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A multi-center phase III randomized controlled study to evaluate the efficacy of Hypofractionated SRS (HFSRS) along with EGFR-TKI in patients with brain metastasis from non-small cell lung cancer (NSCLC). Assuming that HFSRS is not inferior to EGFR-TKI concurrent with whole brain radiotherapy (WBRT), the primary end point is intracranial PFS (iPFS), while secondary outcomes included overall survival (OS), evaluation of cognitive function, quality of life (QoL) and adverse events.
WBRT remains to be standard of care for NSCL patients. Long term survival from WBRT may have noticeable cognitive dysfunction. The EGFR TKI has reasonable control for intracranial disease, but the duration of EGFR TKI control disease is variable due to tendency of drug resistance. To maintain intracranial disease control and improve cognitive function, the investigators propose using hypofractionated SRS in multiple brain metastases or large brain lesions alone with TKI.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| WBRT along with TKI | Active Comparator | Drug: EGFR-TKI Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid Other Name: Gefitinib/Tarceva/Icotinib Radiation: whole brain radiotherapy 3750Gy/15F Other Name: WBRT |
|
| HFSRS with EGFR TKI | Experimental | Drug: EGFR-TKI Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid Other Name: Gefitinib/Tarceva/Icotinib Radiation: whole brain radiotherapy 25 to 40 Gy/5F Other Name: HFSRS |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gefitinib 250mg po qd or Tarceva 150mg po qd or Icotinib 125mg po tid Other Name: Gefitinib/Tarceva/Icotinib | Drug | radiation given along with one of kind TKI |
|
| Measure | Description | Time Frame |
|---|---|---|
| iPFS | intracranial progression-free survival | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| cognitive function | Neurocognitive effects evaluated according to Mini-Mental Status Examination Evaluated according to Mini-Mental Status Examination | 18 month |
| Overall survival (OS) | Overall survival |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| YiFeng Bai, MD PhD | Contact | 008618183298718 | 15756285949@qq.com | |
| ming zeng, MD PhD | Contact | 17708131336 | miller2002@yahoo.com |
| Name | Affiliation | Role |
|---|---|---|
| Ming Zeng, MD PhD | Sichuan Provincial People Hospital, Sichuan Academy of Medical Sciences | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sichuan PPH, Cancer Center | Recruiting | Chengdu | Sichuan | 710062 | China |
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|
| WBRT | Radiation | 3750 cGy in 15 fractions given within 3 weeks time. |
|
| HFSRS | Radiation | All HFSRS given in 5 fractions. dose per fraction ranges from 5 to 8 Gy depending on the target volume and organs at risk tolerance. |
|
| 18 months |
| ID | Term |
|---|---|
| D000077156 | Gefitinib |
| D000069347 | Erlotinib Hydrochloride |
| C531470 | icotinib |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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