Table 1. Timeline of clinical trials evaluating the efficacy of EGFR TKIs in an unselected or EGFR-wt NSCLC population.
Trial title | Author(s) | Year | Trial phase | Treatment | Disease line and population | PFS (months) |
---|---|---|---|---|---|---|
ISEL | Thatcher et al. | 2005 | III | Gefitinib vs. placebo | Second; third-line chemotherapy refractory*; prior platinum mandatory; EGFR unselected | 5.6 (g) vs. 5.1 (p); P=0.087 |
BR.21 | Shepherd et al. | 2005 | III | Erlotinib vs. placebo | Second; third-line, prior combination chemotherapy and not eligible for further chemotherapy; EGFR unselected (EGFR expression testing optional) | 2.2 (e) vs. 1.8 (p); P<0.001 |
ISTANA | Lee et al. | 2008 | III | Gefitinib vs. docetaxel | Second-line, platinum refractory or recurrence and candidate for further chemotherapy; EGFR unselected | 3.4 (d) vs. 3.3 (g); P=0.0134 |
V-15-32 | Maruyama et al. | 2008 | III | Gefitinib vs. docetaxel | Second; third-line, chemotherapy failure including platinum; EGFR unselected | 2.0 (d) vs. 2.0 (g); P=0.335 |
INTEREST | Kim et al. | 2008 | III | Gefitinib vs. docetaxel | Second-line platinum refractory and non-refractory; EGFR unselected (EGFR copy number gain sub-group reported) | 2.7 (d) vs. 2.2 (g); P=0.47 |
IPASS | Mok et al. | 2008 | III | Gefitinib vs. platinum-doublet chemotherapy | First line, EGFR-wt sub-group (EGFR mutated and unknown population also reported) | Not reported as absolute number, approx. 2 mo (g); significantly in favour of chemotherapy (HR =2.85; 95% CI, 2.05–3.98, P<0.001) |
SATURN | Capuzzo et al. | 2010 | III | Erlotinib vs. placebo | Maintenance post first-line platinum chemotherapy; EGFR-unselected (EGFR testing mandatory with missing data) | 2.9 (e) vs. 2.6 (p); P<0.0001 |
CTONG0806 | Zhou et al. | 2011 | II | Gefitinib vs. pemetrexed | Second-line, platinum pre-treated; EGFR-wt | 4.8 (p) vs. 1.6 (g); P<0.001 |
IFCT-GFPC | Pérol et al. | 2012 | III | Erlotinib or gemcitabine vs. observation | Maintenance post first-line platinum chemotherapy; EGFR-unselected (also included EGFR mutations) | 3.8 (g) vs. 2.9 (e) vs. 1.9 (o); P=0.3867 |
TITAN | Ciuleanu et al. | 2012 | III | Erlotinib vs. docetaxel | Second-line; disease progression on platinum doublet chemotherapy* shared first line chemotherapy run-in phase with SATURN; EGFR-wt | 2.0 (d) vs. 1.5 (e); P=0.089 |
TORCH | Gridelli et al. | 2012 | III | Erlotinib then second-line chemotherapy vs. chemotherapy then second-line erlotinib | First (and second-line), switch therapy; EGFR-wt and mutated | 5.4 (c) vs. 2.2 (e) (P value not reported) |
TAILOR | Garassino et al. | 2013 | III | Erlotinib vs. docetaxel | Second-line; recurrence or progression after failing platinum chemotherapy; EGFR-wt | 2.9 (d) vs. 2.4 (e); P=0.02 |
DELTA | Kawaguchi et al. | 2014 | III | Erlotinib vs. docetaxel | Second; third-line; post chemotherapy (including platinum); EGFR-wt | 3.2 (d) vs. 2.0 (e); P=0.09 |
HORG | Karampeazis et al. | 2013 | III | Erlotinib vs. pemetrexed | Second; third-line; disease progression after chemotherapy (platinum not mandatory in ≥65 years); EGFR unselected [subgroup (n=11/123) with EGFR mutation reported on] | 3.6 (e) vs. 2.9 (p); P=0.136 |
LUX-Lung 8 | Soria et al. | 2015 | III | Afatinib vs. erlotinib | Second-line; squamous histology, progression after prior platinum chemotherapy; EGFR unselected | 2.4 (a) vs. 1.9 (e); P=0.043 |
IUNO | Cicènas et al. | 2016 | III | Maintenance erlotinib vs. placebo and late erlotinib at disease progression in placebo arm | Second-line; prior platinum chemotherapy without progression; EGFR-wt | Maintenance-3 (e) vs. 2.9 (p); P=0.48; |
‘Early’ vs. ‘Late’ erlotinib; P=0.4759 |
*, refractory defined as recurrent or progressive disease within 90 days of the last chemotherapy dose; PFS, progression free survival. g, gefitinib; p, placebo; e, erlotinib; d, docetaxel; o, observation; c, chemotherapy; a, afatinib.