Randomized to Assess the Efficacy of Whole Brain Radiation Therapy (WBRT) With Concomitant Gefitinib Followed by Maintenance Gefitinib, and Gefitinib Alone, in Lung Cancer Patients With Brain Metastasis
Overview
- Phase
- Not Applicable
- Intervention
- whole brain radiotherapy
- Conditions
- EGFR-mutated Lung Adenocarcinoma
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 1
- Locations
- 1
- Primary Endpoint
- To assess the objective response rate of brain metastases in each arm
- Status
- Terminated
- Last Updated
- 11 years ago
Overview
Brief Summary
Multicentre randomised (1:1) trial assessing the efficacy of whole brain radiotherapy in addition to Gefitinib for the management of brain metastasis in lung cancer patients with a mutated EGFR.
Detailed Description
Lung cancer patients with newly diagnosed CNS metastasis with- at least one brain lesion measuring \> 1 cm in longest dimension - not eligible for surgery or stereotactic radio-surgeryOpen-label, multicentre, national, randomised (1:1) phase II trialArm A: WBRT and Concurrent Gefitinib followed by Gefitinib Maintenance Arm B: Gefitinib
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients must have signed a written informed consent form prior to any study specific screening procedures
- •18 years or older
- •KPS ≥ 50%
- •Histologically confirmed adenocarcinoma of the lung
- •Activating mutation of EGFR
- •Newly diagnosed CNS metastasis or in progression with at least one measurable lesion in the brain (defined as any lesion \> 1 cm on T1-weighted contrast enhanced MRI)
- •Patients could enter the study regardless of previous treatment (included chemotherapy) for metastatic extracranial disease, except TKI.
- •No steroids or stable or decreasing dose of steroids for at least 5 days before the MRI evaluation.
- •Adequate hematologic, liver and renal functions: neutrophil count ≥ 1.5 x 109/L; platelets ≥ 100 x 109/L; Hb ≥ 9 g/Dl; Total bilirubin \< 1.5 x ULN; AST or ALT \< 2.5 x ULN (\< 5 x ULN in patients with liver metastases); Serum creatinine ≤ 1.5 x ULN or Creatinine clearance ≥ 50 mL/min
Exclusion Criteria
- •Prior treatment of brain metastases with WBRT or TKI
- •Patient eligible for radiosurgery or surgical resection
- •Contre indication at the radiotherapy
- •Leptomeningeal disease
- •Previous history of cancer (other than curatively treated basal and squamous cell carcinoma of the skin and/or in-situ carcinoma of the cervix) within the the 5 years before study entry
- •Prior treatment with Gefitinib or other TKI
- •Pregnant or breast feeding women
- •Women with an intact uterus (unless amenorrhoeic for the last 24 months) not using effective means of contraception
Arms & Interventions
Arm A : Gefitinib + WBRT
Arm A : WBRT and Concurrent Gefitinib followed by Gefitinib Maintenance
Intervention: whole brain radiotherapy
Arm B : Gefitinib
Arm B : Gefitinib alone
Intervention: Gefitinib (IRESSA)
Outcomes
Primary Outcomes
To assess the objective response rate of brain metastases in each arm
Time Frame: at 6 weeks
Secondary Outcomes
- Number of Participants with neurological Adverse Events(at 6 weeks, 3 months, 4.5 months and 6 months)
- Progression-free survival (PFS)(at 6 months)
- Overall survival(at 6 months)