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Erlotinib or Placebo Following Chemoradiotherapy (Chemo/RT) in Stage III Non-Small Cell Lung Cancer (NSCLC)

Phase 3
Completed
Conditions
Carcinoma, Non-Small-Cell Lung
Non-small Cell Lung Cancer
NSCLC
Interventions
Registration Number
NCT00153803
Lead Sponsor
Dartmouth-Hitchcock Medical Center
Brief Summary

This is a national, randomized, web-based, double-blind study to determine whether erlotinib (Tarceva) compared to placebo improves progression-free survival (PFS) for patients with inoperable, stage III NSCLC following concurrent docetaxel, carboplatin and thoracic radiotherapy. We hypothesize that the introduction of this orally active, well-tolerated agent following concurrent chemoradiation and prior to the emergence of drug resistance will prolong the progression-free survival by 40% (10 months → 14 months).

Detailed Description

The promising activity of erlotinib as a single agent in advanced refractory NSCLC along with its oral administration and favorable adverse event profile makes this agent an excellent candidate to incorporate into combined modality therapy in the early stages of lung cancer. Based on these data, erlotinib is an attractive novel approach to maintenance therapy in unresectable stage III NSCLC following completion of concomitant chemoradiation. Although, a subset of patients with unresectable stage III NSCLC will be long-term survivors following chemotherapy and thoracic radiation therapy, the vast majority relapse within the first year following therapy and eventually die from chemotherapy refractory disease. We hypothesize that the introduction of an potent tyrosine kinase inhibitor to the epidermal growth factor receptor following effective concomitant chemoradiotherapy with docetaxel and carboplatin will prolong the progression-free survival time for these patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
245
Inclusion Criteria
  • Unresectable, stage IIIA or IIIB NSCLC (measurable disease is not required)
  • No evidence of metastatic disease
  • No prior treatment
  • Adequate organ function
  • Adequate pulmonary function (FEV >= 1.0L or predicted FEV >0.8L)
Exclusion Criteria
  • Metastasis
  • Prior treatment
  • Malignant pleural or pericardial effusion
  • Peripheral neuropathy >= grade 2

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Erlotinib (tarceva)Erlotinib (Tarceva) 150mg: Erlotinib 150mg orally each day. Patients will be treated on a continuous, once daily oral dosing schedule until disease progression, withdrawal of consent, unacceptable adverse events, death or completion of 3 years of therapy.
2PlaceboMatched Placebo: Matched placebo orally each day. Patients will be treated on a continuous, once daily oral dosing schedule until disease progression, withdrawal of consent, unacceptable adverse events death or completion of 3 years of therapy.
Primary Outcome Measures
NameTimeMethod
Progression Free Survival5 years

Progression Free Survival is defined as time from randomization until documented disease progression or death from any cause. The Response Evaluation Criteria In Solid Tumors Criteria (RECIST 1.0) was used to determine disease progression. Irradiated target lesions were considered non-measurable disease. Symptomatic radiographic changes of irradiated non-measurable disease required pathologically confirmation or positive FDG-PET scan 6 months following completion of concurrent chemoradiation to be considered locoregional disease progression. Global deterioration of health status requiring discontinuation of treatment without objective evidence of progression was considered distant disease progression.

Secondary Outcome Measures
NameTimeMethod
Overall SurvivalFrom date of randomization until the date of death from any cause, assessed up to 50 months
Percent of Participants Surviving 3 Years36 months
Serious Adverse Event Profile Relating to Death, Disability, Life-threatening, Hospitalization, and Impairment/Damage for Concurrent Chemoradiation18 months

Number of participants with treatment-related serious adverse events (SAEs) observed in each SAE category for each arm relating to death, disability, life-threatening, hospitalization, and impairment/damage is reported. For participants with multiple SAEs, the SAE report having the strongest relationship to study drug is summarized.

Serious Adverse Event Profile Relating to Death, Disability, Life-threatening, Hospitalization, and Impairment/Damage for Erlotinib and Placebo18 months

Number of participants with treatment-related serious adverse events (SAEs) observed in each SAE category for each arm relating to death, disability, life-threatening, hospitalization, and impairment/damage is reported. For participants with multiple SAEs, the SAE report having the strongest relationship to study drug is summarized.

Trial Locations

Locations (65)

Mercy General Hospital

🇺🇸

Sacramento, California, United States

MD Anderson

🇺🇸

Orlando, Florida, United States

Lincoln Hospital

🇺🇸

Bronx, New York, United States

Cooper Clinic

🇺🇸

Fort Smith, Arkansas, United States

George Bray Cancer Center/New Britain General Hospital

🇺🇸

New Britain, Connecticut, United States

Whittingham Cancer Center at Norwalk Hospital

🇺🇸

Norwalk, Connecticut, United States

Hematology/Oncology PC/Carl and Dorothy Bennet Cancer Center

🇺🇸

Stamford, Connecticut, United States

Palm Beach Cancer Institute

🇺🇸

West Palm Beach, Florida, United States

Fallon Clinic Hematology/ Oncology

🇺🇸

Worcester, Massachusetts, United States

Florida Cancer Specialists

🇺🇸

Fort Myers, Florida, United States

Queens Medical Associates

🇺🇸

Fresh Meadows, New York, United States

SCOA-SC Onc Assoc

🇺🇸

Columbia, South Carolina, United States

Morgantown Internal Medicine Group

🇺🇸

Morgantown, West Virginia, United States

Nevada Cancer Research Foundation

🇺🇸

Las Vegas, Nevada, United States

Birmingham Hematology and Oncology Associates, LLC

🇺🇸

Birmingham, Alabama, United States

VA Department of Hematology/Oncology

🇺🇸

Houston, Texas, United States

Methodist Cancer Center

🇺🇸

Omaha, Nebraska, United States

St. Francis Hospital Cancer Center

🇺🇸

Hartford, Connecticut, United States

Lee Cancer Clinic

🇺🇸

Fort Myers, Florida, United States

Investigative Clinical Research of Indiana LLC

🇺🇸

Indianapolis, Indiana, United States

Winthrop University Hospital

🇺🇸

Mineola, New York, United States

Veterans Administration Medical Center

🇺🇸

White River Junction, Vermont, United States

Pasco/Hernando Oncology

🇺🇸

New Port Richey, Florida, United States

Bay Medical Cancer Center

🇺🇸

Bay City, Michigan, United States

Northstate Cancer Speciality

🇺🇸

Redding, California, United States

Oncology Specialties, P.C.

🇺🇸

Huntsville, Alabama, United States

Genesis Cancer Center

🇺🇸

Hot Springs, Arkansas, United States

Connecticut Oncology Group

🇺🇸

Middletown, Connecticut, United States

Pasco Hernando Oncology Associates

🇺🇸

Brooksville, Florida, United States

Jupiter Medical Center

🇺🇸

Jupiter, Florida, United States

Oncology & Hematology Association of West Broward

🇺🇸

Tamarac, Florida, United States

Mid Florida Oncology

🇺🇸

Orange City, Florida, United States

Joliet Hematology Associates

🇺🇸

Joliet, Illinois, United States

McFarland Clinic

🇺🇸

Ames, Iowa, United States

Howard Regional Health System

🇺🇸

Kokomo, Indiana, United States

Maine Center for Cancer Medicine

🇺🇸

Scarborough, Maine, United States

Kentucky Cancer Clinic

🇺🇸

Hazard, Kentucky, United States

Union Memorial Hospital

🇺🇸

Baltimore, Maryland, United States

Sinai Hospital of Baltimore

🇺🇸

Baltimore, Maryland, United States

Harbor View Cancer Center

🇺🇸

Baltimore, Maryland, United States

Franklin Square Hospital Center

🇺🇸

Baltimore, Maryland, United States

Community Hematology Oncology

🇺🇸

Olney, Maryland, United States

Norris Cotton Cancer Center

🇺🇸

Lebanon, New Hampshire, United States

Frederick Smith, MD

🇺🇸

Chevy Chase, Maryland, United States

Southeast Nebraska Hematology/Oncology

🇺🇸

Lincoln, Nebraska, United States

Dartmouth-Hitchcock-Keene

🇺🇸

Keene, New Hampshire, United States

The Center for Cancer and Hematologic Disease

🇺🇸

Cherry Hill, New Jersey, United States

Sussex County Medical Associates

🇺🇸

Newton, New Jersey, United States

Hematology Oncology Associates of Rockland, PC

🇺🇸

New York, New York, United States

Southeastern Medical Oncology Center

🇺🇸

Goldsboro, North Carolina, United States

Aultman Cancer Center

🇺🇸

Canton, Ohio, United States

The Cleveland Clinic Foundation Hematology/Med Oncology

🇺🇸

Cleveland, Ohio, United States

Legacy Good Samaritan

🇺🇸

Portland, Oregon, United States

Hope Oncology

🇺🇸

Richardson, Texas, United States

Tyler Hematology/Oncology

🇺🇸

Tyler, Texas, United States

Western Hematology Oncology

🇺🇸

Paducah, Kentucky, United States

Olympic Hematology/Oncology

🇺🇸

Bremerton, Washington, United States

Alta Bates Comprehensive Cancer Center

🇺🇸

Berkeley, California, United States

Washington Cancer Institute

🇺🇸

Washington, District of Columbia, United States

Oncology and Hematology Associates, PC

🇺🇸

New London, Connecticut, United States

Virginia Oncology Associates Research Program

🇺🇸

Newport News, Virginia, United States

Cancer Care of North Florida

🇺🇸

Lake City, Florida, United States

Alexian Brothers Hospital Network

🇺🇸

Elk Grove Village, Illinois, United States

Blood and Cancer Center of East Texas

🇺🇸

Tyler, Texas, United States

Lahey Clinic Medical Center

🇺🇸

Burlington, Massachusetts, United States

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