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Pemetrexed and/or Sunitinib as Second-Line Therapy in Treating Patients With Stage IIIB or Stage IV Non-Small Cell Lung Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), May 2009
First Received: June 14, 2008   Last Updated: May 7, 2009   History of Changes
Sponsors and Collaborators: Cancer and Leukemia Group B
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00698815
  Purpose

RATIONALE: Drugs used in chemotherapy, such as pemetrexed, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Sunitinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth and by blocking blood flow to the tumor. Giving pemetrexed together with sunitinib may kill more tumor cells. It is not yet known whether pemetrexed and sunitinib are more effective when given alone or together in treating non-small cell lung cancer.

PURPOSE: This randomized phase II trial is studying pemetrexed and sunitinib to compare how well they work when given alone or together as second-line therapy in treating patients with stage IIIB or stage IV non-small cell lung cancer.


Condition Intervention Phase
Lung Cancer
Drug: pemetrexed disodium
Drug: sunitinib malate
Phase II

MedlinePlus related topics: Cancer Lung Cancer
Drug Information available for: Pemetrexed Pemetrexed disodium Sunitinib malate Sunitinib
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized
Official Title: A Randomized Phase II Study to Assess the Efficacy of Pemetrexed or Sunitinib (NSC # 736511, IND # 74019) or Pemetrexed Plus Sunitinib in the Second-Line Treatment of Advanced Non-Small Cell Lung Cancer

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • 18-week progression-free survival rate [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Progression-free survival [ Designated as safety issue: No ]
  • Response rate, duration of response, rate of stable disease, and overall survival [ Designated as safety issue: No ]
  • Toxicity profile [ Designated as safety issue: Yes ]
  • Changes in tumor size at 6 weeks as an early predictor of therapeutic activity of pemetrexed disodium and/or sunitinib malate as second-line treatment for non-small cell lung cancer [ Designated as safety issue: No ]

Estimated Enrollment: 225
Study Start Date: April 2008
Estimated Primary Completion Date: August 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Arm I: Active Comparator
Patients receive pemetrexed disodium IV over 10 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive sunitinib malate as in arm II as third-line therapy.
Drug: pemetrexed disodium
Given IV
Arm II: Experimental
Patients receive oral sunitinib malate once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive pemetrexed disodium as in arm I as third-line therapy.
Drug: sunitinib malate
Given orally
Arm III: Experimental
Patients receive pemetrexed disodium IV over 10 minutes on day 1 and oral sunitinib malate once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive third-line therapy at the discretion of the treating physician.
Drug: pemetrexed disodium
Given IV
Drug: sunitinib malate
Given orally

Detailed Description:

OBJECTIVES:

Primary

  • To compare the 18-week progression-free survival rate in patients with stage IIIB or IV non-small cell lung cancer treated with pemetrexed disodium alone vs sunitinib malate alone vs pemetrexed disodium in combination with sunitinib malate as second-line therapy.

Secondary

  • To compare the progression-free survival of patients treated with these regimens.
  • To compare the response rate, duration of response, rate of stable disease, and overall survival of patients treated with these regimens.
  • To characterize the toxicity profiles of these regimens in these patients.
  • To determine the response rate, duration of response, rate of stable disease, and overall survival of patients who receive sunitinib malate in the third-line setting.
  • To assess the toxicity of sunitinib malate when administed in the third-line setting in these patients.
  • To test changes in tumor size at 6 weeks as an early predictor of therapeutic activity of these second-line treatment regimens.

OUTLINE: This is a multicenter study. Patients are stratified according to ECOG performance status (0 vs 1), disease stage (IIIB vs IV), and gender.

Patients are randomized to 1 of 3 treatment arms.

  • Arm I: Patients receive pemetrexed disodium IV over 10 minutes on day 1. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive sunitinib malate as in arm II as third-line therapy.
  • Arm II: Patients receive oral sunitinib malate once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive pemetrexed disodium as in arm I as third-line therapy.
  • Arm III: Patients receive pemetrexed disodium IV over 10 minutes on day 1 and oral sunitinib malate once daily on days 1-21. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients with documented disease progression may then receive third-line therapy at the discretion of the treating physician. After completion of study therapy, patients are followed every 6 weeks until disease progression and then every 6 months for 2 years.
  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)

    • Stage IIIB or IV disease
  • Must have evidence of disease progression after first-line therapy
  • Measurable or non-measurable disease

    • Measurable disease is defined as lesions that can be accurately measured in ≥ 1 dimension as ≥ 2 cm by conventional techniques or ≥ 1 cm by spiral CT scan
    • Non-measurable disease is defined as all other lesions, including small lesions (i.e., longest diameter < 20 mm by conventional techniques or < 10 mm by spiral CT scan) and truly non-measurable lesions, including any of the following:

      • Bone lesions
      • Leptomeningeal disease
      • Ascites
      • Pleural or pericardial effusion
      • Lymphangitis cutis or pulmonis
      • Abdominal mass that are not confirmed and followed by imaging techniques
      • Cystic lesions
  • No cavitary lesions
  • No pleural effusions or ascites detectable on physical exam
  • No symptomatic or untreated CNS metastases

    • Patients with CNS metastases are eligible provided the metastases were definitively treated with surgery or radiotherapy AND patient is asymptomatic and off steroids or on a stable dose of steroids for 2 weeks prior to study entry
  • Concurrent enrollment on CALGB-580702 (imaging study) required

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-1
  • Granulocytes ≥ 1,500/μL
  • Platelet count ≥ 100,000/μL
  • Magnesium ≥ lower limit of normal
  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • AST and ALT ≤ 2.5 times ULN
  • PTT ≤ 1.5 times ULN
  • INR ≤ 1.5
  • Creatinine clearance ≥ 45 mL/min
  • Quantitative urine protein < 30 mg/dL OR ≤ 1+ on dipstick
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after completion of study therapy
  • QTc interval ≤ 500 msec
  • No ongoing cardiac dysrhythmias
  • No atrial fibrillation
  • No symptomatic congestive heart failure within the past 12 months

    • NYHA class I heart failure allowed
    • Patients with a history of NYHA class II heart failure are eligible provided at least 1 of the following criteria is met:

      • Asymptomatic on treatment
      • Previously treated with anthracycline
      • Previously treated with central thoracic radiotherapy that included the heart in the radiotherapy port
  • No myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft or stenting, cerebrovascular accident, or transient ischemic attack within the past year
  • No hypertension that cannot be controlled by medications (i.e., blood pressure > 150/100 mm Hg despite optimal medical therapy)
  • No history of venous thrombosis, pulmonary embolism, or hypercoagulopathy syndrome
  • No history of pulmonary hemorrhage, bleeding diathesis, or evidence of hemoptysis

    • Patients with blood-tinged or blood-streaked sputum are eligible provided the hemoptysis is < 5 mL of blood per episode and < 10 mL of blood per 24-hour period, in the best estimate of the investigator
  • No interstitial pneumonitis or pulmonary fibrosis on baseline CT scan
  • No abdominal fistula, gastrointestinal perforation, intra-abdominal abscess, or serious or non-healing wound, ulcer, or bone fracture within the past 28 days
  • History of hypothyroidism allowed provided patient is currently euthyroid

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • At least 28 days since prior first-line therapy

    • No more than one prior chemotherapy regimen (platinum or non-platinum based) in the first-line setting for NSCLC
  • Prior adjuvant therapy allowed provided the patient received one regimen in the advanced setting
  • At least 4 weeks since prior EGFR inhibitors or bevacizumab
  • At least 28 days since prior major surgery (6 weeks since resection of brain metastases)
  • At least 14 days since prior radiotherapy
  • More than 7 days since prior and no concurrent CYP3A4 inhibitors, including any of the following:

    • Azole antifungals (e.g., ketoconazole or itraconazole)
    • Diltiazem
    • Clarithromycin
    • Erythromycin
    • Verapamil
    • Delavirdine
    • HIV protease inhibitors (e.g., indinavir, saquinavir, ritonavir, atazanavir, or nelfinavir)
  • More than 12 days since prior and no concurrent CYP3A4 inducers, including any of the following:

    • Rifampin
    • Rifabutin
    • Carbamazepine
    • Phenobarbital
    • Phenytoin
    • St. John's wort
    • Efavirenz
    • Tipranavir
  • No prior pemetrexed disodium
  • No prior VEGFR inhibitors (e.g., semaxanib, SU6668, AZ6474, sunitinib malate, vatalanib, cediranib, AEE-788, or sorafenib)
  • No concurrent chronic daily treatment with aspirin (> 325 mg/day) or non-steroidal anti-inflammatory agents known to inhibit platelet function
  • No concurrent dipyridamole (Persantine), ticlopidine (Ticlid), clopidogrel (Plavix), and/or cilostazol (Pletal)
  • No concurrent therapeutic anticoagulation for thromboembolic disease

    • Concurrent low-dose warfarin (≤ 2 mg/day) allowed for prophylaxis of thrombosis
  • No concurrent agents with proarrhymthic potential (e.g., quinidine, procainamide, disopyramide, sotalol, probucol, bepridel, haloperidol, risperidone, indapamide, or flecainide)
  • No concurrent hormonal therapy, except steroids for adrenal failure, hormones for non-disease-related conditions (e.g., insulin for diabetes), or dexamethasone used intermittently as an antiemetic or as premedication for pemetrexed disodium
  • No other concurrent chemotherapy
  • No concurrent palliative radiotherapy
  • No concurrent G-CSF (filgrastim), GM-CSF (sargramostim), and/or pegfilgrastim
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00698815

  Hide Study Locations
Locations
United States, California
Alta Bates Summit Medical Center - Summit Campus Recruiting
Oakland, California, United States, 94609
Contact: Clinical Trials Office - Alta Bates Summit Medical Center - Su     510-204-1414        
Bay Area Breast Surgeons, Incorporated Recruiting
Oakland, California, United States, 94609
Contact: James H. Feusner, MD     510-428-3689        
CCOP - Bay Area Tumor Institute Recruiting
Oakland, California, United States, 94609
Contact: James H. Feusner, MD     510-428-3689        
Contra Costa Regional Medical Center Recruiting
Martinez, California, United States, 94553-3156
Contact: James H. Feusner, MD     510-428-3689        
El Camino Hospital Cancer Center Recruiting
Mountain View, California, United States, 94040
Contact: Clinical Trials Office - El Camino Hospital Cancer Center     650-988-7623        
East Bay Radiation Oncology Center Recruiting
Castro Valley, California, United States, 94546
Contact: James H. Feusner, MD     510-428-3689        
Eden Medical Center Recruiting
Castro Valley, California, United States, 94546
Contact: James H. Feusner, MD     510-428-3689        
Doctors Medical Center - San Pablo Campus Recruiting
San Pablo, California, United States, 94806
Contact: James H. Feusner, MD     510-428-3689        
Highland General Hospital Recruiting
Oakland, California, United States, 94602
Contact: James H. Feusner, MD     510-428-3689        
Kaiser Permanente Medical Office -Vandever Medical Office Recruiting
San Diego, California, United States, 92120
Contact: Han A. Koh     619-528-2596        
Larry G Strieff MD Medical Corporation Recruiting
Oakland, California, United States, 94609
Contact: James H. Feusner, MD     510-428-3689        
Tom K Lee, Incorporated Recruiting
Oakland, California, United States, 94609
Contact: James H. Feusner, MD     510-428-3689        
Valley Care Medical Center Recruiting
Pleasanton, California, United States, 94588
Contact: James H. Feusner, MD     510-428-3689        
Valley Medical Oncology Consultants - Castro Valley Recruiting
Castro Valley, California, United States, 94546
Contact: James H. Feusner, MD     510-428-3689        
Valley Medical Oncology Consultants - Pleasanton Recruiting
Pleasanton, California, United States, 94588
Contact: James H. Feusner, MD     510-428-3689        
Valley Medical Oncology Recruiting
Fremont, California, United States, 94538
Contact: James H. Feusner, MD     510-428-3689        
United States, Connecticut
Helen and Harry Gray Cancer Center at Hartford Hospital Recruiting
Hartford, Connecticut, United States, 06102-5037
Contact: Clinical Trials Office - Helen and Harry Gray Cancer Center     860-545-5363        
United States, Delaware
CCOP - Christiana Care Health Services Recruiting
Newark, Delaware, United States, 19713
Contact: Clinical Trial Office - CCOP - Christiana Care Health Services     302-733-6227        
Tunnell Cancer Center at Beebe Medical Center Recruiting
Lewes, Delaware, United States, 19958
Contact: Clinical Trials Office - Tunnell Cancer Center     302-645-3171        
United States, Florida
CCOP - Mount Sinai Medical Center Recruiting
Miami Beach, Florida, United States, 33140
Contact: Rogerio C. Lilenbaum, MD     305-535-3310        
Ella Milbank Foshay Cancer Center at Jupiter Medical Center Recruiting
Jupiter, Florida, United States, 33458
Contact: Clinical Trials Office - Ella Milbank Foshay Cancer Center     561-745-5768        
Michael and Dianne Bienes Comprehensive Cancer Center at Holy Cross Hospital Recruiting
Fort Lauderdale, Florida, United States, 33308
Contact: Clinical Trials Office - Michael and Dianne Bienes Comprehensi     954-776-3239        
United States, Illinois
Joliet Oncology-Hematology Associates, Limited - West Recruiting
Joliet, Illinois, United States, 60435
Contact: Sanjiv S. Modi     815-730-3098        
University of Chicago Cancer Research Center Recruiting
Chicago, Illinois, United States, 60637-1470
Contact: Clinical Trials Office - University of Chicago Cancer Research     773-834-7424        
University of Illinois Cancer Center Recruiting
Chicago, Illinois, United States, 60612-7243
Contact: Clinical Trial Office - University of Illinois Cancer Center     312-355-3046        
United States, Iowa
Hematology Oncology Associates of the Quad Cities Recruiting
Bettendorf, Iowa, United States, 52722
Contact: Shobha R. Chitneni, MD, MBBS     563-355-7733        
United States, Maine
CancerCare of Maine at Eastern Maine Medical Center Recruiting
Bangor, Maine, United States, 04401
Contact: Clinical Trials Office - CancerCare of Maine     207-973-4274        
United States, Maryland
Union Hospital Cancer Program at Union Hospital Recruiting
Elkton MD, Maryland, United States, 21921
Contact: Stephen S. Grubbs, MD     302-366-1200        
United States, Massachusetts
Dana-Farber/Brigham and Women's Cancer Center Recruiting
Boston, Massachusetts, United States, 02115
Contact: Clinical Trials Office     617-724-5200        
Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute Recruiting
Boston, Massachusetts, United States, 02115
Contact: Contact Person     617-632-3474        
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114
Contact: Clinical Trials Office - Massachusetts General Hospital     877-726-5130        
United States, Minnesota
Masonic Cancer Center at University of Minnesota Recruiting
Minneapolis, Minnesota, United States, 55455
Contact: Clinical Trials Office - Masonic Cancer Center at University o     612-624-2620        
United States, Missouri
Arch Medical Services, Incorporated at Center for Cancer Care and Research Recruiting
Saint Louis, Missouri, United States, 63141
Contact: Alan P. Lyss, MD     314-996-5514        
Ellis Fischel Cancer Center at University of Missouri - Columbia Recruiting
Columbia, Missouri, United States, 65203
Contact: Clinical Trial Office - Ellis Fischel Cancer Center     573-882-4894        
Missouri Baptist Cancer Center Recruiting
Saint Louis, Missouri, United States, 63131
Contact: Alan P. Lyss, MD     314-996-5514        
United States, Nebraska
Alegant Health Cancer Center at Bergan Mercy Medical Center Recruiting
Omaha, Nebraska, United States, 68124
Contact: Clinical Trials Office - Alegant Health Cancer Center at Berge     402-398-6060        
Callahan Cancer Center at Great Plains Regional Medical Center Recruiting
North Platte, Nebraska, United States, 69103
Contact: Clinical Trials Office - Callahan Cancer Center at Great Plain     308-696-7864        
Cancer Resource Center - Lincoln Recruiting
Lincoln, Nebraska, United States, 68510
Contact: Alan R. Berg, MD     402-420-7000        
CCOP - Missouri Valley Cancer Consortium Recruiting
Omaha, Nebraska, United States, 68106
Contact: Gamini S. Soori, MD, FACP, FRCP, MBA     402-393-3110        
Saint Francis Cancer Treatment Center at Saint Francis Memorial Health Center Recruiting
Grand Island, Nebraska, United States, 68803
Contact: Apar K. Ganti     308-398-5450        
Immanuel Medical Center Recruiting
Omaha, Nebraska, United States, 68122
Contact: Gamini S. Soori, MD, FACP, FRCP, MBA     402-393-3110        
Methodist Estabrook Cancer Center Recruiting
Omaha, Nebraska, United States, 68114
Contact: Robert M. Langdon, MD     402-399-8762        
Creighton University Medical Center Recruiting
Omaha, Nebraska, United States, 68131-2197
Contact: Clinical Trials Office - Creighton University Medical Center     402-280-4100        
UNMC Eppley Cancer Center at the University of Nebraska Medical Center Recruiting
Omaha, Nebraska, United States, 68198-6805
Contact: Clinical Trials Office - UNMC Eppley Cancer Center at the Univ     800-999-5465        
United States, New Jersey
Cancer Institute of New Jersey at Cooper - Voorhees Recruiting
Voorhees, New Jersey, United States, 08043
Contact: Clinical Trials Office - Cancer Institute of New Jersey at Coo     856-325-6757        
United States, New York
CCOP - North Shore University Hospital Recruiting
Manhasset, New York, United States, 11030
Contact: Haralambos Raftopoulos, MD     212-305-0591        
Charles R. Wood Cancer Center at Glens Falls Hospital Recruiting
Glens Falls, New York, United States, 12801
Contact: Clinical Trials Office - Charles R. Wood Cancer Center at Glen     518-926-6700        
SUNY Upstate Medical University Hospital Recruiting
Syracuse, New York, United States, 13210
Contact: Clinical Trials Office - SUNY Upstate Medical University Hospi     315-464-5476        
Long Island Jewish Medical Center Recruiting
New Hyde Park, New York, United States, 11040
Contact: Haralambos Raftopoulos, MD     212-305-0591        
Monter Cancer Center of the North Shore-LIJ Health System Recruiting
Lake Success, New York, United States, 11042
Contact: Haralambos Raftopoulos, MD     212-305-0591        
Don Monti Comprehensive Cancer Center at North Shore University Hospital Recruiting
Manhasset, New York, United States, 11030
Contact: Clinical Trials Office - Don Monti Comprehensive Cancer Center     516-734-8900        
Veterans Affairs Medical Center - Syracuse Recruiting
Syracuse, New York, United States, 13210
Contact: Ajeet Gajra, MD     315-425-4666        
United States, North Carolina
Annie Penn Cancer Center Recruiting
Reidsville, North Carolina, United States, 27320
Contact: Clinical Trials Office - Annie Penn Cancer Center     336-621-8374        
Kinston Medical Specialists Recruiting
Kinston, North Carolina, United States, 28501
Contact: Peter R. Watson, MD     252-559-2200ext.201        
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill Recruiting
Chapel Hill, North Carolina, United States, 27599-7295
Contact: Clinical Trials Office - Lineberger Comprehensive Cancer Cente     877-668-0683; 919-966-4432        
Moses Cone Regional Cancer Center at Wesley Long Community Hospital Recruiting
Greensboro, North Carolina, United States, 27403-1198
Contact: Clinical Trials Office - Moses Cone Regional Cancer Center at     336-621-8374        
Wayne Memorial Hospital, Incorporated Recruiting
Goldsboro, North Carolina, United States, 27534
Contact: James N. Atkins, MD     919-580-0000        
Randolph Hospital Recruiting
Asheboro, North Carolina, United States, 27203-5400
Contact: Clinical Trails Office - Randolph Hospital     336-832-0821        
Wake Forest University Comprehensive Cancer Center Recruiting
Winston-Salem, North Carolina, United States, 27157-1096
Contact: Clinical Trials Office - Wake Forest University Comprehensive     336-713-6771        
Presbyterian Cancer Center at Presbyterian Hospital Recruiting
Charlotte, North Carolina, United States, 28233-3549
Contact: Clinical Trials Office - Presbyterian Cancer Center at Presbyt     704-384-5369        
United States, Ohio
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center Recruiting
Columbus, Ohio, United States, 43210-1240
Contact: Ohio State University Cancer Clinical Trial Matching Service     866-627-7616     osu@emergingmed.com    
United States, Rhode Island
Memorial Hospital of Rhode Island Recruiting
Pawtucket, Rhode Island, United States, 02860
Contact: Humera Khurshid     401-729-2000        
United States, South Carolina
CCOP - Greenville Recruiting
Greenville, South Carolina, United States, 29615
Contact: Jeffrey K. Giguere, MD, FACP     864-987-7000        
McLeod Regional Medical Center Recruiting
Florence, South Carolina, United States, 29501
Contact: Clinical Trials Office - McLeod Regional Medical Center     843-679-7256        
United States, Vermont
Fletcher Allen Health Care - University Health Center Campus Recruiting
Burlington, Vermont, United States, 05401
Contact: Clinical Trials Office - Fletcher Allen Health Care     802-656-8990        
Mountainview Medical Recruiting
Berlin, Vermont, United States, 05602
Contact: Steven M. Grunberg, MD     802-847-3827        
United States, Virginia
Ravenel Oncology Center at Memorial Hospital of Martinsville and Henry County Recruiting
Martinsville, Virginia, United States, 24115
Contact: Arthur Sleeper, MD     276-666-7200        
United States, West Virginia
St. Mary's Regional Cancer Center at St. Mary's Medical Center Recruiting
Huntington, West Virginia, United States, 25702
Contact: Gerrit A. Kimmey, MD     304-528-4645        
Sponsors and Collaborators
Cancer and Leukemia Group B
Investigators
Study Chair: Mark A. Socinski, MD UNC Lineberger Comprehensive Cancer Center
Investigator: Rebecca S. Heist, MD Harvard School of Public Health
  More Information

Additional Information:
No publications provided

Responsible Party: Cancer and Leukemia Group B ( Richard L. Schilsky )
Study ID Numbers: CDR0000589102, CALGB-30704
Study First Received: June 14, 2008
Last Updated: May 7, 2009
ClinicalTrials.gov Identifier: NCT00698815     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
stage IIIB non-small cell lung cancer
stage IV non-small cell lung cancer
recurrent non-small cell lung cancer

Study placed in the following topic categories:
Antimetabolites
Thoracic Neoplasms
Folate
Folinic Acid
Folic Acid Antagonists
Angiogenesis Inhibitors
Vitamin B9
Recurrence
Carcinoma
Pemetrexed
Folic Acid
Respiratory Tract Diseases
Lung Neoplasms
Sunitinib
Lung Diseases
Non-small Cell Lung Cancer
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Thoracic Neoplasms
Antimetabolites
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Neoplasms by Site
Respiratory Tract Diseases
Sunitinib
Lung Neoplasms
Therapeutic Uses
Growth Inhibitors
Angiogenesis Modulating Agents
Respiratory Tract Neoplasms
Neoplasms by Histologic Type
Growth Substances
Enzyme Inhibitors
Folic Acid Antagonists
Angiogenesis Inhibitors
Pharmacologic Actions
Carcinoma
Pemetrexed
Neoplasms
Lung Diseases
Carcinoma, Non-Small-Cell Lung
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 14, 2009