Erlotinib 100mg qd Versus Gefitinib 250mg qd for EGFR Mutant Nsclc (NSCLC EGFR TKI)

This study is currently recruiting participants. (see Contacts and Locations)
Verified September 2013 by Sun Yat-sen University
Sponsor:
Information provided by (Responsible Party):
Li Zhang, Sun Yat-sen University
ClinicalTrials.gov Identifier:
NCT01955421
First received: September 24, 2013
Last updated: October 4, 2013
Last verified: September 2013
  Purpose

This study is a multicenter, randomized, open-label Phase II trial that compares reduced dose erlotinib 100mg daily and standard dose gefitinib 250mg daily in patients with advanced non-small cell lung cancer who harbor EGFR mutations. The primary endpoint is disease control rate (DCR) and the key secondary endpoint is progression free survival (PFS). A total of 224 eligible patients will be randomized to receive either erlotinib 100mg daily or gefitinib 250mg daily in a 1:1 ratio until patients experience disease progression. Independent assessment of the major endpoints will be completed in a treatment-blinded manner. Randomization will be stratified based on treatment-lines (first-line vs. maintenance vs. second-line therapy). Tumor response and progression will be assessed according to RECIST 1.1.


Condition Intervention Phase
Advanced Stage Non Small Cell Lung Cancer
Drug: Erlotinib 100mg qd
Drug: Gefitinib 250mg qd
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Randomized, Open-label Phase II Trial of Erlotinib 100mg Daily Versus Gefitinib 250mg Daily in Patients With Advanced Non-small Cell Lung Cancer Who Harbor EGFR Mutations.

Resource links provided by NLM:


Further study details as provided by Sun Yat-sen University:

Primary Outcome Measures:
  • disease control rate [ Time Frame: 2 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • progression free survival [ Time Frame: 2 years ] [ Designated as safety issue: No ]
  • adverse events [ Time Frame: 2 years ] [ Designated as safety issue: Yes ]
    rash, diarrhea, ILD, etc.


Estimated Enrollment: 224
Study Start Date: July 2013
Estimated Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Erlotinib100
Patients will be randomized to buy and receive erlotinib 100mg qd.
Drug: Erlotinib 100mg qd
Experimental: Gefitinib250
Patients will be randomized to buy and receive gefitinib 250mg qd.
Drug: Gefitinib 250mg qd

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Diagnosis of advanced stage NSCLC (stage IIIB or IV) which is confirmed by histology or cytology methods.
  2. Harboring a PCR-confirmed activating mutation of EGFR, including an exon 19 deletion or an exon 21 L858R point mutation.
  3. Measurable disease according to RECIST1.1.
  4. Eastern Cooperative Oncology Group (ECOG) score of 0-2
  5. Adequate organ function, defined as all of the following:

    1. LVEF >50% or within institution normal values.
    2. Absolute neutrophil count (ANC)>1500/mm3.
    3. Platelet count >75,000/mm3
    4. Estimated creatinine clearance>45m1/min.
    5. Total bilirubin<1.5 times institutional ULN (Patients with Gilbert's Syndrome total bilirubin must be <4 times institutional ULN).
    6. Aspartate amino transferase (AST) or alanine amino transferase (ALT) < three times the institutional upper limit of normal (ULN) (if related to liver metastases<five times institutional ULN).
  6. Recovered from any previous therapy related toxicity to ≤CTCAE Grade 1 at study entry (except for stable sensory neurupethy ≤CTCAE Grade 2 and alopecia).
  7. Ability to take oral medication in the opinion of the investigator.
  8. Age ≥ 18 years.
  9. Written informed consent that is consistent with ICH-GCP guidelines.

Exclusion Criteria:

  1. Prior treatment with EGFR directed small molecules or antibodies.
  2. Radiotherapy within 4 weeks prior to randomization, except as follows:

    1. Palliative radiation to target organs other than chest may be allowed up to 2 weeks prior to randomization
    2. Single dose palliative treatment for symptomatic metastasis outside above allowance to be discussed with sponsor prior to enrolling.
  3. Active brain metastases (stable for <4 weeks, symptomatic, or leptomeningeal disease). Dexamethasone therapy will be allowed if administered as a stable dose for at least 4 weeks before randomization.
  4. Any other current malignancy or malignancy diagnosed within the past three (3) years (other than basal-cell carcinoma of the skin, in situ cervical cancer, in situ prostate cancer).
  5. Known pre-existing interstitial lung disease.
  6. Significant or recent acute gastrointestinal disorders with diarrhea as a major symptom e.g. Crohn's disease, malabsorption or CTC grade >2 diarrhoea of any aetiology, based on investigator assessment.
  7. History or presence of clinically relevant cardiovascular abnormalities such as uncontrolled hypertension, congestive heart failure NYHA classification of 3 (Refer to Appendix 10.4), unstable angina or poorly controlled arrhythmia as determined by the investigator. Myocardial infarction within 6 months prior to randomisation.
  8. Any other concomitant serious illness or organ system dysfunction which in the opinion of the investigator would either compromise patient safety or interfere with the evaluation of the safety of the test drug.
  9. Women of child-bearing potential and men who are able to father a child, unwilling to be abstinent or use adequate contraception prior to study entry, for the duration of study participation and for at least 2 months after treatment has ended. Adequate methods of contraception and women of Child-Beanng Potenial are discussed in Section 4.2.2.3.
  10. Female patients of childbearing potential (see Section 4.2.2.3) who are nursing or are pregnant.
  11. Patients unable to complv with the protocol in the opinion of the investigator.
  12. Active hepatitis B infection (detined as presence of Hepatitis B DNA), active hepatitis C infection (defined as vresence of Hepatitis C RNA) and/or known HIV carrier.
  13. Known or suspected active drug or alcohol abuse in the opinion of the investigator.
  14. Requirement for treatment with any of the prohibited concomitant medications listed in Section 4.2.3.
  15. Any contraindications for therapy with gefitinib or erlotinib.
  16. Known hypersensitivity to erlotinib, gefitinib or the exipients of any of the trial drugs
  17. Major surgery within 4 weeks of starting study treatment.
  18. Use of any investigational drug within 4 weeks of randomisation (unless a longer time period is required by local regulations or by the guidelines for the investigational product).
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01955421

Locations
China, Guangdong
Department of Medical Oncology, Cancer Center of Sun Yat-Sen University Recruiting
Guangzhou, Guangdong, China, 510060
Contact: Wenhua Liang, MD    8613710249454    liangwh@sysucc.org.cn   
Principal Investigator: Li Zhang, MD         
Sub-Investigator: Wenhua Liang, MD         
Sponsors and Collaborators
Sun Yat-sen University
  More Information

No publications provided

Responsible Party: Li Zhang, Professor, Sun Yat-sen University
ClinicalTrials.gov Identifier: NCT01955421     History of Changes
Other Study ID Numbers: E100VG250, Tarceva100vsIressa250
Study First Received: September 24, 2013
Last Updated: October 4, 2013
Health Authority: China: Ministry of Health

Keywords provided by Sun Yat-sen University:
NSCLC
stage IIIB
stage IV)
confirmed by histology or cytology methods
Harboring a PCR-confirmed activating mutation of EGFR, including an exon 19 deletion or an exon 21 L858R point mutation

Additional relevant MeSH terms:
Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Erlotinib
Gefitinib
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Antineoplastic Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on October 01, 2014