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Study of Pemetrexed Versus Pemetrexed Plus Erlotinib as Treatment of Nonsquamous Non-Small Cell Lung Cancer (NSCLC)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Eli Lilly and Company
ClinicalTrials.gov Identifier:
NCT00447057
First received: March 9, 2007
Last updated: September 12, 2011
Last verified: September 2011
Results First Received: June 17, 2011  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Safety/Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Open Label;   Primary Purpose: Prevention
Condition: Histological or Cytological Diagnosis of Locally Advanced or Metastatic NSCLC of Nonsquamous Histology and Not Amenable to Curative Therapy.
Interventions: Drug: Pemetrexed
Drug: Erlotinib

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
No text entered.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
This is a 2-arm study; however, results for participant disposition and baseline characteristics are presented for 4 groups including each study arm (Pemetrexed and Pemetrexed + Erlotinib) by histology (Nonsquamous and Squamous). Efficacy results are presented for participants with nonsquamous histology only.

Reporting Groups
  Description
Pemetrexed (Nonsquamous) Pemetrexed: 500 mg/m² intravenous (iv) over 10 minutes on the first day of each 21-day cycle until disease progression or unacceptable toxicity
Pemetrexed + Erlotinib (Nonsquamous)

Pemetrexed: 500 mg/m² iv over 10 minutes on the first day of each 21 day cycle until disease progression or unacceptable toxicity

Erlotinib: 150 mg given orally (po), daily (QD), starting on the first day of the first cycle

Pemetrexed (Squamous) Pemetrexed: 500 mg/m² iv over 10 minutes on the first day of each 21 day cycle until disease progression or unacceptable toxicity
Pemetrexed + Erlotinib (Squamous)

Pemetrexed: 500 mg/m² iv over 10 minutes on the first day of each 21 day cycle until disease progression or unacceptable toxicity

Erlotinib: 150 mg given po, QD, starting on the first day of the first cycle


Participant Flow:   Overall Study
    Pemetrexed (Nonsquamous)   Pemetrexed + Erlotinib (Nonsquamous)   Pemetrexed (Squamous)   Pemetrexed + Erlotinib (Squamous)
STARTED   83   76   19   26 
COMPLETED   0   3   0   0 
NOT COMPLETED   83   73   19   26 
Adverse Event                4                10                0                3 
Death due to study disease                6                4                1                1 
Lost to Follow-up                0                1                0                0 
Entry criteria not met                1                1                0                0 
Protocol Violation                0                1                0                0 
Withdrawal by Subject                4                5                1                1 
Physician Decision                9                6                3                1 
Sponsor decision                1                1                0                0 
Progressive disease                58                43                13                18 
Death due to adverse event                0                0                1                2 
Death, study drug related                0                1                0                0 



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
Pemetrexed (Nonsquamous) Pemetrexed: 500 mg/m² iv over 10 minutes on the first day of each 21-day cycle until PD or unacceptable toxicity
Pemetrexed + Erlotinib (Nonsquamous)

Pemetrexed: 500 mg/m² iv over 10 minutes on the first day of each 21-day cycle until PD or unacceptable toxicity

Erlotinib: 150 mg given orally, Daily, starting on the first day of the first cycle

Pemetrexed (Squamous) Pemetrexed: 500 mg/m² intravenous (iv) over 10 minutes on the first day of each 21 day cycle until disease progression or unacceptable toxicity
Pemetrexed + Erlotinib (Squamous)

Pemetrexed: 500 mg/m² iv over 10 minutes on the first day of each 21-day cycle until PD or unacceptable toxicity

Erlotinib: 150 mg given po, QD, starting on the first day of the first cycle

Total Total of all reporting groups

Baseline Measures
   Pemetrexed (Nonsquamous)   Pemetrexed + Erlotinib (Nonsquamous)   Pemetrexed (Squamous)   Pemetrexed + Erlotinib (Squamous)   Total 
Overall Participants Analyzed 
[Units: Participants]
 83   76   19   26   204 
Age 
[Units: Years]
Mean (Standard Deviation)
 59.8  (10.25)   63.5  (9.70)   63.9  (9.33)   66.1  (8.58)   62.3  (9.96) 
Gender 
[Units: Participants]
         
Female   34   30   0   2   66 
Male   49   46   19   24   138 
Race/Ethnicity, Customized 
[Units: Participants]
         
Caucasian   82   75   19   26   202 
African   0   0   0   0   0 
Hispanic   1   0   0   0   1 
Native American   0   0   0   0   0 
East Asian   0   0   0   0   0 
West Asian   0   1   0   0   1 
Region of Enrollment 
[Units: Participants]
         
Austria   4   5   2   0   11 
Germany   44   37   6   15   102 
Spain   18   9   7   7   41 
Hungary   12   14   4   4   34 
Sweden   5   11   0   0   16 
Eastern Cooperative Oncology Group (ECOG) Performance Status [1] 
[Units: Participants]
         
Status 0   33   33   7   9   82 
Status 1   39   33   7   13   92 
Status 2   11   9   5   4   29 
Unknown   0   1   0   0   1 
[1]

Eastern Cooperative Oncology Group (ECOG) Performance Status classifies patients according to their functional impairment. Scores range from 0 (Fully Active) to 5 (Death).

0 - Fully Active

  1. - Ambulatory, Restricted Strenuous Activity
  2. - Ambulatory, No Work Activities
  3. - Partially Confined to Bed, Limited Self Care
  4. - Completely Disabled
Basis for Diagnosis 
[Units: Participants]
         
Histopathological   64   61   18   22   165 
Cytological   19   15   1   4   39 
Initial Pathological Diagnosis 
[Units: Participants]
         
Adenocarcinoma of the lung   70   61   0   0   131 
Mixed cell (squamous/adenocarcinoma)   1   1   0   0   2 
Large cell lung carcinoma   6   9   0   0   15 
Bronchioalveolar carcinoma   4   1   0   0   5 
Squamous cell carcinoma of the lung   0   0   19   26   45 
Unknown   2   4   0   0   6 
Stage of Disease at Study Entry [1] 
[Units: Participants]
         
Stage I   0   0   0   0   0 
Stage II   0   0   0   0   0 
Stage IIIA   3   1   2   0   6 
Stage IIIB   10   11   4   5   30 
Stage IV   70   64   13   21   168 
[1]

Disease Stage means how big the tumor is and how far it has spread. Stages range from 0 (not spread) to IV (spread throughout the body).

Stage 0 - the cancer has not spread beyond the inner lining of the lung Stage I - the cancer is small and hasn't spread to the lymph nodes Stage II - the cancer has spread to some lymph nodes near the original tumor Stage III - the cancer has spread to nearby tissue or spread to far away lymph nodes Stage IV - the cancer has spread to other organs of the body such as the other lung, brain, or liver

Smoking status 
[Units: Participants]
         
Never smoked   14   10   0   0   24 
Ex-smoker   44   51   12   19   126 
Current smoker   25   15   7   7   54 
Pack-years, smokers only [1] 
[Units: Participants]
         
Up to 15 pack-years   5   13   1   1   20 
More than 15 pack-years   60   48   15   25   148 
Unknown   18   15   3   0   36 
[1] Pack-year equals the number of cigarette packs smoked per day multiplied by the number of years the participant has smoked. For example, 1 pack-year is equal to smoking an average of 20 cigarettes per day (1 pack) for 1 year.


  Outcome Measures
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1.  Primary:   Progression Free Survival (PFS)   [ Time Frame: Baseline to date of measured PD or death from any cause. Maximum follow-up was from baseline to 32.2 months ]

2.  Secondary:   Percentage of Participants With Best Response of Stable Disease (SD), Partial Response (PR) or Complete Response (CR) (Disease Control Rate)   [ Time Frame: Baseline to measured PD. Maximum follow-up was from Baseline to 34 months ]

3.  Secondary:   Percentage of Participants With Best Response of Complete Response (CR) or Partial Response (PR) (Response Rate)   [ Time Frame: Baseline to measured progressive disease. Maximum follow-up was from Baseline to 34 months ]

4.  Secondary:   Time to Treatment Failure (TTTF)   [ Time Frame: Baseline to first date among death from any cause, PD, or study treatment discontinuation for any reason other than "protocol complete" or "satisfactory response". Maximum follow-up was from Baseline to 32.2 months ]

5.  Secondary:   Overall Survival (OS)   [ Time Frame: Baseline to date of death from any cause. Maximum follow-up was from Baseline to 42.6 months. ]

6.  Secondary:   Percentage of Participants Surviving at 1 Year   [ Time Frame: Baseline to date of death from any cause up to 1 year ]

7.  Secondary:   Number of Participants With Adverse Events (AEs)   [ Time Frame: Baseline up to 42.2 months ]


  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
Baseline Characteristics are presented by histology (nonsquamous/squamous) for each arm. Per the protocol amendment of August 2008, study entry criteria were changed to exclude participants with predominantly squamous cell histology.


  More Information
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Certain Agreements:  
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
The agreement is:
unchecked The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 60 days. The sponsor cannot require changes to the communication and cannot extend the embargo.
unchecked Other disclosure agreement that restricts the right of the PI to discuss or publish trial results after the trial is completed.


Results Point of Contact:  
Name/Title: Chief Medical Officer
Organization: Eli Lilly and Company
phone: 800-545-5979



Responsible Party: Eli Lilly and Company
ClinicalTrials.gov Identifier: NCT00447057     History of Changes
Other Study ID Numbers: 10721
H3E-MC-S102 ( Other Identifier: Eli Lilly and Company )
Study First Received: March 9, 2007
Results First Received: June 17, 2011
Last Updated: September 12, 2011
Health Authority: Austria: Agency for Health and Food Safety
Germany: Federal Institute for Drugs and Medical Devices
Hungary: National Institute of Pharmacy
Spain: Ministry of Health