1. Title and stage of study A Phase II Study to Assess Efficacy of Combined Treatment with Erlotinib (Tarceva) and Silybin-phytosome (Siliphos) in Patients with EGFR mutant lung adenocarcinoma 2. Endpoints Primary Endpoint : tumour response rate Secondary Endpoint : progression-free survival, overall survival, and safety assessment 3. Study Rationale Even though it is commonly accepted that EGFR TKIs are effective to EGFR mutation positive lung cancer patients, still remains its resistance issue. The Silybin which is extract from mugwort bean Thistle and used for hepatoprotective drug for a long time with very low adverse events in Eastern countries. Recently, there are some reports regarding its anti-cancer effects through several preclinical studies. The safety of Siliphos which is developed agent from silybin for improving intestinal absorption was demonstrated in Phaseâ… trial. Recently investigators found out Silybin is effective for blocking EGFR signal in different mechanism from Erlotinib and it can be expected additional impact with combination therapy with preclinical data. Our research team can expect to improve Lung cancer treatment if the combination therapy (Silybin_Erlotinib) improves patients' response and Overall survivor. 4. Treatment method Erlotinib (Tarceva 150 mg/day) and Silybin (Siliphos 1g bid/day) q 4 weeks 5. Assessment criteria For toxicity assessment, posttreatment recurrence and survival rates will be investigated based on NCI-CTCAE ver 4.0 and RTOG. Efficacy assessment will be conducted through measurement of lesions by CT and RECIST criteria. Overall survival (OS), progression-free survival (PFS), and time to tumour progression (TTP) will be estimated using a Kaplan-Meier analysis. In addition, effect of pre-treatment T790M on response and PFS will be analyzed.
Name: Erlotinib
Description: Erlotinib 150 mg/day q 4 weeksType: DrugErlotinib and Silibin
Name: Silybin-phytosome
Description: Silybin-phytosome 1g bid/day q 4 weeksType: Dietary SupplementErlotinib and Silibin
Description: Efficacy assessment will be conducted through measurement of lesions by CT and RECIST criteria.
Measure: Tumour response rate Time: 12 monthsDescription: For toxicity assessment, posttreatment recurrence and survival rates will be investigated based on NCI-CTCAE ver 4.0 and RTOG.
Measure: Safety assessment Time: 12 monthsSingle Group Assignment
There is one SNP
In addition, effect of pre-treatment T790M on response and PFS will be analyzed. --- T790M ---
In addition, effect of pre-treatment T790M on response and PFS will be analyzed. --- T790M ---