Study of Blood and Tissue Samples in Predicting Response to Second-Line Therapy Using Erlotinib Hydrochloride or Chemotherapy in Patients With Advanced Non-Small Cell Lung Cancer

NCT ID: NCT00989690

Last Updated: 2013-08-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

275 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-02-29

Brief Summary

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RATIONALE: Studying the proteins expressed in samples of blood and tissue from patients with cancer may help doctors identify biomarkers related to cancer. It may also help doctors predict how patients will respond to treatment.

PURPOSE: This randomized phase III trial is studying blood and tissue samples in predicting response to second-line therapy using erlotinib hydrochloride or chemotherapy in patients with advanced non-small cell lung cancer.

Detailed Description

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OBJECTIVES:

* To evaluate the predictive value of proteomic profiling on the effect of second-line therapy with erlotinib hydrochloride vs standard chemotherapy (pemetrexed disodium or docetaxel) in patients with advanced non-small cell lung cancer.
* To assess the role of other known tissue-based predictive markers (e.g., EGFR-gene copy number, EGFR-protein expression, pAkt, pMAPK, EGFR mutations, EMT markers, and k-Ras mutation).

OUTLINE: This is a multicenter study. Patients are stratified according to smoking status, performance status, proteomic profile, and participating center. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive standard chemotherapy with pemetrexed disodium, docetaxel, or another standard drug.
* Arm II: Patients receive standard non-chemotherapy treatment with erlotinib hydrochloride.

Serum is collected after failure of first-line therapy for proteomic analysis by matrix-associated laser desorption/ionization-time of flight. Tissue and blood samples are collected periodically for analysis including EGFR based on IHC and FISH, EGFR and k-Ras mutations, pAkt, pMAPK by IHC, and EMT markers based on IHC and breath condensate protein profile.

After completion of study treatment, patients are followed every 2 months.

Conditions

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Lung Cancer

Keywords

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recurrent non-small cell lung cancer stage IIIB non-small cell lung cancer stage IV non-small cell lung cancer

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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docetaxel

Intervention Type DRUG

erlotinib hydrochloride

Intervention Type DRUG

pemetrexed disodium

Intervention Type DRUG

fluorescence in situ hybridization

Intervention Type GENETIC

mutation analysis

Intervention Type GENETIC

proteomic profiling

Intervention Type GENETIC

immunohistochemistry staining method

Intervention Type OTHER

laboratory biomarker analysis

Intervention Type OTHER

matrix-assisted laser desorption/ionization time of flight mass spectrometry

Intervention Type OTHER

breath test

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically or cytologically confirmed diagnosis of non-small cell lung cancer (NSCLC)

* Advanced NSCLC (stage IIIB or IV)
* Measurable disease
* Underwent previous treatment with 1 non-tyrosine kinase inhibitor as first-line therapy for advanced NSCLC
* No clinical evidence of uncontrolled brain metastases

PATIENT CHARACTERISTICS:

* Caucasian
* ECOG performance status 0-2
* Absolute granulocyte count ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3
* Bilirubin ≤ 1.5 times upper limit of normal (ULN) (≤ 2.5 times ULN in patients with known liver metastases)
* ALT or AST ≤ 3 times ULN (≤ 5 times ULN in patients with known liver metastases)
* Creatinine clearance ≥ 50 mL/min
* Not pregnant or nursing
* Able to comply with planned study procedures
* No multiple severe diseases that can compromise safety (cardiac and renal failure, peripheral neuropathy)
* No other malignancy (except for basal cell skin carcinoma) or pre-neoplastic condition requiring chemotherapeutic treatment

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* At least 3 weeks since prior surgery or radiotherapy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istituto Scientifico H. San Raffaele

OTHER

Sponsor Role lead

Principal Investigators

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Vanesa Gregor, MD

Role: PRINCIPAL_INVESTIGATOR

Istituto Scientifico H. San Raffaele

Locations

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Istituto Scientifico H. San Raffaele

Milan, , Italy

Site Status RECRUITING

Countries

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Italy

Facility Contacts

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Vanesa Gregor, MD

Role: primary

References

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Gregorc V, Novello S, Lazzari C, Barni S, Aieta M, Mencoboni M, Grossi F, De Pas T, de Marinis F, Bearz A, Floriani I, Torri V, Bulotta A, Cattaneo A, Grigorieva J, Tsypin M, Roder J, Doglioni C, Levra MG, Petrelli F, Foti S, Vigano M, Bachi A, Roder H. Predictive value of a proteomic signature in patients with non-small-cell lung cancer treated with second-line erlotinib or chemotherapy (PROSE): a biomarker-stratified, randomised phase 3 trial. Lancet Oncol. 2014 Jun;15(7):713-21. doi: 10.1016/S1470-2045(14)70162-7. Epub 2014 May 13.

Reference Type DERIVED
PMID: 24831979 (View on PubMed)

Other Identifiers

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CDR0000652115

Identifier Type: REGISTRY

Identifier Source: secondary_id

2007-006299-13

Identifier Type: -

Identifier Source: secondary_id

EU-20975

Identifier Type: -

Identifier Source: secondary_id

SRSI-HSRL-02-2007

Identifier Type: -

Identifier Source: org_study_id