Non-Small Cell Lung Cancer Clinical Trial
Official title:
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.
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.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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