Lung Cancer Clinical Trial
Official title:
A Randomized Phase II Chemoprevention Study of Iloprost Versus Placebo in Patients at High Risk for Lung Cancer
RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent the
development or recurrence of cancer. Iloprost may be effective in preventing lung cancer.
PURPOSE: This randomized phase II trial is studying how well iloprost works in preventing
lung cancer in patients who are at high risk for this disease.
OBJECTIVES:
Primary
- Compare the reversal of premalignant histological changes in the bronchial epithelium of
patients at high risk for lung cancer (defined by > 20 pack years of smoking and sputum
atypia) treated with iloprost vs placebo.
- Determine whether this drug modulates Ki-67 proliferation index (Antigen Ki-67) in these
patients.
- Determine whether this drug affects prostaglandin metabolism in these patients.
- Determine the toxicity profile of this drug in these patients.
Secondary
- Determine whether this drug modulates a panel of biomarkers, including
MCM-2(Minichromosome maintenance protein: forms DNA helicase), EGFR (Epidermal growth
factor receptor: cell surface receptor for the epidermal growth factor family of
proteins. Mutations in EGFR expression or activity can result in cancer.) , HER2/neu
(Human epidermal growth factor receptor 2 HER2 is a member of the EGFR family), RARĪ²
(Retinoic Acic Receptor Beta is a nuclear transcription regulator and a member of the
thyroid-steroid hormone receptor superfamily), p53, FHIT (Fragile histidine triad
protein is an enzyme involved in purine metabolism and had been demonstrated to be a
tumor suppressor), apoptotic index, and microvessel density, in these patients.
- Determine the genes whose expression is altered by this drug in these patients.
OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients
are stratified according to smoking status (current vs former) and participating center.
Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral iloprost twice daily.
- Arm II: Patients receive oral placebo twice daily. In both arms, treatment continues for
6 months in the absence of unacceptable toxicity.
Patients are followed at 1 month and then annually thereafter.
PROJECTED ACCRUAL: A total of 152 patients (76 [38 current smokers and 38 former smokers] per
treatment arm) will be accrued for this study within 2 years.
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