A Randomized Phase II Study of Gefitinib Alone Versus Gefitinib Plus Thalidomide for Advanced Non-small Cell Lung Cancer With Epidermal Growth Factor Receptor Activating Mutations
Overview
- Phase
- Phase 2
- Intervention
- Thalidomide
- Conditions
- NSCLC Stage IV
- Sponsor
- Fujian Cancer Hospital
- Enrollment
- 128
- Locations
- 2
- Primary Endpoint
- PFS
- Last Updated
- 8 years ago
Overview
Brief Summary
EGFR-TKIs are the standard first-line treatment option for EGFR-mutant NSCLC. After a randomized phase II trial, JO25567 was presented at 2014 ASCO, the synergistic effect of progression-free survival(PFS) could be expected when EGFR TKI, Gefitinib is combined with Antiangiogenesis agent thalidomide, Therefore Chinese data of treating EGFR mutation positive NSCLC patients with Gefitinib and thalidomide is significantly necessary for developing new standard treatment in first-line therapy in Chinese EGFR mutant NSCLC patients.
In this study, The investigators will investigate the efficacy and safety of Gefitinib and thalidomide combination compare to Gefitinib alone in Chinese EGFR-mutant NSCLC patients.
Detailed Description
EGFR-TKIs are the standard first-line treatment option for EGFR-mutant NSCLC. After a randomized phase II trial, JO25567 was presented at 2014 ASCO, the synergistic effect of progression-free survival(PFS) could be expected when EGFR TKI, Gefitinib is combined with Antiangiogenesis agent thalidomide, . Even Chinese and Japanese are classified as Asian based on location, the figure of Chinese is more tended to Western people due to the dietary life in recent years. However the incidence rate of EGFR mutation positive patients in Chinese is much higher than Western countries. Therefore Chinese data of treating EGFR mutation positive NSCLC patients with Gefitinib and thalidomide is significantly necessary for developing new standard treatment in first-line therapy in Chinese EGFR mutant NSCLC patients. In this study, The investigators will investigate the efficacy and safety of Gefitinib and thalidomide combination compare to Gefitinib alone in Chinese EGFR-mutant NSCLC patients.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Pathologically confirmed stage IIIB \& IV non-small cell lung cancer other than squamous cell carcinoma
- •Patients with one or more measurable lesion based on Response Evaluation Criteria in Solid Tumors (RECIST 1.1)
- •Locally diagnosed sensitive EGFR mutation positive (Exon 19 deletion or L858R)
- •ECOG performance 0\~1
- •Age ≥ 19 years and - No previous treatment
- •Adequate organ function by following:
- •ANC ≥1,500/uL, hemoglobin ≥9.0g/dL, platelet ≥100,000/uL
- •Serum bilirubin \< 1 x UNL, AST (SGOT) and ALT (SGPT) \< 2.5 x UNL, If Liver metastasis, Serum bilirubin \< 3 x UNL, AST (SGOT) and ALT (SGPT) \< 5 x UNL
- •Serum Cr ≤ 1 x UNL
- •Patients who have had undergone radiotherapy are acceptable if patients meet all of the following criteria:
Exclusion Criteria
- •• Previous history of malignancy within 3 years from study entry except treated non-melanomatous skin cancer, uterine cervical cancer in situ, or thyroid cancer
- •Prior chemotherapy or systemic anti-cancer therapy for metastatic disease but postoperative adjuvant or neoadjuvant therapy of 6 months or more previously is allowed
- •Patients who received previous treatment for lung cancer with drugs
- •Symptomatic or uncontrolled central nervous system (CNS) metastases
- •Patients with increased risk of bleeding, clinically significant cardiovascular diseases, a history of thrombosis or thromboembolism in the 6 months prior to treatment, gastrointestinal problems, and neurologic problems
- •Any significant ophthalmologic abnormality
- •Pre-existing parenchymal lung disease such as pulmonary fibrosis
- •Known allergic history of Erlotinib or Bevacizumab
- •Interstitial lung disease or fibrosis on chest radiogram
- •Active infection, uncontrolled systemic disease (cardiopulmonary insufficiency, fatal arrhythmias, hepatitis)
Arms & Interventions
Gefitinib 250mg qd thalidomide 200mg qn
Intervention: Thalidomide
Gefitinib 250mg qd
Intervention: Thalidomide
Outcomes
Primary Outcomes
PFS
Time Frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to at least 36 months
progression-free survival
Secondary Outcomes
- ORR(through study completion, and average of 2 years)
- OS(From date of randomization until the date of death or date of last visit/contact, whichever came first, assessed to at least 36 months)