High Dose Vitamin A Compound in Treating Participants With Resectable Non-Small Cell Lung Cancer
Study Details
Study Description
Brief Summary
This trial studies how well high dose vitamin A compound works in treating participants with non-small cell lung cancer that can be removed by surgery. Vitamin A compound may increase the number of germinal centers (immune centers that make antibodies mature) in tumor and lymph tissues which may be beneficial to patients with cancer.
Condition or Disease | Intervention/Treatment | Phase |
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Early Phase 1 |
Detailed Description
PRIMARY OBJECTIVES:
- To compare the percentage of resected cancers containing germinal centers (GCs) in patients who receive neoadjuvant vitamin A compound (vitamin A) to controls.
SECONDARY OBJECTIVES:
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To compare the abundance of GCs in adjacent lymph nodes in patients who receive neoadjuvant vitamin A to controls.
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To compare histopathologic responses based on tumor necrosis in lung cancer patients who receive neoadjuvant vitamin A to controls.
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To compare overall survival of patients who receive neoadjuvant vitamin A to controls.
EXPLORATORY OBJECTIVES:
- To describe immunophenotypic changes of monocytes including myeloid derived suppressor cells (MDSCs) in pre- and post-treatment blood samples.
OUTLINE: Participants are randomized to 1 of 2 groups.
GROUP I: Participants receive vitamin A compound orally (PO) for 7 consecutive days in the absence of disease progression or unacceptable toxicity. Within 21 days of completing treatment, participants then undergo surgical resection.
GROUP II: Participants undergo surgical resection.
After completion of study treatment, participants are followed up for 30 days.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Vitamin A compound Participants receive vitamin A compound PO for 7 consecutive days in the absence of disease progression or unacceptable toxicity. Within 21 days of completing treatment, participants then undergo surgical resection. |
Drug: Vitamin A Compound
Participants randomized to this arm will receive 7 consecutive days of of Vitamin A compound without disease progression or unacceptable toxicities. Within 21 days of completion of treatment participants will undergo surgical resection
Other Names:
|
Active Comparator: Therapeutic Conventional Surgery Description Participants undergo surgical resection. |
Procedure: Therapeutic Conventional Surgery
Participants randomized to this arm will receive surgical resection
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Outcome Measures
Primary Outcome Measures
- Presence or absence of germinal centers in resected tissue [Up to 2 years]
Presence/absence of germinal centers (GCs) in resected cancer tissues from patients who receive neoadjuvant vitamin A and controls.
Secondary Outcome Measures
- Proportion of Germinal Centers in Lymph Nodes [Up to 2 years]
Measurement of GCs per unit area in adjacent lymph nodes will be assessed using semi-quantitative designation (Score of high, moderate, low, or absent) in patients who receive neoadjuvant vitamin A and controls.
- Presence or Absence of Tumor Necrosis [Up to 2 years]
Pathologic response will be defined by tumor necrosis which will be dichotomized as present or absent in patients who receive neoadjuvant vitamin A and controls
- Overall Survival [Up to 2 years]
Overall survival of patients receiving neoadjuvant Vitamin A and in controls.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patient must be 18 years of age or older.
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Patients must have either biopsy proven or radiographically suspected non-small cell lung cancer.
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Patients must have disease in the chest that is felt to be surgically resectable.
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ECOG performance status of 0-2.
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Ability to understand and the willingness to sign an IRB-approved informed consent document
Exclusion Criteria:
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Patients younger than 18 years of age
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Women who are pregnant or breast feeding.
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Patients may not be receiving any other investigational agents for the treatment of nonsmall cell lung cancer.
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Patients may not be taking the following medications: high dose vitamin A supplement (multivitamin supplements prohibited only if vitamin A content is greater than 3,500 international units), bexarotene, alitretinoin, tretinoin, adapalene, isotretinoin, acitretin, doxycycline, minocycline, or demeclocycline,
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Uncontrolled intercurrent illness including, but not limited to, pancreatitis, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
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Hypervitaminosis A - toxic effects of ingesting too much vitamin A.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Wake Forest Baptist Comprehensive Cancer Center | Winston-Salem | North Carolina | United States | 27157 |
Sponsors and Collaborators
- Wake Forest University Health Sciences
- National Cancer Institute (NCI)
Investigators
- Principal Investigator: William J Petty, MD, Wake Forest University Health Sciences
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- WFBCCC 62218
- NCI-2018-00888
- IRB00050640
- P30CA012197