Non Small Cell Lung Cancer Clinical Trial
Official title:
Impact of Bevacizumab Versus Docetaxel/Erlotinib on Tumor Metrics in Patients With Previously Untreated Advanced Non Small Cell Lung Cancer: A Study by the Hellenic Co-operative Oncology Group
To determine the more effective dosing sequence of intermittent erlotinib and docetaxel for treating patients with the diagnosis of advanced Non-Small-Lung-Cancer.
In 2008, the Hellenic Co-operative Oncology group (HeCOG) initiated a randomized phase II
study to determine the comparative efficacy of intermittent docetaxel/erlotinib chemotherapy,
with erlotinib given for twelve consecutive days either before (group A) or after (group B)
docetaxel, in chemotherapy-naive patients with advanced non small cell lung cancer. Docetaxel
chemotherapy was considered one of the valid non-platinum containing therapeutic options at
that time and today represents one of the approved second-line treatment options after
failure of first-line platinum based chemotherapy. The trial was terminated early due to slow
accrual after enrollment of 51 patients and was published in 2014, showing no clinically
meaningful difference between the two treatment arms.
Based on the aforementioned trial population,a parallel radiological study was conducted,
evaluating sequential tumor metrics on computed tomography performed at baseline and after
each cycle of treatment in patients receiving either bevacizumab or docetaxel/erlotinib.
Given the differential mechanism of action of these agents, it was hypothesized that the
different parameters of radiological tumor response evaluation, namely the maximum diameter,
tumor volume and tumor density, would respond differently for each therapeutic category (a
chemotherapeutic agent, a molecular agent and and an anti-angiogenic agent). For bevacizumab,
in particular, it was hypothesized that its unique mechanism of action, inducing central
tumor necrosis and subsequent shrinkage, would lead to completely different tumor metrics as
compared to the other two agents. Herein the final results of this analysis are presented,
showing the comparison of the three agents in terms of tumor response metrics, as evaluated
in CT scans performed at baseline and after each cycle of treatment
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