Lung Cancer Clinical Trial
Official title:
A Open-label, One-arm Trial of Gefitinib Combined With Radiotherapy as Adjuvant Therapy in Completely Resected Patients With Pathological Stage IIIA-N2 Non-small Cell Lung Cancer Harbouring Sensitive Mutations of EGFR
To explore the survival benefit of the gefitinib combined with radiotherapy as adjuvant therapy for completely resected patients with Pathological stage IIIA-N2 NSCLC harbouring sensitive mutations of EGFR.
Cisplatin-based adjuvant chemotherapy is standard of care for patients with stage II-IIIA
non-small cell lung cancer (NSCLC). Activating somatic mutations of the tyrosine kinase
domain of epidermal growth factor receptor (EGFR) have been characterized in a subset of
patients with advanced NSCLC. The recently study of gefitinib (G) versus
vinorelbine+cisplatin (VP) as adjuvant treatment in stage II-IIIA (N1-N2) NSCLC with
EGFR-activating mutation (ADJUVANT)shows that G had significantly longer median DFS (28.7
months) than VP (18.0months). 3-year DFS was significantly better with G (34.0% vs 27.0%; p=
0.013) and subgroup analysis of patients treated with G, lymph node status (pN1/N2)
demonstrated significant correlation with DFS.
At present, postoperative radiotherapy has been widely used in the treatment of all kinds of
cancer, and the guidelines also recommend postoperative radiotherapy for stage IIIA-pN2
NSCLC. The retrospective study of Lee et. al. reported on the use of postoperative
radiotherapy (PORT) as first strategy after resection of stage IIIA-pN2 NSCLC. The result
showed that the five-year overall OS was significantly higher in patients treated with PORT
and postoperative chemotherapy (POCT) than in patients treated with PORT alone. This
open-label phase II trial is studying gefitinib combined with radiotherapy to see how well it
works in treating patients who have undergone surgery for Pathological stage IIIA-N2 NSCLC
with EGFR activating mutation.
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