Phase III Study (Tarceva®) vs Chemotherapy to Treat Advanced Non-Small Cell Lung Cancer in Patients With Mutations in the TK Domain of EGFR (EURTAC)
Non-Small Cell Lung Cancer

About this trial
This is an interventional treatment trial for Non-Small Cell Lung Cancer focused on measuring Lung, cancer, EGFR, Epidermal Growth Factor Receptor, tyrosine kinase, Tarceva®, Erlotinib
Eligibility Criteria
Inclusion criteria:
- Informed consent
- Histologically confirmed diagnosis of NSCLC, non epidermoid, stage IV or IIIB with pleural effusion, or N3 tumours not candidate for thoracic radiotherapy, harbouring deletions in the exon 19 or mutation in the exon 21 in the TK of the EGFR.
- Either measurable or evaluable disease.
- Age > 18 years.
- ECOG performance status < 2.
- Adequate bone marrow function
- Adequate renal function
- Adequate hepatic function
- Patients must be accessible for treatment and follow-up.
- Patients capable of following an adequate therapeutic compliance
- Women of child bearing potential: negative pregnancy test.
- Patients of both genders at a fertile age, including those women having their last menstruation within the two previous years, must follow effective contraceptive measures.
- Ability to swallow.
- Patients with asymptomatic brain metastasis and stable with medical treatment will be eligible for the study. Patients having received radiotherapy for their brain metastasis prior to the systemic treatment for the NSCLC will be also eligible.
- Absence of gastrointestinal tract problems
Exclusion criteria:
- Pregnant or lactating women.
- Women of child bearing potential having a positive pregnancy test in the basal visit or not accomplishing the test.
- Patients of both genders sexually active (at a fertile age) not following contraceptive measures during the study.
- Prior chemotherapy for metastatic disease. Both prior neoadjuvant and adjuvant chemotherapy allowed provided that completed ≥ 6 months before entering the study.
- Prior treatment with EGFR targeted therapies.
- Patients may have received radiotherapy, provided that the irradiated lesion is not the only evaluable lesion for response and completed before entering the study.
- Prior experimental pharmacological agent within the 3 weeks prior to the inclusion of the study.
- Any significant ophthalmologic impairment of the eye surface. Use of contact lenses is not recommended.
- Pre-existing motor or sensorial neurotoxicity grade > 2, according to the NCI-CTC criteria.
- Evidence of spinal cord compression.
- Inability to take oral medication and surgical procedures affecting the absorption or implying intravenous or parenteral feeding.
Any other severe disease or clinical conditions, as, but not only:
- Unstable cardiopathy despite treatment, myocardial infarction within the 6 months before entering the study
- History of significant neurological or psychiatric disorders, including dementia and epileptic seizures.
- Uncontrolled active infection.
- Uncontrolled peptic ulcer.
- Unstable diabetes mellitus or any other contraindication for treatment with corticosteroids.
- AST and/or ALT > 1.5 x UNL associated to alkaline phosphatase > 2.5 x UNL.
- Any other underlying severe process affecting the ability to take part in the study.
- Absolute contraindication for steroids.
- Dementia or significant mental disorder interfering the understanding and giving the informed consent.
- History of other malignancy except adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, radically treated prostatic carcinoma with good prognostic (Gleason = 6). History of other curatively treated malignancy and no evidence of disease within the past 5 years.
Sites / Locations
- Centre Hospitalier Universitaire D'Angers
- Hôpital Auguste Morvan
- Centre François Baclesse
- Centre Hospitalier René Dubos
- Centre Hospitalier Intercommunal
- Hôpital A. Mignot
- Centre Hospitalier Du Mans
- Centre Oscar Lambret
- Hôpital du Cluzeau
- Centre Hospitalier Régional
- Centre Hospitalier de Meaux
- Centre Hospitalier de Mulhouse
- Hôpital Saint Antoine
- Centre Hospitalier
- Centre Hospitalier de La Région D'Annecy
- CHU Rennes Hôpital Ponchaillou
- Centre Hosiptalier Genéral de Roanne
- Institut de Cancérologie de La Loire
- Hôpital Larrey
- CRO di Aviano
- AO Materdomini
- AOU Policlinico G. Martino
- AO Monaldi
- Casa di Cura "La Maddalena"
- Istituti Fisioterapici Ospitalieri
- AO S.Camillo Forlanini
- Università di Roma "La Sapienza" Az.Policlinico Umb.I°
- PO di SS.ma Annunziata
- H. Virgen de los Lirios
- H. Torrevieja Salud
- ICO - H. Germans Trias i Pujol
- Hospital de Mataró
- H. Marqués de Valdecilla
- H. Provincial de Castellón
- Hospital Insular Gran Canaria
- F.H.Alcorcón
- H. Fuenlabrada
- H. Son Dureta
- H. Ntra. Sra. de la Candelaria
- Hospital de Cruces
- H.G.U. Alicante
- H. Santa Creu i Sant Pau
- Instituto Universitario Dexeus
- H.U.Vall D´Hebrón
- H. Clinic i Provincial
- H. Althaia
- H. Duran i Reynals-ICO
- H. Reina Sofía
- ICO Girona -H. Dr. Josep Trueta
- H. Virgen de las Nieves
- Complejo Hospitalario de Jaén
- Complejo Hosp. Univ. Juan Canalejo
- Hospital San Millan Y San Pedro
- H. Arnau de Vilanova
- H. de la Princesa
- H. Gregorio Marañón
- H. Ruber Internacional
- H.U. Puerta de Hierro
- Fundación Jimenez Diaz
- Hospial Clinico San Carlos
- H. La Paz
- H. 12 de Octubre
- H. Ramon y Cajal
- H. Carlos Haya
- H.C.Universitario Virgen de la Victoria
- H. Son Llàtzer
- Clinica Rotger
- H. de Donostia
- H. Virgen del Rocío
- H. Nuestra Sra. de Valme
- H.C.U.Valencia
- H. General U. de Valencia
- H. Arnau de Vilanova Valencia
- H. Dr. Peset
- H. Miguel Servet
- H. Clínico Lozano Blesa
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
A
B
Erlotinib (Tarceva)150 mg /day Patients will receive treatment until disease progression or unacceptable toxicity. For all practical effects a treatment cycle will be defined as three weeks of continuous treatment with erlotinib
4 cycles of Chemotherapy: Cisplatin / Gemcitabine; Cisplatin /Docetaxel; Carboplatin / Gemcitabine; Carboplatin / Docetaxel. - Cisplatin plus docetaxel: cisplatin 75 mg/m2 i.v. day 1 and docetaxel 75 mg/m2 i.v. day 1. Repeat cycles every 3 weeks. - Cisplatin plus gemcitabine: Cisplatin 75 mg/m2 i.v. on day 1 and gemcitabine 1250 mg/m2 on days 1 and 8. Repeat cycles every 3 weeks. In the case of patients not eligible for treatment with cisplatin, cisplatin can be replaced by carboplatin. The schedules will be the following: Docetaxel 75 mg/m2 day 1 and carboplatin AUC = 6 day 1, every 21 days. Gemcitabine 1000 mg/m2 days 1 and 8 and carboplatin AUC = 5 day 1, every 21 days. Patients in the chemotherapy arm will receive the treatment until disease progression or unacceptable toxicity occurs, or until a maximum of 4 treatment cycles are given.