Non-Small Cell Lung Cancer
Conditions
Brief summary
This study will evaluate the efficacy and safety of Tarceva in two groups of patients with non-small cell lung cancer who have not been pre-treated with chemotherapy. One group, consisting of patients who have never smoked, will receive Tarceva 150 mg/day, and the other group, consisting of current/former smokers, will receive Tarceva 150 mg/day increasing to a maximum of 300 mg/day. The anticipated time on study treatment is 1-2 years.
Interventions
Erlotinib tablets taken orally once daily in the morning.
Sponsors
Study design
Eligibility
Inclusion criteria
* adult patients, \>=18 years of age; * histologically documented advanced non-small cell lung cancer (stage IIIB/IV); * Eastern Cooperative Oncology Group (ECOG) performance status 0-2; * no previous chemotherapy.
Exclusion criteria
* previous therapy which acts on Epidermal Growth Factor Receptor (EGFR) axis; * clinical evidence of brain metastasis; * any unstable systemic disease; * unable to take oral medication; * any significant ophthalmological abnormality.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Non-Progression Rate (NPR) at 8 Weeks | Week 8 | Non-Progressive Rate (NPR) was defined as the percentage of participants without progression (had stable disease (SD) or better) based on (Response Evaluation Criteria in Solid Tumours (RECIST) criteria 8 weeks after start of treatment. Diagnosis of Progressive Disease (PD) was made by objective criteria (RECIST criteria) on the target lesion(s), or by documenting, with Computerised Tomography/Magnetic Resonance Imaging (CT/MRI) scans, the presence of newly occurring lesion(s) arising outside the scanned areas of the target lesions. PD required at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease Control Rate | Up to 2 years | Disease Control Rate was defined as the percentage of participants with Complete Response (CR), Partial Response (PR) or Stable Disease (SD) by Response Evaluation Criteria in Solid Tumours (RECIST). CR was defined as the disappearance of all target lesions; for non-target lesions disappearance of lesions and normal tumour marker levels. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, using as reference the Baseline sum LD. SD was 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; for non-target lesions persistence of one or more non-target lesion(s) and/or maintenance of tumour marker level above the normal limits. |
| Duration of Response | Up to 2 years | Duration of overall response was defined as the time in months from Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST) until the first date Progressive Disease (PD) was objectively documented (taking as reference for PD the smallest measurements recorded since the treatment started) or until the date of death. CR was defined as the disappearance of all target lesions; for non-target lesions disappearance of lesions and normal tumour marker levels.PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, using as reference the Baseline sum LD. PD was defined as at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. |
| Time to Progression | Up to 2 years | Time to progression was defined as the time from start of treatment until the first date criteria for Progressive Disease (PD) was met (taking as reference the smallest measurements recorded since the treatment started). Diagnosis of PD was made by objective criteria (RECIST criteria) on the target lesion(s), or by documenting, with Computerised Tomography/Magnetic Resonance Imaging (CT/MRI) scans, the presence of newly occurring lesion(s) arising outside the scanned areas of the target lesions. PD required at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. |
| Objective Response Rate | Up to 2 years | Objective response rate was defined as the percentage of participants with Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST). The best overall response was the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for PD the smallest measurements recorded since the treatment started). The patient's best response assignment depended on the achievement of both measurement and confirmation criteria. To be assigned the status of PR or CR, changes in tumour measurements were to be confirmed by repeated assessments no less than 4 weeks after the criteria for response were first met. CR was defined as the disappearance of all target lesions; for non-target lesions disappearance of lesions and normal tumour marker levels. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, using as reference the Baseline sum LD. |
| Overall Survival | Up to 2 years | Overall survival was defined as the time in months from the start of treatment to the date of death irrespective of the cause of death. |
| Safety: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) | Up to 2 years | An AE was considered any unfavorable and unintended sign, symptom, or disease associated with the use of the study drug, whether or not considered related to the study drug. Preexisting conditions that worsened during the study and laboratory or clinical tests that resulted in a change in treatment or discontinuation from study drug were reported as adverse events. A SAE was any experience that: resulted in death, was life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect or was medically significant. |
| Progression-Free Survival | Up to 2 years | Progression-Free Survival (PFS) was defined as the time in months from the start of treatment until the first date criteria for Progressive Disease (PD) were met (taking as reference the smallest measurements recorded since the treatment started), or the date of death for any reason in the absence of PD. Diagnosis of PD was made by objective criteria (RECIST criteria) on the target lesion(s), or by documenting, with Computerised Tomography/Magnetic Resonance Imaging (CT/MRI) scans, the presence of newly occurring lesion(s) arising outside the scanned areas of the target lesions. |
Countries
France, Germany, Italy, Netherlands, Spain, United Kingdom
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Current/Former Smokers Current Smokers (participants who smoked \> 100 cigarettes in entire lifetime and either quit smoking \< 1 year ago or were currently smoking) or Former Smokers (participants who smoked \> 100 cigarettes in entire lifetime and quit smoking ≥ 1 year ago) received erlotinib \[Tarceva\] 150 mg orally daily, increasing to a maximum of 300 mg orally daily until disease progression or unacceptable toxicity. | 29 |
| Never Smokers Never Smokers (participants who smoked ≤ 100 cigarettes in entire lifetime or had never smoked cigarettes) received erlotinib \[Tarceva\] 150 mg orally daily until disease progression or unacceptable toxicity. | 23 |
| Total | 52 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 0 |
| Overall Study | Death | 1 | 2 |
| Overall Study | Other reasons off treatment | 5 | 2 |
| Overall Study | Patient non-compliance | 1 | 0 |
| Overall Study | Patient refusal | 2 | 0 |
| Overall Study | Progressive disease (PD) | 14 | 17 |
| Overall Study | Symptomatic deterioration | 3 | 1 |
Baseline characteristics
| Characteristic | Current/Former Smokers | Never Smokers | Total |
|---|---|---|---|
| Age, Continuous | 64 years | 66 years | 65 years |
| Sex: Female, Male Female | 15 Participants | 19 Participants | 34 Participants |
| Sex: Female, Male Male | 14 Participants | 4 Participants | 18 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 26 / 26 | 23 / 23 |
| serious Total, serious adverse events | 14 / 26 | 7 / 23 |
Outcome results
Non-Progression Rate (NPR) at 8 Weeks
Non-Progressive Rate (NPR) was defined as the percentage of participants without progression (had stable disease (SD) or better) based on (Response Evaluation Criteria in Solid Tumours (RECIST) criteria 8 weeks after start of treatment. Diagnosis of Progressive Disease (PD) was made by objective criteria (RECIST criteria) on the target lesion(s), or by documenting, with Computerised Tomography/Magnetic Resonance Imaging (CT/MRI) scans, the presence of newly occurring lesion(s) arising outside the scanned areas of the target lesions. PD required at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
Time frame: Week 8
Population: Intent-to-Treat Population included all registered participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Current/Former Smokers | Non-Progression Rate (NPR) at 8 Weeks | 41.4 percentage of participants |
| Never Smokers | Non-Progression Rate (NPR) at 8 Weeks | 65.2 percentage of participants |
Disease Control Rate
Disease Control Rate was defined as the percentage of participants with Complete Response (CR), Partial Response (PR) or Stable Disease (SD) by Response Evaluation Criteria in Solid Tumours (RECIST). CR was defined as the disappearance of all target lesions; for non-target lesions disappearance of lesions and normal tumour marker levels. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, using as reference the Baseline sum LD. SD was 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; for non-target lesions persistence of one or more non-target lesion(s) and/or maintenance of tumour marker level above the normal limits.
Time frame: Up to 2 years
Population: Intent-to-Treat Population included all registered participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Current/Former Smokers | Disease Control Rate | 41 percentage of participants |
| Never Smokers | Disease Control Rate | 65 percentage of participants |
Duration of Response
Duration of overall response was defined as the time in months from Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST) until the first date Progressive Disease (PD) was objectively documented (taking as reference for PD the smallest measurements recorded since the treatment started) or until the date of death. CR was defined as the disappearance of all target lesions; for non-target lesions disappearance of lesions and normal tumour marker levels.PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, using as reference the Baseline sum LD. PD was defined as at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
Time frame: Up to 2 years
Population: Participants from the Intent-to-Treat (ITT) Population, that included all participants, with CR or PR. Patients still responding to treatment at the time of analysis were treated as censored observations for duration of response on the date of the last tumour assessment.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Current/Former Smokers | Duration of Response | 13.1 months |
| Never Smokers | Duration of Response | 5.7 months |
Objective Response Rate
Objective response rate was defined as the percentage of participants with Complete Response (CR) or Partial Response (PR) by Response Evaluation Criteria in Solid Tumours (RECIST). The best overall response was the best response recorded from the start of the treatment until disease progression/recurrence (taking as reference for PD the smallest measurements recorded since the treatment started). The patient's best response assignment depended on the achievement of both measurement and confirmation criteria. To be assigned the status of PR or CR, changes in tumour measurements were to be confirmed by repeated assessments no less than 4 weeks after the criteria for response were first met. CR was defined as the disappearance of all target lesions; for non-target lesions disappearance of lesions and normal tumour marker levels. PR was defined as at least a 30% decrease in the sum of the longest diameter (LD) of target lesions, using as reference the Baseline sum LD.
Time frame: Up to 2 years
Population: Intent-to-Treat Population included all registered participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Current/Former Smokers | Objective Response Rate | 17 percentage of participants |
| Never Smokers | Objective Response Rate | 35 percentage of participants |
Overall Survival
Overall survival was defined as the time in months from the start of treatment to the date of death irrespective of the cause of death.
Time frame: Up to 2 years
Population: Safety Population included all participants with at least one study treatment and had at least one safety follow-up. Patients who had not died at the time of the final analysis were censored at the date of last contact.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Current/Former Smokers | Overall Survival | 9.9 months |
| Never Smokers | Overall Survival | 13.9 months |
Progression-Free Survival
Progression-Free Survival (PFS) was defined as the time in months from the start of treatment until the first date criteria for Progressive Disease (PD) were met (taking as reference the smallest measurements recorded since the treatment started), or the date of death for any reason in the absence of PD. Diagnosis of PD was made by objective criteria (RECIST criteria) on the target lesion(s), or by documenting, with Computerised Tomography/Magnetic Resonance Imaging (CT/MRI) scans, the presence of newly occurring lesion(s) arising outside the scanned areas of the target lesions.
Time frame: Up to 2 years
Population: Safety Population included all registered participants who received at least one study treatment and had at least one safety follow-up. Patients without PD at the time of analysis were censored on the date of the last tumour assessment. Patients without PD who received a second anti-cancer therapy were censored prior to start of new therapy.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Current/Former Smokers | Progression-Free Survival | 1.9 months |
| Never Smokers | Progression-Free Survival | 4.1 months |
Safety: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE)
An AE was considered any unfavorable and unintended sign, symptom, or disease associated with the use of the study drug, whether or not considered related to the study drug. Preexisting conditions that worsened during the study and laboratory or clinical tests that resulted in a change in treatment or discontinuation from study drug were reported as adverse events. A SAE was any experience that: resulted in death, was life-threatening, required in-patient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect or was medically significant.
Time frame: Up to 2 years
Population: Safety Population included all registered participant who received at least one study treatment and had at least one safety follow-up.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Current/Former Smokers | Safety: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) | Adverse Events | 26 participants |
| Current/Former Smokers | Safety: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) | Serious Adverse Events | 14 participants |
| Never Smokers | Safety: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) | Adverse Events | 23 participants |
| Never Smokers | Safety: Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) | Serious Adverse Events | 7 participants |
Time to Progression
Time to progression was defined as the time from start of treatment until the first date criteria for Progressive Disease (PD) was met (taking as reference the smallest measurements recorded since the treatment started). Diagnosis of PD was made by objective criteria (RECIST criteria) on the target lesion(s), or by documenting, with Computerised Tomography/Magnetic Resonance Imaging (CT/MRI) scans, the presence of newly occurring lesion(s) arising outside the scanned areas of the target lesions. PD required at least a 20% increase in the sum of the longest diameter (LD) of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.
Time frame: Up to 2 years
Population: Safety Population included all registered patients who received at least 1 dose of study treatment and had at least 1 safety follow-up. Patients without PD at the time of analysis were censored on the date of the last tumour assessment. Patients without PD who received a second anti-cancer therapy were censored prior to start of new therapy.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Current/Former Smokers | Time to Progression | 1.9 months |
| Never Smokers | Time to Progression | 5.5 months |