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    Clinical Trial Results:
    OPEN LABEL STUDY OF ERLOTINIB (TARCEVA®) AS SINGLE AGENT FIRST LINE TREATMENT OF PATIENTS WITH LOCALLY ADVANCED OR METASTATIC LUNG ADENOCARCINOMA WITH ACTIVATING EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) MUTATIONS

    Summary
    EudraCT number
    2011-002168-26
    Trial protocol
    HU   LV  
    Global end of trial date
    30 Jan 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    25 Feb 2016
    First version publication date
    25 Feb 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    ML27880
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01609543
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    F.Hoffmann-LaRoche AG, Roche Trial Information Hotline, 41 616878333, global.trial_information@roche.com
    Scientific contact
    F.Hoffmann-LaRoche AG, Roche Trial Information Hotline, 41 616878333, global.trial_information@roche.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    30 Jan 2015
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Jan 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This was a Phase IV, open label, multicenter study to evaluate the effectiveness of erlotinib hydrochloride (Tarceva) in participants with locally advanced or metastatic lung adenocarcinoma with activating Epidermal Growth Factor Receptor (EGFR).
    Protection of trial subjects
    The study was conducted in accordance with the principles of the “Declaration of Helsinki” and Good Clinical Practice (GCP).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    28 Mar 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Hungary: 35
    Country: Number of subjects enrolled
    Latvia: 12
    Country: Number of subjects enrolled
    Turkey: 15
    Worldwide total number of subjects
    62
    EEA total number of subjects
    47
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    24
    From 65 to 84 years
    36
    85 years and over
    2

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 651 participants were screened and among them 62 participants were enrolled in the study.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Erlotinib Hydrochloride
    Arm description
    Participants received a single 150 milligrams (mg) oral dose of erlotinib hydrochloride (Tarceva) tablet daily from Day 1 until disease progression, death, unacceptable toxicity or consent withdrawal, whichever occurred first up to 34 months.
    Arm type
    Experimental

    Investigational medicinal product name
    Erlotinib Hydrochloride
    Investigational medicinal product code
    Other name
    Tarceva
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received single 150 mg oral dose of erlotinib hydrochloride tablet daily from Day 1 until disease progression, death, unacceptable toxicity or consent withdrawal, whichever occurred first up to 34 months.

    Number of subjects in period 1
    Erlotinib Hydrochloride
    Started
    62
    Completed
    20
    Not completed
    42
         Consent withdrawn by subject
    1
         Adverse Event
    5
         Death
    7
         Disease Progression
    28
         Protocol deviation
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Study (overall period)
    Reporting group description
    Participants received a single 150 milligrams (mg) oral dose of erlotinib hydrochloride (Tarceva) tablet daily from Day 1 until disease progression, death, unacceptable toxicity or consent withdrawal, whichever occurred first up to 34 months.

    Reporting group values
    Overall Study (overall period) Total
    Number of subjects
    62 62
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    67.69 ± 10.562 -
    Gender categorical
    Units: Subjects
        Female
    50 50
        Male
    12 12

    End points

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    End points reporting groups
    Reporting group title
    Erlotinib Hydrochloride
    Reporting group description
    Participants received a single 150 milligrams (mg) oral dose of erlotinib hydrochloride (Tarceva) tablet daily from Day 1 until disease progression, death, unacceptable toxicity or consent withdrawal, whichever occurred first up to 34 months.

    Primary: Progression-Free Survival (PFS)

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    End point title
    Progression-Free Survival (PFS) [1]
    End point description
    PFS was defined as median time from the first dose of study treatment to the first documentation of objective tumor progression (according to Response Evaluation Criteria in Solid Tumours [RECIST] version 1.1) or to death due to any cause, whichever occurred first. Progressive Disease (PD) was defined as at least a 20 percent (%) increase in the sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Unequivocal progression of existing non-target lesions. The appearance of one or more new lesions is also considered progression. Median and the 95% confidence interval were estimated using Kaplan-Meier survival methodology. Intent-to-treat (ITT) population included all enrolled participants.
    End point type
    Primary
    End point timeframe
    Baseline to progressive disease or death (up to 34 months)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: As the study was non-comparative in nature, no statistical analysis was performed.
    End point values
    Erlotinib Hydrochloride
    Number of subjects analysed
    62
    Units: months
        median (confidence interval 95%)
    12.846 (9.901 to 15.791)
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Best Overall Response (BOR)

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    End point title
    Percentage of Participants With Best Overall Response (BOR)
    End point description
    BOR was defined as best tumor response (as per RECIST version 1.1) recorded for a participant during study. Complete Response (CR): disappearance of all target and non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (less than [<] 10 millimeters [mm] short axis). Partial Response (PR): at least a 30% decrease in sum of diameters of target lesions, taking as reference the baseline sum diameters. PD: at least a 20% increase in sum of diameters of target lesions, taking as reference the smallest sum on study. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. Unequivocal progression of existing non-target lesions. Appearance of one or more new lesions is also considered progression. Stable Disease (SD): neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study. ITT population.
    End point type
    Secondary
    End point timeframe
    Baseline to progressive disease or death (up to 34 months)
    End point values
    Erlotinib Hydrochloride
    Number of subjects analysed
    62
    Units: percentage of participants
    number (not applicable)
        CR
    1.8
        PR
    64.3
        SD
    32.1
        PD
    1.8
    No statistical analyses for this end point

    Secondary: Percentage of Participants Who Were Alive at 1 Year

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    End point title
    Percentage of Participants Who Were Alive at 1 Year
    End point description
    ITT population. Here, number of participants analyzed signifies those participants who were evaluable for this outcome.
    End point type
    Secondary
    End point timeframe
    1 Year (12 months)
    End point values
    Erlotinib Hydrochloride
    Number of subjects analysed
    40
    Units: percentage of participants
        number (not applicable)
    82.5
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to 28 days after the last dose of study medication (up to 34 months)
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.1
    Reporting groups
    Reporting group title
    Erlotinib Hydrochloride
    Reporting group description
    Participants received a single 150 mg oral dose of erlotinib hydrochloride tablet daily from Day 1 until disease progression, death, unacceptable toxicity or consent withdrawal, whichever occurred first up to 34 months.

    Serious adverse events
    Erlotinib Hydrochloride
    Total subjects affected by serious adverse events
         subjects affected / exposed
    26 / 62 (41.94%)
         number of deaths (all causes)
    13
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Infected neoplasm
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pain
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sudden cardiac death
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemothorax
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pleural effusion
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pulmonary haemorrhage
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Liver function test abnormal
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Balance disorder
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences causally related to treatment / all
    4 / 5
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ileus paralytic
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Nausea
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 62 (4.84%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Hepatic function abnormal
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Liver injury
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences causally related to treatment / all
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    Rash generalised
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Rash maculo-papular
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Musculoskeletal chest pain
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    2 / 62 (3.23%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypovolaemia
         subjects affected / exposed
    1 / 62 (1.61%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Erlotinib Hydrochloride
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    49 / 62 (79.03%)
    Investigations
    Blood alkaline phosphatase increased
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences all number
    5
    Weight decreased
         subjects affected / exposed
    4 / 62 (6.45%)
         occurrences all number
    5
    Nervous system disorders
    Headache
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences all number
    5
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences all number
    6
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences all number
    9
    Eye disorders
    Growth of eyelashes
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences all number
    5
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    17 / 62 (27.42%)
         occurrences all number
    26
    Nausea
         subjects affected / exposed
    4 / 62 (6.45%)
         occurrences all number
    5
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    8 / 62 (12.90%)
         occurrences all number
    8
    Dyspnoea
         subjects affected / exposed
    5 / 62 (8.06%)
         occurrences all number
    5
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    7 / 62 (11.29%)
         occurrences all number
    7
    Dry skin
         subjects affected / exposed
    11 / 62 (17.74%)
         occurrences all number
    15
    Pruritus
         subjects affected / exposed
    9 / 62 (14.52%)
         occurrences all number
    10
    Rash
         subjects affected / exposed
    36 / 62 (58.06%)
         occurrences all number
    43
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    7 / 62 (11.29%)
         occurrences all number
    8
    Infections and infestations
    Conjunctivitis
         subjects affected / exposed
    6 / 62 (9.68%)
         occurrences all number
    8
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    4 / 62 (6.45%)
         occurrences all number
    4

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    31 May 2013
    The protocol was amended to modify the required number of enrolled participants, number of initiated sites, and expansion of the recruitment period; to include permission for uric acid test and rescreening, tumour measurement and reporting of survival status at the end of study visit were included; to allow further participation in study after erlotinib was widely reimbursed for the countries and exclusion of data of non-compliant participant from the statistical analysis; to include guided questionnaire for the predefined events to monitor, to revise AE/SAE reporting requirement. Additional administrative changes and clarification were also made.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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