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Sponsors and Collaborators: |
Duke University Eli Lilly and Company |
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Information provided by: | Duke University |
ClinicalTrials.gov Identifier: | NCT00509366 |
This study will assign subjects to either pemetrexed/gemcitabine or cisplatin/gemcitabine chemotherapy using a genomic-based platinum predictor to determine chemotherapy sensitivity and predict response to chemotherapy for first-line therapy in advanced non-small cell lung cancer.
Condition | Intervention | Phase |
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Non Small Cell Lung Cancer |
Drug: Cisplatin and Gemcitabine Drug: Pemetrexed & Gemcitabine |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Uncontrolled, Parallel Assignment, Efficacy Study |
Official Title: | Phase II Prospective Study Evaluating the Role of Pemetrexed Plus Gemcitabine Chemotherapy for Chemo-Naive Select Stage IIIB and IV NSCLC in Patients Using a Genomic Predictor of Platinum Resistance to Guide Therapy |
Estimated Enrollment: | 100 |
Study Start Date: | February 2007 |
Estimated Study Completion Date: | March 2010 |
Estimated Primary Completion Date: | December 2009 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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Cisplatin Sensitive: Active Comparator
Assignment to Treatment Group based on tumor genomics analysis Cisplatin day 1, Gemcitabine days 1 & 8
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Drug: Cisplatin and Gemcitabine
Gemcitabine 1250 mg/m2 IV over 30 minutes day 1 and 8 followed by Cisplatin 75 mg/m2 IV over 60 minutes on Day 1 repeat every 21 days up to 6 cycles
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Cisplatin Resistant: Active Comparator
Assignment to Treatment Group based on tumor genomics analysis Pemetrexed day 1, Gemcitabine days 1 & 8
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Drug: Pemetrexed & Gemcitabine
Pemetrexed 500 mg/m2 IV infusion over approximately 10 minutes Day 1, followed by Gemcitabine 1250 mg/m2 over 30-60 minutes day 1 and repeated alone on Day 8
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Lung cancer is the leading cause of cancer death in both men and women. The majority of patients with lung cancer have non-small cell type (NSCLC). The current standard of care for treating selected stage IIIB and stage IV NSCLC is a doublet chemotherapy regimen, such as cisplatin plus gemcitabine, carboplatin plus paclitaxel, or a platinum agent plus vinorelbine. All of these regimens have comparable response rates as first-line therapy. Alternative doublet therapy for first-line treatment of NSCLC per ASCO and NCCN guideline also include a non-platinum doublet or single agent therapy.
Although platinum agents are routinely used as first-line therapy for advanced NSCLC, genomics studies have shown that only 30% of these patients have disease that is sensitive to platinum agents. Of the patients who are resistant to platinum agents, 60% of those patients have disease that is sensitive to pemetrexed. However, this technology is not yet used to guide therapy for individual patients and it is not known how the use of this technology may affect outcomes.
An individual patient's response to chemotherapy is the result of complex interactions between the drug(s) and the patient's genetics and environment. Using Affymetrix gene expression data with corresponding drug response data for cisplatin from the NCI60 lines panel, a robust gene expression based model predicative of cisplatin-resistant has been developed. Based on preclinical observations, a first-line chemotherapy regimen for each patient will be individualized based on gene expression patterns seen in a given patient.
Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Required lab data within 2 weeks of enrollment:
Exclusion Criteria:
Contact: Debra M Shoemaker, RN | 919-668-6498 | shoem002@mc.duke.edu |
Contact: Toni Bjurstrom, RN | 919-668-6495 | bjurs002@mc.duke.edu |
United States, North Carolina | |
Duke University Medical Center | Recruiting |
Durham, North Carolina, United States, 27710 | |
Contact: Anil Potti, MD 919-619-5260 anil.potti@duke.edu | |
Principal Investigator: Anil Potti, MD | |
Sub-Investigator: Santiago Martinez-Jimenez, MD | |
Sub-Investigator: Momen Wahidi, MD | |
Sub-Investigator: Amy Abernethy, MD | |
Sub-Investigator: Neal Ready, MD | |
Duke Raleigh | Recruiting |
Raleigh, North Carolina, United States, 27609 | |
Contact: Lynda Owens, PhD 919-419-4631 lynda.owens@duke.edu | |
Contact: Melanie Watson, MSN, ANP-C 919-419-5010 melanie.watson@duke.edu | |
Sub-Investigator: Michael Spiritos, MD | |
Sub-Investigator: Linda Sutton, MD | |
Sub-Investigator: Gina Vaccaro, MD | |
Sub-Investigator: Yuri Fesko, MD | |
Sub-Investigator: Sharon Taylor, MD |
Principal Investigator: | Anil Potti, MD | Duke University |
Responsible Party: | Duke Comprehensive Medical Center ( Anil Potti, MD ) |
Study ID Numbers: | Pro00004599 |
Study First Received: | July 30, 2007 |
Last Updated: | December 29, 2008 |
ClinicalTrials.gov Identifier: | NCT00509366 |
Health Authority: | United States: Institutional Review Board |
genomics genomics predictor genomics analysis |
Folic Acid Pemetrexed Thoracic Neoplasms Non-small cell lung cancer Cisplatin Respiratory Tract Diseases |
Lung Neoplasms Lung Diseases Gemcitabine Carcinoma, Non-Small-Cell Lung Neoplasms, Glandular and Epithelial Carcinoma |
Antimetabolites Anti-Infective Agents Respiratory Tract Neoplasms Neoplasms by Histologic Type Antimetabolites, Antineoplastic Immunologic Factors Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Physiological Effects of Drugs |
Enzyme Inhibitors Folic Acid Antagonists Immunosuppressive Agents Antiviral Agents Pharmacologic Actions Neoplasms Neoplasms by Site Radiation-Sensitizing Agents Therapeutic Uses |