Molecular Profiling in Lung Cancer Patients

Study Description

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Brief Summary:

The main purpose of this study of pemetrexed combined with cisplatin used as neoadjuvant chemotherapy (2 or 3 cycles) in participants with operable non-small cell lung cancer (NSCLC) is to look at various genes present in participants' blood and tumor tissue to see if there is any link between the levels or changes in the genes and how participants with lung cancer respond to pemetrexed and cisplatin treatment.

Condition or disease	Intervention/treatment	Phase
Non-Small Cell Lung Cancer; Carcinoma	Drug: pemetrexed; Drug: cisplatin; Procedure: Radical Non-Small Cell Lung Cancer (NSCLC) surgery	Phase 2

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	30 participants
Allocation:	Non-Randomized
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Treatment
Official Title:	Molecular Profiling and Safety Study of Operable Lung Cancer Patients Treated With Alimta Combined With Cisplatin as Neoadjuvant Chemotherapy
Study Start Date :	May 2005
Actual Primary Completion Date :	July 2008
Actual Study Completion Date :	December 2010

Arms and Interventions

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Arm	Intervention/treatment
Experimental: Pemetrexed + Cisplatin; Pemetrexed: 500 milligrams per square meter (mg/m^2) intravenous (IV) every 21 days (q 21 days) for 3 cycles unless disease progression occurs Cisplatin: 75 mg/m^2 IV q 21 days for 3 cycles unless disease progression occurs	Drug: pemetrexed; 500 mg/m^2 IV q 21 days for 3 cycles unless disease progression occurs; Other Names: LY231514; Alimta Drug: cisplatin; 75 mg/m^2 IV q 21 days for 3 cycles unless disease progression occurs Procedure: Radical Non-Small Cell Lung Cancer (NSCLC) surgery; All participants proceeded to surgery within 4-8 weeks from the last dose of pemetrexed.

Outcome Measures

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Primary Outcome Measures :

1. High/Low Expression of Selected Molecular Markers in Tumor Tissues and Hypermethylated Genes in Peripheral Blood [ Time Frame: Baseline, Cycle 2, and surgery (4-8 weeks after last dose of pemetrexed) ]
   Molecular markers assessed by immunohistochemistry: thymidylate synthase, glycinamide ribonucleotide formyl transferase (GARFT), epidermal growth factor receptor (EGFR); and by polymerase chain reaction: dihydrofolate reductase (DHFR), dihydropyrimidine dehydrogenase (DPD), folylpolyglutamate synthetase (FPGS), reduced folate carrier, alpha folate receptor, Excision Repair Cross-Complementation Group 1 (ERCC1), folylpolyglutamate hydrolase (FPGH). Hypermethylated genes assessed by methylation-specific polymerase chain reaction. Due to small sample size, tumor-tissue analyses were not done.

Secondary Outcome Measures :

1. Percentage of Participants With Objective Tumor Response (Response Rate) [ Time Frame: Treatment start to disease progression or surgery (4-8 weeks after last dose of pemetrexed) ]
   Tumor response to treatment using Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Complete Response (CR)=disappearance of all target lesions; Partial Response (PR)=30% decrease in sum of longest diameter of target lesions; Progressive Disease (PD)=20% increase in sum of longest diameter of target lesions; Stable Disease (SD)=small changes that do not meet above criteria. Response rate was estimated as the total number of CR or PR, divided by the total number of participants treated.
2. Duration of Response [ Time Frame: Time of response to disease progression (up to 44.4 months) ]
   The duration of response was defined as the time from complete response (CR) or partial response (PR) to disease progression. Complete Response (CR)=disappearance of all target lesions; Partial Response (PR)=30% decrease in sum of longest diameter of target lesions; Progressive Disease (PD)=20% increase in sum of longest diameter of target lesions.
3. Disease Free Survival (DFS) [ Time Frame: Treatment start to disease progression or death from any cause (up to 45.5 months) ]
   DFS was the time from date of first dose to first observation of progressive disease (PD) or death due to any cause. PD=20% increase in sum of longest diameter of target lesions. If a participant was not known to have died or have PD, DFS was censored at the date of the last objective progression-free disease assessment.
4. Overall Survival (OS) [ Time Frame: Treatment start to death from any cause (up to 47.6 months) ]
   OS was defined as the time from treatment start to death from any cause. For participants who were alive, OS was censored at the last contact date.

Eligibility Criteria

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Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• pathologic documentation of non-small cell lung cancer (NSCLC)
• tumor must be accessible by bronchoscopy for tumor tissue sample collection
• patients must have lung cancer with clinical stage IB, II, IIIA
• Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
• patients must not have received prior systemic chemotherapy or radiation therapy for NSCLC (prior resection of lung is allowed provided at least 5 years have elapsed between prior surgery and enrolment)

Exclusion Criteria:

• bronchoalveolar carcinoma or stage IIIA tumor involving the superior sulcus (Pancoast tumors)
• pregnant or breast feeding patients
• patients who have received treatment within the last 30 days with a drug that has not received regulatory approval for any indication at the time of study entry
• patients with history or presence of other malignancy except in situ carcinoma of the skin or prior malignancy treated more than 5 years before without recurrence (excluding melanoma, breast cancer and hypernephroma)
• unwillingness to take folic acid or vitamin B12 supplementation

Contacts and Locations

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Locations

Poland
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
Bystra Slaska, Poland, 43-360
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
Poznan, Poland, 60-569
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
Warsaw, Poland, 02-781

Sponsors and Collaborators

Eli Lilly and Company

Investigators

Study Director:	Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5 PM Eastern time (UTC/ GMT - 5 hours, EST)	Eli Lilly and Company

More Information

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Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information

Additional Information:

Lilly Clinical Trial Registry 

Responsible Party:	Eli Lilly and Company
ClinicalTrials.gov Identifier:	NCT00191308 History of Changes
Other Study ID Numbers:	9356; H3E-PL-S051 ( Other Identifier: Eli Lilly and Company )
First Posted:	September 19, 2005
Results First Posted:	April 20, 2010
Last Update Posted:	October 21, 2011
Last Verified:	October 2011

Additional relevant MeSH terms:

Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases; Carcinoma, Bronchogenic	Bronchial Neoplasms; Cisplatin; Pemetrexed; Antineoplastic Agents; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action; Folic Acid Antagonists; Nucleic Acid Synthesis Inhibitors