Docetaxel Combined With Pulsatile Erlotinib (Tarceva®) In Patients With Metastatic Non Small Cell Lung Cancer (NSCLC) (DOPERLO)
1. Male and female patients aged 18 to 75 years inclusive, with histologically confirmed
metastatic NSCLC will be enrolled.
2. Patients must have not been previously treated with anticancer drugs for advanced
3. ECOG performance status of 0 - 1.
4. Life expectancy of at least 12 weeks.
5. Patients must be able to take oral medication.
6. At least 4 weeks since any prior major surgery or extended-field radiotherapy.
Patients who, in the opinion of the investigator, have fully recovered from limited
surgery or have undergone limited-field radiotherapy within 2 weeks may also be
considered eligible for the study
7. Granulocyte count > 1,500/mm3 and platelet count > 100,000/mm3. Haemoglobin ³
8. SGOT (AST) and SGPT (ALT) < 2,5 x ULN in the absence of liver metastases or up to 5 x
ULN in case of liver metastases
9. Alkaline phosphatase (ALP) < 2,5 x ULN. If alkaline phosphatase is > 2.5 x ULN, SGOT
(AST) and SGPT (ALT) must be < 1.5 x ULN. If alkaline phosphatase is ³ 2.5 x ULN in
the presence of liver metastases, SGOT and SGPT must be < 5 x ULN
10. Serum creatinine <= 1.5 ULN or creatinine clearance > 60 ml/min.
11. Normal serum calcium.
12. For all females of childbearing potential a negative pregnancy test must be obtained
within 48 hours before starting Tarceva/placebo treatment.
13. Patients with reproductive potential must use effective contraception.
14. Able to comply with study and follow-up procedures.
15. Written (signed) Informed Consent to participate in the study.
16. Written (signed) Informed Consent for use of tumour samples.
17. Presence of measurable or evaluable disease (lesions that are present but do not
fulfil the criteria for measurable disease).
18. Formalin-fixed, paraffin-embedded tumour tissue samples representative of the tumour
will be provided to sponsor within 3 weeks of the patient starting chemotherapy
1. Prior exposure to agents directed at the HER axis (e.g. gefitinib, cetuximab,
2. Prior chemotherapy or therapy with systemic anti-neoplastic therapy (e.g., monoclonal
antibody therapy) for advanced disease. Prior surgery and/or localised irradiation is
3. Patients who have undergone complete tumour resection after responding to platinum
4. Any unstable systemic disease (including active infections, significant
cardiovascular disease, [including myocardial infarction within the previous year],
any significant hepatic, renal or metabolic disease) metabolic dysfunction, physical
examination finding, or clinical laboratory finding that contraindicates the use of
study medication(s) or that might affect the interpretation of the results or render
the patient at high risk from treatment complications.
5. Any other malignancies within 5 years (except for adequately treated carcinoma in
situ of the cervix or basal or squamous cell skin cancer).
6. Patients are excluded if they have symptomatic brain metastasis or spinal cord
compression that has not yet been definitively treated with surgery and/or radiation;
patients with CNS metastases with evidence of stable disease (clinically stable
imaging) and stable neurologic function are allowed to enter the study.
7. Patients who are at risk (in the investigator's opinion) of transmitting human
immunodeficiency virus (HIV) through blood or other body fluids are excluded.
8. Any inflammatory changes of the surface of the eye.
9. Patients who cannot take oral medication, who require intravenous alimentation, have
had prior surgical procedures affecting absorption, or have active peptic ulcer
10. Nursing and/or pregnant women.
11. Hypersensitivity to erlotinib (Tarceva) or to docetaxel or to any of the excipients.