Phase I/II study of intermitted erlotinib in combination with docetaxel in patients with recurrent non-small cell lung cancer (WJOG4708L). (26th June 2019)

• Record Type: Journal Article
• Authors: Kimura, Tatsuo; Kawaguchi, Tomoya; Chiba, Yasutaka; Yoshioka, Hiroshige; Watanabe, Katsuya; Kijima, Takashi; Kogure, Yoshihito; Oguri, Tetsuya; Yoshimura, Naruo; Niwa, Takashi; Kasai, Takashi; Hayashi, Hidetoshi; Ono, Akira; Asai, Kazuhisa; Tanaka, Hiroshi; Yano, Seiji; Yamamoto, Nobuyuki; Nakanishi, Yoichi; Nakagawa, Kazuhiko
• Is Part Of: Japanese journal of clinical oncology. Volume 49:Number 10(2019)
• Page Start: 947
• Page End: 955
• Publication Date: 2019-06-26
• Subjects: NSCLC -- EGFR negative -- erlotinib -- docetaxel -- sequential; Oncology -- Periodicals; Cancer -- Periodicals; 616.994005
• DOI: 10.1093/jjco/hyz088
• Languages: English
• ISSNs: 0368-2811

Abstract

Abstract : We report the phase I/II clinical trial testing intermittent dosing of erlotinib plus docetaxel. This combination was clinically feasible in phase I but not significantly improve ORR in phase II. Abstract: Background: Preclinical data suggest sequential administration of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) following chemotherapy may improve efficacy. We hypothesized that intermittent delivery of EGFR-TKI following chemotherapy may increase efficacy. Methods: This was a multicenter, single-arm phase I/II study to evaluate the efficacy of intermitted erlotinib in combination with docetaxel in patients with EGFR -negative NSCLC who failed one prior chemotherapy. The phase I primary objectives were to determine the maximum tolerated dose (MTD) and recommended dose (RD) of erlotinib. Erlotinib was administered orally once per day on days 2–16 in combination with 60 mg/m 2 docetaxel on day1 for 21 days. A standard 3 + 3 dose escalation design was employed for erlotinib from 100 to 150 mg/dose. The phase II primary endpoint was the objective response rate (ORR). The ORR and 95% confidence interval (CI) were calculated using a binomial distribution. This study required 45 patients. Results: In the phase I part, the planned dose escalation was completed without reaching MTD. The RD of erlotinib was determined as 150 mg/dose. In the phase II part, the ORR and disease control rate were 17.1% (95%CI: 7.2–32.1%) and 53.7% (95%CI: 37.4–69.3%), respectively. Median progression-free survival and overall survival were 3.5 (95%CI: 3.1–4.5) and 11.3 (95%CI: 8.6–16.6) months, respectively. The common non-hematological adverse event was febrile neutropenia (grade 3–4:19.6%). Two treatment-related deaths were occurred because of interstitial lung disease and pleural infection. Conclusions: Intermittent dosing of erlotinib plus docetaxel is clinically feasible in phase I part but did not significantly improve ORR in phase II part.