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Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), including gefitinib demonstrate excellent effect on the treatment of non-small cell lung cancer (NSCLC) patients with EGFR mutations. However, patients who are initially sensitive to the drugs eventually become resistance. Apatinib is a highly selective VEGFR2 inhibitor and reduces the angiogenesis of tumor efficiently. In this study, the investigators aim to explore the efficacy and reasonable dosage of apatinib combining with EGFR-TKI in advanced non-squamous non-small cell lung cancer with EGFR-TKI resistance.
Primary Outcome Measure: efficacy and reasonable dosage of the combination of apatinib and EGFR-TKI in advanced non-squamous non-small cell lung cancer with EGFR-TKI resistance.
Secondary Outcome Measures: Progression free survival, overall survival, Side effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Apatinib | Experimental | Apatinib in combination with EGFR-TKIs |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Apatinib Mesylate Tablets | Drug | 250mg, 500mg, 750mg, q.d., p.o. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Optimal Dosage | Optimal dosage of Apatinib which combine with EGFR-TKIs | 9 months |
| Progression free survival | PFS is evaluated in 24 months since the treatment begin | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival | Overall survival is evaluated in the 24th month since the treatment began | 24 months |
| Side effects | Side effects evaluated in the 24th month since the treatment began according to the Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 |
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Inclusion Criteria:
Obtain of informed consent.
Histologically or cytologically confirmed, inoperable, recurrence or metastasis advanced non-small cell lung cancer (TNM Stage â…¢B or stage â…£), took EGFR-TKI longer than 6 months and appeared disease progression.
At least one measurable lesion (helical CT scan long diameter ≥10mm, meet the requirements of the standard Response Evaluation Criteria In Solid Tumors(RESCIST) version 1.1).
Eastern Cooperative Oncology Group(ECOG)Performance Status(PS) :0-2.
Aged from 18 to 75 years (18 and 75 years are included).
Life expectancy ≥12 weeks.
Adequate bone marrow reserve and organ function as follows:
Have history of hypertension (less than 135/85mmHg).
Females of child-bearing potential must have negative serum pregnancy test. Sexually active males and females (of childbearing potential) willing to practice contraception during the study.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Li Liang, Prof. M.D. | Contact | liang.dr@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Li Liang, Prof. M.D. | Peking University Third Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Third Hospital | Recruiting | Beijing | Beijing Municipality | China |
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| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
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| ID | Term |
|---|---|
| C553458 | apatinib |
| D000069347 | Erlotinib Hydrochloride |
| D000077156 | Gefitinib |
| C000596361 | osimertinib |
| ID | Term |
|---|---|
| D011799 | Quinazolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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| EGFR-TKIs (Erlotinib, Gefitinib and Osimertinib) |
| Drug |
EGFR-TKIs include but are not limited erlotinib, gefitinib and osimertinib |
|
| 24 months |
| D013899 |
| Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |