Patient case: 54-year-old female with non-small cell lung cancer; genetic feature: EGFR (D770N)

Clinical trial: To Evaluate the Efficacy and Safety of Gefitinib in Adjuvant Chemotherapy for Lung Adenocarcinoma

Summary: The purpose of this study was to evaluate the efficacy and safety of targeted gefitinib versus oral vinorelbine and carboplatin in EGFR-mutant NSCLC patients.

Detailed description: The purpose of this study was to evaluate the efficacy and safety of targeted gefitinib versus oral vinorelbine and carboplatin in EGFR-mutant NSCLC patients. The purpose is to explore the role of TKI in neoadjuvant therapy, and to further improve disease-free survival (DFS) and pathologic complete remission (pCR) in EGFR-mutant populations; and reduce surgical complications and mortality.
  OBJECTIVES: To evaluate the efficacy of oral gefitinib versus neoadjuvant vinorelbine and carboplatin in operable stage II-IIIA EGFR-mutant non-squamous NSCLC patients, with a 2-year disease-free survival rate. 2yDFS).
  Secondary objective: To evaluate pCR, 0RR, and other efficacy measures (safety, complete) for oral gefitinib vs. neoadjuvant vinorelbine and carboplatin in patients with operable stage II-IIIA EGFR-mutant non-squamous cell carcinoma NSCLC. Resection rate, tumor regression, mediastinal lymph node clearance, perioperative complications, and mortality rate).

Eligibility: Inclusion Criteria:
  1. The pathological diagnosis is non-squamous cell carcinoma and non-small cell lung cancer. The pre-treatment tumor stage is stage II-IIIA;
  2. The gene detects EGFR mutations is positive;
  3. The age is between 18-70 years;
  4. ECOG 0-1;
  5. Liver and kidney function and Bone marrow hematopoiesis is normal;
  6. There are no serious systemic, respiratory, cardiovascular and other important systemic dysfunctions and severe malnutrition;
  7. No other malignant diseases within 5 years;
  8. Patients who have not received radiotherapy, systemic chemotherapy, or biological therapy;
  9. Understand the whole process of the trial and voluntarily participate in and sign the informed consent form.
  Exclusion Criteria:
  1. The tumor has invaded the surrounding tissue;
  2. Preoperative evidence suggests that distant metastases of the lesion include contralateral mediastinal lymph node metastasis;
  3. Arrhythmias require anti-arrhythmia therapy (β-blocker or digoxin Except), symptomatic coronary artery disease or myocardium. Ischemic or congestive heart failure exceeds NYHA class II;
  4. severe hypertension with poor drug control;
  5. moderate to severe proteinuria;
  6. HIV fluHistory of infection or active chronic hepatitis B or C;
  7. Malnutrition, decompensation of organ function;
  8. History of chest radiotherapy;
  9. Incomplete inflammation of eyes;
  10. Patients with seizures that need to be treated;
  11. Interstitial pneumonia;
  12. Drug abuse and others that may interfere with patients' participation in the study or studyThe assessment of the results has an impact;
  13. Allergies to the study drug are known or suspected to be allergic to or administered to any drug associated with this test;
  14. Any instability. The condition of the patient may jeopardize patient safety and compliance;
  15. Pregnancy or breastfeeding women and having fertility without adequate contraception.

Relevance to patient case: possibly relevant