Stage IV Non-small Cell Lung Cancer Clinical Trial
Official title:
Phase II/Pharmacodynamic Study of the γ-secretase Inhibitor RO4929097 in Patients Who Have Recently Completed Front-Line Chemotherapy for Advanced Non-small Cell Lung Cancer
This phase II trial is studying how well RO4929097 works in treating patients with advanced non-small cell lung cancer who have recently completed treatment with front-line chemotherapy. RO4929097 may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
PRIMARY OBJECTIVES:
I. To assess clinical activity of the gamma-secretase inhibitor RO4929097 in patients with
non-small cell lung cancer (NSCLC) who have recently completed front-line chemotherapy for
advanced disease.
II. To assess whether percent change in tumor size 6 weeks after initiation of RO4929097
correlates with tumor expression of Notch pathway markers and stem cell markers and/or with
host genotype polymorphisms for selected components of the Notch pathway.
SECONDARY OBJECTIVES:
I. To assess whether response by RECIST criteria and TTF correlate with tumor expression of
Notch pathway markers and stem cell markers and/or with host genotype polymorphisms for
selected components of the Notch pathway.
II. To compare tumor expression of Notch pathway and stem cell markers in this patient
population with expression of these markers in tumors from our tumor bank from chemo-naive
NSCLC patient.
III. To correlate expression of Notch pathway markers with expression of stem cell markers.
IV. To correlate host genotype polymorphisms for selected components of the Notch pathway
and other stem cell pathways with tumor expression of Notch pathway and stem cell markers.
V. To correlate the presence of tumor EGFR activating mutations with: a) notch expression,
b) stem cell marker expression, and c) response to RO4929097.
VI. To assess change in expression of Notch pathway markers and stem cell markers over the 3
days of therapy in a subset of patients and to correlate this with: a) subsequent response
to therapy and TTF, b) changes of each marker over the first 3 days of therapy with changes
in the other markers of interest and with changes in level of tumor cell apoptosis by TUNEL
assay.
VII. For patients in whom pre chemotherapy tissue can be obtained, we will compare the post
chemotherapy (pre RO4929097) expression of Notch pathway and stem cell markers to those
observed in the pre chemotherapy tissue.
OUTLINE:
Patients receive oral gamma-secretase inhibitor RO4929097 once daily on days 1-3, 8-10, and
15-17. Courses repeat every 21 days in the absence of disease progression or unacceptable
toxicity.
Blood and tumor tissue samples are collected for pharmacogenetic, pharmacodynamic, and
biomarker studies by IHC, FISH, and TUNEL assay.
After completion of study therapy, patients are followed up periodically.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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