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Gefitinib for EGFR Sensitive Mutation Postoperative Stage Ib NSCLC Patients

14 de dezembro de 2017 atualizado por: Lunxu Liu

The Postoperative Adjuvant Therapy of Gefitinib for High Risk Stage Ib NSCLC Patients With EGFR Sensitive Mutation, an Open, Paired, Non-interventional, Multi-center Clinical Study

Currently, whether adjuvant therapy should be applied to Stage Ib non-small cell lung cancer (NSCLC) patients who received radical resection remains controversial. There is still no clear evidence that the postoperative adjuvant chemotherapy or other treatments can improve the survival rate for patients with stage Ib NSCLC. Tyrosine Kinase Inhibitors (TKIs) such as Gefitinib and Erlotinib are widely accepted as the first-line therapy for Epidermal growth factor receptor (EGFR) gene mutation late stage NSCLC patients. However the effect is largely uncertain for early stage patients who received surgery. The investigators aim to evaluate the effect of postoperative adjuvant use of Gefitinib for high risk stage Ib EGFR sensitive mutation NSCLC patients.

Visão geral do estudo

Status

Rescindido

Condições

Descrição detalhada

Currently, whether adjuvant therapy should be applied to Stage Ib non-small cell lung cancer (NSCLC) patients who received radical resection remains controversial. CALGB9633 studies have shown that for patients with stage Ib NSCLC who received radical resection, postoperative adjuvant chemotherapy does not benefit for all patients, only patients with high risk (cancer diameter >4cm) can benefit. There is still no clear evidence that the postoperative adjuvant chemotherapy or other treatments can improve the survival rate for patients with stage Ib NSCLC.

The EGFR gene mutation rate is about 10% for European patients, and about 30-40% for patients of Asian origins. In a retrospective observation study of 1118 stage I to stage III NSCLC patients who received surgery, D'Angelo et al. found that the risk of death for patients with EGFR sensitive mutation is lower than those without mutation. The authors indicated that postoperative use of TKI for EGFR sensitive mutation patients might be the possible reason. Since the mutation rate of EGRF gene is higher in Asian patients, compared with patients of other origins, the investigators speculate that Asian patients might benefit for postoperative use of TKIs.

EGFR gene mutation detection is routinely prescribed nowadays for lung adenocarcinoma patients who received surgical resection. According to NCCN guideline, stage IB patients with high risk factors are recommended to receive adjuvant chemotherapy. For patients who can not tolerate or decline chemotherapy, non-specific treatment ( Chinese herbal medicine and nonspecific immunomodulators as adjuvant anti-cancer treatment for 2 years) is recommended, otherwise, TKIs(Gefitinib 250 mg daily for 2 years) is also an alternative choice if the cancer has EGFR sensitive mutation. Based on patient's own choice of postoperative adjuvant therapy , the patients were enrolled for observation of prognosis.

Tipo de estudo

Observacional

Inscrição (Real)

10

Contactos e Locais

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Locais de estudo

    • Sichuan
      • ChengDu, Sichuan, China
        • West China Hospital

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos a 78 anos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Método de amostragem

Amostra de Probabilidade

População do estudo

NSCLC patients received complete resection at stage Ib with deletion of exon 19 or mutation of L858R at exon 21 in EGFR

Descrição

Inclusion Criteria:

  1. High-risk who meet one of the following descriptions: 1). Poorly differentiated carcinoma (including neuroendocrine tumors); 2). Vascular invasion; 3). Tumor diameter≥4cm 5). Visceral pleura involvement.
  2. Patients with pathology confirmed Ib stage NSCLC
  3. Patients with deletion of exon 19 or mutation of L858R at exon 21 in EGFR gene
  4. ECOG score of 0-1
  5. Life expectancy over 12 weeks
  6. Absolute neutrophil count (ANC) >= 1.75 x 109 / L, platelet >= 100 x 109 / L, hemoglobin is more than or equal to 9 g / dl
  7. Total bilirubin <= the normal value of 1.5 times the upper limit of normal (ULN); liver metastases, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) <= 2.5 times of upper limit of normal (ULN)
  8. Serum creatinine <=1.25 times of the upper limit of normal value, creatinine clearance rate > 60 or ml/min
  9. received the informed consent from patient or his/her legal representative

Exclusion Criteria:

  1. Patients who was serious allergy to any of the ingredients of drugs used in this study
  2. Patients who unable to comply with the study plan or research program;
  3. Patients with severe systemic disease that the researchers judged will be unable to complete the study;
  4. Patients have severe heart disease, such as myocardial infarction within 6 months;
  5. Patients have interstitial pneumonia;
  6. Patients who were confirmed to be positive pathology for cutting edge;
  7. The preoperative chest CT showed nodules >= 50%, and showed ground glass opacity;
  8. Patients received wedge resection;
  9. Patients used HER2 pathways involved drugs such as erlotinib, gefitinib, cetuximab rituximab, trastuzumab)
  10. Patients who have received chemotherapy or systemic antitumor therapy (such as monoclonal antibody therapy);
  11. Patients received radiotherapy;
  12. Having other malignant tumors in the last 5 years, but not including who has been cured through surgery and survived 5 year of disease-free;
  13. Any unstable systemic diseases (including active infection, uncontrolled hypertension, unstable angina, congestive heart failure, or myocardial infarction, serious arrhythmias, liver, kidney or metabolic diseases within six months).
  14. Patients who do not get effective treatment of inflammation, eye infections or predisposing factors;
  15. Physical examination or laboratory findings evidence reasonable doubt who is ill or use of related drugs could affect the study;
  16. Patients with serious active infections;
  17. Patients with T790M mutations at 20 exon;
  18. Woman who are pregnant or lactating.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

Coortes e Intervenções

Grupo / Coorte
Gefitinib
Stage IB NSCLC Patients with high risk factors and EGFR gene sensitive mutation who can not tolerate or decline chemotherapy and choose Gefitinib for postoperative therapy (Gefitinib 250 mg daily for 2 years).
Non-specific treatment
Stage IB NSCLC Patients with high risk factors and EGFR gene sensitive mutation who can not tolerate or decline chemotherapy and choose Non-specific treatment.(Chinese herbal medicine and nonspecific immunomodulators as adjuvant anti-cancer treatment for 2 years).

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Prazo
Relapse Free Survival in 2 years
Prazo: Treatment period: 2 years (24 months)
Treatment period: 2 years (24 months)

Medidas de resultados secundários

Medida de resultado
Prazo
Relapse Free Survival in 3 years
Prazo: Follow-up: 3 years
Follow-up: 3 years
5 year Overall Survival
Prazo: Follow-up: 5 years
Follow-up: 5 years
Relapse Free Survival in 5 years
Prazo: Follow-up: 5 years
Follow-up: 5 years

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Investigador principal: Lunxu Liu, Professor, West China Hospital

Publicações e links úteis

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Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

11 de novembro de 2015

Conclusão Primária (Real)

7 de junho de 2016

Conclusão do estudo (Real)

7 de junho de 2016

Datas de inscrição no estudo

Enviado pela primeira vez

11 de agosto de 2015

Enviado pela primeira vez que atendeu aos critérios de CQ

17 de agosto de 2015

Primeira postagem (Estimativa)

18 de agosto de 2015

Atualizações de registro de estudo

Última Atualização Postada (Real)

18 de dezembro de 2017

Última atualização enviada que atendeu aos critérios de controle de qualidade

14 de dezembro de 2017

Última verificação

1 de dezembro de 2017

Mais Informações

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

Ensaios clínicos em NSCLC

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