Gefitinib Combined With Chemotherapy or Antiangiogensis in Patients With Bim Deletion or Low EGFR Mutation Abundance
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ClinicalTrials.gov Identifier: NCT02930954 |
Recruitment Status : Unknown
Verified October 2016 by Caicun Zhou, Tongji University.
Recruitment status was: Not yet recruiting
First Posted : October 12, 2016
Last Update Posted : October 13, 2016
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Condition or disease | Intervention/treatment | Phase |
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Non-small-cell Lung Cancer | Drug: Gefitinib Drug: pemetrexed or gemcitabine plus carboplatin, Drug: bevacizumab | Phase 2 |
BIM deletion polymorphism and low EGFR mutation abundance were poor clinical response markers to EGFR-TKIs in NSCLC patients who had EGFR mutations.This is a phase II clinical trial to investigate the efficacy of combination treatment for patients harboring risk factors.
Advanced EGFR mutated NSCLC Patients with Bim deletion or EGFR low mutation abundance were randomizely divided into three treatment groups:
A:Gefitinib 250mg Qd B:Gefitinib 250mg Qd combined with doublet chemotherapy: Pemetrexed (500mg/m²day 1 intravenously) plus carboplatin (AUC=5,day 1,intravenously) every 21 days, Gemcitabine (1000 mg/m² days 1, day8, intravenously) plus carboplatin (AUC=5,day 1,intravenously) every 21 days C:Gefitinib 250mg Qd combined with bevacizumab 7.5mg/kg intravenously per 21 days.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 180 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Combination of Gefitinib With Chemotherapy or Anti-angiogenesis as 1st Line Treatment in Advanced NSCLC Patients Detected With Bim Deletion or Low EGFR Activating Mutation Abundance |
Study Start Date : | November 2016 |
Estimated Primary Completion Date : | December 2018 |
Estimated Study Completion Date : | December 2018 |

Arm | Intervention/treatment |
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Active Comparator: Gefitinib single agent
Advanced NSCLC patients with EGFR activating mutation (L858R, 19Del) received Gefitinib 250mg Qd orally until progression, intolerable toxicity or death.
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Drug: Gefitinib
Patients received Gefitinib 250mg Qd orally until disease progression, intolerable toxicity or death.
Other Name: Iressa |
Experimental: Gefitinib combined with chemotherapy
Gefitinib 250mg Qd combined with pemetrexed or gemcitabine plus carboplatin: Pemetrexed (500mg/m²day 1 intravenously) plus carboplatin (AUC=5,day 1,intravenously) every 21 days, Gemcitabine (1000 mg/m² days 1,d8, intravenously) plus carboplatin (AUC=5,day 1,intravenously) every 21 days
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Drug: Gefitinib
Patients received Gefitinib 250mg Qd orally until disease progression, intolerable toxicity or death.
Other Name: Iressa Drug: pemetrexed or gemcitabine plus carboplatin, doublet chemotherapy with pemetrexed or gemcitabine plus carboplatin per 3 weeks
Other Name: Alimita or Gimza |
Experimental: Gefitinib combined with antiangiogenesis
Gefetinib 250mg Qd combined with bevacizumab 7.5mg/kg per 21 days
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Drug: Gefitinib
Patients received Gefitinib 250mg Qd orally until disease progression, intolerable toxicity or death.
Other Name: Iressa Drug: bevacizumab bevacizumab 7.5mg/kg intravenously per 3 weeks |
- Progression free survival [ Time Frame: 8 weeks ]From start of anti-cancer therapy untill progression or death
- overall survival [ Time Frame: 36 months ]evaluated in the 36th since treatment begain
- side effect [ Time Frame: 8 weeks ]toxicities related to anti-cancer therapy
- quality of life [ Time Frame: 24 months ]evaluated since treatment began

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Ages Eligible for Study: | 18 Years to 70 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically documented, locally advanced or recurrent (stage IIIb and not amenable to combined modality treatment) or metastatic (stage IV) non-small cell lung cancer, anti-cancer treatment naiive
- EGFR exon 19 deletion or exon 21 L858R.
- Bim deletion by realtime PCR, or low abundance for EGFR mutation, for 19Del less than 4.9%, for L858R less than 9.5%.
- ECOG performance status of ≤ 1.
- Patients must have measurable disease according to the RECIST (version 1.1) criteria.
- Life expectancy of at least 12 weeks
- Written (signed) informed Consent to participate in the study.
- Adequate organ function as defined by the following criteria:
Liver function: SGOT (AST) and SGPT (ALT) ≤ 2.5 X ULN in the absence of liver metastases or up to 5 X ULN in case of liver metastases. Total bilirubin ≤ 1.5ULN.
Bone marrow function: Granulocyte count ≥ 1,500/mm3 and platelet count ≥100,000/mm3 and hemoglobin ≥90g/dl.
Renal function: serum creatinine ≤ 1.5 ULN or creatinine clearance ≥ 60 ml/min. (based on modified Cockcroft-Gault formula).
- For all females of childbearing potential a negative serum/urine pregnancy test must be obtained within 48 hours before enrollment. Postmenopausal women must have been amenorrhoeic for at least 12 months to be considered of non-childbearing potential.
Exclusion Criteria:
- Patients with prior chemotherapy or systemic anti-cancer therapy including target therapy targeting HER family members (such as erlotinib, gefitinib, cetuximab, trastuzumab, etc). Previous adjuvant or neo-adjuvant treatment for non-metastatic disease is permitted if completed ≥ 6 months before the enrollments.
- Patients with history of any other malignancies within 5 years (except for adequately treated carcinoma in situ of the cervix or basal or squamous cell skin cancer).
- Patients who have brain metastasis or spinal cord compression. It is permitted if the patient has been treated with surgery and/or radiation with evidence of stable disease for at least 4 weeks.
- Patients who are at risk (in the investigator's opinion) of transmitting human immunodeficiency virus (HIV) through blood or other body fluids.
- lactating women
- Sexually active males and females (of childbearing potential) unwilling to practice contraception during the study.
- Unwilling to write informed consent to participate in the study or unwilling to receive follow-up
- Tumor invade big vessels or close to big vessels (less than 5mm)
- Obvious cavity or necrosis formed in the tumor, Uncontrolled hypertension, Myocardial ischemia or infarction more than stage II, cardiac insufficiency. Abnormal coagulation (INR>1.5 or PT>ULN+4, or APTT>1.5 ULN), bleeding tendency or receiving coagulation therapy
- Hemoptysis, more than 2.5ml daily
- Thrombosis in 12 months, including pulmonary thrombosis, stoke, or deep venous thrombosis.
- Unhealed bone fracture or wound for long time

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02930954
Contact: Caicun Zhou, MD,PhD | 86-21-65115006 ext 3049 | caicunzhoudr@163.com | |
Contact: shengxiang Ren, MD,PhD | 86-21-65115006 ext 3050 | harry_ren@126.com |
China | |
Department of Oncology, Shanghai pulmonary hospital | |
Shanghai, China, 200433 |
Principal Investigator: | Caicun Zhou, MD,PhD | Shanghai Pulmonary Hospital, Tongji University |
Responsible Party: | Caicun Zhou, Professor, doctor, Tongji University |
ClinicalTrials.gov Identifier: | NCT02930954 |
Other Study ID Numbers: |
FK1408 |
First Posted: | October 12, 2016 Key Record Dates |
Last Update Posted: | October 13, 2016 |
Last Verified: | October 2016 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | Share the patient characteristics, results of test, treatment and outcome. |
NSCLC, EGFR, Bim, mutation abundance |
Carcinoma, Non-Small-Cell Lung Carcinoma, Bronchogenic Bronchial Neoplasms Lung Neoplasms Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site Neoplasms Lung Diseases Respiratory Tract Diseases Bevacizumab Carboplatin Gemcitabine Pemetrexed Gefitinib |
Antineoplastic Agents, Immunological Antineoplastic Agents Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Physiological Effects of Drugs Growth Inhibitors Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action Enzyme Inhibitors Folic Acid Antagonists Nucleic Acid Synthesis Inhibitors Protein Kinase Inhibitors |