Saint Louis, Missouri 63141

  • Small Cell Lung Cancer


The optimal treatment for Stage I or Stage IIA non-small cell lung cancer (NSCLC) remains controversial. Radiographic surveillance alone has been recommended for stage I and stage IIA patients after the tumor is removed surgically from the lung, and this standard has been based on the fact that no previous clinical trial has demonstrated a benefit for Stage I or Stage IIA NSCLC patients who receive post-operative chemotherapy. These patients, however, have a substantial risk of death within five years after operation, ranging from approximately 30% to 45%, largely due to metastatic disease that is present immediately after surgery but that is undetectable by conventional methods. Some leading organizations therefore currently recommend post-operative chemotherapy as an alternative standard of care in Stage I or Stage IIA NSCLC patients who are considered to be at particularly high-risk. Up until now, however, there has not been a well-validated means to identify stage I and stage IIA NSCLC patients at high risk of death within five years after operation. A new prognostic tool, a 14-Gene Prognostic Assay, which has been validated and definitively demonstrated in large scale studies to identify intermediate and high-risk stage I or Stage IIA patients with non-squamous NSCLC, is now available to all clinicians through a CLIA-certified laboratory. It is therefore now possible to compare the outcomes of patients randomly assigned to one or the other of these competing standards of care.


Inclusion Criteria: - Written informed consent - Age ≥ 18 years - Adequate tissue sample for the 14-Gene Prognostic Assay - Histologically documented completely resected (R0) Stage I or Stage IIA non-squamous NSCLC. Mixed histologies that include a squamous cell, small cell or neuroendocrine component are eligible for the study, as long as they contain at least some component that is neither squamous cell nor small cell nor neuroendocrine. Eligible resections include segmentectomy, lobectomy, bi-lobectomy, sleeve lobectomy, and pneumonectomy. Resections via wedge resection will not be eligible. Complete resection must also be accompanied by mediastinal lymph node sampling through mediastinoscopy, bronchoscopic sampling (e.g. endobronchial ultrasound guided biopsy) or surgical sampling. Nodes must be sampled from at least one of the following nodal stations: Levels 2, 4, 7, 8, 9 for right- sided cancer and levels 2,4,5,6,7,8 9 for left-sided cancers. - Life expectancy excluding NSCLC diagnosis ≥ 5 years - ECOG performance status 0-1 - Adequate haematological function: 1. Absolute neutrophil count (ANC) ≥ 1500 cells/mm3 AND 2. Platelet count ≥ 100000 cells/mm3 AND 3. Haemoglobin ≥ 9 g/dL (may be transfused to maintain or exceed this level) - Adequate liver function: 1. Total bilirubin < 1.5 x upper limit of normal (ULN) AND 2. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 2.5 x ULN - Adequate renal function, with Serum creatinine ≤ 1.5 x ULN - Completely healed incisions Exclusion Criteria: - Final pathologic diagnosis of purse squamous cell histology, pure small cell or pure neuroendocrine histology, or any combination of only these three histologies. - Evidence of greater than stage II A pathologic staging - Evidence of incomplete resection - Pregnant or lactating women - Unwilling to use an effective means of contraception - Active infection, either systemic or at site of primary resection - Prior systemic chemotherapy or anti-cancer agent - Any pre- or post-operative radiotherapy - Malignancies other than NSCLC within 5 years prior to randomization, except for adequately treated CIS of the cervix, basal or squamous cell skin cancer, localized prostate cancer treated surgically, ductal carcinoma in situ treated surgically - Treatment with any investigational drug or participation in another clinical trial within 28 days prior to enrollment - Known hypersensitivity to any of the study treatment agents - Evidence of any other disease including infection that contraindicates the use of systemic cytotoxic chemotherapy or puts the patient at high risk for treatment related complications



Primary Contact:

Principal Investigator
David R Spigel, MD
Sarah Cannon, The Cancer Institute of HCA Healthcare

Michael Mann, MD
Phone: 650-535-0030

Backup Contact:

Carolyn Clary, RN
Phone: 650-535-0030

Location Contact:

Saint Louis, Missouri 63141
United States

Erin Cattoor

Site Status: Recruiting

Data Source:

Date Processed: September 26, 2021

Modifications to this listing: Only selected fields are shown, please use the link below to view all information about this clinical trial.

Click to view Full Listing

If you would like to be contacted by the clinical trial representative please fill out the form below.