Stage IV Non-small Cell Lung Cancer Clinical Trial
Official title:
A Pilot Trial of Platinum, Gemcitabine, or Pemetrexed Single- or Multi-Agent Therapy With Serial Tumor Specimen Collection in Patients With Advanced Non-Small-Cell Lung Cancer
This pilot clinical trial studies whether the levels of certain genes in the tissue and blood are related to how well patients with stage IV non-small cell lung cancer respond to chemotherapy. Genes may affect how sensitive or resistant tumors are to chemotherapy. Studying the levels of genes related to tumor response before and after chemotherapy may help doctors learn whether they can predict how well patients will respond to treatment.
PRIMARY OBJECTIVES:
I. To describe the association between baseline gene expression levels at the protein and
messenger ribonucleic acid (mRNA) level and best treatment response after two cycles of
single-agent or multi-agent chemotherapy
SECONDARY OBJECTIVES:
I. To describe changes in protein and mRNA levels of ribonucleotide reductase M1 (RRM1),
thymidylate synthetase (TS), and excision repair cross-complementing rodent repair
deficiency, complementation group 1 (ERCC1) in serial biopsies obtained from patients being
treated with gemcitabine (gemcitabine hydrochloride), pemetrexed (pemetrexed disodium), and
platinum.
II. To describe the association between changes in marker levels and changes in tumor
diameters.
TERTIARY OBJECTIVES:
I. To explore the relationship between marker levels in circulating tumor cells and solid
tumor specimens.
II. To explore the relationship between marker levels in viable peripheral blood mononuclear
cells (PBMCs), circulating tumor cells, and tumor specimens.
III. Should sufficient amounts and numbers of tumor specimens remain after these analyses,
they will be used to assess if other genes implicated in non-small cell lung cancer (NSCLC)
outcome and response to treatment might be useful as prognostic or predictive markers for
patient outcome.
OUTLINE:
Patients receive 1 of 3 chemotherapy regimens at the discretion of the primary oncologist,
including docetaxel intravenously (IV) on day 1, pemetrexed disodium IV on day 1, or
gemcitabine hydrochloride IV on days 1 and 8. Treatment repeats every 3 weeks for 2 courses
in the absence of disease progression or unacceptable toxicity. After course 2, patients may
continue treatment off-study at the discretion of the treating physician.
After completion of study treatment, patients are followed up for 12 months.
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