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Erlotinib With or Without Carboplatin and Paclitaxel in Treating Patients With Stage III or Stage IV Non-Small Cell Lung Cancer

Basic Trial Information
Trial Description
     Summary
     Further Trial Information
     Eligibility Criteria
Trial Contact Information

Basic Trial Information

PhaseTypeStatusAgeSponsorProtocol IDs
Phase IITreatmentClosed18 and overNCINCI-2009-00464
CALGB-30406, U10CA031946, CDR0000437097, NCT00126581

Trial Description

Summary

This randomized phase II trial is studying how well giving erlotinib alone or together with carboplatin and paclitaxel works in treating patients with stage III or stage IV non-small cell lung cancer. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving erlotinib together with carboplatin and paclitaxel may kill more tumor cells

Further Study Information

PRIMARY OBJECTIVES:

I. Determine the progression-free survival of patients with chemotherapy-naïve select stage IIIB or stage IV non-small cell lung cancer treated with erlotinib with or without carboplatin and paclitaxel.

SECONDARY OBJECTIVES:

I. Determine the radiographic response rate in patients treated with these regimens.

II. Correlate the frequency of epidermal growth factor receptor (EGFR) mutations and K-ras mutations with the response rate and time to progression in patients treated with these regimens.

III. Determine the median and overall survival of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study. Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients receive oral erlotinib once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity.

ARM II: Patients receive erlotinib as in arm I. Patients also receive paclitaxel IV over 1-3 hours and carboplatin IV over 15-30 minutes on day 1. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. After completion of 6 courses of treatment, patients may continue to receive erlotinib alone as above.

After completion of study treatment, patients are followed at least every 3 months for 1 year and then every 6 months for up to 2 years.

Eligibility Criteria

Inclusion Criteria:

  • Renal: Creatinine =< 1.5 mg/dL
  • Histologically confirmed primary non-small cell lung cancer (NSCLC)
  • Adenocarcinoma histology, including any of the following histologic variants: pure or mixed bronchoalveolar cell carcinoma, adenosquamous cell carcinoma
  • No NSCLC not otherwise specified
  • Pathology block or unstained slides from initial or subsequent diagnosis available
  • At least a core biopsy required
  • Fine needle aspirate alone is not sufficient
  • Meets 1 of the following stage criteria: s
  • elect stage IIIB disease with cytologically documented malignant pleural or
  • pericardial effusion or stage IV disease
  • Measurable disease, defined as >= 1 unidimensionally measurable lesion >= 20 mm by conventional techniques OR >= 10 mm by spiral CT scan
  • The following are considered non-measurable disease:
  • bone lesions,
  • leptomeningeal disease;
  • ascites;
  • pleural or pericardial effusion;
  • lymphangitis cutis/pulmonis;
  • abdominal masses not confirmed and followed by imaging techniques;
  • cystic lesions
  • Meets 1 of the following criteria for smoking history:
  • non-smoker,
  • defined as a person who smoked =< 100 cigarettes in their lifetime;
  • former light smoker,
  • defined as a person who smoked =< 10 pack years AND
  • quit smoking >= 1 year ago
  • No uncontrolled CNS metastases (i.e., any known CNS lesion that is radiographically unstable, symptomatic, and/or requires corticosteroids)
  • ECOG 0-1
  • Hematopoietic:
  • Granulocyte count >= 1,500/mm^3;
  • Platelet count >= 100,000/mm^3;
  • Hemoglobin >= 9.0 g/dL
  • Hepatic:
  • AST =< 2.5 times upper limit of normal (ULN);
  • Total bilirubin =< ULN
  • Gastrointestinal:
  • Able to swallow tablets intact or dissolved in water;
  • no dysphagia;
  • no active gastrointestinal disease or disorder that would alter gastrointestinal motility or absorption;
  • no lack of integrity of the gastrointestinal tract
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No prior trastuzumab (Herceptin) or cetuximab
  • No prior chemotherapy, including neoadjuvant or adjuvant chemotherapy
  • No other concurrent chemotherapy
  • No concurrent hormonal therapy except for the following:
  • hormones for non-disease-related conditions (e.g., insulin for diabetes);
  • steroids for adrenal failure;
  • intermittent use of dexamethasone as an antiemetic or to prevent paclitaxel hypersensitivity reactions
  • At least 3 weeks since prior radiotherapy, including cranial irradiation
  • No concurrent radiotherapy, including palliative radiotherapy
  • At least 3 weeks since prior major surgery
  • No prior significant surgical resection of the stomach or small bowel
  • No prior erlotinib, gefitinib, or lapatinib
  • No other prior treatment targeting the HER family axis
  • More than 4 weeks since prior and no other concurrent investigational agents

Trial Contact Information

Trial Lead Organizations/Sponsors

National Cancer Institute

Pasi JannePrincipal Investigator

Link to the current ClinicalTrials.gov record.
NLM Identifer NCT00126581
ClinicalTrials.gov processed this data on January 15, 2014

Note: Information about this trial is from the ClinicalTrials.gov database. The versions designated for health professionals and patients contain the same text. Minor changes may be made to the ClinicalTrials.gov record to standardize the names of study sponsors, sites, and contacts. Cancer.gov only lists sites that are recruiting patients for active trials, whereas ClinicalTrials.gov lists all sites for all trials. Questions and comments regarding the presented information should be directed to ClinicalTrials.gov.

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