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Customizing First Line Chemotherapy in Advanced Non-Small Cell Lung Cancer (Customizing)

19 januari 2014 uppdaterad av: National Guard Health Affairs

A Pilot Study of Customizing First Line Chemotherapy in Advanced Non-Small Cell Lung Cancer Based on Molecular Markers

The study aims at piloting the concept of customization of chemotherapy based on molecular markers in patients with stage IIIB (with pleural effusion) and IV with performance status ≤ 2 with pathologically proven non-small cell lung cancer (NSCLC). The study will not test or compare individual regimen but rather it will test the approach of customization concept as a whole.

The results of this pilot study will help in designing more definitive trials in our patient population.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

The treatment of advanced NSCLC cancer includes various chemotherapies with equivalent regimens that have reached a therapeutic plateau. The selection of these regimens is completely empirical and physician dependent. Potential predictors of specific agent efficacy exist in the form of tumor molecular markers that are a reflection of the individual's genetic make up. Thus our study aims at utilizing these markers to more efficiently select the regimen in order to maximize the benefit to the patients rather than using empiric approaches. Fortunately, each of our selected regimens contains active and well-studied agents in the treatment of lung cancer (Table 1). This pilot study will help us determine the benefit, and safety of this approach (not individual regimen). The study is not to compare individual regimens but it aims at testing the whole concept of customization of chemotherapy based on molecular markers to help us in the future at selecting regimens based on these markers and not empirically. The results then will be used to determine more definitive future studies.

Furthermore, circulating tumor cells in the blood represent the future distant metastases that result in disease progression to incurable stages. The circulating tumor cells have the ability to cross into vessels, travel in circulation, and exit the vessels into tissues where they have the capability to grow. Therefore, these cells may express different biological and molecular features from the stationary cells in the primary tumors. Therefore, exploiting these circulating tumor cells for augmenting treatment approaches is of vital importance and utility.

Studietyp

Interventionell

Inskrivning (Faktisk)

3

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Saudiarabien
      • Riyadh, Saudiarabien
        • King Abdul Aziz Medical City for National Guard Health Affairs

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. Microscopic diagnosis of NSCLC stages IIIB (with malignant pleural effusion) and IV
  2. Having adequate tissue sample to perform the markers testing
  3. Age ≥ 18 years
  4. No prior chemotherapy treatment for lung cancer (Surgery and radiotherapy are acceptable)
  5. No other concurrent cancer treatment
  6. Performance status of 0- 2 per ECOG scale (Appendix II)

  7. Adequate laboratory values as follows as follows:

    Absolute neutrophil count ≥ 1500/mm3 Platelet count ≥100, 000/ mm3 Total bilirubin ≤ 1.25X institutional upper normal level AST and ALT ≤ 3 X institutional upper normal level Serum creatinine ≤ 1.5 X institutional upper normal level

  8. Presence of measurable disease

Exclusion Criteria:

  1. Prior systemic treatment for lung cancer
  2. History of hypersensitivity to drugs used
  3. Diagnosis of other malignancy in the last 5 years excluding curatively treated non-melanoma skin cancer and in-situ cervical cancer
  4. Medical illness that puts the patient at significant risk per investigator's discretion
  5. Uncontrolled CNS disease. Patients with CNS metastatic disease treated with radiotherapy or surgery will be eligible if the CNS disease is stable 4 weeks after the treatment initiation without increase dose of steroids
  6. Positive pregnancy test or refusal to use contraception during treatment. (Gynecology consultant for contraception)

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Cisplatin,Docetaxel,Gemzar, Premetrexed
Patients will receive treatment for up to six cycles of the assigned regimen unless there is disease progression or unacceptable toxicities. After treatment, the patients will be seen every 2 months for the first year, then every 3 months for the second year and every 6 months afterwards.
Läkemedel: Cisplatin, Gemzar, Docetaxel, Alimta
Patients will be assigned to treatment according to the molecular biological results which will analyze excision repair cross-complementing (ERCC1), ribonucleotide reductase subunit M1 (RRM1) and beta-tubulin genes in primary tumor cells which are present in tissues and peripheral blood.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Efficacy and Safety
Tidsram: 3 years

  1. Efficacy is measured by:

    • overall response rate (partial response and complete response) using RECIST Criteria
    • time to disease progression (TTP)
    • progression free survival (PFS)
    • overall survival (OS)

  2. To evaluate the Number of participants with Adverse Events and Serious Adverse Events.Safety will include 5 parameters to be collected for all patients who receive the study regimen which are:

    • Adverse Events
    • Laboratory Assessments
    • Vital Signs
    • Physical Examinations
    • ECG
3 years

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Tumor marker
Tidsram: 3 years
  1. The molecular characteristics of circulating tumor cells harvested from peripheral blood
  2. Correlation between the markers of circulating tumor cells and primary tumor.
3 years

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

National Guard Health Affairs

Utredare

  • Huvudutredare: Abdulrahman Jazieh, MD/MPH, King Abdul Aziz Medical City for National Guard

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 maj 2010

Primärt slutförande (Faktisk)

1 maj 2013

Avslutad studie (Faktisk)

1 maj 2013

Studieregistreringsdatum

Först inskickad

19 mars 2011

Först inskickad som uppfyllde QC-kriterierna

18 maj 2011

Första postat (Uppskatta)

19 maj 2011

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

22 januari 2014

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

19 januari 2014

Senast verifierad

1 januari 2014

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • RC09/095

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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