Clinical Trials /

Erlotinib Hydrochloride Before Surgery in Treating Patients With Stage III Non-Small Cell Lung Cancer

NCT01857271

Description:

This phase II trial studies how well erlotinib hydrochloride works before surgery in treating patients with stage III non-small cell lung cancer. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving erlotinib hydrochloride before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Terminated

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Erlotinib Hydrochloride Before Surgery in Treating Patients With Stage III Non-Small Cell Lung Cancer
  • Official Title: EValuation of Erlotinib as a Neoadjuvant Therapy in Stage III NSCLC Patients With EGFR Mutations (EVENT Trial)

Clinical Trial IDs

  • ORG STUDY ID: 2013-233
  • SECONDARY ID: NCI-2013-02219
  • SECONDARY ID: 2013-233-004
  • SECONDARY ID: 2013-233
  • SECONDARY ID: P30CA013330
  • NCT ID: NCT01857271

Conditions

  • Stage IIIA Non-Small Cell Lung Cancer
  • Stage IIIB Non-Small Cell Lung Cancer

Interventions

DrugSynonymsArms
Erlotinib HydrochlorideCp-358,774Treatment (erlotinib hydrochloride and thoracotomy)

Purpose

This phase II trial studies how well erlotinib hydrochloride works before surgery in treating patients with stage III non-small cell lung cancer. Erlotinib hydrochloride may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving erlotinib hydrochloride before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.

Detailed Description

      PRIMARY OBJECTIVES:

      I. To estimate the rate of mediastinal nodal clearance and complete pathological response
      after neoadjuvant erlotinib (erlotinib hydrochloride) in patients with epidermal growth
      factor receptor (EGFR) mutated stage III non-small cell lung cancer (NSCLC).

      SECONDARY OBJECTIVES:

      I. To determine the progression free survival in patient population of EGFR mutated stage III
      NSCLC patients who are treated with neoadjuvant erlotinib therapy.

      II. To determine the overall survival. III. To estimate the overall response rate from
      neoadjuvant erlotinib. IV. To estimate the surgical resection rate. V. To evaluate the safety
      of neoadjuvant erlotinib.

      TERTIARY OBJECTIVES:

      I. To determine several molecular and cellular biomarkers in the tumors, the skin and the
      serum that are predictive of the efficacy of neoadjuvant erlotinib.

      OUTLINE:

      Patients receive erlotinib hydrochloride orally (PO) once daily (QD) for 2 months and then
      undergo thoracotomy.

      After completion of study treatment, patients are followed up at 30 days, every 3 months for
      1 year, and then every 6 months for 5 years.
    

Trial Arms

NameTypeDescriptionInterventions
Treatment (erlotinib hydrochloride and thoracotomy)ExperimentalPatients receive erlotinib hydrochloride PO QD for 2 months and then undergo thoracotomy.
  • Erlotinib Hydrochloride

Eligibility Criteria

        Inclusion Criteria:

          -  Pathologically proven (either histologic or cytologic) diagnosis of stage IIIA or IIIB
             non-small cell lung cancer; (according to American Joint Committee on Cancer [AJCC]
             staging, 7th edition) within 4 weeks of registration; the patient should have
             histologically or cytologically confirmed N2 disease

          -  Activating mutation in EGFR

          -  No prior chemotherapy or radiation for lung cancer

          -  Patients may be potentially resectable or unresectable

          -  Stage III A or B disease, including no distant metastases- based on following
             diagnostic workup:

               -  History/physical examination prior to registration

               -  Computed tomography (CT) scan of the chest or positron emission tomography (PET)
                  scan within 28 days of study entry

               -  CT scan of abdomen or magnetic resonance imaging (MRI) of abdomen or PET scan
                  within 28 days of study entry

               -  An MRI of the brain or head CT scan with contrast within 28 days of study entry

               -  Total body PET scan within 28 days of study entry

               -  Mediastinoscopies are highly recommended

          -  Patients must have measurable or evaluable disease

          -  Eastern Cooperative Oncology Group (ECOG) performance status 0-2

          -  Absolute neutrophil count (ANC) >= 1,500 cells/ul

          -  Platelets >= 100,000 cells/ul

          -  Hemoglobin >= 9.0 g/dl (note: the use of transfusion or other intervention to achieve
             hemoglobin [Hgb] >= g/dl is acceptable)

          -  Serum creatinine =< 1.5 x upper limit of normal (ULN)

          -  Total bilirubin < 2.0 times the institutional upper limit of normal (ULN)

          -  Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x the ULN

          -  Women of childbearing potential must have:

               -  A negative serum or urine pregnancy test (sensitivity =< 25 IU human chorionic
                  gonadotropin [HCG]/L) within 72 hours prior to the start of study drug
                  administration

               -  Persons of reproductive potential must agree to use and utilize an adequate
                  method of contraception throughout treatment and for at least 4 weeks after study
                  drug is stopped prior to study enrollment, women of childbearing potential must
                  be advised of the importance of avoiding pregnancy during trial participation and
                  the potential risk factors for an unintentional pregnancy

          -  Ability to take oral medication

          -  Patient must sign study specific informed consent prior to study entry

        Exclusion Criteria:

          -  Pleural or pericardial effusion

               -  Pleural effusions allowed if one of the following conditions are met: 1) negative
                  cytology after adequate sampling by thoracentesis 2) effusion seen on CT scan but
                  not on chest x-ray and deemed too small to tap under CT or ultrasound guidance

          -  Severe, active co-morbidity, defined as follows:

               -  Cardiac symptoms; any of the following should be considered for exclusion:

                    -  Uncontrolled angina, congestive heart failure or myocardial infarction (MI)
                       within (6 months)

                    -  Diagnosed congenital long QT syndrome

                    -  Any history of clinically significant ventricular arrhythmias (such as
                       ventricular tachycardia, ventricular fibrillation, or Torsades de pointes)

                    -  Prolonged corrected QT (QTc) interval on pre-entry electrocardiogram (> 450
                       msec)

          -  History of significant bleeding disorder unrelated to cancer, including:

               -  Diagnosed congenital bleeding disorders (e.g., von Willebrand's disease)

               -  Diagnosed acquired bleeding disorder within one year (e.g., acquired anti-factor
                  VIII antibodies)

               -  Ongoing or recent (=< 3 months) significant gastrointestinal bleeding

          -  Prisoners or subjects who are compulsorily detained (involuntarily incarcerated) for
             treatment of either a psychiatric or physical (e.g., infectious) illness

          -  Men and women who:

               -  Are unwilling or unable to use an acceptable method to avoid pregnancy for the
                  entire study period and for at least 4 weeks after cessation of study drug, or
                  women who:

                    -  Have a positive pregnancy test at baseline, or

                    -  Are pregnant or breastfeeding
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Rate of Mediastinal Nodal Clearance, Defined as Pathologically Negative N2 Disease in the Final Surgical Resection Specimen or Mediastinoscopy
Time Frame:3 years 9 months
Safety Issue:
Description:

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Terminated
Lead Sponsor:Albert Einstein College of Medicine

Last Updated

July 8, 2020