Hypofractionated Brain Radiation In EGFR Mutated Adenocarcinoma Cranial Disease (Hybrid)

NCT ID: NCT02882984

Last Updated: 2016-08-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

325 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-03-31

Study Completion Date

2020-12-31

Brief Summary

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A multi-center phase III randomized controlled study to evaluate the efficacy of Hypofractionated SRS (HFSRS) along with EGFR-TKI in patients with brain metastasis from non-small cell lung cancer (NSCLC). Assuming that HFSRS is not inferior to EGFR-TKI concurrent with whole brain radiotherapy (WBRT), the primary end point is intracranial PFS (iPFS), while secondary outcomes included overall survival (OS), evaluation of cognitive function, quality of life (QoL) and adverse events.

Detailed Description

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WBRT remains to be standard of care for NSCL patients. Long term survival from WBRT may have noticeable cognitive dysfunction. The EGFR TKI has reasonable control for intracranial disease, but the duration of EGFR TKI control disease is variable due to tendency of drug resistance. To maintain intracranial disease control and improve cognitive function, the investigators propose using hypofractionated SRS in multiple brain metastases or large brain lesions alone with TKI.

Conditions

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Stage IV EGFR Mutated NSCL With Brain Metastases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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WBRT along with TKI

Drug: EGFR-TKI

Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid

Other Name: Gefitinib/Tarceva/Icotinib

Radiation: whole brain radiotherapy

3750Gy/15F

Other Name: WBRT

Group Type ACTIVE_COMPARATOR

Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid Other Name: Gefitinib/Tarceva/Icotinib

Intervention Type DRUG

radiation given along with one of kind TKI

WBRT

Intervention Type RADIATION

3750 cGy in 15 fractions given within 3 weeks time.

HFSRS with EGFR TKI

Drug: EGFR-TKI

Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid

Other Name: Gefitinib/Tarceva/Icotinib

Radiation: whole brain radiotherapy

25 to 40 Gy/5F

Other Name: HFSRS

Group Type EXPERIMENTAL

Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid Other Name: Gefitinib/Tarceva/Icotinib

Intervention Type DRUG

radiation given along with one of kind TKI

HFSRS

Intervention Type RADIATION

All HFSRS given in 5 fractions. dose per fraction ranges from 5 to 8 Gy depending on the target volume and organs at risk tolerance.

Interventions

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Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid Other Name: Gefitinib/Tarceva/Icotinib

radiation given along with one of kind TKI

Intervention Type DRUG

WBRT

3750 cGy in 15 fractions given within 3 weeks time.

Intervention Type RADIATION

HFSRS

All HFSRS given in 5 fractions. dose per fraction ranges from 5 to 8 Gy depending on the target volume and organs at risk tolerance.

Intervention Type RADIATION

Other Intervention Names

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EGFR-TKI

Eligibility Criteria

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Inclusion Criteria

* Histological or cytological confirmation of non-small cell lung cancer (NSCLC);
* Diagnosis of brain metastases on a Gadolinium-enhanced MRI.
* More than 3 sites of intracranial metastases, or the longest diameter of the intracranial lesion is more than 4 cm.
* Positive EGFR mutation.
* Life expectancy ≥3months.
* Have one or more measurable encephalic lesions according to RECIST.
* Adequate hematological function: Absolute neutrophil count (ANC) ≥1.5 x 109/L, and Platelet count ≥100 x 109/L.
* Adequate renal function: Serum creatinine ≤1.5 x ULN, or ≥ 50 ml/min.
* Adequate liver function: Total bilirubin ≤ 1.5 x upper limit of normal (ULN) and Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) \< 2.5 x ULN in the absence of liver metastases, or \< 5 x ULN in case of liver metastases.
* Female subjects should not be pregnant.
* All human subjects should able to comply with the required protocol and follow-up procedures, and able to receive oral medications.
* Written informed consent provided.

Exclusion Criteria

* Previous usage of EGFR-TKI or antibody to EGFR: gefitinib, erlotinib, herceptin, erbitux.
* CSF or MRI findings consistent with metastases of spinal cord, meninges or meningeal.
* Allergic to Icotinib.
* Lack of physical integrity of the upper gastrointestinal tract, or malabsorption syndrome, or inability to take oral medication, or have active peptic ulcer disease.
* Pregnancy or breast-feeding women.
* Participate in the other anti-tumor clinical trials in 4 weeks.
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sichuan Provincial People's Hospital

OTHER

Sponsor Role lead

Responsible Party

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ming zeng, MD

Director of Cancer Center

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ming Zeng, MD PhD

Role: STUDY_CHAIR

Sichuan Provincial People Hospital, Sichuan Academy of Medical Sciences

Locations

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Sichuan PPH, Cancer Center

Chengdu, Sichuan, China

Site Status RECRUITING

Countries

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China

Central Contacts

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YiFeng Bai, MD PhD

Role: CONTACT

008618183298718

ming zeng, MD PhD

Role: CONTACT

17708131336

Facility Contacts

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Yifeng Bai, MD PhD

Role: primary

18183298718

Ming zeng, MD PhD

Role: backup

008617708131336

Other Identifiers

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Hybrid

Identifier Type: -

Identifier Source: org_study_id

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