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| Name | Class |
|---|---|
| Shanghai Chest Hospital | OTHER |
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The investigators performed a randomized, double-blind controlled, prospective study method on observation of Traditional Chinese Medicine combined with targeted therapy to prolong the efficacy of long-term survival of advanced pulmonary Adenocarcinoma patients.The investigators plan to involve 404 cases for observation in 3 years (202 cases for each group), expecting that integrated TCM combined with targeted therapy has a better efficacy on prolonging progression-free survival time, overall survival, improving QOL of patients than that of targeted therapy.
At present, the third generation of platinum-based regimens (NCCN clinical practice guidelines recommended the use of vinorelbine or gemcitabine, or Taxol, etc.) is the first-line treatment for advanced lung cancer patients. Its effective rate is 20-30%, the median survival time is 7-9 months, 1-year and 2-year survival rate is 31-36% and 10-13% respectively. The efficacy has reached the platform and it is difficult to have more breakthroughs. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) such as Iressa and Erlotinib have proved effective in first or second line therapy for advanced non-small cell lung cancer(NSCLC).First-SIGNAL and IPASS research have laid first-line status for gefitinib in treatment of NSCLC and the progression-free survival time was maintained at 9-10 months. EGFR-TKIs treatment is simple, well tolerated, drug side effects, etc. There are also a rash, diarrhea and other adverse reactions, affecting the quality of life of patients with serious or even give patients a great deal of pain.Literature and our preliminary studies have shown that traditional Chinese medicine (TCM) can prolong survival time and improve quality of life QOL, but high-level evidences are needed.
The investigators perform a randomized, double-blind controlled, prospective study in Advanced Pulmonary Adenocarcinoma patients with stage Ⅲa~Ⅳ. Patients are randomized over observational group (TCM granules plus first-line targeted therapy and TCM granules plus second-line targeted therapy ), and control group (TCM placebo plus first-line targeted therapy and TCM placebo plus second-line targeted therapy). The investigators will observe 6 months and after that regular follow-up will be arranged. The primary efficacy assessments are: PFS (progression-free survival); Secondary efficacy assessments are: (1) OS(overall survival); (2) Objective response rate; (3) TTP(Time-to-Progression); (4) QOL (Functional Assessment of Cancertherapy-lung, FACT-L4.0 scales;Lung Cancer Symptom Scale,LCSS); (5)other efficacy assessments are: 1) TCM symptoms changes; 2) Toxicity, side effects and security of the treatments will be assessed at the same time. The investigators expect that integrated TCM combined with targeted therapy has a better efficacy on prolonging progression-free survival time, overall survival, improving QOL of patients than that of targeted therapy. Therefore our study can provide evidences for optimizing and promoting integrated TCM combined with Western Medicine treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TCM plus EGFR-TKIs | TCM:oral granules,YangYinFang or YiQiFang or YiQiYangYinFang,four packages,twice a day, six months; EGFR-TKIs:oral tablet,Gefitinib 250mg daily or Erlotinib 150mg daily or Icotinib 125 mg three times a day ,until progression or unacceptable toxicity; |
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| Placebo plus EGFR-TKIs | TCM Placebo:oral granules,YangYinFang or YiQiFang or YiQiYangYinFang,four packages,twice a day ,six months; EGFR-TKIs:oral tablet,Gefitinib 250mg daily or Erlotinib 150mg daily or Icotinib 125 mg three times a day until progression or unacceptable toxicity; |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TCM | Drug | TCM: In China,TCM herbs are given on the basis of the TCM syndrome differentiation as diagnosed by the TCM herbal specialist. Prescriptions formulated into granules origin from Professor Liu Jia-xiang in Longhua hospital. Package of granules is made into three types with functions such as benefiting Qi recipe, benefiting Yin recipe and detoxication and resolving masses recipe.The herbal treatment is adapted to the syndromes. |
| Measure | Description | Time Frame |
|---|---|---|
| Progression-free survival(PFS) | 2 months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate(ORR) | 2 months | |
| overall survival(OS) | 2 months | |
| Time-to-Progression(TTP) |
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Inclusion Criteria:
Exclusion Criteria:
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pulmonary adenocarcinoma patients with stage Ⅲa~Ⅳ; TCM syndromes are deficiency of Yin, deficiency of Qi and deficiency of both Qi and Yin.
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| Name | Affiliation | Role |
|---|---|---|
| Ling Xu, MD & PhD | Longhua Hospital | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31333456 | Derived | Jiao L, Xu J, Sun J, Chen Z, Gong Y, Bi L, Lu Y, Yao J, Zhu W, Hou A, Feng G, Jia Y, Shen W, Li Y, Zhang Z, Chen P, Xu L. Chinese Herbal Medicine Combined With EGFR-TKI in EGFR Mutation-Positive Advanced Pulmonary Adenocarcinoma (CATLA): A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial. Front Pharmacol. 2019 Jul 2;10:732. doi: 10.3389/fphar.2019.00732. eCollection 2019. |
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D008175 | Lung Neoplasms |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D008171 | Lung Diseases |
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| EGFR-TKI | Drug | Erlotinib 150 mg oral once a day or Gefitinib 250 mg oral once a day or Icotinib 125 mg oral three times a day |
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| 2 months |
| quality of life(QOL), | 2 months |
| D012140 |
| Respiratory Tract Diseases |