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.
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
Interventions
Drug | Synonyms | Arms |
---|
erlotinib | The 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
Name | Type | Description | Interventions |
---|
erlotinib | Experimental | This 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 | |
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