Rash Clinical Trial
Official title:
A Randomized Controlled Trial of Systemic and Topical Treatments for Rash Secondary to Erlotinib in Advanced Stage IIIB or IV Non-Small Cell Lung Cancer
The purpose of this trial is to determine if rash caused by erlotinib can be successfully
treated and if so to determine the optimal treatment approach.
Hypothesis:
Hypothesis 1: If the incidence of rash is 50% while on erlotinib, prophylactic monotherapy
with minocycline can prevent occurrence in 50% of these patients.
Hypothesis 2: Treatment of rash is successful in improving rash by at least one Grade in 80%
of patients.
Hypothesis 3: In patients with untreated rash, the rash will be self-limiting in 25% of
patients, and 65% will be grade 1, 2A, and 2b. Ten percent will be grade 3 requiring
treatment with monotherapy intervention.
Erlotinib has been shown to prolong survival in NSCLC patients who are no longer candidates
for further chemotherapy. In July 2005, erlotinib was approved in Canada for the treatment
of patients with locally advanced or metastatic NSCLC, following failure of first or
second-line chemotherapy.
Erlotinib's side effect profile includes rash. The incidence of rash in clinical trials has
been reported to be approximately 50 - 75%, and has been hypothesised to parallel tumour
response (20).
The treatment of rash is controversial and many oncologists believe it is untreatable and
self-limiting. The cause of the rash is not well understood but is felt to be a systemic
event. Clinical experience of the investigators has suggested that minocycline 100 mg orally
given twice-daily for 4 weeks and clindamycin 2% and hydrocortisone 1% topical cream for
moderate to severe rash is a successful treatment.
The objectives of this trial are to better delineate the rash and its features and to
describe an optimal treatment. Since the rash is often facial in distribution and can
therefore lead to physical and psychological distress to the patient, a dermatology life
quality index will also be completed throughout the study.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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