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This is a Phase II, single-Arm, prospective study of neoadjuvant Icotinib with chemotherapy for the treatment of patients with epidermal growth factor receptor mutation positive, resectable for stage II to IIIB(N2) Non-small Cell Lung Cancer
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Icotinib with platinum-based chemotherapy | Experimental | Icotinib 125 mg TID plus investigator's choice of platinum-based standard of care chemotherapy (pemetrexed/carboplatin or pemetrexed/cisplatin) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Icotinib | Drug | Oral |
| |
| Cisplatin |
| Measure | Description | Time Frame |
|---|---|---|
| Major Pathological Response (MPR) | Defined as ≤10% residual cancer cells in the main tumour, as assessed per central pathology laboratory post-surgery | From date of randomization to an average of 12 weeks after the first dose |
| Measure | Description | Time Frame |
|---|---|---|
| Pathological complete response (pCR) | Defined as absence of any residual cancer cells in the dissected tumour samples, including the main tumour and lymph nodes, assessed post-surgery | From date of randomization to an average of 12 weeks after the first dose |
| Overall Survival (OS) |
| Measure | Description | Time Frame |
|---|---|---|
| EGFR Mutation Detection of plasma samples for the following-up patients who take TKI. | Monitor the change of plasma EGFR mutation copy number before neoadjuvant therapy, cycle 2 chemotherapy and pre-surgery. | Up to 8 days |
| Change Between Pre-treatment and Post-treatment SUVmax (Standardized Uptake Values) in primary tumor and metastatic lymph node. |
Inclusion Criteria:
Evidence of a personally signed and dated informed consent document indicating that the patient (or a legally acceptable representative) has been informed of all pertinent aspects of the study.
Male or female, at least 18 years of age.
Histologically or cytologically documented lung adenocarcinoma within 60 days prior to study enrollment.
Clinical stage IIA/IIB/IIIA/IIIB assessed by EBUS-TBNA or PET(positron emission tomography)/CT can be resected.
EGFR mutation was detected by Amplification Refractory Mutation System(ARMS) and confirmed to be one of the 2 common EGFR mutations known to be associated with EGFR-TKI (epidermal growth factor receptor tyrosine kinase inhibitors)sensitivity (Ex19del, L858R).
Presence of at least one accurately measurable lesion, CT showing a maximum diameter of 10mm at baseline (except for lymph nodes with a short axis of 15mm required) and suitable for accurate repeat measurements.
Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 at enrolment.
Hematology , liver and kidney function are adequate for neoadjuvant therapy.
Cardiopulmonary function suitable for surgical treatment (ECG, echocardiography, pulmonary function or blood gas analysis).
Serum pregnancy test (for females of childbearing potential) negative at screening.Female patients of non-childbearing potential must meet at least 1 of the following criteria:
â‘ Achieved postmenopausal status, defined as follows: cessation of regular menses forat least 12 consecutive months with no alternative pathological or physiological cause; status may be confirmed with a serum follicle- stimulating hormone (FSH)level confirming the postmenopausal state;
â‘¡ Have undergone a documented hysterectomy and/or bilateral oophorectomy;
③ Have medically confirmed ovarian failure. All other female patients (including female patients with tubal ligations) are considered to be of childbearing potential.
Male subjects must be willing to use barrier contraception
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| NAN Wu, M.D. | Contact | 8613466692698 | nanwu@bjmu.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| BeijingCancerH | Recruiting | Beijing | 100176 | China |
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| Drug |
Cisplatin (75mg/m2) to be administered with pemetrexed on Day 1 of every 3-week cycle for 2 cycles. |
|
| Carboplatin | Drug | Carboplatin (AUC5) to be administered with pemetrexed on Day 1 of every 3-week cycle for 2 cycles |
|
| Pemetrexed | Drug | Pemetrexed (500 mg/m2) to be administered with cisplatin or carboplatin on Day 1 of every 3-week cycle for 2 cycles |
|
Defined as the time from the date of entry to the date of death from any cause. |
| Up to approximately 5.5 years after the last patient is randomized |
| Disease free survival (DFS) | DFS is defined as the time from the date of surgery until the first date of disease recurrence (local or distant) or date of death due to any cause, whichever occurs first. | From date of randomization up to approximately 42 months after date of resection |
| Objective response rate(ORR) | ORR is defined as the percentage of participants having a complete response or a partial response, measured by RECIST 1.1. | Baseline (Prior to surgery) |
| Disease control rate(DCR) | DCR is defined as the percentage of participants having a complete response , a partial response and disease stability measured by RECIST 1.1. | Baseline (Prior to surgery) |
| R0 surgical resection rate | the proportion of resection margin without macroscopic or microscopic tumor residue (negative resection margin) | Post surgery (within one week) |
| Incidence of Adverse Events | AE captured by CYCAE 5.0 | From the time of enrollment to either 28-days after the last dose of last study treatment for patients who do not undergo surgery, or 90-days post-surgery |
The reduction degree of SUVmax in primary tumor and metastatic lymph nodes before and after neoadjuvant therapy was detected by PET-CT. |
| Up to 8 weeks |
| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| C531470 | icotinib |
| D002945 | Cisplatin |
| D016190 | Carboplatin |
| D000068437 | Pemetrexed |
| ID | Term |
|---|---|
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017672 | Nitrogen Compounds |
| D017671 | Platinum Compounds |
| D056831 | Coordination Complexes |
| D009930 | Organic Chemicals |
| D006147 | Guanine |
| D007042 | Hypoxanthines |
| D011688 | Purinones |
| D011687 | Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D005971 | Glutamates |
| D024342 | Amino Acids, Acidic |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000600 | Amino Acids, Dicarboxylic |
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