Table 2. Selected trials of radio(chemo)therapy combined with EGFR tyrosine kinase inhibitors in NSCLC.
| Therapy | Trial ID, ref. | Phase | No pts/stage | Induction | Concurrent | Consolidation/maintenance | RT | Median OS (months) | Toxicity |
|---|---|---|---|---|---|---|---|---|---|
| G | CRITICAL, Ball et al., (43) | I | 28 | – | Car/Pac + G | +/− surgery | 60 Gy/3 0fx | Not reached, 2Y OS 60% | No DLTs |
| G | Center et al., (44) | I | 16 | – | Do c + G | Doc | 70 Gy/35 fx Elective nodal irradiation 40 Gy | 21 | G3/4 hematologic 27%, G3/4 esophagitis 27%, G3-5 pulmonary toxicity 20% |
| G | Stinchcombe et al., (45) | I | 23 | Car + Irinotecan + Pac + Pegfilgrastim | Car/Pac + G | – | 74 Gy/37 fx | 16 | G3 esophagitis 19.5%, G3 cardiac arrhythmia 9.5%, anterior spinal cord syndrome 1 patient |
| G | Kelly et al., (46) | III | +/− G | Eto +/− Cis/ | Doc | 61 Gy/33 fx | G arm: 23 | G3/4 pneumonitis 3%, G3 diarrhea 7%, G3 rash 7% | |
| No G arm: 35 | G3/4 neutropenia 43%, G≥3 esophagitis 13% | ||||||||
| G | Ready et al., (47) | II | Stratum 1: poor risk: 21 | Car/Pac | G | G | 66 Gy/33 fx | 19 | Stratum 1: G≥3 esophagitis 19%, pneumonitis 15%, diarrhea 10% |
| Stratum 2: good risk: 39 | Car/Pac/irinotecan | Car/Pac + G | G | Elective nodal irradiation 44 Gy | 13 | Stratum 2: G≥3 esophagitis 31%, diarrhea 18%, pneumonitis 16%, no increased acute radiation-induced toxicity | |||
| E | Choong et al., (51) | I | Arm A: 17 | – | Cis/Eto + E | Doc | 66 Gy/33 fx, ENI 44 Gy | Arm A: 10.2 | Arm A: G3/4 neutropenia 8 pts, esophagitis 3 pts, diarrhea 2 pts, pneumonitis 1 pt |
| Arm B: 17 | Car/Pac | Ca/Pac + E | – | Arm B: 13.7 | Arm B: G3/4, esophagitis 6 pts, neutropenia 3 pts | ||||
| E | Wang et al., (52) | II | G:19, E:7 | – | G, E | G, E | Median 70 y | 21.8 | G3: acne-like rash 8%, esophagitis 4%, pneumonitis 4%, diarrhea 4% |
| G4: symptomatic pulmonary fibrosis 14%, neutropenia 4% | |||||||||
| E | Martinez et al., (54) | II | Arm A: 10 | – | Arm A: No E | Arm A: No E | 66 Gy/33 fx | Not reached | Arm A: G3: pneumonitis 1 pt |
| Arm B: 13 | – | Arm B: E | Arm B: E | Arm B: G3 radiodermatitis 1 pt | |||||
| E | Komaki et al., (55) | II | 48 | – | Pac/Car + E (daily, except days of chemotherapy) | Pac | 63 Gy/35 fx | 25.8 | G3: acne 2 pts, esophagitis 1 pt, pneumonitis 3 pts |
ref, reference; RT, radiotherapy; OS, overall survival; DLT, dose limiting toxicity; gefitinib, G; Erlotinib, E; Paclitaxel, Pac; Docetaxel, Doc; Car, Carboplatin; Eto, Etoposide; ENI, elective nodal irradiation; pt, patient.