E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced non-small cell lung cancer with multiple brain metastases |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To estimate the effect on neurological progression-free survival at 2 months (n = neurological progression or death) of WBRT, with concomitant Tarceva compared to WBRT alone in patients with advanced NSCLC with multiple brain metastases |
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E.2.2 | Secondary objectives of the trial |
(i) Toxicity (ii) Response rate (iii) Quality of life (iv) Change in Performance Status (v) Steroid dosing (vi) Sites of progression (cranial or extracranial) will also be recorded.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
a) Histologically or cytologically confirmed NSCLC. A biopsy of metastatic disease in the brain is not required for study enrolment. b) Patients with newly diagnosed single or multiple brain metastases in whom immediate chemotherapy is not required for palliation of systemic extra-cranial disease. Patients with a solitary brain metastasis are only eligible for the trial providing they are not suitable for stereotactic radiotherapy or surgical resection. c) Diagnosis of brain metastases must be confirmed on MRI or contrast CT scan. d) Able to start treatment within 4 weeks of the baseline measurement scans of the brain, chest & abdomen. e) Patients with post-craniotomy incomplete resection will be permitted. f) No prior cranial radiotherapy. g) ≥ 28 days from any chemotherapy to Day 1 of trial treatment. h) Clinician certain of the role of WBRT. i) Glasgow Coma Score ≥14. j) Karnofsky performance status ≥ 70, RTOG RPA class I and II (modified by age to <76 years). k) Maximum of 3 sites (organ systems) of extracranial metastases (not including lung primary). l) Age > 18 years and < 76 years. m) Able to take oral medication. n) Adequate renal function, serum creatinine <1.5 x ULN and C&G GFR >40ml/min, absence of evidence of acute renal failure. m) Adequate liver function, ALT or AST < 2 x ULN without liver metatases or < 5 x ULN with liver metatases; serum bilirubin < 2 x ULN. o) Willing to use effective contraception, if of reproductive potential, whilst on trial drug and for at least 2 weeks after completing trial drug. (Women of childbearing potential must have a negative pregnancy test performed by a healthcare professional prior to randomisation.) p) Willing and able to give informed consent. q) Willing to participate in the biological study. r) Carer able and willing to participate. s) Patient and carer with access to telephone and willing to respond to telephone interview.
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E.4 | Principal exclusion criteria |
a) Presence of a solitary brain metastasis suitable for stereotactic radiosurgery or surgical resection. b) Patients who require immediate chemotherapy for symptom control. c) Clinician certain that WBRT will NOT be of benefit. d) Clinician uncertain of the role of WBRT. e) Previous treatment with any EGFR anti-cancer therapy (e.g. Tarceva, Iressa or Cetuximab). f) Previous treatment for brain metastases (radiosurgery, radiotherapy or chemotherapy) - however prior radiotherapy or surgery to the primary tumour and/or systemic treatment to metastatic sites of disease is acceptable. g) Glasgow Coma Score < 14. h) Pregnant or lactating women. i) Evidence of other significant laboratory finding or concurrent uncontrolled medical illness which in the opinion of the investigator would interfere with protocol treatment or results comparison or render the subject at high risk from treatment complications. For example: - Severe uncontrolled infection - Cardiovascular: unstable angina, myocardial infarction within 1 month - Gastro-intestinal: uncontrolled inflammatory bowel disease (e.g. Crohn’s or ulcerative colitis) - Hepatic: serum bilirubin ≥ to 2x upper limit of normal (ULN), serum transaminases ≥ 2x ULN in the absence of liver metastases or ≥ 5x ULN with liver metastases - Renal: acute renal failure, serum creatinine ≥1.5 x ULN. j) Other previous or current malignant disease likely to interfere with protocol treatment or comparisons. k) Current treatment with Cox II inhibitor. l) > 75 years of age.
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E.5 End points |
E.5.1 | Primary end point(s) |
Neurological progression-free survival at 2 months |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Information not present in EudraCT |
E.6.2 | Prophylaxis | Information not present in EudraCT |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Information not present in EudraCT |
E.6.7 | Pharmacodynamic | Information not present in EudraCT |
E.6.8 | Bioequivalence | Information not present in EudraCT |
E.6.9 | Dose response | Information not present in EudraCT |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | Information not present in EudraCT |
E.6.12 | Pharmacoeconomic | Information not present in EudraCT |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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For the purposes of this protocol the end of trial is defined as the date the last patient completes two months of treatment. This coincides with the primary endpoint of neurological progression free survival at 2 months. However, given the very limited treatment options for this patient population, patients may continue to take the study drug for up to 24 months. All patients will be followed until death. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | |