Stage IB Non-Small Cell Lung Carcinoma Clinical Trial
Official title:
Randomized Phase II Trial of Adjuvant Combined Epigenetic Therapy With 5-Azacitidine and Entinostat in Resected Stage I Non-small Cell Lung Cancer Versus Standard Care
This study combines the deoxyribonucleic acid (DNA) methyltransferase inhibitor, 5-azacitidine (5-AZA), with an orally bioavailable histone deacetylase inhibitor, entinostat (SNDX-275), for the adjuvant treatment of patients with resected stage I non-small cell lung cancer (NCSLC).
PRIMARY OBJECTIVES:
I. To assess the effect of 5-azacitidine and entinostat on the hazard of 3 year
progression-free survival in patients with resected stage I non-small cell lung cancer.
SECONDARY OBJECTIVES:
I. To assess the safety, tolerability and toxicity of entinostat and 5-azacitidine in
patients with resected stage I non-small cell lung cancer.
II. To explore the effect of entinostat and 5-azacitidine on median disease-free and overall
survival in patients with resected stage I non-small cell lung cancer.
III. To assess the pharmacodynamic effects of 5-azacitidine and entinostat on DNA methylation
and gene re-expression in patients with resected stage I NSCLC through analysis of sputum.
IV. To estimate the effect of entinostat and 5-azacitidine on progression free survival
comparing patients with N2 lymph nodes categorized as methylated pre-treatment with those who
are categorized as unmethylated.
V. To establish factors that predict clinical outcome in patients treated with combination
epigenetic therapy by performing genome-wide analyses on pre-treatment tumor DNA.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients receive azacitidine subcutaneously (SC) on days 1-5 and 8-10 and entinostat
orally (PO) once daily (QD) on days 3 and 10. Treatment repeats every 28 days for up to 6
courses in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive standard of care.
After completion of study treatment, patients are followed up every 3 months for 2 years and
then every 6 months for 3 years.
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