Multicenter Phase III Study of Gefitinib Mono-therapy or Gefitinib Combined With Chemotherapy in Patients With Brain Metastases From Non-small Cell Lung Cancer Harboring EGFR Mutation
Overview
- Phase
- Phase 3
- Intervention
- Gefitinib and Pemetrexed/platinum
- Conditions
- Non-small Cell Lung Cancer
- Sponsor
- Sun Yat-sen University
- Enrollment
- 160
- Locations
- 1
- Primary Endpoint
- iPFS(intracranial progression free survival
- Last Updated
- 4 years ago
Overview
Brief Summary
This is a multi-center phase III randomized controlled study to assess the efficacy of Gefitinib alone and Gefitinib combination with Pemetrexed/platinum on patients with brain metastasis from non-small cell lung cancer(NSCLC) harboring EGFR mutation type by intracranial PFS(iPFS),also PFS ,DCR and OS.The side effect is evaluated as well.
Investigators
Li-kun Chen
medical doctor
Sun Yat-sen University
Eligibility Criteria
Inclusion Criteria
- •Patient who was confirmed stage IV NSCLC with EGFR activating mutation and brain metastases by pathologic histology or cytology
- •Patients who had never received therapy (including chemotherapy,WBRT,EGFR-TKI and EGFR monoclonal antibody) after diagnosed brain metastases
- •Patients had at least three metastatic lesions in brain, or patients with 1-2 intracranial lesions who were not suitable for brain radiotherapy, or patients with 1-2 intracranial lesions who refused brain radiotherapy, at least one intracranial lesion with the longest diameter of \>5 mm
- •Adult patients (≥ 18 years and ≤75 years). ECOG Performance Status 0 or 1 Life expectancy of at least 12 weeks.,Haemoglobin ³ 10.0 g/dl, Absolute neutrophil count (ANC) ³1.5 x 109/L, platelets ³ 100 x 109/L. Total bilirubin £ 1.5 x upper limit of normal (ULN). ALT and AST \< 2.5 x ULN in the absence of liver metastases, or \< 5 x ULN in case of liver metastases. Creatinine clearance ³ 60ml/min (calculated according to Cockcroft-gault formula).
- •Patients should be contraceptive during the period of the trial until 8 weeks after the last administration of icotinib.
- •Able to comply with the required protocol and follow-up procedures, and able to receive oral medications.
Exclusion Criteria
- •Patient was received irradiation of brain. Patient with meningeal metastases were confirmed by MRI or cytology test of cerebrospinal fluid.
- •Patient is received the treatment of Phenytoin, carbamazepine, rifampicin, phenobarbital, or St. John's Wort.
- •Patient was received EGFR Tyrosine Kinase Inhibitor or EGFR monoclonal antibody.
- •Interstitial pneumonia.Pericardial effusion, pleural effusion is uncontrolled .
- •Any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the previous year, serious cardiac arrhythmia requiring medication, hepatic, renal, or metabolic disease).
- •Any significant ophthalmologic abnormality ,especially severe dry eye syndrome ,keratoconjunctivitis sicca,Sjogren syndrome,severe exposure keratitis or any other disorder likely to increase the risk of corneal epithelial lesions.
- •Lack of physical integrity of the upper gastrointestinal tract, or malabsorption syndrome, or inability to take oral medication, or have active peptic ulcer disease.
- •The symptoms of increased intracranial pressure are uncontrolled after dehydration and cortisone treatment
Arms & Interventions
Gefitinib and Pemetrexed/platinum
Gefitinib 250mg is Taken Orally on day 1-28,combined Pemetrexed (D1)+cisplatin (D1-3) chemotherapy or Pemetrexed (D1)+nedaplatin (D1) chemotherapy, every 28 days
Intervention: Gefitinib and Pemetrexed/platinum
Gefitinib mono-therapy
Gefitinib 250mg is Taken Orally everyday
Intervention: Gefitinib mono-therapy
Outcomes
Primary Outcomes
iPFS(intracranial progression free survival
Time Frame: 2 years
defined as time from randomization to intracranial progressive disease or death.
Secondary Outcomes
- ORR(2 years)
- intracranial objective response rate (iORR)(2 years)
- PFS(Progression Free Survival)(2 years)
- OS(Overall Survival)(3 years)
- adverse events(3 years)