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Tarceva Italian Lung Optimization tRial (TAILOR)
This study is currently recruiting participants.
Verified by Fatebenefratelli and Ophthalmic Hospital, July 2008
First Received: March 12, 2008   Last Updated: July 11, 2008   History of Changes
Sponsors and Collaborators: Fatebenefratelli and Ophthalmic Hospital
Mario Negri Institute for Pharmacological Research
Niguarda Hospital
Information provided by: Fatebenefratelli and Ophthalmic Hospital
ClinicalTrials.gov Identifier: NCT00637910
  Purpose

The aim of this study is to assess whether clinical and biological features are able to predict efficacy of Tyrosine kinase inhibitors.


Condition Intervention Phase
Non Small Cell Lung Cancer (NSCLC)
Drug: Erlotinib
Drug: Docetaxel
Phase III

MedlinePlus related topics: Cancer Lung Cancer
Drug Information available for: Docetaxel Erlotinib hydrochloride Erlotinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study
Official Title: Optimization of Erlotinib for the Treatment of Patients With Advanced Non Small Cell Lung Cancer: an Italian Randomized Trial

Further study details as provided by Fatebenefratelli and Ophthalmic Hospital:

Primary Outcome Measures:
  • Overall Survival [ Time Frame: 12 months after the last patient is randomized ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Progression Free Survival [ Time Frame: with 4 years and 12 months after the last patient is randomized ] [ Designated as safety issue: No ]
  • Response assessed with RECIST criteria [ Time Frame: within 4 years ] [ Designated as safety issue: No ]
  • Quality of Life assessed with QLQ-C30 and QLQ-LC13 questionnaires [ Time Frame: within 4 years ] [ Designated as safety issue: No ]
  • Toxicity, graded according to the NCI-CTAE version 3.0 [ Time Frame: within 4 years ] [ Designated as safety issue: Yes ]
  • Frequency and nature of serious adverse reactions [ Time Frame: within 4 years ] [ Designated as safety issue: Yes ]
  • Premature withdrawals [ Time Frame: within 4 years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 1500
Study Start Date: November 2007
Estimated Study Completion Date: May 2012
Estimated Primary Completion Date: November 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Erlotinib Arm: Experimental Drug: Erlotinib
Erlotinib 150 mg/day per os until disease progression or unacceptable toxicity develops
Docetaxel Arm: Active Comparator Drug: Docetaxel
Docetaxel 75 mg/mq on day 1, every 21 days (3-weekly schedule) or Docetaxel 35 mg/mq 0n day 1,8 and 15 every 28 days (weekly schedule). _Until disease progression or unacceptable toxicity develops

Detailed Description:

Erlotinib is registered in all patients affected with NSCLC in second and subsequent lines with a small benefit. Recent evidence suggest that it should be possible to select patients according with clinical and biological features. However, most of these proofs are drawn from case series or post hoc analyses and not from properly planned randomized clinical trials rendering their interpretation controversial. EGFR mutations, EGFR copy number and EGFR expression should positive select responders, while K-ras mutations should predict a negative outcome.

Moreover, recent studies showed that similar information might be drawn also on blood samples.

While it is possible to assume that in patients with EGFR mutations erlotinib improves Overall Survival (OS) and gives prolonged and high responses, the role of erlotinib in patients without EGFR mutations is controversial. On this assumption, the predictive value of K-ras mutations, EGFR protein expression and EGFR gene copy number in determining the effect of erlotinib as compared with chemotherapy will be assessed in patients without EGFR mutations. Aim of the study is to assess whether it is possible to optimize second-line treatment in NSCLC using biological and clinical markers.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age 18 years or older
  • Histological or cytological confirmation of NSCLC (may be from initial diagnosis of NSCLC or subsequent biopsy). Only patients with available tissue samples may be included in the study
  • Absence of EGFR mutations of exons 19 or 21 (randomization)
  • Locally advanced or metastatic NSCLC, not amenable to curative surgery or radiotherapy
  • One prior platinum-based at adequate doses and taxane free regimen
  • Measurable (uni-dimensional) disease by RECIST in a lesion not previously irradiated or non-measurable disease
  • ECOG-PS 0-2
  • ANC greater than 1.5 x 109/L and platelets greater than 100 x 109/L
  • Bilirubin level either normal or <1.5xULN
  • AST (SGOT) and ALT (SGPT) <2.5xULN (≤5 x ULN if liver metastases are present)
  • Serum creatinine <1.5xULN
  • Effective contraception for both, male and female pts, if the risk of conception exists
  • Recovery from all acute toxicities of prior therapies
  • Provision of written informed consent to the analysis of biological markers (registration)
  • Provision of written informed consent to enter the randomized part of the study (randomization)

Exclusion Criteria:

  • Prior therapy with an experimental agent whose primary mechanism of action is inhibition of EGFR or its associated tyrosine kinase
  • Prior chemotherapy with taxanes
  • Newly diagnosed CNS metastases that have not yet been treated with surgery and/or radiation. Pts with previously diagnosed and treated CNS metastases or spinal cord compression may be considered if they have evidence of clinically SD (no steroid therapy or steroid dose being tapered) for at least 28 daysLess than 14 days since completion of prior radiotherapy or persistence of any radiotherapy related toxicity
  • Any unresolved chronic toxicity from previous anticancer therapy that, in the opinion of the investigator, makes it inappropriate for the patient to be enrolled in the study Known severe hypersensitivity to erlotinib or any of the excipients of this product
  • Known hypersensitivity to docetaxel, polysorbate 80 or other drugs formulated with polysorbate 80, or any of the excipients of docetaxel
  • Other co-existing malignancies or malignancies diagnosed within the last 5 years with the exception of basal cell carcinoma or cervical cancer in situ
  • Unable to swallow tablets
  • Any evidence of clinically active interstitial lung disease (patients with chronic, stable, radiographic changes who are asymptomatic or patients with uncomplicated progressive lymphangitic carcinomatosis need not be excluded)
  • As judged by the investigator, any evidence of severe or uncontrolled systemic disease (e.g., unstable or uncompensated respiratory, cardiac, hepatic or renal disease)
  • As judged by the investigator, any inflammatory changes of the surface of the eye
  • Evidence of any other significant clinical disorder or laboratory finding that makes it undesirable for the patient to participate in the study
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00637910

Contacts
Contact: Marina C Garassino, MD +39 0263632223 marina.garassino@fbf.milano.it
Contact: Aurora Rizzo, PharmD +39 0263632223 oncologia.ricerca@fbf.milano.it

  Show 94 Study Locations
Sponsors and Collaborators
Fatebenefratelli and Ophthalmic Hospital
Mario Negri Institute for Pharmacological Research
Niguarda Hospital
Investigators
Principal Investigator: Alberto Scanni, MD Fatebenefratelli and Ophthalmic Hospital
  More Information

Publications:
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Herbst RS, Prager D, Hermann R, Fehrenbacher L, Johnson BE, Sandler A, Kris MG, Tran HT, Klein P, Li X, Ramies D, Johnson DH, Miller VA; TRIBUTE Investigator Group. TRIBUTE: a phase III trial of erlotinib hydrochloride (OSI-774) combined with carboplatin and paclitaxel chemotherapy in advanced non-small-cell lung cancer. J Clin Oncol. 2005 Sep 1;23(25):5892-9. Epub 2005 Jul 25.
Gatzemeier U, Pluzanska A, Szczesna A, Kaukel E, Roubec J, De Rosa F, Milanowski J, Karnicka-Mlodkowski H, Pesek M, Serwatowski P, Ramlau R, Janaskova T, Vansteenkiste J, Strausz J, Manikhas GM, Von Pawel J. Phase III study of erlotinib in combination with cisplatin and gemcitabine in advanced non-small-cell lung cancer: the Tarceva Lung Cancer Investigation Trial. J Clin Oncol. 2007 Apr 20;25(12):1545-52.
Marchetti A, Martella C, Felicioni L, Barassi F, Salvatore S, Chella A, Camplese PP, Iarussi T, Mucilli F, Mezzetti A, Cuccurullo F, Sacco R, Buttitta F. EGFR mutations in non-small-cell lung cancer: analysis of a large series of cases and development of a rapid and sensitive method for diagnostic screening with potential implications on pharmacologic treatment. J Clin Oncol. 2005 Feb 1;23(4):857-65.
Sequist LV, Joshi VA, Jänne PA, Muzikansky A, Fidias P, Meyerson M, Haber DA, Kucherlapati R, Johnson BE, Lynch TJ. Response to treatment and survival of patients with non-small cell lung cancer undergoing somatic EGFR mutation testing. Oncologist. 2007 Jan;12(1):90-8.
Taron M, Ichinose Y, Rosell R, Mok T, Massuti B, Zamora L, Mate JL, Manegold C, Ono M, Queralt C, Jahan T, Sanchez JJ, Sanchez-Ronco M, Hsue V, Jablons D, Sanchez JM, Moran T. Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor are associated with improved survival in gefitinib-treated chemorefractory lung adenocarcinomas. Clin Cancer Res. 2005 Aug 15;11(16):5878-85.
van Zandwijk N, Mathy A, Boerrigter L, Ruijter H, Tielen I, de Jong D, Baas P, Burgers S, Nederlof P. EGFR and KRAS mutations as criteria for treatment with tyrosine kinase inhibitors: retro- and prospective observations in non-small-cell lung cancer. Ann Oncol. 2007 Jan;18(1):99-103. Epub 2006 Oct 23.
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Responsible Party: Fatebenefratelli and Ophthalmic Hospital ( Alberto Scanni )
Study ID Numbers: FARM6F5JER, EudraCT Number 2007-004786-17
Study First Received: March 12, 2008
Last Updated: July 11, 2008
ClinicalTrials.gov Identifier: NCT00637910     History of Changes
Health Authority: Italy: Ethics Committee;   Italy: Ministry of Health;   Italy: National Bioethics Committee;   Italy: National Institute of Health;   Italy: National Monitoring Centre for Clinical Trials - Ministry of Health;   Italy: The Italian Medicines Agency

Keywords provided by Fatebenefratelli and Ophthalmic Hospital:
Advanced NSCLC
EGFR
EGFR copy number
Kras mutations
EGRF mutations
Docetaxel
Erlotinib
Polymorphisms

Study placed in the following topic categories:
Erlotinib
Docetaxel
Thoracic Neoplasms
Respiratory Tract Diseases
Lung Neoplasms
Lung Diseases
Non-small Cell Lung Cancer
Protein Kinase Inhibitors
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial
Carcinoma

Additional relevant MeSH terms:
Thoracic Neoplasms
Erlotinib
Respiratory Tract Neoplasms
Neoplasms by Histologic Type
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Enzyme Inhibitors
Protein Kinase Inhibitors
Pharmacologic Actions
Carcinoma
Docetaxel
Neoplasms
Neoplasms by Site
Respiratory Tract Diseases
Lung Neoplasms
Therapeutic Uses
Lung Diseases
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 07, 2009