Stage IA Non-small Cell Lung Cancer Clinical Trial
Official title:
Pilot Study Involving Active Surveillance With CT Imaging and Liquid BiOpsies iN Stage IA Lung Cancer (ACTION-Lung)
Cancer patients are often given the choice of delaying or avoiding treatment as one of their options. However, there is not much information guiding lung cancer patients and their clinicians regarding this approach. Active surveillance is a way of either delaying or avoiding treatment and its possible side effects through carefully watching for changes in the tumor and considering treatment if there is progression. The purpose of this research study is to evaluate active surveillance and ways to better understand if and when to treat patients with stage IA lung cancer.
The University of Vermont Medical Center is looking at determining if active surveillance is
a viable option for low risk lung cancer patients. Currently, the National Cancer Care
Network (NCCN) guidelines recommends considering stereotactic ablative radiotherapy (SABR)
for patients not well enough for surgery, which is generally well tolerated, but it's also
been shown to cause significant worsening of shortness of breath, fatigue, chest pain, and in
extreme cases, death. Investigators are using this pilot study as a means to determine
outcomes for patients who choose an active surveillance approach. This information could
change future conversations between doctor and patient regarding treatment options, giving
patients the choice to choose radiation therapy or to delay treatment by taking an active
surveillance approach.
Investigators have published outcomes for 12 elderly patients with stage IA lung cancer who
had chosen the active surveillance approach, reserving radiation therapy for when rapid tumor
growth was determined (PMID 30648024). The clinical outcomes were similar to those expected
if treatment had been provided, and at two years from the time the tumor was found almost
half the patients were able to avoid getting radiation.
By deciding to participate in this study, patients are agreeing to postpone their treatment
for an active surveillance approach while continuing with a computed tomography (CT) scan
regimen to follow tumor growth. Once their tumor size is determined there are parameters in
place to decide when patients should consider radiation. These parameters are based on speed
of tumor growth over time and tumor size.
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