Customizing First Line Chemotherapy in Advanced Non-Small Cell Lung Cancer (Customizing)
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ClinicalTrials.gov Identifier: NCT01356368 |
Recruitment Status :
Terminated
(slow accrual rate)
First Posted : May 19, 2011
Last Update Posted : January 22, 2014
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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.
Condition or disease | Intervention/treatment | Phase |
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Non-Small Cell Lung Cancer | Drug: Cisplatin, Gemzar, Docetaxel, Alimta | Phase 2 |
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.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 3 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Pilot Study of Customizing First Line Chemotherapy in Advanced Non-Small Cell Lung Cancer Based on Molecular Markers |
Study Start Date : | May 2010 |
Actual Primary Completion Date : | May 2013 |
Actual Study Completion Date : | May 2013 |

Arm | Intervention/treatment |
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Experimental: Cisplatin,Docetaxel,Gemzar, Premetrexed
Patients will receive treatment for up to six cycles of the assigned regimen unless there is disease progression or unacceptable toxicities. After treatment, the patients will be seen every 2 months for the first year, then every 3 months for the second year and every 6 months afterwards.
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Drug: Cisplatin, Gemzar, Docetaxel, Alimta
Patients will be assigned to treatment according to the molecular biological results which will analyze excision repair cross-complementing (ERCC1), ribonucleotide reductase subunit M1 (RRM1) and beta-tubulin genes in primary tumor cells which are present in tissues and peripheral blood. |
- Efficacy and Safety [ Time Frame: 3 years ]
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Efficacy is measured by:
- overall response rate (partial response and complete response) using RECIST Criteria
- time to disease progression (TTP)
- progression free survival (PFS)
- overall survival (OS)
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To evaluate the Number of participants with Adverse Events and Serious Adverse Events.Safety will include 5 parameters to be collected for all patients who receive the study regimen which are:
- Adverse Events
- Laboratory Assessments
- Vital Signs
- Physical Examinations
- ECG
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- Tumor marker [ Time Frame: 3 years ]
- The molecular characteristics of circulating tumor cells harvested from peripheral blood
- Correlation between the markers of circulating tumor cells and primary tumor.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Microscopic diagnosis of NSCLC stages IIIB (with malignant pleural effusion) and IV
- Having adequate tissue sample to perform the markers testing
- Age ≥ 18 years
- No prior chemotherapy treatment for lung cancer (Surgery and radiotherapy are acceptable)
- No other concurrent cancer treatment
- Performance status of 0- 2 per ECOG scale (Appendix II)
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Adequate laboratory values as follows as follows:
Absolute neutrophil count ≥ 1500/mm3 Platelet count ≥100, 000/ mm3 Total bilirubin ≤ 1.25X institutional upper normal level AST and ALT ≤ 3 X institutional upper normal level Serum creatinine ≤ 1.5 X institutional upper normal level
- Presence of measurable disease
Exclusion Criteria:
- Prior systemic treatment for lung cancer
- History of hypersensitivity to drugs used
- Diagnosis of other malignancy in the last 5 years excluding curatively treated non-melanoma skin cancer and in-situ cervical cancer
- Medical illness that puts the patient at significant risk per investigator's discretion
- Uncontrolled CNS disease. Patients with CNS metastatic disease treated with radiotherapy or surgery will be eligible if the CNS disease is stable 4 weeks after the treatment initiation without increase dose of steroids
- Positive pregnancy test or refusal to use contraception during treatment. (Gynecology consultant for contraception)

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01356368
Saudi Arabia | |
King Abdul Aziz Medical City for National Guard Health Affairs | |
Riyadh, Saudi Arabia |
Principal Investigator: | Abdulrahman Jazieh, MD/MPH | King Abdul Aziz Medical City for National Guard |
Responsible Party: | National Guard Health Affairs |
ClinicalTrials.gov Identifier: | NCT01356368 |
Other Study ID Numbers: |
RC09/095 |
First Posted: | May 19, 2011 Key Record Dates |
Last Update Posted: | January 22, 2014 |
Last Verified: | January 2014 |
Lung cancer |
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 Docetaxel Antineoplastic Agents Tubulin Modulators Antimitotic Agents Mitosis Modulators Molecular Mechanisms of Pharmacological Action |