Clinical Trials /

Low Dose Daily Erlotinib in Combination With High Dose Twice Weekly Erlotinib in Patients With EGFR-Mutant Lung Cancer

NCT01967095

Description:

The purpose of this study is to test the safety of different ways of taking erlotinib. The investigators want to find out what effects, good and/or bad, combination daily low dose and twice weekly high dose erlotinib has on the patient and lung cancer. The investigators are also seeing whether different schedules of erlotinib are better at treating lung cancer that has spread to the central nervous system. CNS expansion phase: The pulse continuous regimen will be then assess in patients with EGFR mutant lung cancers and CNS involvement. An additional expansion cohort (A) will enroll 19 patients with newly diagnosed EGFR mutant lung cancer with CNS involvement at diagnosis. The patients in the expansion cohorts will undergo the same treatment plan as the patients in the dose expansion cohort. A patient in the expansion cohorts will not be replaced if he/she does not finish the first 28 day (cycle 1) treatment period.

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

Completed

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: Low Dose Daily Erlotinib in Combination With High Dose Twice Weekly Erlotinib in Patients With EGFR-Mutant Lung Cancer
  • Official Title: A Phase 1 Trial of Low Dose Daily Erlotinib in Combination With High Dose Twice Weekly Erlotinib in Patients With EGFR-Mutant Lung Cancer

Clinical Trial IDs

  • ORG STUDY ID: 12-278
  • NCT ID: NCT01967095

Conditions

  • EGFR-Mutant Lung Cancer

Interventions

DrugSynonymsArms
erlotinibThe assigned dosing schedule will be repeated weekly x 3 to complete a 3 week, (21 day) cycle. Cycle 1 will be 4 weeks to account for one week of lead in, pulse dose erlotinib only.erlotinib

Purpose

The purpose of this study is to test the safety of different ways of taking erlotinib. The investigators want to find out what effects, good and/or bad, combination daily low dose and twice weekly high dose erlotinib has on the patient and lung cancer. The investigators are also seeing whether different schedules of erlotinib are better at treating lung cancer that has spread to the central nervous system. CNS expansion phase: The pulse continuous regimen will be then assess in patients with EGFR mutant lung cancers and CNS involvement. An additional expansion cohort (A) will enroll 19 patients with newly diagnosed EGFR mutant lung cancer with CNS involvement at diagnosis. The patients in the expansion cohorts will undergo the same treatment plan as the patients in the dose expansion cohort. A patient in the expansion cohorts will not be replaced if he/she does not finish the first 28 day (cycle 1) treatment period.

Trial Arms

NameTypeDescriptionInterventions
erlotinibExperimentalThis protocol is a phase 1, single arm, open label study of combination daily low dose erlotinib plus twice weekly high dose erlotinib in patients with EGFR-Mutant lung cancer who have not yet received erlotinib or gefitinib. Six dose levels are planned for escalation, with the pulse dose erlotinib increasing. Expansion cohort A: Treat an additional 19 pts at the MTD with CNS involvement at diagnosis
  • erlotinib

Eligibility Criteria

        Inclusion Criteria:

          -  MSKCC pathologically-proven diagnosis locally advanced Stage III not amenable to
             definitive, curative treatment or Stage IV or recurrent non-small cell lung cancer

          -  Documented presence of EGFR mutation confirmed by MSKCC or a local facility.

          -  No prior treatment with erlotinib, gefitinib, or other EGFR tyrosine kinase inhibitors

          -  Age ≥ 18 years

          -  Measurable (RECIST 1.1) indicator lesion not previously irradiated.

          -  Karnofsky Performance Status ≥ 70%

          -  Ability to take oral medications

          -  A negative serum pregnancy test obtained within 4 weeks prior to the start of
             treatment in all women of child-bearing potential.

          -  All women of child bearing potential and sexually active men must agree to use
             adequate methods of birth control throughout the study which includes use of oral
             contraceptives with an additional barrier methods, double barrier methods,
             Depo-Provera, permanent sterilization of patient or partner or total abstinence.

        Expansion A:

          -  brain metastases or leptomeningeal not previously treated with radiation or surgery

        Exclusion Criteria:

          -  Inadequate recovery from any toxicity related to prior treatment (to Grade 2 or
             baseline).

          -  Inadequate hematologic function defined as ANC < 1000 cells/mm³, Platelet count
             <75,000/mm³ or Hemoglobin <9.0g/dL.

          -  Inadequate hepatic function defined by AST/ALT >3x upper limit of normal (ULN), Total
             bilirubin>2x ULN, Alkaline phosphatase >3x ULN.

          -  Symptomatic brain metastasis requiring radiation therapy or escalating doses of
             steroids.

          -  Patients with clinically stable brain metastases or leptomeningeal disease (previously
             treated or untreated) are eligible. Patients in expansion cohort A must have at least
             one untreated CNS lesion

          -  Women who are breastfeeding or pregnant.

          -  Any evidence of clinically active interstitial lung disease.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:to determine the maximum tolerated dose (MTD)
Time Frame:1 year
Safety Issue:
Description:The study will use a standard 3+3 dose escalation design. Three to six patients will need to be enrolled at each dose level and assessed for DLT for 1 full cycle (28 days for cycle 1) before dose escalation decision is made.

Secondary Outcome Measures

Measure:to evaluate the safety profile
Time Frame:1 year
Safety Issue:
Description:Toxicity will be graded according to NCI CTCAE, version 4.0. The analysis of safety/tolerability data will be descriptive; toxicity events will be individually tabulated.
Measure:Progression Free Survival (PFS)
Time Frame:1 year
Safety Issue:
Description:Progression free survival (PFS) is defined as the duration of time from first treatment to time of progression or death, whichever occurs first.
Measure:Response rate (RR)
Time Frame:1 year
Safety Issue:
Description:sum of complete responses and partial responses according to RECIST 1.1
Measure:Overall survival (OS)
Time Frame:1 year
Safety Issue:
Description:Overall survival (OS) is defined as the duration of time from first treatment to time of death.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Completed
Lead Sponsor:Memorial Sloan Kettering Cancer Center

Trial Keywords

  • Erlotinib
  • 12-278
  • CNS involvement

Last Updated

November 13, 2018