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Sorafenib and Erlotinib in Treating Patients With Stage IIIB or Stage IV Non-Small Cell Lung Cancer That Has Not Responded to Chemotherapy
Conditions: Official terms:
Carcinoma, Non-Small-Cell Lung
recurrent non-small cell lung cancer
stage IIIB non-small cell lung cancer
stage IV non-small cell lung cancer
None (Open Label)
polymerase chain reaction
protein expression analysis
immunohistochemistry staining method
laboratory biomarker analysis
RATIONALE: Sorafenib and erlotinib may stop the growth of tumor cells by blocking some of the
enzymes needed for cell growth. Sorafenib may also stop the growth of non-small cell lung
cancer by blocking blood flow to the tumor. Giving sorafenib together with erlotinib may kill
more tumor cells.
PURPOSE: This phase II trial is studying how well giving sorafenib together with erlotinib
works in treating patients with stage IIIB or stage IV non-small cell lung cancer that has
not responded to chemotherapy.
- To assess the response rate of sorafenib tosylate in combination with erlotinib
hydrochloride in patients with stage IIIB-IV non-small cell lung cancer refractory to 1
or 2 prior chemotherapy regimens.
- To assess the response duration in patients treated with this regimen.
- To assess the disease control rate in patients treated with this regimen.
- To assess the progression-free survival of patients treated with this regimen.
- To assess the overall survival of patients treated with this regimen.
- To assess the safety and tolerability of this regimen in these patients.
- To analyze biomarkers, including evaluation of EGFR expression, mutational analysis of
EGFR and K-ras, and immunohistochemical analysis of EGFR downstream pathway
(phospho-EGFR, phospho-AKT, phospho-Erk, phospho-STAT3).
OUTLINE: This is a multicenter study.
Patients receive oral erlotinib hydrochloride once daily and oral sorafenib tosylate twice
daily on days 1-28. Courses repeat every 28 days in the absence of disease progression or
Tissue samples are analyzed at the nucleic acid level for EGFR mutation (exon 18-21) and
K-ras mutation (exon 2), DNA mutations via PCR, presence of EGFR protein by IHC, and
downstream effectors of EGFR activation by IHC.
After completion of study therapy, patients are followed periodically.
Criteria for eligibility:
- Histologically or cytologically confirmed non-small cell lung cancer
- Advanced (stage IIIB-IV) or recurrent disease
- Must have failed 1 or 2 prior chemotherapy regimens, including platinum-containing
- At least 1 unidimensionally measurable lesion > 10 mm by spiral CT scan or > 20 mm by
conventional CT scan
- Previously irradiated lesions cannot be included as sites of measurable disease
unless clear tumor progression has been documented in the lesions since the end
- No known or suspected brain metastases
- Patients with clinical signs or symptoms that are suspicious of brain metastasis
must have a pre-treatment CT scan or MRI of the brain
- Patients with prior brain metastases are eligible provided they have completed
their treatment for brain metastases, no longer require corticosteroids, and are
- ECOG performance status 0-2
- WBC 4,000-12,000/μL
- Neutrophil ≥ 1,500/μL
- Platelet count ≥ 100,000/μL
- Hemoglobin ≥ 9.0 g/dL
- Total bilirubin ≤ 1.5 times upper limit of normal (ULN)
- AST and ALT ≤ 2.0 times ULN
- Alkaline phosphatase ≤ 2.0 times ULN
- Serum creatinine ≤ 1.5 times ULN
- Not pregnant or nursing
- No active clinically serious infections
- No prior or concurrent cancer that is distinct in primary site or histology from the
cancer being evaluated in this study except cervical carcinoma in situ, treated basal
cell carcinoma, superficial bladder tumors (Ta, Tis and T1), or any cancer curatively
treated > 5 years before study
- Able to swallow oral medications
- No substance abuse or medical, psychological, or social conditions that may interfere
with participation in the study or evaluation of the study results
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Recovered from all prior therapy
- No prior anti-EGFR targeted therapy
- At least 4 weeks since prior surgery
- At least 4 weeks since prior and no concurrent radiotherapy
- No prior radiotherapy to the whole pelvis or chest or to ≥ 25% of the bone marrow
- No other concurrent anticancer agents (e.g., chemotherapy or immunotherapy agents)
which might affect evaluation of study treatment
Yonsei Cancer Center at Yonsei University Medical Center
Korea, Republic of
Joo-Hang Kim, MD
National Cancer Institute (NCI)
Record processing date:
ClinicalTrials.gov processed this data on April 01, 2022