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Parallel Phase II Trials of ZD1839 (Iressa) Alone or Weekly Carboplatin and Paclitaxel Followed by ZD1839 (Iressa) (Oncologists Must Choose) for Metastatic Non-Small Cell Lung Cancer in Patients > or = 65 Years of Age

Phase 2
65 Years
Not Enrolling
Lung Cancer

Thank you

Trial Information

Parallel Phase II Trials of ZD1839 (Iressa) Alone or Weekly Carboplatin and Paclitaxel Followed by ZD1839 (Iressa) (Oncologists Must Choose) for Metastatic Non-Small Cell Lung Cancer in Patients > or = 65 Years of Age



- Determine the 6-month progression status of older patients with unresectable or
metastatic non-small cell lung cancer treated with gefitinib alone or with carboplatin
and paclitaxel.


- Determine the response rate in patients treated with these regimens.

- Determine the quality of life of patients treated with these regimens.

- Determine whether serum-secreted or soluble epidermal growth factor receptor (EGFR)
concentrations predict response in patients treated with these regimens.

- Correlate the presence of social support for these patients with toxicity and efficacy
of these regimens.

- Determine whether social support for these patients differs according to gender.

- Determine the reasons an oncologist would choose a chemotherapy vs a nonchemotherapy
regimen for these patients.


- Correlate EGFR signaling pathway markers, RNA expression profile, gene polymorphisms of
prespecified germline and tumor genes, and plasma and urine proteomic patterns with
response rate and time to progression of patients receiving treatment in group I.

OUTLINE: This is a nonrandomized, multicenter study. Patients are assigned to 1 of 2
treatment groups as determined by their treating physician.

- Group I: Patients receive oral gefitinib on days 1-28. Courses repeat every 28 days in
the absence of disease progression or unacceptable toxicity.

- Group II: Patients receive paclitaxel IV over 1 hour and carboplatin IV over 30 minutes
on days 1, 8, and 15. Treatment repeats every 28 days for up to 4 courses in the
absence of disease progression or unacceptable toxicity. After completion of
chemotherapy and in the absence of disease progression, patients receive oral gefitinib
as in group I.

Quality of life is assessed at baseline and after the completion of course 2.

Patients are followed every 3 months for 5 years.

PROJECTED ACCRUAL: A total of 107 patients (51 for group I and 56 for group II) will be
accrued for this study within 1.7 years.

Inclusion Criteria


- Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)

- Metastatic or unresectable disease

- Measurable disease

- At least 1 lesion at least 2.0 cm

- Disease must be completely outside prior radiotherapy port OR documented disease
progression since the completion of radiotherapy

- No meningeal carcinomatosis

- No untreated brain metastases

- Current metastatic CNS disease must have been treated and clinically stable for
at least 2 weeks prior to study chemotherapy

- No potentially curative treatment options available (e.g., chemotherapy with surgery
or radiotherapy)



- 65 and over

Performance status

- ECOG 0-2

Life expectancy

- At least 12 weeks


- Absolute neutrophil count at least 1,500/mm^3

- Platelet count at least 100,000/mm^3

- Hemoglobin at least 10.0 g/dL


- Bilirubin no greater than 2.0 mg/dL

- No uncontrolled hepatic disease


- Creatinine no greater than 2 times upper limit of normal

- No uncontrolled renal disease


- No uncontrolled cardiac disease


- No clinically active interstitial lung disease

- Asymptomatic, chronic stable radiographic changes allowed

- No uncontrolled respiratory disease


- Fertile patients must use effective contraception

- Able and willing to complete questionnaires alone or with assistance

- No known hypersensitivity to gefitinib or any of its excipients

- No active infection within the past 2 weeks

- No other prior malignancy within the past 5 years except basal cell skin cancer

- No grade 2 or greater peripheral neuropathy (CTC v2.0)

- No uncontrolled diabetes mellitus (for patients receiving study chemotherapy)

- No dysphagia or inability to swallow intact capsules

- No significant medical condition that would preclude study treatment or follow-up

- No severe or uncontrolled systemic disease


Biologic therapy

- Not specified


- See Disease Characteristics

- No prior chemotherapy for metastatic NSCLC

Endocrine therapy

- Concurrent steroids allowed provided the dose is not changed


- See Disease Characteristics

- At least 3 weeks since prior radiotherapy and recovered

- No prior radiotherapy to more than 25% of marrow-containing skeleton

- No concurrent radiotherapy (including palliative)


- See Disease Characteristics

- At least 3 weeks since prior major surgery

- No surgery within 7 days after study participation


- More than 30 days since prior non-FDA approved investigational drugs

- No concurrent oral retinoids

- No concurrent CYP3A4-inducing agents, including the following:

- Carbamazepine

- Oxcarbazepine

- Modafinil

- Ethosuximide

- Griseofulvin

- Nafcillin

- Phenobarbital

- Phenylbutazone

- Phenytoin

- Primidone

- Rifampin

- Hypericum perforatum (St. John's wort)

- Barbiturates

- Sulfinpyrazone

- No concurrent drugs that cause sustained elevation of gastric pH (≥ 5)

- No concurrent antacids within 4 hours before, during, and within 4 hours after
gefitinib administration

- No concurrent itraconazole, fluconazole, ketoconazole, or erythromycin

Type of Study:


Study Design:

Allocation: Non-Randomized, Primary Purpose: Treatment

Outcome Measure:

Progression status at 6 months

Safety Issue:


Principal Investigator

Aminah Jatoi, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Mayo Clinic


United States: Federal Government

Study ID:




Start Date:

October 2004

Completion Date:

Related Keywords:

  • Lung Cancer
  • stage IV non-small cell lung cancer
  • stage IIIB non-small cell lung cancer
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms



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