A Randomized, Open-label, Multi-center Phase III Study of Erlotinib Versus Gemcitabine/Carboplatin in Chemo-naive Stage IIIB/IV Non-Small Cell Lung Cancer Patients With EGFR Exon 19 or 21 Mutation (Optimal)
1. Stage IIIB (cytological confirmed with malignant pleural effusion or pericardial
effusion) or histopathological or cytological confirmed stage IV NSCLC or relapsed
after complete resection .
2. EGFR exon19 deletions or exon 21 L858R mutation by the DNA direct PCR sequencing
using fresh tumor sample or paraffin embed tumor sample.
3. Measurable lesions as defined by RECIST criteria .
4. Palliative radiotherapy allowed if it was finished 3 weeks after the first drug
administration, but the target lesions should not be included in the radiotherapy
5. Patients with operation are allowed if the operation is 4 weeks before the first drug
6. Men or women of at least 18 years of age.
7. ECOG Performance status of 0 to 2.
8. Estimated life expectancy of at least 12 weeks.
9. Patient compliance and geographic proximity that allow adequate follow-up.
10. Adequate organ function tested 7 days before the first drug administration:
hemoglobin ≥9 g/dL,absolute neutrophil count (ANC) ≥1.5*109/L, platelets ≥100
*109/L,bilirubin ≤1.5ULN, alkaline phosphatase (AP), aspartate transaminase (AST) and
alanine transaminase (ALT) ≤2.5 upper limited number(ULN) (AP, AST, ALT ≤5ULN is
acceptable if liver has tumor involvement).INR≤1.5, APTT in the normal range(
11. Informed consent from the patient.
1. Have received systemic anti-cancer therapy, including Cytotoxic drugs, targeted
therapy, experimental treatment, adjuvant or neo-adjuvant therapy(except the disease
relapse 6 months after the final drug)
2. Wild type EGFR.
3. Uncontrolled pericardial or pleural effusions prior to study entry.
4. History of cardiovascular disease: Congestive Heart Failure > grade II in NYHA.
Unstable angina patients (have angina symptoms in rest) or a new occurrence of angina
(began in the last 3 months) or myocardial infarction happens in the last 6 months
5. Brain metastasis (controlled brain metastasis and steroid free need is excluded).
6. HIV infection
7. Active infection, >grade 2 in Common Terminology Criteria for Adverse Events(CTCAE)
8. A history of operation or serious traumatic 3 weeks before the first drug
9. Patient with other malignant tumor except NSCLC 5 years previous to study entry.
Excluding cervical carcinoma in situ, cured basal cell carcinoma, bladder epithelial
tumor [including Ta and Tis]
10. Mixed with small cell lung cancer
11. Unable to swallow drugs.
13. Pregnant or child breast feeding women
14. Childbearing patients will not use a reliable method of contraception before the
study entry, during process of the study and within 30 days after discontinuation of
the study. Reliable contraceptive methods will be determined by principal
investigator or a designated officer.