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WBRT & Erlotinib in Advanced NSCLC and Brain Metastases (TACTIC)

This study has been terminated.
(IDMC made a recommendation to stop the trial as the target for continuing to the 2nd phase was not met.)
Sponsor:
Collaborators:
Cancer Research UK
Roche Pharma AG
Information provided by (Responsible Party):
University College, London
ClinicalTrials.gov Identifier:
NCT00554775
First received: November 6, 2007
Last updated: December 9, 2011
Last verified: December 2011

November 6, 2007
December 9, 2011
January 2008
November 2010   (final data collection date for primary outcome measure)
Neurological progression-free survival at 2 months [ Time Frame: at 2 months ] [ Designated as safety issue: No ]
Neurological progression-free survival at 2 months
Complete list of historical versions of study NCT00554775 on ClinicalTrials.gov Archive Site
  • Toxicity [ Time Frame: during and for 28 days following Tarceva/placebo treatment. ] [ Designated as safety issue: Yes ]
  • Response rate [ Time Frame: from date of randomisation to radiological progression ] [ Designated as safety issue: No ]
  • Quality of life [ Time Frame: completed monthly for the first 12 months and at 18 and 24 months from randomisation ] [ Designated as safety issue: No ]
  • Change in performance status [ Time Frame: from baseline ] [ Designated as safety issue: No ]
  • Steroid dosing [ Time Frame: from baseline ] [ Designated as safety issue: No ]
  • Sites of progression (cranial or extracranial) [ Time Frame: from baseline ] [ Designated as safety issue: No ]
  • Toxicity
  • Response rate
  • Quality of life
  • Change in performance status
  • Steroid dosing
  • Sites of progression (cranial or extracranial)
Not Provided
Not Provided
 
WBRT & Erlotinib in Advanced NSCLC and Brain Metastases
A Randomised Phase II Double Blind Placebo Controlled Trial of Whole Brain Radiotherapy (WBRT) and Tarceva (OSI-774, Erlotinib) in Patients With Advanced Non-Small Cell Lung Cancer (NSCLC) With Multiple Brain Metastases [TACTIC]

RATIONALE: Radiation therapy uses high energy x-rays to kill tumor cells. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Erlotinib may also make tumor cells more sensitive to radiation therapy. It is not yet known whether giving whole-brain radiation therapy together with erlotinib is more effective than whole-brain radiation therapy alone in treating patients with non-small cell lung cancer and brain metastases.

PURPOSE: This randomized phase II trial is studying whole-brain radiation therapy and erlotinib to see how well they work compared with whole-brain radiation therapy alone in treating patients with advanced non-small cell lung cancer and brain metastases.

OBJECTIVES:

Primary

  • Compare the effect of whole-brain radiotherapy (WBRT) and erlotinib hydrochloride vs WBRT alone on neurological progression-free survival at 2 months in patients with advanced non-small cell lung cancer and multiple brain metastases.

Secondary

  • Compare the toxicity of these regimens.
  • Compare the response rate in these patients.
  • Compare quality of life of these patients.
  • Compare change in performance status in these patients.
  • Compare steroid dosing in these patients.
  • Compare sites of progression (cranial or extracranial) in these patients.

OUTLINE: This is a multicenter study. Patients are stratified by presence of extracranial metastases (yes vs no), RTOG recursive partitioning analysis (RPA) score (I vs II) and treatment center. Patients are randomized to 1 of 2 treatment arms.

  • Arm I: Patients undergo whole-brain radiotherapy (WBRT) once daily for 5 days. Patients also receive oral erlotinib hydrochloride once daily for up to 24 months.
  • Arm II: Patients undergo WBRT as in arm I. Patients also receive oral placebo once daily for up to 24 months.

Quality of life is assessed at baseline, monthly for 12 months, and then at 18 and 24 months.

After completion of study therapy, patients are followed every 1-2 months.

Peer Reviewed and Funded or Endorsed by Cancer Research UK.

Interventional
Phase 2
Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
  • Lung Cancer
  • Metastatic Cancer
  • Drug: erlotinib hydrochloride
    PO 100 mg daily during WBRT, increasing to 150mg daily after WBRT for up to 24 months
    Other Names:
    • tarceva
    • OSI-774
  • Drug: placebo
    WBRT plus matched placebo for the same schedule and duration as erlotinib hydrochloride
  • Experimental: erlotinib hydrochloride
    WBRT plus Tarceva (OSI-774, erlotinib) PO 100 mg daily during WBRT, increasing to 150mg daily after WBRT for up to 24 months
    Intervention: Drug: erlotinib hydrochloride
  • Placebo Comparator: placebo
    WBRT plus matched placebo for the same schedule and duration as erlotinib hydrochloride arm
    Intervention: Drug: placebo
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Terminated
80
November 2010
November 2010   (final data collection date for primary outcome measure)

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed advanced non-small cell lung cancer (NSCLC) meeting 1 of the following criteria:

    • Newly diagnosed multiple brain metastases not suitable for first-line chemotherapy
    • Relapsed NSCLC with newly diagnosed multiple brain metastases
    • Relapsed after second-line chemotherapy with newly diagnosed multiple brain metastases NOTE: *Biopsy of brain metastases is not required
  • Diagnosis of brain metastases must be confirmed by contrast CT scan or MRI within the past 4 weeks

    • Symptoms attributable to brain metastases
    • Patients who have undergone craniotomy with incomplete resection are eligible
  • Clinician certain that whole-brain radiotherapy (WBRT) will be beneficial
  • No evidence of solitary brain metastasis on MRI that can be treated with surgical resection, radiosurgery, or stereotactic radiotherapy
  • No more than 3 sites (organ systems) of extracranial metastases

    • No liver metastases

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 70-100%
  • RTOG recursive partitioning analysis (RPA) class I or II
  • Serum bilirubin < 2 times upper limit of normal (ULN)
  • AST and ALT < 2 times ULN (< 5 times ULN if liver metastases are present)
  • Creatinine < 5 times ULN
  • Able to take oral medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Caretaker able and willing to participate in the study
  • Patient and caretaker have access to a telephone and willing to respond to telephone interview
  • No other prior or concurrent malignant disease likely to interfere with study treatment or comparisons
  • No evidence of other significant laboratory finding or concurrent uncontrolled medical illness, that in the opinion of the investigator, would interfere with study treatment or results comparison or render the patient at high risk for treatment complications including, but not limited to, any of the following:

    • Severe uncontrolled infection
    • Unstable angina
    • Myocardial infarction within the past month
    • Uncontrolled inflammatory bowel disease (e.g., Crohn's disease or ulcerative colitis)
    • Acute renal failure

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • At least 28 days since prior chemotherapy (for relapsed patients originally treated with chemotherapy)
  • No prior cranial radiotherapy
  • No prior anti-cancer EGFR therapy (e.g., erlotinib, gefitinib, or cetuximab)
  • No prior treatment for brain metastases (e.g., radiosurgery, radiotherapy, or chemotherapy)

    • Prior radiotherapy to the primary tumor and/or systemic treatment to metastatic sites of disease allowed
  • No concurrent cyclooxygenase-2 (COX-2) inhibitors
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
United Kingdom
 
NCT00554775
CDR0000573254, CRUK-UCL-BRD-05-177, BRD/05/177, EUDRACT-2006-000113-38, CRUK-TACTIC, EU-20792, ISRCTN31916843
Yes
University College, London
University College, London
  • Cancer Research UK
  • Roche Pharma AG
Study Chair: Siow M. Lee, MD, PhD, FRCP University College London Hospitals
University College, London
December 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP