RATIONALE: Gefitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy, such as gemcitabine and cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells. Giving gefitinib as first-line therapy followed by gemcitabine and cisplatin after disease progression may be an effective treatment for non-small cell lung cancer. PURPOSE: This phase II trial is studying how well gefitinib works as first-line therapy followed by gemcitabine and cisplatin in treating patients with stage III or stage IV non-small cell lung cancer.
OBJECTIVES: Primary * Determine the efficacy of gefitinib as first-line therapy, in terms of response rate (complete and partial response) or stability of disease, in patients with de novo or recurrent stage IIIB or IV non-small cell lung cancer. Secondary * Determine the safety of this drug in these patients. * Determine the efficacy of gemcitabine combined with cisplatin when administered after first-line gefitinib in these patients. * Determine quality of life of patients treated with this regimen. OUTLINE: This is an open-label, multicenter study. Patients receive oral gefitinib once daily until disease progression or unacceptable toxicity. Within 3 weeks after documented disease progression, patients receive gemcitabine IV over 30 minutes on days 1 and 8 followed by cisplatin IV over 1 hour on day 1. Treatment repeats every 21 days for 6 courses in the absence of disease progression or unacceptable toxicity. Quality of life is assessed at baseline, weeks 3, 6, 12, 18, and then every 12 weeks thereafter during gefitinib treatment. During chemotherapy, quality of life is assessed 1 week prior to starting chemotherapy treatment, day 1 of courses 3 and 5, and then every 12 weeks until disease progression. After completion of study therapy, patients are followed every 3 months. PROJECTED ACCRUAL: 'A total of 24-63 patients will be accrued for this study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
63
Saint Claraspital AG
Basel, Switzerland
Universitaetsspital-Basel
Basel, Switzerland
Inselspital Bern
Bern, Switzerland
Kantonsspital Bruderholz
Bruderholz, Switzerland
Spitaeler Chur AG
Chur, Switzerland
Hopital Cantonal Universitaire de Geneve
Geneva, Switzerland
Centre Hospitalier Universitaire Vaudois
Lausanne, Switzerland
Kantonsspital
Liestal, Switzerland
Kantonsspital - St. Gallen
Sankt Gallen, Switzerland
Regionalspital
Thun, Switzerland
...and 4 more locations
Disease stabilization (complete response [CR], partial response [PR], or stable disease [SD]) after 12 weeks of study treatment
Disease stabilization (CR, PR, or SD) after 6 and 18 weeks of study treatment
Objective response (CR and PR) to gefitinib treatment after weeks 6, 12, and 18
Adverse reactions to gefitinib treatment measured after completion of study treatment
Time to progression (TTP) with gefitinib treatment after completion of study treatment
Event-free survival (EFS) with gefitinib treatment after completion of study treatment
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