The purpose of this study is to select the more promising method of combining cetuximab with gemcitabine for treating patients with advanced non small-cell lung cancer, who are not candidates for platinum based therapy.
The standard treatment for advanced non small cell lung cancer (NSCLC) is combination chemotherapy with cisplatin or carboplatin. Due to its toxicity, this therapy may not be suited for certain patients including the elderly, those whose general condition is poor. Combining chemotherapy with a biologic agent ("targeted therapy") is a new strategy being evaluated for the treatment of NSCLC, and cetuximab is one of the drugs that has shown promise for its activity and tolerability. This study aims to determine the more promising of 2 methods of combining gemcitabine with cetuximab (in combination vs. sequential administration), in two groups of patients who are not candidates for combination platinum based chemotherapy: patients under age 70 with performance status 2 (expected enrollment 42) , and patients over age 70 (expected enrollment 58). Patients will be randomly assigned to one of two treatment arms: * Arm A: Cetuximab + Gemcitabine: * Cetuximab given intravenously weekly AND * Gemcitabine given intravenously for a maximum of 6 cycles (on days 1 and 8 of each 3 week cycle) * Arm B: Gemcitabine followed by Cetuximab: * Gemcitabine given intravenously for a maximum of 6 cycles (on days 1 and 8 of each 3 week cycle) THEN * Cetuximab given intravenously weekly In Arm B, Cetuximab is administered as maintenance therapy when there has been an objective response to chemotherapy, or as second line therapy in patients who had disease progression during chemotherapy
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
100
400 mg/m2 first dose then weekly at 250 mg/m2 until disease progression
1200 mg/m2 days 1 and 8 every 3 weeks for a maximum of 6 cycles
1200 mg/m2 IV days 1 and 8 every 3 weeks for a maximum of 6 cycles
Azienda Sanitaria S. Giuseppe Moscati
Monteforte Irpino, AV, Italy
one year survival rate
Time frame: one year
toxicity
Time frame: weekly
overall survival
Time frame: 18 months
overall response rate
Time frame: one year
prognostic role of cetuximab associated skin toxicities
Time frame: one year
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400 mg/m2 first dose followed by 250 mg/m2 weekly
Ospedale A. Cardarelli
Campobasso, CB, Italy
Università di Chieti
Chieti, CH, Italy
Ospedale Umberto di Frosinone
Frosinone, FR, Italy
Ospedale Villa Scassi
Genova, GE, Italy
Ospedale di Gaeta
Gaeta, LT, Italy
Azienda Ospedaliera Universitaria Policlinico G. Martino
Messina, ME, Italy
Ospedale S. Giuseppe
Milan, MI, Italy
Istituto Scientifico S. Raffaele
Milan, MI, Italy
Ospedale S. Paolo
Milan, MI, Italy
...and 15 more locations