UMIN-CTR Clinical Trial

Public title

Phase III study of perioperative pirfenidone therapy in patients with non-small-cell lung cancer combined with idiopathic pulmonary fibrosis (IPF) for confirming the effect for prevention of postoperative acute exacerbation

Acronym

PIII-PEOPLE study

Scientific Title

Phase III study of perioperative pirfenidone therapy in patients with non-small-cell lung cancer combined with idiopathic pulmonary fibrosis (IPF) for confirming the effect for prevention of postoperative acute exacerbation

Scientific Title:Acronym

PIII-PEOPLE study

Region

Japan

Condition

non-small-cell lung cancer combined with idiopathic pulmonary fibrosis

Classification by specialty

Chest surgery

Classification by malignancy

Malignancy

Genomic information

NO

Narrative objectives1

The effect of suppressing acute exacerbation by perioperative pirfenidone therapy for IPF-associated lung cancer patients subject to surgery is examined by comparison with the control group.

Basic objectives2

Efficacy

Basic objectives -Others

Trial characteristics_1

Trial characteristics_2

Developmental phase

Phase III

Primary outcomes

IPF exacerbation rate within 30 days after surgery

Key secondary outcomes

1) postoperative IPF exacerbation free period (within 90 days)
2) Comparison of incidence of complications due to pirfenidone, or general postoperative complications.
3) Overall and recurrence free survival rate for 2 years after surgery, exacerbation free survival rate of IPF, and sub-analysis for each other preventive treatment.
4) Comparison of acute exacerbation risk score, and assessment of adequacy of the risk score.
5) Evaluation of correct rate of radiological IPF diagnosis after central decision.
6) Sub-analysis for IPF and non-IPF after central decision, of the rate of acute exacerbation within 30 days after surgery, IPF exacerbation free period, and effects of pirfenidone.

Study type

Interventional

Basic design

Parallel

Randomization

Randomized

Randomization unit

Individual

Blinding

Open -no one is blinded

Control

Active

Stratification

YES

Dynamic allocation

YES

Institution consideration

Institution is considered as adjustment factor in dynamic allocation.

Blocking

Concealment

Central registration

No. of arms

2

Purpose of intervention

Treatment

Type of intervention

Medicine

Interventions/Control_1

Oral pirfenidone (600mg) is administrated for 14days after registration, and oral pirfenidone (1200mg) for more 14days before surgery. It's recommended continuing oral pirfenidone as long as possible even after surgery.

Interventions/Control_2

Acute exacerbation prophylaxis is performed (not specified. but decided in each facility)

Interventions/Control_3

Interventions/Control_4

Interventions/Control_5

Interventions/Control_6

Interventions/Control_7

Interventions/Control_8

Interventions/Control_9

Interventions/Control_10

Age-lower limit

20

years-old

<=

Age-upper limit

Not applicable

Gender

Male and Female

Key inclusion criteria

(1) Cases with ages over 20
(2) Cases with c-stage 0-IIIA non-small cell lung cancer diagnosed cytologically or histologically, or strongly suspected radiologically
(3) Cases diagnosed as IPF on HRCT (possible UIP / definitive UIP under the 2011 International Guidelines)
(4) Cases that are tolerable to general anesthesia
(5) Cases with resectable lesions by lobectomy
(6) Cases that satisfy the following criteria within 14 days before registration.
1) Neutrophils: 1,500 / mm3 or more
2) Hemoglobin: not less than 10.0 g / dL
3) Platelets: 10.0 x 10^4 / mm3 or more
4) AST: 3 times or less of upper limit of facility reference value
5) ALT: 3 times or less of upper limit of facility reference value
6) Total bilirubin: 1.5 times or less of upper limit of the facility reference value
7) SpO 2 90% or more
8) Serum creatinine: 1.5 times or less of upper limit of facility reference value
(7) Cases with postoperative predicted FEV1 is more than 1000 mL
(8) Cases with good oral intake
(9) Cases in which performance status (ECOG Scale) is 0 or 1
(10) Cases in which written consent has been obtained from the patient himself / herself after adequate explanation was made before study registration

Key exclusion criteria

(1) Patients with past thoracotomy or thoracoscopic surgery (the cases with surgical biopsy for IPF diagnostic purposes or the cases after 6 months or more since biopsy were excluded)
(2) Cases with prior therapies for IPF (pirfenidone, nintedanib, immunosuppressive drugs, etc.)
(3) Cases in which corticosteroids, macrolide antibiotics or both are currently administered
(4) Cases with a history of chemotherapy and/or radiotherapy in which the lung enters the irradiation field
(5) Cases in which the cause of interstitial pneumonia is revealed, such as drug properties, environmental exposure, collagen disease, etc.
(6) Cases receiving oxygen therapy
(7) Cases with local or systemic active infections requiring treatment
(8) Cases with severe complications such as poor control heart disease, glaucoma, diabetes, gastrointestinal bleeding, etc.
(9) Cases with a history of severe hypersensitivity
(10) Cases those are considered difficult to register due to mental illness
(11) Pregnant women, lactating women, women who are currently pregnant, or women who are not willing to contraceptive
(12) Cases with a history of obvious IPF acute exacerbation in the past
(13) Other cases judged inappropriate by the attending doctors.

Target sample size

230

Name of lead principal investigator

1st name
Middle name
Last name	Ichiro Yoshino

Organization

Chiba University Graduate School of Medicine

Division name

Department of General Thoracic Surgery

Zip code

Address

1-8-1, Inohana, Chuo-ku, Chiba

TEL

043-222-7171

Email

iyoshino@faculty.chiba-u.jp

Name of contact person

1st name
Middle name
Last name	Yuichi Sakairi

Organization

Chiba University Graduate School of Medicine

Division name

Department of General Thoracic Surgery

Zip code

Address

1-8-1, Inohana, Chuo-ku, Chiba

TEL

043-222-7171

Homepage URL

Email

y_sakairi1@chiba-u.jp

Institute

North East Japan Study Group

Institute

Department

Personal name

Organization

North East Japan Study Group

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization

Co-sponsor

Name of secondary funder(s)

Organization

Address

Tel

Email

Secondary IDs

NO

Study ID_1

Org. issuing International ID_1

Study ID_2

Org. issuing International ID_2

IND to MHLW

Institutions

Date of disclosure of the study information

2017

Year

10

Month

15

Day

URL releasing protocol

Publication of results

Unpublished

URL related to results and publications

Number of participants that the trial has enrolled

Results

Results date posted

Results Delayed

Results Delay Reason

Date of the first journal publication of results

Baseline Characteristics

Participant flow

Adverse events

Outcome measures

Plan to share IPD

IPD sharing Plan description

Recruitment status

Open public recruiting

Date of protocol fixation

2017

Year

08

Month

28

Day

Date of IRB

Anticipated trial start date

2017

Year

10

Month

15

Day

Last follow-up date

Date of closure to data entry

Date trial data considered complete

Date analysis concluded

Other related information

Registered date

2017

Year

10

Month

04

Day

Last modified on

2019

Year

02

Month

02

Day

Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000033606