Adjuvant Afatinib in Stage I-III NSCLC With EGFR Mutation
This research study is a Phase II clinical trial, which tests the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific cancer. "Investigational" means that the drug is still being studied. It also means that the FDA has not yet approved afatinib for use in patients.
In this research study the investigators are looking to see if taking afatinib after surgery works better when taken over a short period of time, compared to a long period of time.
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:||Randomized Phase II Study Comparing Concise Versus Prolonged Afatinib as Adjuvant Therapy for Patients With Resected Stage I-III NSCLC With EGFR Mutation|
- Recurrence-free survival [ Time Frame: 2 years ]The primary objective of this study is to demonstrate that prolonged adjuvant therapy with afatinib will improve recurrence free survival (RFS) compared to a concise adjuvant course in patients with resected stage I-III non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation.
- Number of patients with adverse events [ Time Frame: 2 years ]To determine the safety and tolerability of adjuvant afatinib
- Molecular genotype of recurrent cancers [ Time Frame: 2 years ]We aim to collect clinical data from patients with recurrent NSCLC after treatment with adjuvant afatinib, including molecular characteristics of recurrent cancer analyzed as part of routine care, and time to treatment failure for patients treated with alternative chemotherapies for recurrent lung cancer.
- overall survival [ Time Frame: 2 years ]To estimate overall survival
|Study Start Date:||January 2013|
|Estimated Study Completion Date:||August 2019|
|Estimated Primary Completion Date:||August 2019 (Final data collection date for primary outcome measure)|
Active Comparator: Concise Afatinib
Afatinib oral daily dose for 3 months
Active Comparator: Prolonged Afatinib
Afatinib oral daily dose for 2 years
In order to determine if one is eligible to participate in this study they would be asked to undergo some screening tests or procedures. Many of these tests and procedures are likely to be part of regular cancer care and may be done even if it turns out that one does not take part in the research study. If the patient has had some of these tests or procedures recently, they may or may not have to be repeated. These tests and procedures include: a medical history, performance status, physical exam and vital signs including height and weight, an assessment of your tumor, routine blood tests, pregnancy test, electrocardiogram, echocardiogram and/or multigated acquisition scan. If these tests show that a patient is eligible to participate in the research study, they will begin the study treatment. If one does not meet the eligibility criteria, they will not be able to participate in this research study.
Because no one knows which of the study options is best, the patients will be "randomized" into one of the study groups. They will take afatinib by mouth every day for either 3 months (short course) or for 2 years (long course). Randomization means that one is put into a group by chance. It is like flipping a coin. Neither the patient, nor the research doctor will choose what group the patient will be in. You will have a 50/50 chance of being placed in any group.
Regardless of which study group one is put in, all patients will take afatinib by mouth every day. The first cycle will last 28 days. All cycles after that will last 25-31 days. Patients will take their medication (tablets) by mouth once a day, at about the same time each day. They should take afatinib with a glass of water. Afatinb treatment will continue until the assigned course is completed, or until there are side effects that cannot be tolerated, or one decides to stop study treatment, of if the lung cancer returns.
Patients will be asked to come to the clinic at the following time points:
- Day 1 and 8 of Cycle 1
- Day 1 of Cycles 2, 3 and 4
- Off treatment visit-28 days after the last dose of study drug
If one is assigned to the long course, one will also need to come in for clinic visits on Day 1 of Cycles 7, 10, 13, 16, 19, 22 and 25. If one is assigned to the short course, one does not need to come in for these additional clinic visits.
The following tests and procedures will be done to monitor for side effects of afatinib.
- Routine blood tests-about 2 tablespoons of blood
- Performance status
- Physical exam and vital signs, including height and weight
The following tests and procedures will be done to monitor for recurrence of lung cancer. These visits are the same, regardless of whether one is taking a short course, or a long course of afatinib. There will be clinic visits once every 6 months for 3 years (months 7, 13, 19, 25, 31, 37 and 49), and then one more visit 1 year later. The following tests and procedures will be done at these follow up visits: a CT scan of the chest, routine blood tests, performance status and a physical exam, including height and weight.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01746251
|United States, California|
|Palo Alto, California, United States, 94304|
|United States, Massachusetts|
|Beth Israel Deaconess Medical Center|
|Boston, Massachusetts, United States, 02115|
|Massachusetts General Hospital|
|Boston, Massachusetts, United States, 02115|
|United States, New York|
|Memorial Sloan Kettering|
|New York, New York, United States, 10065|
|Principal Investigator:||Lecia Sequist, MD, MPH||Massachusetts General Hospital|