- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00446225
Phase III Study (Tarceva®) vs Chemotherapy to Treat Advanced Non-Small Cell Lung Cancer in Patients With Mutations in the TK Domain of EGFR (EURTAC)
Phase III, Multicenter, Open-label, Randomized Trial of Tarceva® vs Chemotherapy in Patients With Advanced NSCLC With Mutations in the TK Domain of the EGFR
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a multicenter, phase III, randomized, open-label clinical trial.
146 patients with a diagnosis of advanced (stage IIIB and stage IV), non-squamous-cell, non-small-cell pulmonary carcinoma not treated previously for their disease with chemotherapy who present mutation in the tyrosine kinase domain of the epidermal growth factor receptor, EGFR will be recluted.
The primary objective is to compare the progression-free survival in both treatment arms of the study (conventional chemotherapy vs. erlotinib) in patients with non-squamous-cell, non-small-cell lung cancer (NSCLC) in advanced stage (stages IIIB and stage IV) who have not received previous chemotherapy for their disease and who present mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR).
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Angers, France
- Centre Hospitalier Universitaire d'Angers
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Brest, France, 29200
- Hôpital Auguste Morvan
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Caen, France, 14000
- Centre François Baclesse
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Cergy Pontoise, France
- Centre Hospitalier Rene Dubos
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Creteil, France, 94010
- Centre Hospitalier Intercommunal
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Le Chesnay, France
- Hôpital A. Mignot
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Le Mans, France
- Centre Hospitalier du Mans
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Lille, France, 59000
- Centre Oscar Lambret
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Limoges, France, 87042
- hôpital du Cluzeau
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Longjumeau, France
- Centre Hospitalier Regional
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Meaux, France
- Centre Hospitalier de Meaux
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Mulhouse, France
- Centre Hospitalier de Mulhouse
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Paris, France, 75571
- Hôpital Saint Antoine
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Perigueux, France
- Centre hospitalier
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Pringy, France
- Centre Hospitalier de la région d'Annecy
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Rennes, France, 35033
- CHU Rennes Hôpital Ponchaillou
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Roanne, France
- Centre Hosiptalier Genéral de Roanne
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St-Priest en Jarez, France
- Institut de Cancérologie de la Loire
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Toulouse, France, 31059
- Hopital Larrey
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Aviano, Italy, 33081
- CRO di Aviano
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Catanzaro, Italy, 88100
- AO Materdomini
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Messina, Italy, 98125
- AOU Policlinico G. Martino
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Napoli, Italy, 80131
- AO Monaldi
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Palermo, Italy, 90146
- Casa di Cura "La Maddalena"
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Roma, Italy, 00128
- Istituti Fisioterapici Ospitalieri
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Roma, Italy, 00149
- AO S.Camillo Forlanini
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Roma, Italy, 00161
- Università di Roma "La Sapienza" Az.Policlinico Umb.I°
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Sassari, Italy, 07100
- PO di SS.ma Annunziata
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Alicante, Spain
- H.G.U. Alicante
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Barcelona, Spain, 08028
- Instituto Universitario Dexeus
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Barcelona, Spain, 08243
- H. Althaia
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Barcelona, Spain, 08907
- H. Duran i Reynals-ICO
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Barcelona, Spain, 08036
- H. Clínic i Provincial
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Barcelona, Spain, 08035
- H.U.Vall D´Hebrón
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Barcelona, Spain, 08025
- H. Santa Creu i Sant Pau
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Córdoba, Spain, 14004
- H. Reina Sofía
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Girona, Spain, 17007
- ICO Girona -H. Dr. Josep Trueta
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Granada, Spain, 18014
- H. Virgen de las Nieves
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Jaén, Spain, 23007
- Complejo Hospitalario de Jaén
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La Coruña, Spain, 15006
- Complejo Hosp. Univ. Juan Canalejo
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Logroño, Spain
- Hospital San Millan Y San Pedro
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Lérida, Spain, 25198
- H. Arnau de Vilanova
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Madrid, Spain, 28040
- Fundacion Jimenez Diaz
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Madrid, Spain
- H. 12 de Octubre
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Madrid, Spain, 28035
- H.U. Puerta de Hierro
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Madrid, Spain, 28006
- H. de la Princesa
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Madrid, Spain
- H. Ramón y Cajal
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Madrid, Spain, 28007
- H. Gregorio Marañón
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Madrid, Spain, 28034
- H. Ruber Internacional
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Madrid, Spain, 28040
- Hospial Clinico San Carlos
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Madrid, Spain, 28046
- H. La Paz
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Málaga, Spain, 29010
- H. Carlos Haya
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Málaga, Spain, 29010
- H.C.Universitario Virgen de la Victoria
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Palma de Mallorca, Spain
- Clínica Rotger
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Palma de Mallorca, Spain, 07198
- H. Son Llatzer
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San Sebastian, Spain, 20014
- H. de Donostia
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Sevilla, Spain, 41013
- H. Virgen del Rocío
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Sevilla, Spain, 41014
- H. Nuestra Sra. de Valme
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Valencia, Spain, 46010
- H.C.U.Valencia
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Valencia, Spain, 46014
- H. General U. de Valencia
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Valencia, Spain, 46015
- H. Arnau de Vilanova Valencia
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Valencia, Spain, 46017
- H. Dr. Peset
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Zaragoza, Spain, 50009
- H. Miguel Servet
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Zaragoza, Spain, 59009
- H. Clínico Lozano Blesa
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Alicante
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Alcoy, Alicante, Spain, 03804
- H. Virgen de los Lirios
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Torrevieja, Alicante, Spain, 03193
- H. Torrevieja Salud
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Barcelona
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Badalona, Barcelona, Spain
- ICO - H. Germans Trias i Pujol
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Mataró, Barcelona, Spain, 08304
- Hospital de Mataró
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Cantabria
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Santander, Cantabria, Spain, 39008
- H. Marques De Valdecilla
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Castellón
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Castelló de la Plana, Castellón, Spain, 12002
- H. Provincial de Castellón
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Las Palmas
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Las Palmas De Gran Canaria, Las Palmas, Spain, 35016
- Hospital Insular Gran Canaria
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Madrid
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Alcorcon, Madrid, Spain, 28922
- F.H.Alcorcón
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Fuenlabrada, Madrid, Spain, 28942
- H. Fuenlabrada
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Mallorca
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Palma de Mallorca, Mallorca, Spain, 07014
- H. Son Dureta
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Tenerife
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Santa Cruz de Tenerife, Tenerife, Spain, 38010
- H. Ntra. Sra. de la Candelaria
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Vizcaya
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Baracaldo, Vizcaya, Spain, 48903
- Hospital de Cruces
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria:
- Informed consent
- Histologically confirmed diagnosis of NSCLC, non epidermoid, stage IV or IIIB with pleural effusion, or N3 tumours not candidate for thoracic radiotherapy, harbouring deletions in the exon 19 or mutation in the exon 21 in the TK of the EGFR.
- Either measurable or evaluable disease.
- Age > 18 years.
- ECOG performance status < 2.
- Adequate bone marrow function
- Adequate renal function
- Adequate hepatic function
- Patients must be accessible for treatment and follow-up.
- Patients capable of following an adequate therapeutic compliance
- Women of child bearing potential: negative pregnancy test.
- Patients of both genders at a fertile age, including those women having their last menstruation within the two previous years, must follow effective contraceptive measures.
- Ability to swallow.
- Patients with asymptomatic brain metastasis and stable with medical treatment will be eligible for the study. Patients having received radiotherapy for their brain metastasis prior to the systemic treatment for the NSCLC will be also eligible.
- Absence of gastrointestinal tract problems
Exclusion criteria:
- Pregnant or lactating women.
- Women of child bearing potential having a positive pregnancy test in the basal visit or not accomplishing the test.
- Patients of both genders sexually active (at a fertile age) not following contraceptive measures during the study.
- Prior chemotherapy for metastatic disease. Both prior neoadjuvant and adjuvant chemotherapy allowed provided that completed ≥ 6 months before entering the study.
- Prior treatment with EGFR targeted therapies.
- Patients may have received radiotherapy, provided that the irradiated lesion is not the only evaluable lesion for response and completed before entering the study.
- Prior experimental pharmacological agent within the 3 weeks prior to the inclusion of the study.
- Any significant ophthalmologic impairment of the eye surface. Use of contact lenses is not recommended.
- Pre-existing motor or sensorial neurotoxicity grade > 2, according to the NCI-CTC criteria.
- Evidence of spinal cord compression.
- Inability to take oral medication and surgical procedures affecting the absorption or implying intravenous or parenteral feeding.
Any other severe disease or clinical conditions, as, but not only:
- Unstable cardiopathy despite treatment, myocardial infarction within the 6 months before entering the study
- History of significant neurological or psychiatric disorders, including dementia and epileptic seizures.
- Uncontrolled active infection.
- Uncontrolled peptic ulcer.
- Unstable diabetes mellitus or any other contraindication for treatment with corticosteroids.
- AST and/or ALT > 1.5 x UNL associated to alkaline phosphatase > 2.5 x UNL.
- Any other underlying severe process affecting the ability to take part in the study.
- Absolute contraindication for steroids.
- Dementia or significant mental disorder interfering the understanding and giving the informed consent.
- History of other malignancy except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, radically treated prostatic carcinoma with good prognostic (Gleason = 6). History of other curatively treated malignancy and no evidence of disease within the past 5 years.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Experimental: A
Erlotinib (Tarceva)150 mg /day Patients will receive treatment until disease progression or unacceptable toxicity. For all practical effects a treatment cycle will be defined as three weeks of continuous treatment with erlotinib |
150 mg/day Patients will receive treatment until disease progression or unacceptable toxicity. For all practical effects a treatment cycle will be defined as three weeks of continuous treatment with erlotinib
Other Names:
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Active Comparator: B
4 cycles of Chemotherapy: Cisplatin / Gemcitabine; Cisplatin /Docetaxel; Carboplatin / Gemcitabine; Carboplatin / Docetaxel. - Cisplatin plus docetaxel: cisplatin 75 mg/m2 i.v. day 1 and docetaxel 75 mg/m2 i.v. day 1. Repeat cycles every 3 weeks. - Cisplatin plus gemcitabine: Cisplatin 75 mg/m2 i.v. on day 1 and gemcitabine 1250 mg/m2 on days 1 and 8. Repeat cycles every 3 weeks. In the case of patients not eligible for treatment with cisplatin, cisplatin can be replaced by carboplatin. The schedules will be the following: Docetaxel 75 mg/m2 day 1 and carboplatin AUC = 6 day 1, every 21 days. Gemcitabine 1000 mg/m2 days 1 and 8 and carboplatin AUC = 5 day 1, every 21 days. Patients in the chemotherapy arm will receive the treatment until disease progression or unacceptable toxicity occurs, or until a maximum of 4 treatment cycles are given. |
Gemcitabine 1000 mg/m2 days 1 and 8 and Carboplatin AUC = 5 day 1, every 21 days. Docetaxel (75 mg/m2) /carboplatin (AUC=6); Gemcitabine (1000 mg/m2; day 1 and 8) / Carboplatin (AUC=5) Patients in the chemotherapy arm will receive the treatment until disease progression or unacceptable toxicity occurs, or until a maximum of 4 treatment cycles are given.
Other Names:
Cisplatin (75 mg/m2) / Gemcitabine (1250 mg/m2; day 1 and 8) Patients in the chemotherapy arm will receive the treatment until disease progression or unacceptable toxicity occurs, or until a maximum of 4 treatment cycles are given.
Other Names:
Cisplatin (75 mg/m2) / Docetaxel (75 mg/m2) Patients in the chemotherapy arm will receive the treatment until disease progression or unacceptable toxicity occurs, or until a maximum of 4 treatment cycles are given.
Other Names:
Cisplatin (75 mg/m2) / Docetaxel (75 mg/m2) Patients in the chemotherapy arm will receive the treatment until disease progression or unacceptable toxicity occurs, or until a maximum of 4 treatment cycles are given.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Progression Free-survival
Time Frame: From the date of randomization to the date of last follow up, assessed up to 24 months
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The time from enrollment in the study to tumor progression or death from any cause (whichever occurs first)
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From the date of randomization to the date of last follow up, assessed up to 24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Objective Response
Time Frame: From the date of randomization to the date of last follow up, assessed up to 24 months
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The objective response rate is defined as the percentage of patients who attain complete response (CR) or partial response (PR); response will be evaluated following RECIST criteria version 1.0. Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Progressive disease (PD): at least a 20% increase in the sum of diameters of target lesions. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD taking as reference the smallest sum of diameters recorded on study. |
From the date of randomization to the date of last follow up, assessed up to 24 months
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Overall Survival
Time Frame: From the date of randomization to the date of last follow up, assessed up to 24 months
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Overall Survival (OS) is defined as the time, in months, from the inclusion date to the death date.
A patient is censored at the last contact date if he/she does not die.Overall survival will be assessed from the date of enrollment in the study until the date of death from any cause.
Patients lost to follow-up will be censured on the date of the last follow-up visit.
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From the date of randomization to the date of last follow up, assessed up to 24 months
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Molecular Markers Related to EGFR and Study Pathology
Time Frame: At baseline
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The study of mutations in serum (serum DNA).
This exploratory analysis was performed to determine whether EGFR mutations can reliably be detected in serum thereby reducing the requirement for invasive techniques as well as to enable detection of mutations in patients where no tumor biopsy samples are available.
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At baseline
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Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Rafael Rosell i Costa, MD, Spanish Lung Cancer Group
- Study Chair: Luis Paz-Ares, MD, Spanish Lung Cancer Group
Publications and helpful links
General Publications
- Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, Felip E, Palmero R, Garcia-Gomez R, Pallares C, Sanchez JM, Porta R, Cobo M, Garrido P, Longo F, Moran T, Insa A, De Marinis F, Corre R, Bover I, Illiano A, Dansin E, de Castro J, Milella M, Reguart N, Altavilla G, Jimenez U, Provencio M, Moreno MA, Terrasa J, Munoz-Langa J, Valdivia J, Isla D, Domine M, Molinier O, Mazieres J, Baize N, Garcia-Campelo R, Robinet G, Rodriguez-Abreu D, Lopez-Vivanco G, Gebbia V, Ferrera-Delgado L, Bombaron P, Bernabe R, Bearz A, Artal A, Cortesi E, Rolfo C, Sanchez-Ronco M, Drozdowskyj A, Queralt C, de Aguirre I, Ramirez JL, Sanchez JJ, Molina MA, Taron M, Paz-Ares L; Spanish Lung Cancer Group in collaboration with Groupe Francais de Pneumo-Cancerologie and Associazione Italiana Oncologia Toracica. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012 Mar;13(3):239-46. doi: 10.1016/S1470-2045(11)70393-X. Epub 2012 Jan 26.
- Karachaliou N, Mayo-de las Casas C, Queralt C, de Aguirre I, Melloni B, Cardenal F, Garcia-Gomez R, Massuti B, Sanchez JM, Porta R, Ponce-Aix S, Moran T, Carcereny E, Felip E, Bover I, Insa A, Reguart N, Isla D, Vergnenegre A, de Marinis F, Gervais R, Corre R, Paz-Ares L, Morales-Espinosa D, Viteri S, Drozdowskyj A, Jordana-Ariza N, Ramirez-Serrano JL, Molina-Vila MA, Rosell R; Spanish Lung Cancer Group. Association of EGFR L858R Mutation in Circulating Free DNA With Survival in the EURTAC Trial. JAMA Oncol. 2015 May;1(2):149-57. doi: 10.1001/jamaoncol.2014.257.
- Karachaliou N, Gimenez-Capitan A, Drozdowskyj A, Viteri S, Moran T, Carcereny E, Massuti B, Vergnenegre A, de Marinis F, Molina MA, Teixido C, Rosell R. ROR1 as a novel therapeutic target for EGFR-mutant non-small-cell lung cancer patients with the EGFR T790M mutation. Transl Lung Cancer Res. 2014 Jun;3(3):122-30. doi: 10.3978/j.issn.2218-6751.2014.03.02.
- Costa C, Molina MA, Drozdowskyj A, Gimenez-Capitan A, Bertran-Alamillo J, Karachaliou N, Gervais R, Massuti B, Wei J, Moran T, Majem M, Felip E, Carcereny E, Garcia-Campelo R, Viteri S, Taron M, Ono M, Giannikopoulos P, Bivona T, Rosell R. The impact of EGFR T790M mutations and BIM mRNA expression on outcome in patients with EGFR-mutant NSCLC treated with erlotinib or chemotherapy in the randomized phase III EURTAC trial. Clin Cancer Res. 2014 Apr 1;20(7):2001-10. doi: 10.1158/1078-0432.CCR-13-2233. Epub 2014 Feb 3.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimated)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Respiratory Tract Diseases
- Lung Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Carcinoma, Bronchogenic
- Bronchial Neoplasms
- Lung Neoplasms
- Carcinoma, Non-Small-Cell Lung
- Tyrosine Kinase Inhibitors
- Antineoplastic Agents
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Protein Kinase Inhibitors
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Docetaxel
- Erlotinib Hydrochloride
- Gemcitabine
- Carboplatin
Other Study ID Numbers
- EURTAC-SLCG // GECP06/01
- 2006-003568-73 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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