De Novo Resistance to Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors
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Purpose
This study is based on the following hypothesis "De novo resistance to EGFR-TKI in EGFR mutation positive patients is related with mutations in EGFR downstream genes".
Investigators will prospectively collect genomic DNA and clinical data regarding treatment outcomes to EGFR-TKI in NSCLC patients with activating EGFR mutations. Investigators will sequence candidate mutations of EGFR downstream genes and analyze c-met gene amplification and protein expression in PTEN, HGF, and IGFR. To identify genetic mutations, amplification, and protein over expression as predictive markers of treatment outcomes, investigators analyzed the association of treatment outcomes with the presence of genetic alteration or protein over expression. Investigators will attempt to identify biomarkers that are able to predict de novo resistance to EGFR-TKI in EGFR mutated NSCLC.
| Condition |
|---|
|
NSCLC |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | Pilot Study to Identify the Mechanism of De Novo Resistance to Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors (EGFR-TKIs) in NSCLC With EGFR Mutation. |
- hazard rates of PFS [ Time Frame: 1year ] [ Designated as safety issue: No ]The primary objective is to compare hazard rates of PFS in patients treated with Iressa between with and without any molecular aberrancy in EGFR-downstream genes/proteins.
- OS [ Time Frame: 2years ] [ Designated as safety issue: No ]Overall survival (OS) of EGFR-TKI according to each biomarker (i.e. PIK3CA, AKT, PTEN, and STK11 mutation and HGF, c-met, and IGFR amplification) Disease control rate (DCR) of EGFR-TKI according to each biomarker (i.e. PIK3CA, AKT, PTEN, and STK11 mutation and HGF, c-met, and IGFR amplification) Progression-free survival (PFS) of EGFR-TKI according to each biomarker (i.e. PIK3CA, AKT, PTEN, and STK11 mutation and HGF, c-met, and IGFR amplification)
Biospecimen Retention: Samples With DNA
DNA extracted from FFPE tissue sample
| Estimated Enrollment: | 155 |
| Study Start Date: | October 2012 |
| Estimated Study Completion Date: | September 2014 |
| Estimated Primary Completion Date: | September 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
|
Iressa
Lung cancer patients with EGFR mutation
|
Detailed Description:
Investigators will prospectively enroll patients who match the following criteria: pathologically proven unresectable NSCLC, planning to treat with EGFR-TKI, patients with activating EGFR mutations, and available tissue sample for DNA extraction.
Eligibility| Ages Eligible for Study: | 20 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
NSCLC patient with EGFR mutation
Inclusion Criteria:
- Pathologically proven unresectable NSCLC
- 20 years of age or older
- Planned treatment with Iressa®
- Patients with activating EGFR mutation (del 19, L858R)
- Available detailed smoking history
- Available tissue samples (archival tissue) for mutational or molecular analysis (representative paraffin block or unstained sections from tumor diagnostic specimen are mandatory)
- Available blood sample
- At least one lesion that is measurable according to the RECIST 1.1 criteria by CT or MRI
- Written informed consent
Exclusion Criteria:
- More than 3rd line treatment
- Previously treated with other EGFR-TKI
- Life expectancy of less than 12 weeks
- Pregnant or lactating female
- Any unresolved toxicity greater than CTC grade 2 (version 4.0) from previous anti cancer treatment.
- Unsuitable patient in this treatment as determined by doctor.
Contacts and Locations| Contact: Joo Hang Kim, MD, PhD | 82-2-2228-8131 | kjhang@yuhs.ac |
| Principal Investigator: | Joo Hang Kim, MD, PhD | Severance Hospital |
More Information
No publications provided
| Responsible Party: | Joo Hang Kim, Severance Hospital |
| ClinicalTrials.gov Identifier: | NCT01697163 History of Changes |
| Other Study ID Numbers: | ISSIRES0067 |
| Study First Received: | September 12, 2012 |
| Last Updated: | September 26, 2012 |
| Health Authority: | Korea: Food and Drug Administration |
Keywords provided by Severance Hospital:
|
De Novo Resistance Iressa EGFR mutation lung cancer |
Additional relevant MeSH terms:
|
Carcinoma, Non-Small-Cell Lung Carcinoma, Bronchogenic Bronchial Neoplasms Lung Neoplasms Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site |
Neoplasms Lung Diseases Respiratory Tract Diseases Mitogens Mitosis Modulators Molecular Mechanisms of Pharmacological Action Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013