Using Biomarkers for Diagnosis, Risk Stratification of Post -Treatment Recurrence and Long-Term Surveillance of Lung Cancer
Lung; Node, Adenocarcinoma of Lung
About this trial
This is an interventional other trial for Lung; Node focused on measuring Biomarkers, Lung Cancer Biomarkers
Eligibility Criteria
Inclusion Criteria: Potentially-resectable lung nodule 8-40 mm diameter suspected (no preop diagnosis) of being a clinically node-negative lung cancer [clinical stage IA-IB (cT1a-T2aN0), <4cm diameter]. If surgical resection is recommended, patient will undergo surgery at Moffitt Cancer Center. If a definite tissue diagnosis is obtained and stereotactic body radiotherapy (SBRT) is the recommended treatment instead of surgery, the SBRT will be delivered at Moffitt Cancer Center. >18 years old, male or female. ECOG performance status 0-1. Participants must have adequate organ and bone marrow function as defined below: a. absolute neutrophil count ≥1,000/mcL b. platelets ≥70,000/mcL c. total bilirubin ≤ institutional upper limit of normal (ULN) d. AST(SGOT)/ALT(SGPT) ≤3 × institutional ULN e. creatinine 3.0 ≤ institutional ULN Agree to participate in the follow-up protocol. Any primary lung cancer cell type (except a suspected typical carcinoid tumor, carcinoma in situ or minimally-invasive carcinoma). Ability to understand and the willingness to sign a written, informed consent document. Exclusion Criteria: Participants who have had chemotherapy or radiotherapy within 2 years of entering the study. Participants who have not recovered from adverse events (AEs) due to prior anti-cancer therapy (i.e., have residual toxicities > Grade 1), with the exception of alopecia. Participants who are actively receiving any cancer treatment. History of allergic reactions attributed to adjuvant chemotherapy agents used in study. Participants with uncontrolled intercurrent illness. Prior lung cancer within 5 years. Current active other major cancer except non-melanoma skin cancer. Patients with pure ground glass opacities (nodules) or hilar masses. Suspected typical carcinoid cell type (well-differentiated neuroendocrine carcinoma). Metastatic nodule (suspected) in the lung from an extrapulmonary cancer. Pregnant or lactating female. Patient unable to provide informed consent. Prisoner or incarcerated individual. For surgical patients, a R1 or R2 resection.
Sites / Locations
- Moffitt Cancer CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
High-Risk for Recurrence That Accept Adjuvant Chemotherapy
High-Risk for Recurrence That Decline Adjuvant Chemotherapy
Low-Risk for Recurrence
Participants whose gene assay show that they are at a higher risk of recurrence will be offered to receive postoperative chemotherapy. If participants also have a special mutation on the tumor (EGFR), investigators will recommend that the participant also receive the oral anti-EGFR pill (TagrissoTM) daily for 3 years after completing the chemotherapy. The administration of standard postoperative chemotherapy is not considered part of the study. Only the results of the DetermaRx test and the potential referral to a medical oncologist are part of this study.
Participants whose gene assay show that they are at a higher risk of recurrence will be offered to receive postoperative chemotherapy. If participant declines, investigators will followup with participants periodically every 6-12 months over 5 years.
Participants whose gene assay show that they are at a lower risk of recurrence will not be offered additional treatment after resection. Investigators will followup with participants periodically every 6-12 months over 5 years.