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A Study of Tarceva (Erlotinib) or Placebo in Combination With Platinum-Based Therapy as First Line Treatment in Patients With Advanced or Recurrent Non-Small Cell Lung Cancer

A Randomized, Placebo-controlled, Double-blind Phase III Study of the Effect of First-line Treatment With Intercalated Tarceva Versus Placebo in Combination With Gemcitabine/Platinum on Progression-free Survival in Patients With Stage IIIB/IV Non-small Cell Lung Cancer

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00883779
Enrollment
451
Registered
2009-04-20
Start date
2009-04-30
Completion date
2014-12-31
Last updated
2015-12-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Non-Squamous Non-Small Cell Lung Cancer

Brief summary

This 2 arm study will compare the efficacy and safety of sequential treatment with Tarceva or placebo, plus platinum-based therapy, as first line treatment in patients with advanced or recurrent non-small cell lung cancer. Patients will be randomized to receive gemcitabine (1250mg/m2 iv) on days 1 and 8, and cisplatin (75mg/m2) or carboplatin (5xAUC)on day 1, followed by Tarceva 150mg/day or placebo from day 15 to day 28 of each 4 week cycle for a total of 6 cycles,then followed by Tarceva or placebo monotherapy.The anticipated time on study treatment is until disease progression, and the target sample size is 100-500 individuals.

Interventions

DRUGPlacebo

po on days 15-28 of each 4 week cycle until disease progression

cisplatin --75mg/m2 oon day 1 of each 4 week cycle for 6 cycles or carboplatin--5xAUC on day 1 of each 4 week cycle for 6 cycles

DRUGerlotinib [Tarceva]

150mg po on days 15-28 of each 4 week cycle until disease progression

DRUGgemcitabine

1250mg/m2 iv on days 1 and 8 of each 4 week cycle for 6 cycles

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* adult patients, \>=18 years of age; * advanced (stage IIIB/IV)non-small cell lung cancer; * measurable disease; * Eastern Cooperative Oncology Group (ECOG) Performance Status 0 or 1.

Exclusion criteria

* prior exposure to agents directed at the HER axis; * prior chemotherapy or systemic anti-tumor therapy after advanced disease; * unstable systemic disease; * any other malignancy within last 5 years, except cured basal cell cancer of skin or cured cancer in situ of cervix; * brain metastasis or spinal cord compression.

Design outcomes

Primary

MeasureTime frameDescription
Median Progression Free Survival (PFS) TimeRandomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])Tumor response was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.0). PD was defined as at least a 20 percent (%) increase in the sum of longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions. PFS is the time (in months) between the date of randomization and the date of first documented disease progression or death from any cause, whichever comes first. Participants who had neither progressed nor died at the time of data cut-off or who were lost to follow-up were censored at the date of the last tumor assessment where non-progression was documented or last date of follow up for progression of disease, whichever was last. Participants without post baseline tumor assessments who were known to be alive were censored at the time of randomization. Analysis was performed using Kaplan-Meier method.

Secondary

MeasureTime frameDescription
Median PFS Time Based on Different SubgroupsRandomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])Tumor response was evaluated according to RECIST (version 1.0). PD was defined in outcome measure 1. PFS is the time (in months) between the date of randomization and the date of first documented disease progression or death from any cause, whichever comes first. Participants who had neither progressed nor died at the time of data cut-off or who were lost to follow-up were censored at the date of the last tumor assessment where non-progression was documented or last date of follow up for progression of disease, whichever was last. Participants without post baseline tumor assessments who were known to be alive were censored at the time of randomization. PFS among different subgroups of type of carcinoma, smoking habit, epidermal growth factor receptor (EGFR) mutation type, KRAS mutation type, EGFR immunohistochemistry (IHC) test result type, and EGFR fluorescent in situ hybridization (FISH) result type.
Median Overall Survival (OS) Time-Overall and Among Different SubgroupsRandomization until death (assessed at baseline and every 8 weeks thereafter until death or end of study [up to approximately 5.5 years])OS was defined as the time between the date of randomization and the date of death from any cause. Participants for whom no death was captured on the clinical database were censored at the most recent date they were known to be alive. Participants with no post baseline information were censored at the time of randomization. OS among different subgroups of type of carcinoma, smoking habit, EGFR mutation type, KRAS mutation type, EGFR IHC test result type, and EGFR FISH result type. Analysis was performed using Kaplan-Meier method.
Percentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsRandomization until death (assessed at baseline and every 8 weeks thereafter until death or end of study [up to approximately 5.5 years])
Non-Progression Rate: Percentage of Participants With a Confirmed Best Overall Response of Either Complete Response (CR) or Partial Response (PR) or Stable Disease (SD) for At Least 16 WeeksRandomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])Tumor response was evaluated according to RECIST (version 1.0). CR is defined as the disappearance of all target and non-target lesions and normalization of tumor marker level; PR is defined as at least a 30% decrease in the sum of the LD of target lesions, taking as reference the screening sum LD; SD for target lesions is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started and SD for non-target lesions defined as persistence of 1 or more non-target lesion(s) or/and maintenance of tumor marker level above the normal limits. Responses were confirmed with repeated assessment 4 weeks after initial response was observed.
Objective Response Rate: Percentage of Participants With a Confirmed Best Overall Response of CR or PRRandomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])Tumor response was evaluated according to RECIST (version 1.0). CR is defined as the disappearance of all target and non-target lesions and normalization of tumor marker level; PR is defined as at least a 30% decrease in the sum of the LD of target lesions, taking as reference the screening sum LD. Responses were confirmed with repeated assessment 4 weeks after initial response was observed.
Duration of ResponseRandomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])Duration of response is defined as the time between the date of first documented response (CR or PR, as determined by the RECIST criteria) and the date of first documented PD or death. Participants who did not progress or die after they had a confirmed response (CR or PR) were censored at the date of their last tumor assessment where non-progression was documented or last date of follow-up for progression of disease, whichever was last. CR and PR are defined in Outcome Measure 7.
Time to ProgressionRandomization until PD (assessed at baseline and every 8 weeks thereafter until PD or end of study [up to approximately 1.5 years])Time to progression is defined as the time between the date of randomization and the date of the first documented disease progression. Participants who have not progressed at the time of study completion (or data cut off) or who were lost to follow up were censored at the date of the last tumor assessment where non-progression was documented or last date of follow-up for progression of disease, whichever was latest. PD was defined as at least a 20% increase in the sum of LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions. Participants with no post baseline tumor assessments were censored at the time of randomization. Analysis was performed using Kaplan-Meier method.
Percentage of Participants Alive and Free From Disease ProgressionRandomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])Tumor response was evaluated according to RECIST (version 1.0). PD was defined as at least a 20% increase in the sum of LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions.
Time to Symptomatic ProgressionBaseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)Time to symptomatic progression was the time from randomization until the earlier of a clinically meaningful decline from baseline in LCS score, or death on study. LCS scores were obtained from a 7-item questionnaire from the FACT-L (version 4.0). Participants responded to questions such as shortness of breath, cough, tightness in chest, breathing difficulty, appetite loss, weight loss and unclear thinking; on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 (most symptomatic) to 28 (asymptomatic); higher score indicates fewer symptoms. A clinically meaningful decline used to determine symptomatic progression in this study was at least a three point decline in LCS score from baseline. Participants without symptomatic progression at the time of analysis were censored at the time of the last FACT-L assessment. Analysis was performed using Kaplan-Meier method.
Percentage of Participants With Deterioration in Trial Outcome Index (TOI) Using FACT-L Version 4.0Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)TOI was defined as the sum of the scores of the Physical Well-Being (PWB), Functional Well-Being (FWB), and LCS. PWB, FWB, and LCS scores were obtained from 7-item questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 84; higher score indicates better physical aspects of quality of life (QoL). A clinically meaningful decline used to determine deterioration in TOI was greater than or equal to (≥) 6-point decline from baseline. Participants without deterioration in TOI at the time of analysis were censored at the time of the last FACT-L assessment.
Time to Deterioration in TOI Using FACT-L Version 4.0Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)Time to deterioration in TOI is defined as time from randomization until the earlier of a clinically meaningful decline from baseline in TOI or death on study. TOI is defined as the sum of the scores of the PWB, FWB, and LCS. PWB, FWB, and LCS scores were obtained from 7-item questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 84; higher score indicates better physical aspects of QoL. A clinically meaningful decline used to determine deterioration in TOI was ≥6-point decline from baseline. Participants without deterioration in TOI at the time of analysis were censored at the time of the last FACT-L assessment. Analysis was performed using Kaplan-Meier method.
Percentage of Participants With Deterioration in Quality of Life (QOL) Using FACT-L Version 4.0Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)Total FACT-L score was defined as the sum of the TOI, Social Well Being (SWB) and EWB of the FACT-L questionnaires. TOI (PWB + FWB + LCS), SWB and EWB scores were obtained from 7-item (6-item in the case of EWB) questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 136; higher score indicates better QoL. A clinically meaningful decline used to determine deterioration in QoL was ≥6-point decline from baseline. Participants without deterioration in QoL at the time of analysis were censored at the time of the last FACT-L assessment.
Time to Deterioration in QOL Using FACT-L Version 4.0Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)Time to deterioration in QoL is defined as time from randomization until the earlier of a clinically meaningful decline from baseline in Total FACT-L or death on study. Total FACT-L score was defined as the sum of the TOI, SWB and EWB of the FACT-L questionnaires. TOI (PWB + FWB + LCS), SWB and EWB scores were obtained from 7-item (6-item in the case of EWB) questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 136; higher score indicates better QoL. A clinically meaningful decline used to determine deterioration in QoL was ≥6-point decline from baseline. Participants without deterioration in QoL at the time of analysis were censored at the time of the last FACT-L assessment. Analysis was performed using Kaplan-Meier method.
Median Follow-up Time During the StudyRandomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 5.5 years])Median follow-up was calculated using 'Reverse Kaplan-Meier' analysis for Overall survival.
Percentage of Participants With Symptomatic Progression Assessed Using the Lung Cancer Subscale (LCS)Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)LCS scores were obtained from a 7-item questionnaire from the Functional Assessment of Cancer Therapy - Lung (FACT-L) (version 4.0). Participants responded to questions such as shortness of breath, cough, tightness in chest, breathing difficulty, appetite loss, weight loss and unclear thinking; on a 5-point scale from 0-4, where 0 equaled (=) not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 (most symptomatic) to 28 (asymptomatic); higher score indicates fewer symptoms. A clinically meaningful decline used to determine symptomatic progression in this study was at least a three point decline in LCS score from baseline. Participants without symptomatic progression at the time of analysis were censored at the time of the last FACT-L assessment.

Countries

China, Hong Kong, Indonesia, Philippines, South Korea, Taiwan, Thailand

Participant flow

Participants by arm

ArmCount
Placebo
Participants received 1250 mg/m\^2 of gemcitabine IV infusion on Day 1 and 8, carboplatin 5x AUC or cisplatin 75 mg/m\^2 IV infusion on Day 1 and oral placebo daily from Day 15 to 28 every 4 weeks, continued for 6 cycles (28-day cycle) until PD, unacceptable toxicity or death in the primary study treatment phase. Participants who completed 6 cycles of treatment without PD or unacceptable toxicity, or if they withdrew early because of toxicity from the platinum-doublet chemotherapy, entered the post-study treatment phase and continued same treatment until PD, unacceptable toxicity or death. Participants who withdrew due to PD or toxicity from placebo could not enter the post-study treatment phase. Upon PD (during either the primary or post-study treatment phase), participants had the option to be crossed over to open-label erlotinib 150 mg/day outside the study (Off-study phase).
225
Erlotinib
Participants received 1250 mg/m\^2 of gemcitabine IV infusion on Day 1 and 8, carboplatin 5x AUC or cisplatin 75 mg/m\^2 IV infusion on Day 1 and oral erlotinib 150 mg/day from Day 15 to 28 every 4 weeks, continued for 6 cycles (28-day cycle) until PD, unacceptable toxicity or death in the primary study treatment phase. Participants who completed 6 cycles of treatment without PD or unacceptable toxicity, or if they withdrew early because of toxicity from the platinum-doublet chemotherapy, entered the post-study treatment phase and continued same treatment until PD, unacceptable toxicity or death. Participants who withdrew due to PD or toxicity from erlotinib could not enter the post-study treatment phase. Upon PD (during either the primary or post-study treatment phase), participants were treated at the discretion of the investigators' discretion (Off-study phase).
226
Total451

Withdrawals & dropouts

PeriodReasonFG000FG001
Off-study PhaseDeath185174
Off-study PhaseFailure to return56
Off-study PhaseOther1821
Off-study PhaseRefused treatment11
Post-Study Treatment PhaseAdverse Event23
Post-Study Treatment PhaseDeath13
Post-Study Treatment PhaseDisease progression103122
Post-Study Treatment PhaseOngoing in the study06
Post-Study Treatment PhaseOther30
Post-Study Treatment PhaseProtocol Violation01
Post-Study Treatment PhaseRefused Treatment30
Primary Study Treatment PhaseAdverse Event1616
Primary Study Treatment PhaseDeath23
Primary Study Treatment PhaseDid not receive allocated intervention44
Primary Study Treatment PhaseDisease progression7559
Primary Study Treatment PhaseOther30
Primary Study Treatment PhaseRefused Treatment54

Baseline characteristics

CharacteristicPlaceboErlotinibTotal
Age, Continuous56.4 years
STANDARD_DEVIATION 11.08
57.2 years
STANDARD_DEVIATION 9.71
56.8 years
STANDARD_DEVIATION 10.41
Sex: Female, Male
Female
85 Participants94 Participants179 Participants
Sex: Female, Male
Male
140 Participants132 Participants272 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
217 / 222223 / 226
serious
Total, serious adverse events
76 / 22270 / 226

Outcome results

Primary

Median Progression Free Survival (PFS) Time

Tumor response was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.0). PD was defined as at least a 20 percent (%) increase in the sum of longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions. PFS is the time (in months) between the date of randomization and the date of first documented disease progression or death from any cause, whichever comes first. Participants who had neither progressed nor died at the time of data cut-off or who were lost to follow-up were censored at the date of the last tumor assessment where non-progression was documented or last date of follow up for progression of disease, whichever was last. Participants without post baseline tumor assessments who were known to be alive were censored at the time of randomization. Analysis was performed using Kaplan-Meier method.

Time frame: Randomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])

Population: FAS population.

ArmMeasureValue (MEDIAN)
PlaceboMedian Progression Free Survival (PFS) Time6.0 months
ErlotinibMedian Progression Free Survival (PFS) Time7.6 months
p-value: <0.000195% CI: [0.46, 0.7]Log Rank
Secondary

Duration of Response

Duration of response is defined as the time between the date of first documented response (CR or PR, as determined by the RECIST criteria) and the date of first documented PD or death. Participants who did not progress or die after they had a confirmed response (CR or PR) were censored at the date of their last tumor assessment where non-progression was documented or last date of follow-up for progression of disease, whichever was last. CR and PR are defined in Outcome Measure 7.

Time frame: Randomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])

Population: FAS population participants who were responders (CR or PR).

ArmMeasureValue (MEDIAN)
PlaceboDuration of Response5.6 months
ErlotinibDuration of Response10.3 months
p-value: <0.000195% CI: [0.21, 0.5]Log Rank
Secondary

Median Follow-up Time During the Study

Median follow-up was calculated using 'Reverse Kaplan-Meier' analysis for Overall survival.

Time frame: Randomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 5.5 years])

Population: FAS population.

ArmMeasureValue (MEDIAN)
PlaceboMedian Follow-up Time During the Study50.3 months
ErlotinibMedian Follow-up Time During the Study50.2 months
p-value: 0.91395% CI: [0.6, 1.59]Log Rank
Secondary

Median Overall Survival (OS) Time-Overall and Among Different Subgroups

OS was defined as the time between the date of randomization and the date of death from any cause. Participants for whom no death was captured on the clinical database were censored at the most recent date they were known to be alive. Participants with no post baseline information were censored at the time of randomization. OS among different subgroups of type of carcinoma, smoking habit, EGFR mutation type, KRAS mutation type, EGFR IHC test result type, and EGFR FISH result type. Analysis was performed using Kaplan-Meier method.

Time frame: Randomization until death (assessed at baseline and every 8 weeks thereafter until death or end of study [up to approximately 5.5 years])

Population: FAS population. n is the number of participants evaluable under the specified category.

ArmMeasureGroupValue (MEDIAN)
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsNon-adenocarcinoma (n=57,52)12.4 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsKRAS mutation (n=11,10)11.2 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsCurrent/former smoker (n=118,114)13.0 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsKRAS wild-type (n=101,101)14.1 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsAdenocarcinoma (n=168,174)15.8 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR IHC positive (n=36,40)15.2 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR mutation (n=48,49)20.6 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR IHC negative (n=25,12)12.5 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsNever smoked (n=107,112)17.5 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR FISH positive (n=20,14)17.7 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR wild-type (n=67,69)12.2 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR FISH negative (n=23,25)12.5 months
PlaceboMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsOverall participants (n=225,226)15.2 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR FISH negative (n=23,25)16.7 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsOverall participants (n=225,226)18.2 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsAdenocarcinoma (n=168,174)20.9 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsNon-adenocarcinoma (n=57,52)10.3 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsNever smoked (n=107,112)25.9 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsCurrent/former smoker (n=118,114)13.0 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR mutation (n=48,49)30.3 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR wild-type (n=67,69)14.9 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsKRAS mutation (n=11,10)17.5 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsKRAS wild-type (n=101,101)18.1 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR IHC positive (n=36,40)18.6 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR IHC negative (n=25,12)21.9 months
ErlotinibMedian Overall Survival (OS) Time-Overall and Among Different SubgroupsEGFR FISH positive (n=20,14)43.1 months
Comparison: OS in subgroup never smokedp-value: =0.005695% CI: [0.49, 0.89]Log Rank
Comparison: OS in subgroup current/former smokerp-value: =0.347395% CI: [0.87, 1.5]Log Rank
Comparison: OS in subgroup EGFR mutationp-value: =0.161495% CI: [0.45, 1.14]Log Rank
Comparison: OS in overall participants (FAS population)p-value: =0.121395% CI: [0.7, 1.04]Log Rank
Comparison: OS in subgroup adenocarcinomap-value: =0.035695% CI: [0.62, 0.98]Log Rank
Comparison: OS in subgroup non-adenocarcinomap-value: =0.115795% CI: [0.92, 2.03]Log Rank
Comparison: OS in subgroup EGFR wild-typep-value: =0.169195% CI: [0.55, 1.11]Log Rank
Comparison: OS in subgroup KRAS mutationp-value: =0.141595% CI: [0.19, 1.28]Log Rank
Comparison: OS in subgroup KRAS wild-typep-value: =0.144795% CI: [0.59, 1.08]Log Rank
Comparison: OS in EGFR IHC positivep-value: =0.03195% CI: [0.35, 0.96]Log Rank
Comparison: OS in subgroup EGFR IHC negativep-value: =0.058195% CI: [0.21, 1.05]Log Rank
Comparison: OS of subgroup EGFR FISH positivep-value: =0.006395% CI: [0.14, 0.75]Log Rank
Comparison: OS of subgroup EGFR FISH negativep-value: =0.326895% CI: [0.4, 1.36]Log Rank
Secondary

Median PFS Time Based on Different Subgroups

Tumor response was evaluated according to RECIST (version 1.0). PD was defined in outcome measure 1. PFS is the time (in months) between the date of randomization and the date of first documented disease progression or death from any cause, whichever comes first. Participants who had neither progressed nor died at the time of data cut-off or who were lost to follow-up were censored at the date of the last tumor assessment where non-progression was documented or last date of follow up for progression of disease, whichever was last. Participants without post baseline tumor assessments who were known to be alive were censored at the time of randomization. PFS among different subgroups of type of carcinoma, smoking habit, epidermal growth factor receptor (EGFR) mutation type, KRAS mutation type, EGFR immunohistochemistry (IHC) test result type, and EGFR fluorescent in situ hybridization (FISH) result type.

Time frame: Randomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])

Population: FAS population. n is the number of participants evaluable under the specified category.

ArmMeasureGroupValue (MEDIAN)
PlaceboMedian PFS Time Based on Different SubgroupsAdenocarcinoma (n=168,174)6.5 months
PlaceboMedian PFS Time Based on Different SubgroupsNon-adenocarcinoma (n=57,52)5.8 months
PlaceboMedian PFS Time Based on Different SubgroupsNever smoked (n=107,112)6.6 months
PlaceboMedian PFS Time Based on Different SubgroupsFormer/current smoker (n=118,114)5.9 months
PlaceboMedian PFS Time Based on Different SubgroupsEGFR mutation (n=48,49)6.9 months
PlaceboMedian PFS Time Based on Different SubgroupsEGFR wild-type (n=67,69)5.9 months
PlaceboMedian PFS Time Based on Different SubgroupsKRAS mutation (n=11,10)4.5 months
PlaceboMedian PFS Time Based on Different SubgroupsKRAS wild-type (n=101,101)6.8 months
PlaceboMedian PFS Time Based on Different SubgroupsEGFR IHC positive (n=36,40)6.0 months
PlaceboMedian PFS Time Based on Different SubgroupsEGFR IHC negative (n=25,12)6.7 months
PlaceboMedian PFS Time Based on Different SubgroupsEGFR FISH positive (n=20,14)5.9 months
PlaceboMedian PFS Time Based on Different SubgroupsEGFR FISH negative (n=23,25)6.0 months
ErlotinibMedian PFS Time Based on Different SubgroupsEGFR FISH positive (n=20,14)12.9 months
ErlotinibMedian PFS Time Based on Different SubgroupsAdenocarcinoma (n=168,174)8.2 months
ErlotinibMedian PFS Time Based on Different SubgroupsKRAS mutation (n=11,10)6.0 months
ErlotinibMedian PFS Time Based on Different SubgroupsNon-adenocarcinoma (n=57,52)5.7 months
ErlotinibMedian PFS Time Based on Different SubgroupsEGFR IHC negative (n=25,12)10.1 months
ErlotinibMedian PFS Time Based on Different SubgroupsNever smoked (n=107,112)10.9 months
ErlotinibMedian PFS Time Based on Different SubgroupsKRAS wild-type (n=101,101)8.0 months
ErlotinibMedian PFS Time Based on Different SubgroupsFormer/current smoker (n=118,114)5.7 months
ErlotinibMedian PFS Time Based on Different SubgroupsEGFR FISH negative (n=23,25)7.5 months
ErlotinibMedian PFS Time Based on Different SubgroupsEGFR mutation (n=48,49)15.6 months
ErlotinibMedian PFS Time Based on Different SubgroupsEGFR IHC positive (n=36,40)8.1 months
ErlotinibMedian PFS Time Based on Different SubgroupsEGFR wild-type (n=67,69)7.1 months
Comparison: PFS in adenocarcinoma subgroupp-value: <0.000195% CI: [0.39, 0.64]Log Rank
Comparison: PFS in non-adenocarcinoma subgroupp-value: =0.57995% CI: [0.6, 1.33]Log Rank
Comparison: PFS in never smoked subgroupp-value: <0.000195% CI: [0.28, 0.53]Log Rank
Comparison: PFS in former/current smoker subgroupp-value: =0.206795% CI: [0.64, 1.1]Log Rank
Comparison: PFS in subgroup EGFR mutationp-value: <0.000195% CI: [0.12, 0.35]Log Rank
Comparison: PFS in subgroup EGFR wild-typep-value: =0.751195% CI: [0.67, 1.34]Log Rank
Comparison: PFS in subgroup KRAS mutationp-value: =0.316995% CI: [0.25, 1.58]Log Rank
Comparison: PFS in subgroup KRAS wild-typep-value: <0.000195% CI: [0.37, 0.7]Log Rank
Comparison: PFS in subgroup EGFR IHC positivep-value: =0.009195% CI: [0.31, 0.86]Log Rank
Comparison: PFS in subgroup EGFR IHC negativep-value: =0.017995% CI: [0.18, 0.88]Log Rank
Comparison: PFS in subgroup EGFR FISH positivep-value: =0.001795% CI: [0.11, 0.64]Log Rank
Comparison: PFS in subgroup EGFR FISH negativep-value: =0.18895% CI: [0.37, 1.22]Log Rank
Secondary

Non-Progression Rate: Percentage of Participants With a Confirmed Best Overall Response of Either Complete Response (CR) or Partial Response (PR) or Stable Disease (SD) for At Least 16 Weeks

Tumor response was evaluated according to RECIST (version 1.0). CR is defined as the disappearance of all target and non-target lesions and normalization of tumor marker level; PR is defined as at least a 30% decrease in the sum of the LD of target lesions, taking as reference the screening sum LD; SD for target lesions is defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started and SD for non-target lesions defined as persistence of 1 or more non-target lesion(s) or/and maintenance of tumor marker level above the normal limits. Responses were confirmed with repeated assessment 4 weeks after initial response was observed.

Time frame: Randomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])

Population: FAS population.

ArmMeasureValue (NUMBER)
PlaceboNon-Progression Rate: Percentage of Participants With a Confirmed Best Overall Response of Either Complete Response (CR) or Partial Response (PR) or Stable Disease (SD) for At Least 16 Weeks64.4 percentage of participants
ErlotinibNon-Progression Rate: Percentage of Participants With a Confirmed Best Overall Response of Either Complete Response (CR) or Partial Response (PR) or Stable Disease (SD) for At Least 16 Weeks67.3 percentage of participants
Comparison: Difference in non-progression response ratesp-value: =0.528995% CI: [-6.2, 11.8]Chi-squared
Secondary

Objective Response Rate: Percentage of Participants With a Confirmed Best Overall Response of CR or PR

Tumor response was evaluated according to RECIST (version 1.0). CR is defined as the disappearance of all target and non-target lesions and normalization of tumor marker level; PR is defined as at least a 30% decrease in the sum of the LD of target lesions, taking as reference the screening sum LD. Responses were confirmed with repeated assessment 4 weeks after initial response was observed.

Time frame: Randomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])

Population: FAS population.

ArmMeasureValue (NUMBER)
PlaceboObjective Response Rate: Percentage of Participants With a Confirmed Best Overall Response of CR or PR17.8 percentage of participants
ErlotinibObjective Response Rate: Percentage of Participants With a Confirmed Best Overall Response of CR or PR42.9 percentage of participants
Comparison: Difference in objective response ratesp-value: <0.000195% CI: [16.7, 33.5]Chi-squared
Secondary

Percentage of Participants Alive and Free From Disease Progression

Tumor response was evaluated according to RECIST (version 1.0). PD was defined as at least a 20% increase in the sum of LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions.

Time frame: Randomization until PD or death (assessed at baseline and every 8 weeks thereafter until PD, death or end of study [up to approximately 1.5 years])

Population: FAS population.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Alive and Free From Disease Progression6.2 percentage of participants
ErlotinibPercentage of Participants Alive and Free From Disease Progression22.6 percentage of participants
Secondary

Percentage of Participants Alive at the End of Study-Overall and Among Different Subgroups

Time frame: Randomization until death (assessed at baseline and every 8 weeks thereafter until death or end of study [up to approximately 5.5 years])

Population: FAS population. n is the number of participants evaluable under the specified category.

ArmMeasureGroupValue (NUMBER)
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsNon-adenocarcinoma (n=57,52)8.8 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsKRAS mutation (n=11,10)0.0 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsCurrent/former smoker (n=118,114)13.6 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsKRAS wild-type (n=101,101)14.9 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsAdenocarcinoma (n=168,174)14.9 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR IHC positive (n=36,40)11.1 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR mutation (n=48,49)22.9 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR IHC negative (n=25,12)8.0 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsNever smoked (n=107,112)13.1 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR FISH positive (n=20,14)10.0 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR wild-type (n=67,69)7.5 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR FISH negative (n=23,25)13.0 percentage of participants
PlaceboPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsOverall participants (n=225,226)13.3 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR FISH negative (n=23,25)16.0 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsOverall participants (n=225,226)15.9 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsAdenocarcinoma (n=168,174)19.5 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsNon-adenocarcinoma (n=57,52)3.8 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsNever smoked (n=107,112)23.2 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsCurrent/former smoker (n=118,114)8.8 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR mutation (n=48,49)30.6 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR wild-type (n=67,69)10.1 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsKRAS mutation (n=11,10)20.0 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsKRAS wild-type (n=101,101)17.8 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR IHC positive (n=36,40)25.0 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR IHC negative (n=25,12)33.3 percentage of participants
ErlotinibPercentage of Participants Alive at the End of Study-Overall and Among Different SubgroupsEGFR FISH positive (n=20,14)42.9 percentage of participants
Secondary

Percentage of Participants With Deterioration in Quality of Life (QOL) Using FACT-L Version 4.0

Total FACT-L score was defined as the sum of the TOI, Social Well Being (SWB) and EWB of the FACT-L questionnaires. TOI (PWB + FWB + LCS), SWB and EWB scores were obtained from 7-item (6-item in the case of EWB) questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 136; higher score indicates better QoL. A clinically meaningful decline used to determine deterioration in QoL was ≥6-point decline from baseline. Participants without deterioration in QoL at the time of analysis were censored at the time of the last FACT-L assessment.

Time frame: Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)

Population: FAS population.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With Deterioration in Quality of Life (QOL) Using FACT-L Version 4.079.6 percentage of participants
ErlotinibPercentage of Participants With Deterioration in Quality of Life (QOL) Using FACT-L Version 4.070.4 percentage of participants
Secondary

Percentage of Participants With Deterioration in Trial Outcome Index (TOI) Using FACT-L Version 4.0

TOI was defined as the sum of the scores of the Physical Well-Being (PWB), Functional Well-Being (FWB), and LCS. PWB, FWB, and LCS scores were obtained from 7-item questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 84; higher score indicates better physical aspects of quality of life (QoL). A clinically meaningful decline used to determine deterioration in TOI was greater than or equal to (≥) 6-point decline from baseline. Participants without deterioration in TOI at the time of analysis were censored at the time of the last FACT-L assessment.

Time frame: Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)

Population: FAS population.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With Deterioration in Trial Outcome Index (TOI) Using FACT-L Version 4.075.6 percentage of participants
ErlotinibPercentage of Participants With Deterioration in Trial Outcome Index (TOI) Using FACT-L Version 4.065.9 percentage of participants
Secondary

Percentage of Participants With Symptomatic Progression Assessed Using the Lung Cancer Subscale (LCS)

LCS scores were obtained from a 7-item questionnaire from the Functional Assessment of Cancer Therapy - Lung (FACT-L) (version 4.0). Participants responded to questions such as shortness of breath, cough, tightness in chest, breathing difficulty, appetite loss, weight loss and unclear thinking; on a 5-point scale from 0-4, where 0 equaled (=) not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 (most symptomatic) to 28 (asymptomatic); higher score indicates fewer symptoms. A clinically meaningful decline used to determine symptomatic progression in this study was at least a three point decline in LCS score from baseline. Participants without symptomatic progression at the time of analysis were censored at the time of the last FACT-L assessment.

Time frame: Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)

Population: FAS population.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants With Symptomatic Progression Assessed Using the Lung Cancer Subscale (LCS)72.4 percentage of participants
ErlotinibPercentage of Participants With Symptomatic Progression Assessed Using the Lung Cancer Subscale (LCS)66.4 percentage of participants
Secondary

Time to Deterioration in QOL Using FACT-L Version 4.0

Time to deterioration in QoL is defined as time from randomization until the earlier of a clinically meaningful decline from baseline in Total FACT-L or death on study. Total FACT-L score was defined as the sum of the TOI, SWB and EWB of the FACT-L questionnaires. TOI (PWB + FWB + LCS), SWB and EWB scores were obtained from 7-item (6-item in the case of EWB) questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 136; higher score indicates better QoL. A clinically meaningful decline used to determine deterioration in QoL was ≥6-point decline from baseline. Participants without deterioration in QoL at the time of analysis were censored at the time of the last FACT-L assessment. Analysis was performed using Kaplan-Meier method.

Time frame: Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)

Population: FAS population.

ArmMeasureValue (MEDIAN)
PlaceboTime to Deterioration in QOL Using FACT-L Version 4.04.5 months
ErlotinibTime to Deterioration in QOL Using FACT-L Version 4.05.6 months
p-value: =0.003595% CI: [0.59, 0.9]Log Rank
Secondary

Time to Deterioration in TOI Using FACT-L Version 4.0

Time to deterioration in TOI is defined as time from randomization until the earlier of a clinically meaningful decline from baseline in TOI or death on study. TOI is defined as the sum of the scores of the PWB, FWB, and LCS. PWB, FWB, and LCS scores were obtained from 7-item questionnaires from the FACT-L (Version 4.0). Participants responded to questions on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 to 84; higher score indicates better physical aspects of QoL. A clinically meaningful decline used to determine deterioration in TOI was ≥6-point decline from baseline. Participants without deterioration in TOI at the time of analysis were censored at the time of the last FACT-L assessment. Analysis was performed using Kaplan-Meier method.

Time frame: Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)

Population: FAS population.

ArmMeasureValue (MEDIAN)
PlaceboTime to Deterioration in TOI Using FACT-L Version 4.05.6 months
ErlotinibTime to Deterioration in TOI Using FACT-L Version 4.06.3 months
p-value: =0.018195% CI: [0.61, 0.96]Log Rank
Secondary

Time to Progression

Time to progression is defined as the time between the date of randomization and the date of the first documented disease progression. Participants who have not progressed at the time of study completion (or data cut off) or who were lost to follow up were censored at the date of the last tumor assessment where non-progression was documented or last date of follow-up for progression of disease, whichever was latest. PD was defined as at least a 20% increase in the sum of LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of 1 or more new lesions. Participants with no post baseline tumor assessments were censored at the time of randomization. Analysis was performed using Kaplan-Meier method.

Time frame: Randomization until PD (assessed at baseline and every 8 weeks thereafter until PD or end of study [up to approximately 1.5 years])

Population: FAS population.

ArmMeasureValue (MEDIAN)
PlaceboTime to Progression6.5 months
ErlotinibTime to Progression7.9 months
p-value: <0.000195% CI: [0.45, 0.69]Log Rank
Secondary

Time to Symptomatic Progression

Time to symptomatic progression was the time from randomization until the earlier of a clinically meaningful decline from baseline in LCS score, or death on study. LCS scores were obtained from a 7-item questionnaire from the FACT-L (version 4.0). Participants responded to questions such as shortness of breath, cough, tightness in chest, breathing difficulty, appetite loss, weight loss and unclear thinking; on a 5-point scale from 0-4, where 0 = not at all and 4 = very much. The participants' responses were summed to result in an overall score, scores range on a scale of 0 (most symptomatic) to 28 (asymptomatic); higher score indicates fewer symptoms. A clinically meaningful decline used to determine symptomatic progression in this study was at least a three point decline in LCS score from baseline. Participants without symptomatic progression at the time of analysis were censored at the time of the last FACT-L assessment. Analysis was performed using Kaplan-Meier method.

Time frame: Baseline, Day 1 of Cycles 3 and 5, Day 1 of post-study Visits 1 and 2 until end of study medication administration or PD (up to approximately 1.5 years)

Population: FAS population.

ArmMeasureValue (MEAN)
PlaceboTime to Symptomatic Progression6.6 months
ErlotinibTime to Symptomatic Progression7.2 months
p-value: =0.036495% CI: [0.63, 0.99]Log Rank

Source: ClinicalTrials.gov · Data processed: Mar 23, 2026