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Published in: Trials 1/2018

Open Access 01-12-2018 | Study protocol

Zoledronic acid in the management of mesothelioma - a feasibility study (Zol-A Trial): study protocol for a randomised controlled trial

Authors: Duneesha de Fonseka, Anna Morley, Louise Stadon, Emma Keenan, Steven Walker, Sarah Smith, John E. Harvey, R. Ashley Cox, Adam Dangoor, Charles Comins, Christine Rogers, Anthony Edey, Alfredo Addeo, Nick A. Maskell

Published in: Trials | Issue 1/2018

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Abstract

Background

Nitrogen containing bisphosphonates such as zoledronic acid (ZA) are known to contain certain anti-cancer properties. These have been investigated in the past in various cancers such as breast, prostate and colon. ZA in particular has shown promising results in pre-clinical studies. We propose a multicentre double-blind randomised controlled feasibility study to assess the recruitment and acceptability of ZA/placebo alongside chemotherapy in malignant pleural mesothelioma (MPM).

Methods

Patients will be recruited for a 13-month period from October 2016 to November 2017. Eligible patients will be identified via the regional mesothelioma multidisciplinary team meeting. Those who receive chemotherapy will be randomised to receive either ZA or placebo alongside their chemotherapy. Those who decline chemotherapy will be offered to join the trial on the non-randomised open-labelled arm of the trial. Patients will receive a maximum of six cycles of ZA/placebo, at three-weekly cycles. All patients will be followed up for six months from randomisation.
Semi-structured interviews to gather data on acceptability of trial procedures, tolerability of ZA and other relevant information will take place after the participants have completed their six cycles of treatment. For a better understanding about non-participation in mesothelioma trials we also aim to interview those who decline to take part in the trial.

Discussion

The qualitative and quantitative data gathered in this feasibility trial will hopefully pave the way to designing a robust full phase III trial to investigate the potential synergistic effect of ZA and current standard treatment for MPM, cisplatin-pemetrexed combination chemotherapy.

Trial registration

ISRCTN Registry, ISRCTN45536692. Registered on 9 August 2016. EudraCT no. 2015–004433-26.
Appendix
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Literature
1.
go back to reference Milano MT, Zhang H. Malignant pleural mesothelioma: a population-based study of survival. J Thorac Oncol. 2010;5:1841–8.CrossRefPubMed Milano MT, Zhang H. Malignant pleural mesothelioma: a population-based study of survival. J Thorac Oncol. 2010;5:1841–8.CrossRefPubMed
2.
go back to reference Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003;21:2636–44.CrossRefPubMed Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003;21:2636–44.CrossRefPubMed
3.
go back to reference Zalcman G, Mazieres J, Margery J, Greillier L, Audigier-Valette C, Moro-Sibilot D, et al. Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS): a randomised, controlled, open-label, phase 3 trial. Lancet. 2016;387:1405–14.CrossRefPubMed Zalcman G, Mazieres J, Margery J, Greillier L, Audigier-Valette C, Moro-Sibilot D, et al. Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS): a randomised, controlled, open-label, phase 3 trial. Lancet. 2016;387:1405–14.CrossRefPubMed
4.
go back to reference Rogers MJ. New insights into the molecular mechanisms of action of bisphosphonates. Curr Pharm Des. 2003;9:2643–58.CrossRefPubMed Rogers MJ. New insights into the molecular mechanisms of action of bisphosphonates. Curr Pharm Des. 2003;9:2643–58.CrossRefPubMed
5.
go back to reference Oades GM, Senaratne SG, Clarke IA, Kirby RS, Colston KW. Nitrogen containing bisphosphonates induce apoptosis and inhibit the mevalonate pathway, impairing Ras membrane localization in prostate cancer cells. J Urol. 2003;170:246–52.CrossRefPubMed Oades GM, Senaratne SG, Clarke IA, Kirby RS, Colston KW. Nitrogen containing bisphosphonates induce apoptosis and inhibit the mevalonate pathway, impairing Ras membrane localization in prostate cancer cells. J Urol. 2003;170:246–52.CrossRefPubMed
6.
go back to reference Gnant M, Clezardin P. Direct and indirect anticancer activity of bisphosphonates: a brief review of published literature. Cancer Treat Rev. 2012;38:407–15.CrossRefPubMed Gnant M, Clezardin P. Direct and indirect anticancer activity of bisphosphonates: a brief review of published literature. Cancer Treat Rev. 2012;38:407–15.CrossRefPubMed
7.
go back to reference Diel IJ, Jaschke A, Solomayer EF, Gollan C, Bastert G, Sohn C, et al. Adjuvant oral clodronate improves the overall survival of primary breast cancer patients with micrometastases to the bone marrow: a long-term follow-up. Ann Oncol. 2008;19:2007–11.CrossRefPubMedPubMedCentral Diel IJ, Jaschke A, Solomayer EF, Gollan C, Bastert G, Sohn C, et al. Adjuvant oral clodronate improves the overall survival of primary breast cancer patients with micrometastases to the bone marrow: a long-term follow-up. Ann Oncol. 2008;19:2007–11.CrossRefPubMedPubMedCentral
8.
go back to reference Powles T, Paterson A, McCloskey E, Schein P, Scheffler B, Tidy A, et al. Reduction in bone relapse and improved survival with oral clodronate for adjuvant treatment of operable breast cancer [ISRCTN83688026]. Breast Cancer Res. 2006;8:R13.CrossRefPubMedPubMedCentral Powles T, Paterson A, McCloskey E, Schein P, Scheffler B, Tidy A, et al. Reduction in bone relapse and improved survival with oral clodronate for adjuvant treatment of operable breast cancer [ISRCTN83688026]. Breast Cancer Res. 2006;8:R13.CrossRefPubMedPubMedCentral
9.
go back to reference Wakchoure S, Merrell MA, Aldrich W, Millender-Swain T, Harris KW, Triozzi P, et al. Bisphosphonates inhibit the growth of mesothelioma cells in vitro and in vivo. Clin Cancer Res. 2006;12:2862–8.CrossRefPubMed Wakchoure S, Merrell MA, Aldrich W, Millender-Swain T, Harris KW, Triozzi P, et al. Bisphosphonates inhibit the growth of mesothelioma cells in vitro and in vivo. Clin Cancer Res. 2006;12:2862–8.CrossRefPubMed
10.
go back to reference Matsumoto S, Kimura S, Segawa H, Kuroda J, Yuasa T, Sato K, et al. Efficacy of the third-generation bisphosphonate, zoledronic acid alone and combined with anti-cancer agents against small cell lung cancer cell lines. Lung Cancer. 2005;47:31–9.CrossRefPubMed Matsumoto S, Kimura S, Segawa H, Kuroda J, Yuasa T, Sato K, et al. Efficacy of the third-generation bisphosphonate, zoledronic acid alone and combined with anti-cancer agents against small cell lung cancer cell lines. Lung Cancer. 2005;47:31–9.CrossRefPubMed
11.
go back to reference Li YY, Chang JW, Chou WC, Liaw CC, Wang HM, Huang JS, et al. Zoledronic acid is unable to induce apoptosis, but slows tumor growth and prolongs survival for non-small-cell lung cancers. Lung Cancer. 2008;59:180–91.CrossRefPubMed Li YY, Chang JW, Chou WC, Liaw CC, Wang HM, Huang JS, et al. Zoledronic acid is unable to induce apoptosis, but slows tumor growth and prolongs survival for non-small-cell lung cancers. Lung Cancer. 2008;59:180–91.CrossRefPubMed
12.
go back to reference Jamil MO, Jerome MS, Miley D, Selander KS, Robert F. A pilot study of zoledronic acid in the treatment of patients with advanced malignant pleural mesothelioma. Lung Cancer (Auckl). 2017;8:39–44. Jamil MO, Jerome MS, Miley D, Selander KS, Robert F. A pilot study of zoledronic acid in the treatment of patients with advanced malignant pleural mesothelioma. Lung Cancer (Auckl). 2017;8:39–44.
13.
go back to reference Clive AO, Hooper CE, Edey AJ, Morley AJ, Zahan-Evans N, Hall D, et al. A randomised controlled trial of intravenous zoledronic acid in malignant pleural disease: a proof of principle pilot study. PLoS One. 2015;10:e0118569.CrossRefPubMedPubMedCentral Clive AO, Hooper CE, Edey AJ, Morley AJ, Zahan-Evans N, Hall D, et al. A randomised controlled trial of intravenous zoledronic acid in malignant pleural disease: a proof of principle pilot study. PLoS One. 2015;10:e0118569.CrossRefPubMedPubMedCentral
14.
go back to reference Bibby AC, De Fonseka D, Morley AJ, Keenan E, Addeo A, Smith S, et al. Exploring the characteristics of patients with mesothelioma who decline chemotherapy: a prospective cohort of 200 patients. Thorax. 2016;71:A89–90.CrossRef Bibby AC, De Fonseka D, Morley AJ, Keenan E, Addeo A, Smith S, et al. Exploring the characteristics of patients with mesothelioma who decline chemotherapy: a prospective cohort of 200 patients. Thorax. 2016;71:A89–90.CrossRef
Metadata
Title
Zoledronic acid in the management of mesothelioma - a feasibility study (Zol-A Trial): study protocol for a randomised controlled trial
Authors
Duneesha de Fonseka
Anna Morley
Louise Stadon
Emma Keenan
Steven Walker
Sarah Smith
John E. Harvey
R. Ashley Cox
Adam Dangoor
Charles Comins
Christine Rogers
Anthony Edey
Alfredo Addeo
Nick A. Maskell
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Trials / Issue 1/2018
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-018-2851-9

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