A trial looking at either pemetrexed or etoposide with cisplatin and radiotherapy for locally advanced non small cell lung cancer

Please note - this trial is no longer recruiting patients. We hope to add results when they are available.

Cancer type:

Lung cancer
Non small cell lung cancer




Phase 3

This trial is comparing a combination of pemetrexed, cisplatin and radiotherapy with a combination of etoposide, cisplatin and radiotherapy for non small cell lung cancer (NSCLC) that is locally advanced Open a glossary item and cannot be removed with surgery.

More about this trial

If it is not possible to have surgery to remove NSCLC, you may have treatment with radiotherapy and chemotherapy. Doctors don’t yet know which combination of chemotherapy drugs works best in this situation, but usually it includes a platinum drug Open a glossary item such as cisplatin.

In this trial, the researchers are comparing a drug called etoposide with a drug called pemetrexed. Whichever drug you have, you also have cisplatin and radiotherapy.

The aims of the trial are to

  • Find out which treatment works best for locally advanced non small cell lung cancer
  • Learn more about the side effects

Who can enter

You can enter this trial if you

  • Have non small cell lung cancer that is stage 3A or 3B and cannot be removed with surgery
  • Have satisfactory lung function test Open a glossary item results
  • Have satisfactory blood test results
  • Are well enough to take part in the trial
  • Are at least 18 years old
  • Are willing to use reliable contraception during the trial and for 6 months after if there is any chance you or your partner could become pregnant

You cannot enter this trial if you

  • Have a tumour in which most of the tissue is squamous cell cancer Open a glossary item (your doctor will advise you about this)
  • Have already had chemotherapy for lung cancer
  • Have a pleural effusion or a build up of fluid around the heart (pericardial effusion)
  • Have had radiotherapy to your chest, to more than a quarter of your bone marrow Open a glossary item, or to all of your pelvis
  • Have had radiotherapy in the last month or have not recovered from the side effects of earlier treatment
  • Have lost more than 5% of your body weight in the last 3 months
  • Have hearing loss
  • Have had a heart attack in the last 6 months
  • Have another serious medical condition that cannot be controlled with medication
  • Have had an experimental treatment as part of another clinical trial in the last month
  • Have had a yellow fever vaccination in the last month
  • Have ever had breast cancer or melanoma
  • Have had any another cancer in the last 5 years apart from non melanoma skin cancer or carcinoma in situ Open a glossary item that has been successfully treated
  • Take a high dose of aspirin or another non steroidal anti inflammatory drug and you cannot stop taking it for a few days at a time (you should not stop taking any regular medication without talking to your doctor first)
  • Are unable to take steroids
  • Are known to react to pemetrexed, cisplatin or etoposide
  • Are HIV positive or if your immune system Open a glossary item does not work well for any other reason
  • Are pregnant or breastfeeding

Trial design

This is an international trial that will recruit about 600 people around the world. It is a randomised trial. The people taking part will be put into one of 2 groups by computer. Neither you nor your doctor can decide which group you are in.

If you are in group A, you have pemetrexed and cisplatin through a drip into a vein every 3 weeks. Each 3 week period is called a cycle of treatment. You have 3 cycles of this treatment, then a rest period of between 3 and 5 weeks, followed by 4 more cycles of treatment with pemetrexed alone. To help control the side effects of pemetrexed, you take a steroid tablet called dexamethasone each time you have it. You also have folic acid tablets, and vitamin B12 injections.

On day 1 of the first cycle of chemotherapy treatment, you will also start radiotherapy. You have radiotherapy each day from Monday to Friday for just over 6 weeks.

If you are in group B, you start having chemotherapy in 4 week cycles of treatment. You have etoposide through a drip into a vein on the first 5 days of each cycle. And you have cisplatin on the 1st and 8th day. You have 2 cycles of treatment, then a rest period of between 3 and 5 weeks, followed by 2 more cycles of treatment. For these last 2 cycles of treatment, doctors are looking at different chemotherapy drugs. You may have one of the following

  • Etoposide and cisplatin in 4 week cycles (the same as the first 2 cycles)
  • Vinorelbine and cisplatin in 3 week cycles
  • Paclitaxel and carboplatin in 3 week cycles

Your doctor will decide which combination you have. You will have the drugs through a drip into a vein.

You start radiotherapy on day 1 of the first cycle of chemotherapy. You have it each day from Monday to Friday for just over 6 weeks.

Everybody taking part will be asked to fill in a diary once a week to record whether or not you have had any problems swallowing.

Hospital visits

You will see the doctors and have some tests before you start treatment. The tests include

You have to go to hospital every day for about 6 weeks to have radiotherapy. In most hospitals you have treatment from Monday to Friday with a break at the weekends. On some days you will also have chemotherapy. The number of hospital visits you have after your radiotherapy has finished will depend on the type of chemotherapy you have.

You see the doctors and have blood tests regularly during your treatment. After you finish treatment you will see the doctors every 3 months for up to 5 years.

You will have a number of scans during your treatment and a month after finishing treatment. Then you have a scan

  • After 6, 9 and 12 months
  • Every 4 months in the next year
  • Every 6 months in the following year

Side effects

The side effects of the chemotherapy drugs in this trial include

  • A drop in the number of blood cells causing an increased risk of infection, tiredness, breathlessness, bruising or bleeding problems
  • Sickness
  • Diarrhoea or constipation
  • Hair loss
  • Sore mouth
  • Skin rash
  • Swelling of the limbs or face caused by a build up of fluid
  • Abdominal (tummy) pain
  • Fever or chills
  • Weakness and fatigue
  • Breathing problems or cough
  • Headache
  • Loss of appetite
  • Kidney damage

This list is for all the drugs in the trial. Not everyone gets every side of a drug and nobody will have all the drugs.

There is more information about lung cancer radiotherapy side effects, cisplatin, etoposide, vinorelbine, paclitaxel and carboplatin on CancerHelp UK.

Having radiotherapy and chemotherapy at the same time can mean that side effects such as difficulty swallowing are worse, or that they last longer.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Mayukh Das

Supported by

Eli Lilly and Company Limited
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Around 1 in 5 people take part in clinical trials

3 phases of trials

Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.

Last reviewed:

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