligibility
Healthy Volunteers: No
Maximum Age: 80 Years
Minimum Age: 40 Years
Gender: Both

- Histologically or cytologically confirmed non-small cell lung cancer

- Stage IIIB or IV disease that cannot be treated by radical irradiation

- Tumor lesions must be objectively evaluated according to WHO criteria (maximum diameter is no shorter than twice the slice width and no shorter than 10 mm) by CT scan

- No brain metastasis


- ECOG performance status 0-1

- Life expectancy ≥ 3 months

- Neutrophil count > 2,000/μL

- Hemoglobin > 10.0 g/dL

- Platelet count > 100,000/μL

- Serum bilirubin < 2.0 mg/dL

- ALT and AST < 100 IU/L

- Serum creatinine < 2.0 mg/dL

- PaO_2 ≥ 70 mm Hg

- No cardiac problems, including any of the following:

- Poorly controlled hypertension

- Unstable angina

- Congestive heart failure

- Myocardial infarction within the past year

- Ventricular arrhythmia that requires treatment except single, well-controlled isolated ventricular extrasystole

- No chronic active hepatitis or cirrhosis requiring treatment except hepatitis virus carriers who do not need treatment

- No comorbidity of interstitial pneumonia and pulmonary fibrosis requiring treatment

- No other cancer requiring treatment except a malignant tumor curatively resected with no recurrence

- No severe psychiatric disorders including schizophrenia or dementia

- Cardiothoracic ratio < 60% by chest x-ray

- No history of severe drug allergy or allergy to polyoxyethylene castor oil (in some anesthetic drugs or muscle relaxants) or polysorbate 80

- Patients in whom nitroglycerin preparations are contraindicated are not eligible, including any of the following:

- Severe hypotension (e.g., systolic blood pressure ≤ 80 mm Hg)

- Angle-closure glaucoma

- History of hypersensitivity to nitrate/nitrite ester drugs

- Not pregnant or nursing


- No prior chemotherapy or radiotherapy

- Pleurodesis is not considered chemotherapy

- At least 1 week since prior and no other concurrent nitric oxide donors (e.g., nitroglycerin)

- At least 1 week since prior and no concurrent calcium antagonists

- At least 1 week since prior and no concurrent drugs for erectile dysfunction that inhibit phosphodiesterase 5 (e.g., sildenafil citrate or vardenafil hydrochloride hydrate)

- More than 24 hours since prior and no concurrent administration of the following:

- Antifungal azoles, including ketoconazole, miconazole, or itraconazole

- Macrolides, including erythromycin or clarithromycin

- Cyclosporines

- Benzodiazepines, including diazepam, triazolam, or midazolam

- Vitamin A

- Steroid hormones, including ethinylestradiol

- No concurrent participation in another clinical trial
Kyoto University Hospital
Kyoto, Japan
Status: Recruiting
Contact: Hiroyasu Yasuda, MD, PhD - 81-75-751-4770 -
Start Date
January 2008
Kyoto University
National Cancer Institute (NCI)
Record processing date processed this data on July 28, 2015 page