Overview

WBRT & Erlotinib in Advanced NSCLC and Brain Metastases

Status:
Terminated
Trial end date:
2010-11-01
Target enrollment:
0
Participant gender:
All
Summary
RATIONALE: Radiation therapy uses high energy x-rays to kill tumor cells. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Erlotinib may also make tumor cells more sensitive to radiation therapy. It is not yet known whether giving whole-brain radiation therapy together with erlotinib is more effective than whole-brain radiation therapy alone in treating patients with non-small cell lung cancer and brain metastases. PURPOSE: This randomized phase II trial is studying whole-brain radiation therapy and erlotinib to see how well they work compared with whole-brain radiation therapy alone in treating patients with advanced non-small cell lung cancer and brain metastases.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
University College, London
Collaborators:
Cancer Research UK
Roche Pharma AG
Treatments:
Erlotinib Hydrochloride
Criteria
DISEASE CHARACTERISTICS:

- Histologically or cytologically confirmed advanced non-small cell lung cancer (NSCLC)
meeting 1 of the following criteria:

- Newly diagnosed multiple brain metastases not suitable for first-line
chemotherapy

- Relapsed NSCLC with newly diagnosed multiple brain metastases

- Relapsed after second-line chemotherapy with newly diagnosed multiple brain
metastases NOTE: *Biopsy of brain metastases is not required

- Diagnosis of brain metastases must be confirmed by contrast CT scan or MRI within the
past 4 weeks

- Symptoms attributable to brain metastases

- Patients who have undergone craniotomy with incomplete resection are eligible

- Clinician certain that whole-brain radiotherapy (WBRT) will be beneficial

- No evidence of solitary brain metastasis on MRI that can be treated with surgical
resection, radiosurgery, or stereotactic radiotherapy

- No more than 3 sites (organ systems) of extracranial metastases

- No liver metastases

PATIENT CHARACTERISTICS:

- Karnofsky performance status 70-100%

- RTOG recursive partitioning analysis (RPA) class I or II

- Serum bilirubin < 2 times upper limit of normal (ULN)

- AST and ALT < 2 times ULN (< 5 times ULN if liver metastases are present)

- Creatinine < 5 times ULN

- Able to take oral medication

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- Caretaker able and willing to participate in the study

- Patient and caretaker have access to a telephone and willing to respond to telephone
interview

- No other prior or concurrent malignant disease likely to interfere with study
treatment or comparisons

- No evidence of other significant laboratory finding or concurrent uncontrolled medical
illness, that in the opinion of the investigator, would interfere with study treatment
or results comparison or render the patient at high risk for treatment complications
including, but not limited to, any of the following:

- Severe uncontrolled infection

- Unstable angina

- Myocardial infarction within the past month

- Uncontrolled inflammatory bowel disease (e.g., Crohn's disease or ulcerative
colitis)

- Acute renal failure

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- At least 28 days since prior chemotherapy (for relapsed patients originally treated
with chemotherapy)

- No prior cranial radiotherapy

- No prior anti-cancer EGFR therapy (e.g., erlotinib, gefitinib, or cetuximab)

- No prior treatment for brain metastases (e.g., radiosurgery, radiotherapy, or
chemotherapy)

- Prior radiotherapy to the primary tumor and/or systemic treatment to metastatic
sites of disease allowed

- No concurrent cyclooxygenase-2 (COX-2) inhibitors