Hotta Katsuyuki, Sasaki Jiichiro, Saeki Sho, Takigawa Nagio, Katsui Kuniaki, Takayama Koichi, Nogami Naoyuki, Shioyama Yoshiyuki, Bessho Akihiro, Kishimoto Junji, Tanimoto Mitsune, Kiura Katsuyuki, Ichinose Yukito
Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan.
Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, Sagamihara, Japan.
Clin Lung Cancer. 2016 Jan;17(1):75-9. doi: 10.1016/j.cllc.2015.08.004. Epub 2015 Aug 18.
Herein, we describe an ongoing phase II trial in patients with locally advanced non-small-cell lung cancer (NSCLC) with mutated epidermal growth factor receptor (EGFR). Patients with chemotherapy-naive locally advanced disease with active EGFR mutations will receive the induction treatment, specified as gefitinib monotherapy (250 mg/body) for 8 weeks. Patients whose disease has not progressed during the induction therapy will receive cisplatin and docetaxel (40 mg/m(2)) on days 1, 8, 29, and 36, and concurrent 3-dimensional conformal thoracic radiotherapy with a single daily fraction of 2 Gy, for 5 consecutive days each week to provide a total dose of 60 Gy. The primary end point is overall survival at 24 months. A target sample size of 21 evaluable patients is considered sufficient to validate an expected rate of 85%, and 60% would be the lower limit of interest, with 80% power and a 1-sided α of 5%. Secondary end points include toxicity, response rate, and overall survival. This study will clarify whether tyrosine kinase inhibitors targeted to EGFR can produce a maximal effect in selected NSCLC patients with the relevant driver mutation, even in the locally advanced setting.
在此,我们描述了一项正在进行的针对局部晚期非小细胞肺癌(NSCLC)且表皮生长因子受体(EGFR)突变患者的II期试验。初治的伴有活性EGFR突变的局部晚期疾病患者将接受诱导治疗,具体为吉非替尼单药治疗(250mg/体),持续8周。诱导治疗期间疾病未进展的患者将在第1、8、29和36天接受顺铂和多西他赛(40mg/m²)治疗,并同时进行三维适形胸部放疗,每天单次剂量为2Gy,每周连续5天,总剂量为60Gy。主要终点是24个月时的总生存期。21例可评估患者的目标样本量被认为足以验证85%的预期率,60%将是感兴趣的下限,检验效能为80%,单侧α为5%。次要终点包括毒性、缓解率和总生存期。本研究将阐明针对EGFR的酪氨酸激酶抑制剂是否能在选定的具有相关驱动突变的NSCLC患者中产生最大效应,即使是在局部晚期情况下。