Individualized Therapy Based of Tumoral mRNA Levels of ERCC1, RRM1 and BRCA1 in Advanced Non-Small-Cell Lung Cancer

This study has been terminated.
(Due to poor accrual)
Sponsor:
Collaborator:
University Hospital of Crete
Information provided by (Responsible Party):
Hellenic Oncology Research Group
ClinicalTrials.gov Identifier:
NCT00705549
First received: June 25, 2008
Last updated: February 12, 2013
Last verified: February 2013

June 25, 2008
February 12, 2013
February 2008
September 2011   (final data collection date for primary outcome measure)
Objective Response Rate (ORR) based on the pharmacogenomic profile of the ERCC1, RRM1 and BRCA1 expression [ Time Frame: Objective responses confirmed by CT or MRI ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT00705549 on ClinicalTrials.gov Archive Site
  • Determine the incidence of the different pharmacogenomic profiles as defined by the combined expression of ERCC1, RRM1 and BCRA1 [ Time Frame: Comparison of molecular determinants for response in the primary tumor and peripheral blood (ERCC1 polymorphism ,TXR1 and TSP1 mRNA expression by Q-RT-PCR, Molecular markers related to responsiveness to Alimta ) ] [ Designated as safety issue: No ]
  • Time to Tumor Progression [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Overall Survival [ Time Frame: 1 year ] [ Designated as safety issue: No ]
  • Toxicity [ Time Frame: Toxicity assessment on each chemotherapy cycles ] [ Designated as safety issue: Yes ]
Same as current
Not Provided
Not Provided
 
Individualized Therapy Based of Tumoral mRNA Levels of ERCC1, RRM1 and BRCA1 in Advanced Non-Small-Cell Lung Cancer
Feasibility and Efficacy of Molecular Analysis-Directed Individualized Therapy Based of Tumoral mRNA Levels of ERCC1, RRM1 and BRCA1 in Advanced Non-Small-Cell Lung Cancer

This is a prospective pilot phase II trial, in patients with wet stage IIIb and IV NSCLC using chemotherapy regimens which will be defined according to the pharmacogenomic profile (tumoral expression of ERCC1, BRCA1 and RRM1) of the tumor cells.

Advanced stage NSCLC is essentially a fatal disease and treatment is mainly palliative. Systemic cisplatin-based chemotherapy remains the mainstream for the treatment of advanced non-small cell lung cancer (NSCLC) since it improves survival, symptom control and quality of life compared to best supportive care.

The selection of appropriate treatment for individual patients remains a challenge in clinical oncology, particularly in the advanced disease. Several lines of evidence indicate that polymorphisms, gene transcripts and gene mutations can play a predictive role and can be used to tailor chemotherapy in different subgroups of cancer patients. There are evidence lead us to use the expression levels of ERCC1 by the tumor as a molecular marker for customized chemotherapy. Another gene, the BRCA1 has a crucial role in DNA repair, since it is implicated in transcription-coupled nucleotide excision repair (TC-NER), leading to radio- and chemo-resistance. RRM1,localized in 11p15.5,also acts as a putative tumor suppressor gene. RRM1 overexpression was related to gemcitabine resistance in human oropharyngeal epidermoid carcinoma KB cells as well as in patients with NSCLC. For those reason we decided to conduct a prospective pilot phase II trial, in patients with wet stage IIIb and IV NSCLC using chemotherapy regimens which will be defined according to the pharmacogenomic profile (tumoral expression of ERCC1, BRCA1 and RRM1) of the tumor cells.

Interventional
Phase 2
Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Non-Small-Cell Lung Cancer
  • Drug: Gemcitabine
    Gemcitabine I.V at the dose of 1000mg/m2 on Day 1 and Day 8
    Other Name: Gemzar
  • Drug: Cisplatin
    Cisplatin I.V at the dose of 75mg/m2 on Day 1
    Other Name: CDDP
  • Drug: Docetaxel
    Docetaxel I.V at the dose of 75mg/m2 on Day 1
    Other Name: Taxotere
  • Drug: Cisplatin
    Cisplatin I.V at the dose of 80mg/m2 on Day 1
    Other Name: CDDP
  • Drug: Vinorelbine
    Vinorelbine per os 50mg every Monday, Wednesday and Friday
    Other Name: Navelbine
  • Drug: Pemetrexate
    Pemetrexate I.V 500mg/m2 on Day 1
    Other Name: Alimta
  • Experimental: 1
    Gemzar/Cisplatin
    Interventions:
    • Drug: Gemcitabine
    • Drug: Cisplatin
  • Experimental: 2
    Taxotere/Cisplatin
    Interventions:
    • Drug: Cisplatin
    • Drug: Docetaxel
  • Experimental: 3
    Cisplatin/Navelbine metronomic
    Interventions:
    • Drug: Cisplatin
    • Drug: Vinorelbine
  • Experimental: 4
    Taxotere/Gemzar
    Interventions:
    • Drug: Gemcitabine
    • Drug: Docetaxel
  • Experimental: 5
    Gemzar
    Intervention: Drug: Gemcitabine
  • Experimental: 6
    Taxotere
    Intervention: Drug: Docetaxel
  • Experimental: 7
    Navelbine metronomic
    Intervention: Drug: Vinorelbine
  • Experimental: 8
    Alimta/Cisplatin
    Interventions:
    • Drug: Cisplatin
    • Drug: Pemetrexate
  • Experimental: 9
    Alimta/Gemzar
    Interventions:
    • Drug: Gemcitabine
    • Drug: Pemetrexate
  • Experimental: 10
    Taxotere
    Intervention: Drug: Docetaxel
  • Experimental: 11
    Alimta
    Intervention: Drug: Pemetrexate
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Terminated
88
September 2011
September 2011   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patients with histologically proven Stage IV and Stage III (with malignant pleural or pericardial effusion) squamous or adenocarcinoma carcinomas of the lung
  • Adequate Formalin Fixed Paraffin Embedded tumor sample provided for molecular analysis
  • No previous anticancer treatment for metastatic/advanced disease. Patients who received prior adjuvant chemotherapy are eligible if they have remained free of disease for at least 6 months after the completion of adjuvant therapy.
  • Age above 18 years
  • Performance status (ECOG) 0-2
  • Life expectancy >= 3 months
  • Effective contraception for both male and female subjects if the risk of conception exists
  • Adequate hematologic parameters (absolute neutrophil count >= 1.5x109/L and platelets >= 100x109/L), creatinine (GFR>= 60ml/min) and total bilirubin < 1.5 times the upper limit of normal; aspartate and alanine aminotransferase < 2,5 times the upper limit of normal
  • All patients will have to sign written informed consent in order to participate in the study

Exclusion Criteria:

  • Patients with non-squamous tumors who have no contradiction for administration of bevacizumab
  • Active infection or malnutrition (loss of more than 20% of the body weight)
  • Known hypersensitivity reaction to any of the component of the treatment
  • Concurrent or previous chronic systemic immune therapy
  • Pregnancy (absence to be confirmed by ß-HCG test) or lactation period
  • Known alcohol/drug abuse
  • Legal incapacity or limited legal capacity
  • Medical or psychological condition which in the opinion of the investigator would not permit the subject to complete the study or sign meaningful informed consent
  • A second primary tumor other than non-melanoma skin cancer or in situ cervical carcinoma
  • Previous radiotherapy to the target lesions. Patients treated with palliative radiotherapy had to have measurable metastatic disease outside the irradiation fields
  • Patients with severe cardiac dysfunction, unstable angina petrosis, or high risk of uncontrolled arrhythmia
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Greece
 
NCT00705549
CT/07.23
No
Hellenic Oncology Research Group
Hellenic Oncology Research Group
University Hospital of Crete
Principal Investigator: John Souglakos, MD University Hospital of Crete, Dep of Medical Oncology
Hellenic Oncology Research Group
February 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP