Prophylactic Cranial Irradiation in Erlotinib/Gefitinib-responders With Non-small Cell Lung Cancer (NSCLC) (RT1001)

A Randomized, Phase III Trial of Prophylactic Cranial Irradiation (PCI) in Patients With Advanced Non-small Cell Lung Cancer (NSCLC) Who Are Effective on Erlotinib or Gefitinib(RT1001)

RATIONALE: Radiation therapy to the brain may be effective in preventing brain metastases in patients with advanced non-small cell lung cancer. It is not yet known whether radiation therapy is more effective than observation in patients with advanced non-small cell lung cancer.

PURPOSE: This randomized phase III trial is studying radiation therapy to the brain to see how well it works compared with observation in preventing brain metastases in patients with advanced non-small cell lung cancer

Study Overview

• Status: Unknown
• Conditions: Non-small Cell Lung Cancer
• Intervention / Treatment: Radiation: Prophylactic cranial irradiation; Drug: Erlotinib /Gefitinib

Detailed Description

OBJECTIVES:

Primary

Determine the effectiveness of prophylactic cranial radiotherapy in patients with advanced non-small cell lung cancer that is responsive to gefitinib or erlotinib hydrochloride.

Secondary

Determine the progression-free survival in patients treated with this regimen. Determine the overall survival in patients treated with this regimen. Determine the safety and tolerability of this regimen in these patients. Determine the psycho-neurological effects of this regimen in these patients. Determine the quality of life of patients treated with this regimen. OUTLINE: This is a multicenter study. Patients with good response( CR/PR) to EGFR-TKI(Erlotinib or Gefitinib) are randomized to receive EGFR-TKI plus PCI or EGFR-TKI alone,stratified according to prior chemotherapy regimens (first line vs second line), and disease response status.

Group 1: Patients undergo prophylactic brain radiotherapy. Group 2: Patients undergo observation. Patients complete quality of life questionnaires periodically.

After completion of study therapy, patients are followed up periodically.

• Study Type: Interventional
• Enrollment (Anticipated): 200
• Phase: Phase 3

Contacts and Locations

• Study Contact: Name: Shenglin Ma, MD; Phone Number: +8657188122568; Email: mashenglin@medmail.com.cn
• Study Contact Backup: Name: Yaping Xu, MD; Phone Number: +8657188122082; Email: xuyaping1207@gmail.com

Study Locations

• China
  • Zhejiang
    • Hangzhou, Zhejiang, China, 310022
      • Recruiting
      • ZheJiang Cancer Hospital
      • Contact: XuYa ping, MD; Phone Number: 0086-571-88122082; Email: xuyaping1207@gmail.com
    • Hangzhou, Zhejiang, China
      • Recruiting
      • ZheJiang Cancer Hospital
      • Contact: Shenglin Ma, MD; Phone Number: +8657188122568; Email: mashenglin@medmail.com.cn
      • Contact: Yaping Xu, MD; Phone Number: +8657188122082; Email: xuyaping1207@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Patients were required to have histologically or cytologically documented
2. NSCLC and no brain metastasis documented by magnetic resonance imaging (MRI)within 21 days after confirmed response (RR+SD) to chemotherapy
3. No previous history of radiotherapy and surgery of brain
4. good response( CR/PR) to Erlotinib or Gefitinib.
5. Agree to radiotherapy
6. age > 18 and <75 years,ECOG performance status 1 or less
7. Good renal and hepatic and haematological (absolute neutrophils count 15 x1O9/L and platelet count 90 x 109/L,HB>=80g /DL) functions
8. Have provided informed consent

Exclusion Criteria:

1. Seizure cannot be controled by the drugs
2. Combined with other disease of the brain such as tumour or infarction
3. Hypersensitivity to MR enhancer -

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: prophylactic cranial irradiation; Patients receive Erlotinib or gefitinib until disease progression or intolerable toxicity, and prophylactic cranial irradiation 25GY over 10 fractions.	Radiation: Prophylactic cranial irradiation; 25GY/10fraction; Other Names: PCI; Drug: Erlotinib /Gefitinib; Erlotinib 150mg/d or Gefitinib 250mg/d until disease progression or intolerable toxicity; Other Names: EGFR-TKI
Active Comparator: Conctrol; Patients received Erlotinib or gefitinib until disease progression,or intolerable toxicity	Drug: Erlotinib /Gefitinib; Erlotinib 150mg/d or Gefitinib 250mg/d until disease progression or intolerable toxicity; Other Names: EGFR-TKI

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The primary endpoint is the cumulative incidence of symptomatic brain metastases (BM)	2.5years

Secondary Outcome Measures

Outcome Measure	Time Frame
overall survival	baseline to date of death from any cause

Collaborators and Investigators

• Sponsor: Zhejiang Cancer Hospital
• Investigators: Principal Investigator: Shenglin Ma, MD, ZheJiang Cancer Hospital

Study record dates

Study Major Dates

• Study Start: June 1, 2010
• Primary Completion (Anticipated): May 1, 2013
• Study Completion (Anticipated): December 1, 2013

Study Registration Dates

• First Submitted: June 23, 2010
• First Submitted That Met QC Criteria: July 6, 2010
• First Posted (Estimate): July 8, 2010

Study Record Updates

• Last Update Posted (Estimate): July 8, 2010
• Last Update Submitted That Met QC Criteria: July 6, 2010
• Last Verified: July 1, 2010

More Information

Terms related to this study

• Keywords: prophylactic cranial irradiation; brain metastasis; nonsmall cell lung cancer
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Neoplasms; Lung Diseases; Neoplasms by Site; Respiratory Tract Neoplasms; Thoracic Neoplasms; Carcinoma, Bronchogenic; Bronchial Neoplasms; Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Antineoplastic Agents; Protein Kinase Inhibitors; Erlotinib Hydrochloride; Gefitinib
• Other Study ID Numbers: ZhejiangCH06