Phase II Trial of Erlotinib and Concurrent Palliative Thoracic Radiation Therapy for Non-small Cell Lung Cancer (PEARL)

Inclusion Criteria: * Histologically confirmed non-small cell lung cancer (squamous cell, adenocarcinoma, poorly differentiated non-small cell carcinoma, or some combination of these); and * Symptomatic patients (defined at discretion of investigator) for whom palliative thoracic radiation is planned (3000cGy/10 fractions); and * At least 18 years of age. Exclusion Criteria: * Previous erlotinib therapy; or * Planned concurrent chemotherapy; or * Expected survival of less than 3 months; or * ECOG Performance Status of 3 or 4; or * Multiple CNS metastasis or a single CNS lesion that has not demonstrated radiologic stability (screening CT/MRI or head not required); or * Granulocyte count \<1,500/mm3, platelet count \<100,000/mm3, or haemoglobin \<9.0g/dl; or * SGOT (AST) or SGPT (ALT) \> 2.5 times (x) upper limit of normal (ULN) in the absence of known liver metastases or \> 5 x ULN in case of known liver metastases; or * Alkaline phosphatase (ALP) \> 2.5 x ULN; or * Serum bilirubin \> 1.5 ULN; or * Serum creatinine \> 1.5 ULN or creatinine clearance \< 60 ml/min; or * Serum calcium beyond ULN; or * Patients requiring systemic anti-fungal therapy, clarithromycin, phenytoin, or oral anticoagulation therapy (see Appendix VI for complete list of medications); or * A history of interstitial lung disease; or * Known sensitivity to erlotinib; or * Pregnancy, lactation, or parturition within the previous 30 days; or * Unwillingness or inability to complete the required assessments of the trial; or * Mental incompetence, including psychiatric or addictive disorders which would preclude meaningful informed consent; or * History of recurrent conjunctivitis or keratitis or other inflammatory changes of the surface of the eye. * Geographically inaccessible for treatment or follow-up evaluations; or * Involved in an ongoing therapeutic trial.