Molecular Epidemiology of Lung Adenocarcinoma in Multi-ethnic Asian Phenotype

NCT01774526 | Unknown

• 1 other identifier: DSRB-B/11/139
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Lung Cancer continues to be the major cause of cancer-related mortality in Singapore. Non-small cell lung cancer (NSCLC) accounts for 75% of lung cancers and adenocarcinoma is the most common histological subtype. Although cigarette-smoking is the main cause of lung cancer, more than a third afflicted in Singapore are never-smokers and 69% affect females. For the majority who present with advanced NSCLC, chemotherapy is the mainstay of treatment. Despite advances made with newer chemotherapeutic agents, it is apparent that the benefit of conventional chemotherapy has plateaued. Efforts toward developing novel treatments based on growing understanding of molecular oncology have yielded drugs that target vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR). They have expanded treatment options for patients with advanced NSCLC. However, monoclonal antibody to VEGF is contraindicated in patients with squamous cell carcinoma due to increased incidence of fatal hemoptysis. EGFR tyrosine kinase inhibitors (EGFR-TKI) appear promising but only 40% of east-asian female never-smokers with lung adenocarcinoma harbour EGFR gene mutations. Estrogen, KRAS, BRAF, ERBE and other genetic mutations can confound response. Molecular data obtained from Caucasian and predominantly east-asian population may not apply to our multi-ethnic groups and our aim is to determine the molecular characteristics of our multi-ethnic asian phenotypes to better understand the process of carcinogenesis and treatment response as well as identify potential novel targets for future drug development. Paraffin-embedded tissues are recalled, and DNA is extracted for mutational analysis, which will be correlated to patient demographics, treatment and outcome.

Conditions

Lung Cancer

Outcome Measures

Primary Outcomes (1)

• Descriptive study of our patients with lung adenocarcinoma. Identify novel molecular characteristics so that potential drug development can be reached.

  6 years

Interventions

Characterise the molecular epidemiology of lung adenocarcinoma in multi-ethnic asian phenotypes OTHER

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Asian ethnicity
• Age \> 21 years old
• Non-smoker
• Metastatic pleural effusion due to lung adenocarcinoma
• Good ECOG status (ECOG 1-2) fit to undergo pleuroscopy and biopsy and agreeable for palliative chemotherapy and or EGFR-TKI

You may not qualify if:

• Non-Asian ethnicity
• Age \< 21 years old
• Smoker
• Subjects with poor ECOG status or unwilling to undergo pleuroscopy and biopsy
• Subjects not suitable to receive palliative chemotherapy or EGFR-TKI
• All other histological subtypes and stages of disease

Sponsors & Collaborators

• National University Hospital, Singapore: lead

Study Sites (1)

National University Hospital/ National University of Singapore

Singapore, Singapore, Singapore

RECRUITING

Related Publications (14)

• Toh CK, Gao F, Lim WT, Leong SS, Fong KW, Yap SP, Hsu AA, Eng P, Koong HN, Thirugnanam A, Tan EH. Never-smokers with lung cancer: epidemiologic evidence of a distinct disease entity. J Clin Oncol. 2006 May 20;24(15):2245-51. doi: 10.1200/JCO.2005.04.8033.

  PMID: 16710022 BACKGROUND

• Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, Feuer EJ, Thun MJ. Cancer statistics, 2005. CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30. doi: 10.3322/canjclin.55.1.10.

  PMID: 15661684 BACKGROUND

• Gettinger S. Targeted therapy in advanced non-small-cell lung cancer. Semin Respir Crit Care Med. 2008 Jun;29(3):291-301. doi: 10.1055/s-2008-1076749.

  PMID: 18506667 BACKGROUND

• Ramalingam SS, Dahlberg SE, Langer CJ, Gray R, Belani CP, Brahmer JR, Sandler AB, Schiller JH, Johnson DH; Eastern Cooperative Oncology Group. Outcomes for elderly, advanced-stage non small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: analysis of Eastern Cooperative Oncology Group Trial 4599. J Clin Oncol. 2008 Jan 1;26(1):60-5. doi: 10.1200/JCO.2007.13.1144.

  PMID: 18165641 BACKGROUND

• Isobe T, Herbst RS, Onn A. Current management of advanced non-small cell lung cancer: targeted therapy. Semin Oncol. 2005 Jun;32(3):315-28. doi: 10.1053/j.seminoncol.2005.02.016.

  PMID: 15988686 BACKGROUND

• Kris MG, Natale RB, Herbst RS, Lynch TJ Jr, Prager D, Belani CP, Schiller JH, Kelly K, Spiridonidis H, Sandler A, Albain KS, Cella D, Wolf MK, Averbuch SD, Ochs JJ, Kay AC. Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer: a randomized trial. JAMA. 2003 Oct 22;290(16):2149-58. doi: 10.1001/jama.290.16.2149.

  PMID: 14570950 BACKGROUND

• Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan EH, Hirsh V, Thongprasert S, Campos D, Maoleekoonpiroj S, Smylie M, Martins R, van Kooten M, Dediu M, Findlay B, Tu D, Johnston D, Bezjak A, Clark G, Santabarbara P, Seymour L; National Cancer Institute of Canada Clinical Trials Group. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med. 2005 Jul 14;353(2):123-32. doi: 10.1056/NEJMoa050753.

  PMID: 16014882 BACKGROUND

• Shigematsu H, Lin L, Takahashi T, Nomura M, Suzuki M, Wistuba II, Fong KM, Lee H, Toyooka S, Shimizu N, Fujisawa T, Feng Z, Roth JA, Herz J, Minna JD, Gazdar AF. Clinical and biological features associated with epidermal growth factor receptor gene mutations in lung cancers. J Natl Cancer Inst. 2005 Mar 2;97(5):339-46. doi: 10.1093/jnci/dji055.

  PMID: 15741570 BACKGROUND

• Vikis H, Sato M, James M, Wang D, Wang Y, Wang M, Jia D, Liu Y, Bailey-Wilson JE, Amos CI, Pinney SM, Petersen GM, de Andrade M, Yang P, Wiest JS, Fain PR, Schwartz AG, Gazdar A, Gaba C, Rothschild H, Mandal D, Kupert E, Seminara D, Viswanathan A, Govindan R, Minna J, Anderson MW, You M. EGFR-T790M is a rare lung cancer susceptibility allele with enhanced kinase activity. Cancer Res. 2007 May 15;67(10):4665-70. doi: 10.1158/0008-5472.CAN-07-0217.

  PMID: 17510392 BACKGROUND

• Tang Z, Du R, Jiang S, Wu C, Barkauskas DS, Richey J, Molter J, Lam M, Flask C, Gerson S, Dowlati A, Liu L, Lee Z, Halmos B, Wang Y, Kern JA, Ma PC. Dual MET-EGFR combinatorial inhibition against T790M-EGFR-mediated erlotinib-resistant lung cancer. Br J Cancer. 2008 Sep 16;99(6):911-22. doi: 10.1038/sj.bjc.6604559.

  PMID: 19238632 BACKGROUND

• Eberhard DA, Johnson BE, Amler LC, Goddard AD, Heldens SL, Herbst RS, Ince WL, Janne PA, Januario T, Johnson DH, Klein P, Miller VA, Ostland MA, Ramies DA, Sebisanovic D, Stinson JA, Zhang YR, Seshagiri S, Hillan KJ. Mutations in the epidermal growth factor receptor and in KRAS are predictive and prognostic indicators in patients with non-small-cell lung cancer treated with chemotherapy alone and in combination with erlotinib. J Clin Oncol. 2005 Sep 1;23(25):5900-9. doi: 10.1200/JCO.2005.02.857. Epub 2005 Jul 25.

  PMID: 16043828 BACKGROUND

• Shigematsu H, Takahashi T, Nomura M, Majmudar K, Suzuki M, Lee H, Wistuba II, Fong KM, Toyooka S, Shimizu N, Fujisawa T, Minna JD, Gazdar AF. Somatic mutations of the HER2 kinase domain in lung adenocarcinomas. Cancer Res. 2005 Mar 1;65(5):1642-6. doi: 10.1158/0008-5472.CAN-04-4235.

  PMID: 15753357 BACKGROUND

• Yokoyama T, Kondo M, Goto Y, Fukui T, Yoshioka H, Yokoi K, Osada H, Imaizumi K, Hasegawa Y, Shimokata K, Sekido Y. EGFR point mutation in non-small cell lung cancer is occasionally accompanied by a second mutation or amplification. Cancer Sci. 2006 Aug;97(8):753-9. doi: 10.1111/j.1349-7006.2006.00233.x.

  PMID: 16863509 BACKGROUND

• Wu CC, Hsu HY, Liu HP, Chang JW, Chen YT, Hsieh WY, Hsieh JJ, Hsieh MS, Chen YR, Huang SF. Reversed mutation rates of KRAS and EGFR genes in adenocarcinoma of the lung in Taiwan and their implications. Cancer. 2008 Dec 1;113(11):3199-208. doi: 10.1002/cncr.23925.

  PMID: 18932251 BACKGROUND

MeSH Terms

Conditions

Lung Neoplasms

Condition Hierarchy (Ancestors)

Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases

Study Officials

• Pyng Lee, MD

  National University Hospital, Singapore

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Pyng Lee, MD

CONTACT

+65-67795555; mdclp@nus.edu.sg

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 1, 2013
• First Posted: January 24, 2013
• Study Start: December 1, 2010
• Primary Completion: December 1, 2016
• Study Completion: December 1, 2016
• Last Updated: January 24, 2013

Record last verified: 2012-12

Locations

SG (1)