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A Study of Tarceva (Erlotinib) in Sequential Combination With Gemcitabine as First Line Therapy in Patients With Advanced Non-Small Cell Lung Cancer

A Randomized, Open-label Study of the Effect of First Line Treatment With Tarceva in Sequential Combination With Gemcitabine, Compared to Gemcitabine Monotherapy, on Progression-free Survival in Elderly or ECOG PS of 2 Patients With Advanced Non-small Cell Lung Cancer.

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00940875
Enrollment
54
Registered
2009-07-16
Start date
2009-06-30
Completion date
2011-09-30
Last updated
2015-04-02

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

Conditions

Non-Small Cell Lung Cancer

Brief summary

This 2 arm study will compare the efficacy and safety of sequential treatment with Tarceva and gemcitabine, and of gemcitabine monotherapy, as first line treatment of elderly patients, or patients with ECOG performance status of 2, with advanced non-small cell lung cancer.Patients will be randomized to receive either sequential gemcitabine 1250mg/m2/day on days 1 and 8 + Tarceva 150mg po on days 15-28 of each 4 week cycle, or gemcitabine monotherapy 1000mg/m2/day on days 1, 8 and 15 of each 4 week cycle. The anticipated time on study treatment is 3-12 months, and the target sample size is 100-500 individuals.

Interventions

DRUGerlotinib [Tarceva]

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

DRUGgemcitabine

1250mg/m2/day on days 1 and 8 of each 4 week cycle

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

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

Inclusion criteria

* adult patients, \>=70 years of age or with ECOG PS of 2; * advanced (stage IIIB or IV)non-small cell lung cancer; * no prior systemic chemotherapy for advanced NSCLC or prior treatment with HER-axis targeted drugs.

Exclusion criteria

* active brain metastasis or spinal cord suppression; * unstable systemic disease.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants With Disease Progression or DeathBL, Day 22 of Cycles 2, 4, and 6 (28-day cycles), every 2 months thereafter until disease progression, participant withdrawal, or study termination (12 months after randomization of the last participant).Progression-free survival (PFS) was defined as the time from randomization to the date of first documentation of progressive disease (PD), according to Response Evaluation Criteria in Solid Tumors (RECIST) version (V) 1.0, or date of death from any cause. PD was defined for target lesions (TLs) as at least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded since the start of treatment, and for non-target lesions (NTLs) as unequivocal progression of NTLs. Participants without documented PD were censored at the date of last tumor assessment, the last date recorded in the drug log, or the last date of follow-up the participant was known to be progression free, whichever was last. Participants without a post-Baseline (BL) tumor assessment who were known to be alive were censored at the date of randomization.
PFSBL, Day 22 of Cycles 2, 4, and 6 (28-day cycles), every 2 months thereafter until disease progression, participant withdrawal, or study termination (up to 2 years)The median time, in weeks, between randomization and PFS event. Participants without documented PD were censored at the date of last tumor assessment, the last date recorded in the drug log, or the last date of follow-up the participant was known to be progression free, whichever was last. Participants without a post-BL tumor assessment who were known to be alive were censored at the date of randomization. PFS was estimated by using Kaplan-Meier methodology.

Secondary

MeasureTime frameDescription
Percentage of Participants Who Achieved Confirmed Complete Response (CR) or Partial Response (PR) According to RECIST V 1.0BL, Day 22 of Cycle 2, 4, and 6 (28-day cycles), every 2 months thereafter until disease progression, participant withdrawal, or study termination (12 months after randomization of the last participant).As per RECIST V 1.0: for TLs, CR was defined as the disappearance of all TLs, and PR was defined as at least a 30% decrease in the SLD of TLs taking as reference the BL SLD. For NTLs, CR was defined as the disappearance of all NTLs and normalization of tumor marker levels. The 95% confidence interval (CI) for one-sample binomial was determined using the Pearson-Clopper Method.
Percentage of Participants With Non-Progression at Weeks 8 and 16Weeks 8 and 16Non-progression was defined as CR, PR, or stable disease according to RECIST V 1.0: for TLs, CR was defined as the disappearance of all TLs, PR was defined as at least a 30% decrease in the SLD of TLs taking as reference the BL SLD, and SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest SLD recorded since the start of treatment. For NTLs, CR was defined as the disappearance of all NTLs and normalization of tumor marker levels, and SD was defined as the persistence of 1 or more NTLs and/or maintenance of tumor marker levels above the normal limits. The 95% CI for one-sample binomial was determined using the Pearson-Clopper method.
Percentage of Participants Who DiedBL, Days 1, 8, and 15 of Cycles 1-6 (28-day cycles), every 28 days thereafter until death, participant withdrawal, or study termination up to 2 years.
Overall Survival (OS)BL, Days 1, 8, and 15 of Cycles 1-6 (28-day cycles), every 28 days thereafter until death, participant withdrawal, or study termination up to 2 years.OS was defined as the median time, in weeks, between randomization and death due to any cause. Participants without documented death were censored at the last date recorded in the drug log, or the last date of follow-up the participant was known to be alive, whichever was last. Participants without a post-BL assessment who were known to be alive were censored at the date of randomization. OS was estimated using Kaplan-Meier methodology.
Duration of ResponseBL, Days 1, 8, and 15 of Cycles 1-6 (28-day cycles), every 28 days thereafter until death, participant withdrawal, or study termination up to 2 years.Duration of response was defined as the time between the first documentation of CR or PR (whichever status was recorded first as assessed by the RECIST V 1.0) until the date of documented disease progression or death. Participants with no documented disease progression or death after confirmed CR or PR were censored at the date of the last tumor assessment or last date of follow-up when the participant was known to be progression free, whichever was last.

Countries

Australia

Participant flow

Participants by arm

ArmCount
Gemcitabine Monotherapy
Participants received gemcitabine, 1000 mg/m\^2, IV, on Days 1, 8, and 15 of Cycles 1-6 (28-day cycles). Participants consented to post-treatment survival follow-up received no further treatment.
28
Gemcitabine + Erlotinib
Participants received gemcitabine, 1250 mg/m\^2, IV, on Days 1 and 8 of Cycles 1-6 (28-day cycles). Participants also received erlotinib, 150 mg tablets, PO, once per day on Days 15-28 of Cycles 1-6 (28-day cycles); and 150 mg tablets, PO, once per day thereafter until disease progression, unacceptable toxicity, withdrawal, or study termination (12 months after randomization of the last participant).
26
Total54

Withdrawals & dropouts

PeriodReasonFG000FG001
Post-Study TreatmentDeath01
Post-Study TreatmentDisease Progression02
Treatment PhaseAdverse Event93
Treatment PhaseDeath35
Treatment PhaseDisease progression911
Treatment PhaseLack of Efficacy10
Treatment PhasePhysician Decision10
Treatment PhaseWithdrawal by Subject30

Baseline characteristics

CharacteristicGemcitabine MonotherapyGemcitabine + ErlotinibTotal
Age, Continuous74.8 years
STANDARD_DEVIATION 8.72
72.8 years
STANDARD_DEVIATION 7.91
73.8 years
STANDARD_DEVIATION 8.32
Sex: Female, Male
Female
12 Participants10 Participants22 Participants
Sex: Female, Male
Male
16 Participants16 Participants32 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
28 / 3122 / 23
serious
Total, serious adverse events
20 / 3114 / 23

Outcome results

Primary

Percentage of Participants With Disease Progression or Death

Progression-free survival (PFS) was defined as the time from randomization to the date of first documentation of progressive disease (PD), according to Response Evaluation Criteria in Solid Tumors (RECIST) version (V) 1.0, or date of death from any cause. PD was defined for target lesions (TLs) as at least a 20 percent (%) increase in the sum of the longest diameter (SLD), taking as reference the smallest SLD recorded since the start of treatment, and for non-target lesions (NTLs) as unequivocal progression of NTLs. Participants without documented PD were censored at the date of last tumor assessment, the last date recorded in the drug log, or the last date of follow-up the participant was known to be progression free, whichever was last. Participants without a post-Baseline (BL) tumor assessment who were known to be alive were censored at the date of randomization.

Time frame: BL, Day 22 of Cycles 2, 4, and 6 (28-day cycles), every 2 months thereafter until disease progression, participant withdrawal, or study termination (12 months after randomization of the last participant).

Population: FAS

ArmMeasureValue (NUMBER)
Gemcitabine MonotherapyPercentage of Participants With Disease Progression or Death96.4 percentage of participants
Gemcitabine + ErlotinibPercentage of Participants With Disease Progression or Death96.2 percentage of participants
Primary

PFS

The median time, in weeks, between randomization and PFS event. Participants without documented PD were censored at the date of last tumor assessment, the last date recorded in the drug log, or the last date of follow-up the participant was known to be progression free, whichever was last. Participants without a post-BL tumor assessment who were known to be alive were censored at the date of randomization. PFS was estimated by using Kaplan-Meier methodology.

Time frame: BL, Day 22 of Cycles 2, 4, and 6 (28-day cycles), every 2 months thereafter until disease progression, participant withdrawal, or study termination (up to 2 years)

Population: FAS

ArmMeasureValue (MEDIAN)
Gemcitabine MonotherapyPFS8.0 weeks
Gemcitabine + ErlotinibPFS10.3 weeks
Comparison: Difference between treatment groups in PFSp-value: 0.4798Log Rank
p-value: 0.480595% CI: [0.63, 2.68]Wald Test
Secondary

Duration of Response

Duration of response was defined as the time between the first documentation of CR or PR (whichever status was recorded first as assessed by the RECIST V 1.0) until the date of documented disease progression or death. Participants with no documented disease progression or death after confirmed CR or PR were censored at the date of the last tumor assessment or last date of follow-up when the participant was known to be progression free, whichever was last.

Time frame: BL, Days 1, 8, and 15 of Cycles 1-6 (28-day cycles), every 28 days thereafter until death, participant withdrawal, or study termination up to 2 years.

Population: Data could not be summarized to be included in the data table because there are too few events to calculate a median and confidence intervals.

Secondary

Overall Survival (OS)

OS was defined as the median time, in weeks, between randomization and death due to any cause. Participants without documented death were censored at the last date recorded in the drug log, or the last date of follow-up the participant was known to be alive, whichever was last. Participants without a post-BL assessment who were known to be alive were censored at the date of randomization. OS was estimated using Kaplan-Meier methodology.

Time frame: BL, Days 1, 8, and 15 of Cycles 1-6 (28-day cycles), every 28 days thereafter until death, participant withdrawal, or study termination up to 2 years.

Population: FAS

ArmMeasureValue (MEDIAN)
Gemcitabine MonotherapyOverall Survival (OS)21.3 weeks
Gemcitabine + ErlotinibOverall Survival (OS)17.1 weeks
Comparison: Difference between treatment groups in OSp-value: 0.5393Log Rank
p-value: 0.539995% CI: [0.38, 1.66]Wald Test
Secondary

Percentage of Participants Who Achieved Confirmed Complete Response (CR) or Partial Response (PR) According to RECIST V 1.0

As per RECIST V 1.0: for TLs, CR was defined as the disappearance of all TLs, and PR was defined as at least a 30% decrease in the SLD of TLs taking as reference the BL SLD. For NTLs, CR was defined as the disappearance of all NTLs and normalization of tumor marker levels. The 95% confidence interval (CI) for one-sample binomial was determined using the Pearson-Clopper Method.

Time frame: BL, Day 22 of Cycle 2, 4, and 6 (28-day cycles), every 2 months thereafter until disease progression, participant withdrawal, or study termination (12 months after randomization of the last participant).

Population: FAS

ArmMeasureValue (NUMBER)
Gemcitabine MonotherapyPercentage of Participants Who Achieved Confirmed Complete Response (CR) or Partial Response (PR) According to RECIST V 1.07.1 percentage of participants
Gemcitabine + ErlotinibPercentage of Participants Who Achieved Confirmed Complete Response (CR) or Partial Response (PR) According to RECIST V 1.03.8 percentage of participants
95% CI: [-17.5, 10.9]
Secondary

Percentage of Participants Who Died

Time frame: BL, Days 1, 8, and 15 of Cycles 1-6 (28-day cycles), every 28 days thereafter until death, participant withdrawal, or study termination up to 2 years.

Population: FAS

ArmMeasureValue (NUMBER)
Gemcitabine MonotherapyPercentage of Participants Who Died92.9 percentage of participants
Gemcitabine + ErlotinibPercentage of Participants Who Died76.9 percentage of participants
Secondary

Percentage of Participants With Non-Progression at Weeks 8 and 16

Non-progression was defined as CR, PR, or stable disease according to RECIST V 1.0: for TLs, CR was defined as the disappearance of all TLs, PR was defined as at least a 30% decrease in the SLD of TLs taking as reference the BL SLD, and SD was defined as neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest SLD recorded since the start of treatment. For NTLs, CR was defined as the disappearance of all NTLs and normalization of tumor marker levels, and SD was defined as the persistence of 1 or more NTLs and/or maintenance of tumor marker levels above the normal limits. The 95% CI for one-sample binomial was determined using the Pearson-Clopper method.

Time frame: Weeks 8 and 16

Population: FAS

ArmMeasureGroupValue (NUMBER)
Gemcitabine MonotherapyPercentage of Participants With Non-Progression at Weeks 8 and 16Week 850.0 percentage of participants
Gemcitabine MonotherapyPercentage of Participants With Non-Progression at Weeks 8 and 16Week 1625.0 percentage of participants
Gemcitabine + ErlotinibPercentage of Participants With Non-Progression at Weeks 8 and 16Week 838.5 percentage of participants
Gemcitabine + ErlotinibPercentage of Participants With Non-Progression at Weeks 8 and 16Week 1611.5 percentage of participants
Comparison: Week 895% CI: [-40.3, 17.2]
Comparison: Week 1695% CI: [-36, 9]

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026