Lung cancer prevention trials

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Contributing to Cancer Research. Strategic Planning. Principal Deputy Director's Page. Previous NCI Directors. NCI Frederick. Studying samples of urine in the laboratory from smokers who are at high risk for lung cancer may help doctors learn more about biomarkers related to cancer. The purpose of this study is to assess Methylated DNA tumor markers distributed in blood samples of patients newly diagnosed with different types of lung cancer.

The goal is to develop new blood screening tests that can identify the type and primary site of cancer. The purpose of this study is to learn whether it is better to receive the drug Metformin with standard of care for lung cancer or just standard of care. The purpose of this study is to determine how well the addition of targeted radiation therapy to surgery and the usual chemotherapy treatment works for the treatment of stage I-IIIA malignant pleural mesothelioma.

Targeted radiation therapy such as intensity-modulated radiation therapy or pencil beam scanning uses high energy rays to kill tumor cells and shrink tumors. Drugs used in chemotherapy, such as pemetrexed, cisplatin, and carboplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.

Giving targeted radiation therapy in addition to surgery The purpose of this study is to evaluate the safety and efficacy of cryoablation therapy used to treat tumors in patients with pulmonary metastatic disease. This study is to enroll patients who will undergo cryoablation of at least 1 metastatic pulmonary tumor that is less than or equal to 3.

Patients will be followed 24 months post their cryoablation procedure. The purpose of this study is to evaluate the safety and effectiveness of amatuximab in combination with pemetrexed and cisplatin in subjects with unremovable malignant pleural mesothelioma, who have not received prior systemic therapy. This study will help us to develop better ways to screen people at risk for lung cancer and develop better treatments for patients diagnosed with lung cancer.

This study will also help us to learn whether certain genes inherited factors from your parents increase the risk of developing lung cancer. Prior to entry and randomization to the study, each subject must have tumor Merlin status high or low established by immunohistochemistry performed at a central laboratory.

Subjects will be randomized in a ratio to receive oral VS mg twice per day, or matched placebo. Randomization will be stratified by tumor Merlin status high versus low. Progression will be This may be an effective treatment for extensive stage small cell lung cancer. PURPOSE: This randomized phase II trial is comparing how well radiation therapy to the brain works when given with or without radiation therapy to other areas of the body in treating patients with extensive stage small cell lung cancer.

Monoclonal antibodies, such as anetumab ravtansine and pembrolizumab, may interfere with the ability of tumor cells to grow and spread. The purpose of this study is to evaluate immunogenicity of the vaccine, assessed at week 12, based on the increase in IgG anti-MUC1 antibody titer over the pre-vaccination levels, and to assess the safety throughout the trial and continued observation for 24 weeks.

To gather preliminary safety and outcome data for the multimodality treatment of lung adenocarcinoma in the setting of multifocal BAC. The purpose of this study is identify molecular changes in recurring lung cancer tumors, and to determine the most significant genes, pathways and clinical characteristics in these lung adenocarcinomas which are resistant to tyrosine kinase inhibitor.

The purpose of this study is to better understand how the immune system, the body's natural defense against infection and harmful cells, is affected by the presence of lung cancer and the treatment of lung cancer. This study seeks to study the effectiveness of a short mindfulness based pulmonary rehabilitation program prior to a surgical resection in patients with lung cancer and severe Chronic Obstructive Lung Disease COPD.

This is a Phase 2b, randomized, double-blind, parallel-group study. Subjects with unresectable pleural or peritoneal malignant mesothelioma will be randomized in a ratio to receive either tremelimumab or placebo.

Approximately subjects will be enrolled at study centers in multiple countries. The study consists of a screening period, a treatment period, a day follow-up period for safety, and a long-term survival follow-up period. The primary purpose of this study is to find out what effects good or bad the drugs auranofin and sirolimus have on patients with lung cancer; to find out if auranofin and sirolimus can stop or slow the growth of the lung cancer; to learn more about how auranafin and sirolimus work against lung cancer by testing blood and tissue samples.

The main purpose of this study is to assess the effectiveness and safety of treatment with anetumab ravtansine versus vinorelbine for progression free survival in patients with stage IV mesothelin overexpressing type of malignant pleural mesothelioma. Radiological tumor assessments will be performed at defined time points until the patient's disease progresses. Blood samples will be collected for safety, pharmacokinetic and biomarker analysis.

Archival or fresh biopsy tissue may also be collected for central pathology review and biomarkers. Post market prospective, non-randomized, single-arm, multicenter study, designed to demonstrate dose response of an ablation system using a percutaneous approach in patients with primary, metastatic, or recurrent primary lung tumors.

For patients with this type of cancer, the standard of care is treatment with chemotherapy. Radiation therapy is typically not used. This is because radiation to the entire lining of the lung has many side effects that are often severe including damage to the lung pneumonitis. There is a new radiation technique using Intensity Modulated Radiation Therapy IMRT that has been shown to reduce many of the side effects of standard radiation therapy.

This type of radiation therapy specifically targets the lining of the lung, where you have your cancer, and reduces the risk of damaging the lung itself. The purpose of this study is to assess the possibility, safety, and therapeutic effect of administering a short, quick course of high-dose radiation treatment focused on half of the chest, followed by surgery to remove that portion of the lungs, in patients with malignant pleural mesothelioma.

The hippocampus is part of the brain that is important for memory. Avoiding the hippocampus during whole-brain radiation could decrease the The study seeks to assess the efficacy of veliparib ABT in combination with carboplatin and etoposide in participants with extensive disease small cell lung cancer ED SCLC. ED SCLC is defined herein as any SCLC except a disease confined to the hemithorax of origin, with or without the involvement of regional lymph nodes, including ipsilateral and contralateral mediastinal, ipsilateral and contralateral mediastinal, and ipsilateral supraclavicular nodes.

Piloting the BeWellCG model, in conjunction with usual care delivery for lung cancer patients in Palliative Care, will longitudinally improve the wellbeing and quality of life of care givers within and outside of clinical care settings, in such a way as to positively impact the quality of care of patients themselves. In doing so, we further hypothesize that there will be an improvement in patient-reported and quality of care This research study is being done because we want to better understand the composition of exhaled breath and exhaled breath condensate in health and disease and at different stages of disease to determine if there are markers in this easy to collect sample that can help us understand disease progression and give earlier warning that health or disease status is declining and improve treatment for patients.

This is a Phase 3, randomized, double-blind, placebo-controlled, multinational, and multicenter study to evaluate the efficacy of rovalpituzumab tesirine as maintenance therapy following first-line platinum-based chemotherapy. The purpose of this study is to perform preclinical testing in patient samples and experimental models. The purpose of this study is to describe in detail the smoking history in a population of acute or prior cerebrovasculqar accident CVA patients and identify those who qualify for lung cancer screening by criteria outlined by three separate organizations.

This study will evaluate the impact of a proactive, EHR-supported enrollment strategy that links LDCT-eligible smokers with an evidence-based intervention comprised of a web-based program and integrated text messaging.

The goal is to provide actionable findings about how to most effectively and cost efficiently promote abstinence in LDCT clinics. This pilot clinical trial studies lisinopril in reducing shortness of breath caused by radiation therapy in patients with lung cancer.

Lisinopril may decrease the side effects caused by radiation therapy in patients with lung cancer. TG has been developed for use as an immunotherapy in cancer patients whose tumors express the MUC1 antigen.

TG is intended to induce a MUC1-specific cellular immune response and to produce a non-specific activation of several components of the immune system. The purpose of this study is to design and develop a lung cancer specific MassArray panel, LungCarta, that enables comprehensive detection of mutations in oncogenes frequently affected in lung cancers.

The purpose of this study is to compare whether surgical staging is more accurate than imaging procedures when diagnosing malignant lung mesothelioma. The purpose of this study is to evaluate whether CRS with pembrolizumab is safe and effective in adults with MPM who have failed prior anti-cancer therapy. This study is designed to determine whether or not plasma and sputum microRNA might be an effective, non-invasive biomarker for lung cancer risk.

The purpose of this study is to examine the ease and practicality of extracting central memory T-cells and the potential for their activation and ability to recognize tumor antigens and target lung cancer cells for destruction. Circulating cell-free DNA cfDNA from the plasma will be extracted and sequenced to identify somatic mutations that were exposed to the T-cells.

The purpose of this study is to evaluate if lung ablation improves clinical outcomes for patients deemed to be surgically high-risk. The purpose of this study is to collect data and then design a decision aid for patients who are having a lung screening.

The purpose of this study is to follow patients with malignant mesothelioma of the lung after they have had combined chemotherapy, surgery, and intensity modified radiation therapy and determine response rates and overall survival. RATIONALE: Wedge resection or segmentectomy may be less invasive types of surgery than lobectomy for non-small cell lung cancer and may have fewer side effects and improve recovery.

It is not yet known whether wedge resection or segmentectomy are more effective than lobectomy in treating stage IA non-small cell lung cancer. This study will compare two doses of pembrolizumab versus docetaxel in participants with non-small cell lung cancer NSCLC who have experienced disease progression after platinum-containing systemic therapy. This study will use an adaptive trial design so that the total number of participants randomized will depend upon demonstration of sufficient objective responses at interim analysis.

If the pembrolizumab Low Dose arm is closed, participants may receive pembrolizumab High Dose therapy. The purpose of this study is to find markers for the development of a test that will be used to define the risk of getting lung cancer in heavy smokers or to determine whether a lung nodule is cancer.

The purpose of this study is to test the effectiveness and tolerability of the combination of Nivolumab and Ipilimumab compared to Pemetrexed and Cisplatin or Carboplatin in patients with unresectable pleural mesothelioma. Success of cancer immunotherapy is limited by the ability of solid tumors to evade local and systemic antitumoral immune responses. Several mechanisms of tumor immune evasion have been identified, including low intratumor expression of antigens and elevated expression of inhibitory co-regulatory molecules.

An effective immunotherapy is one which would induce necrotic cell death and accompanying proinflammatory cytokine induction. The purpose of this study is to assess the activity of durvalumab and chemotherapy administered prior to surgery compared with placebo and chemotherapy administered prior to surgery in terms of major pathological response.

The purpose of this study is to evaluate whether engineering gut microbiome using probiotics will alter host immunological response to breast and lung cancers.

The study will also investigate if some proteins measured in the blood or tumor and some imaging features obtained from computed tomography CT scans can help predict whether OSI or topotecan will be effective against Small Cell Lung Cancer.

The purpose of this study is to determine dose escalation of paclitaxel administered as Oraxol in combination with Pembrolizumab, and dose expansion to assess the ORR per Response Evaluation Criteria in subjects with advanced Solid Tumors, Urothelial Carcinoma, Gastric cancer, Gastro-esophageal cancer, and Non-small cell lung cancer.

The trial will evaluate the PK pharmacokinetic effects of PT and the safety and tolerability of the combination as Additional patients limited to those with EGFR mutations may be enrolled following the initial study period as needed to ensure adequate sample sizes needed to examine primary questions of interest in the EGFR mutant population.

Patients will be enrolled over a three year period across approximately 25 geographically diverse academic as The purpose of this study is to compare the progression-free survival PFS of docetaxel in combination with bintrafusp alfa vs.

The purpose of this study is to evaluate the effectiveness and safety of X ensartinib versus crizotinib in patients who have ALK-positive non-small cell lung cancer that have received up to 1 prior chemotherapy regimen and no prior ALK inhibitor. The primary purpose of this study is to evaluate the efficacy of the study drug known as LY, administered alone or in combination with a second drug named Erlotinib, in participants affected by a defined type of lung cancer MET biomarker diagnostic positive Non-Small-Cell Lung Cancer that experienced a disease progression during the most recent treatment with Erlotinib.

The standard way of giving the radiation therapy is to give it once daily for 6 to 7 weeks. The study is currently testing if a higher amount of radiation therapy per treatment can be given as well as shorten the total number of treatments to 4 or 5 weeks. The goal is that a higher dose of Phase 2 multicenter, controlled, randomized, double-blind study to evaluate the efficacy and safety of ficlatuzumab versus placebo when administered with erlotinib in subjects with previously untreated metastatic EGFR-mutated NSCLC and BDX Positive Label.

The primary purpose of this study is to evaluate safety and effectiveness in participants treated with concomitant chemoradiation therapy cCRT plus M followed by M compared to cCRT plus placebo followed by durvalumab.

The purpose of this study is to demonstrate avelumab's overall survival superiority versus docetaxel in patients with programmed death ligand 1 PD-L1 positive non-small cell lung cancer NSCLC after the failure of a platinum-based doublet. This research study is evaluating ways to provide palliative care to patients who have recently been diagnosed with lung cancer and their families.

The purpose of this study is to isolate and measure circulating tumor cells in the blood stream to advance detection of cancer and treatment monitoring. In this study, the investigators will utilize the novel technology for circulating tumor cell detection in order to evaluate their presence in patients with lung cancer. The purpose of this study is to assess the safety and effectiveness of combined gemcitabine and cisplatin chemotherapy plus necitumumab for the treatment of patients who have late stage lung cancer.

This study will assess safety and treatment activity of DSa in combination with pembrolizumab in participants with advanced or metastatic NSCLC without actionable genomic alterations who have had previously treated with platinum-based therapy with or without prior immunotherapy.

The device is an experimental, portable, battery operated device for chronic administration of alternating electric fields termed TTFields or TTF to the region of the malignant tumor, by means of surface, insulated electrode arrays.

This research trial studies genetic testing in screening patients with stage IB-IIIA non-small cell lung cancer that has been or will be removed by surgery.

Studying the genes in a patient's tumor cells may help doctors select the best treatment for patients that have certain genetic changes. The study will also evaluate safety and pharmacokinetics of INC The purpose of this study is to evaluate whether pembrolizumab alone as a first-line treatment, followed by pemetrexed and carboplatin with or without pembrolizumab after disease progression, is superior to induction with pembrolizumab, pemetrexed and carboplatin followed by pembrolizumab and pemetrexed maintenance in treating patients with stage IV non-squamous non-small cell lung cancer.

Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread.

Drugs used in chemotherapy, such as pemetrexed and carboplatin, work in different ways to stop the growth of This trial studies how well atezolizumab added to the usual radiation therapy works in treating patients with stage I-IIA non-small cell lung cancer. Radiation therapy, such as stereotactic body radiation therapy, uses special equipment to position a patient and deliver radiation to tumors with high precision.

This method can kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. Giving atezolizumab and radiation therapy The purpose of this study is to determine the efficacy of pembrolizumab given in combination with either ipilimumab or placebo as first-line treatment in participants with metastatic non-small cell lung cancer NSCLC.

An important early source of data about radiation exposure came from studies of atomic bomb survivors in Japan; these studies demonstrated that a single high-dose exposure to gamma rays is sufficient to increase the risk of lung cancer in a dose-dependent fashion. Studies of patients with tuberculosis who were treated with pneumothorax and monitored with frequent fluoroscopy, with resulting cumulative radiation doses of about 85 rads 0.

The evidence is most abundant for breast cancer [ 36 - 39 ] and Hodgkin lymphoma. The association between radiation exposure and lung cancer has implications for the general population in countries such as the United States, where computed tomography CT scans are relatively common and may contribute to an excess of cancer at the population level.

Because they deposit concentrated energy in tissue, particles e. Radon is an inert gas produced naturally in the decay series of uranium. Along with other supportive scientific evidence, studies of underground uranium miners exposed to very high levels of radon have demonstrated that radon exposure causes lung cancer. Although early evidence from case-control and cohort studies did not support an association between air pollution and lung cancer, the evidence now points to a genuine association.

In an extended follow-up of a study of six U. Studies of dietary factors have yielded intriguing findings, but because the diets of smokers tend to be less healthy than those of nonsmokers, it is challenging to separate the influence of dietary factors from the effects of smoking.

When considering the relationships between lung cancer and dietary factors, confounding factors related to cigarette smoking cannot be dismissed as a possible explanation. While the focus has been on fruit and vegetable consumption and micronutrients, a wide range of dietary and anthropometric factors have been investigated. Anthropometric measures have been studied, indicating a tendency for leaner persons to have increased lung cancer risk relative to those with greater body mass index.

A meta-analysis of leisure-time physical activity and lung cancer risk revealed that higher levels of physical activity protect against lung cancer. The WCRF evidence review rated the inverse association between physical activity and lung cancer as limited suggestive evidence.

Studies of physical activity yield findings consistent with an inverse association, but because physical activity behaviors differ between smokers and nonsmokers, it is difficult to infer that there is a direct relationship between physical activity and lung cancer risk.

An increase in lung cancer risk among never smokers also has been observed with exposure to asbestos, ionizing radiation from sources other than radon, and indoor air pollution caused by combustion of coal or other solid fuel. Substantial harm to public health accrues from addiction to cigarette smoking. Compared with nonsmokers, smokers experience a dose-dependent increase in the risk of developing lung cancer and many other malignancies.

Substantial benefits accrue to the smoker by quitting smoking. Avoidance of tobacco use is the most effective measure to prevent lung cancer. The preventive effect of smoking cessation depends on the duration and intensity of prior smoking and upon time since cessation. The benefits of tobacco control at the population level provide strong quasi-experimental evidence that reducing population-level exposure to cigarettes has resulted in population-level declines in the occurrence of lung cancer.

Reduced tobacco consumption, resulting from decreases in smoking initiation and increases in smoking cessation, led to a decline in overall age-adjusted lung cancer mortality among men since the mids, consistent with reductions in smoking prevalence among men since the s. Nicotine dependence exposes smokers in a dose-dependent fashion to carcinogenic and genotoxic elements that cause lung cancer. Many pharmacotherapies for smoking cessation, including nicotine replacement therapies e.

Based on a synthesis of the results of randomized trials, nicotine replacement therapy treatments, alone or in combination, improve cessation rates over placebos after 6 months RR, 1. In addition to individually focused cessation efforts, a number of tobacco control strategies at the community, state, and national level have been credited with reducing the prevalence of smoking. Strategies include the following:[ 81 , 82 ]. Health indicators including respiratory systems, sensory symptoms, and hospital admissions were reported as outcomes in 25 studies.

With respect to health outcomes, a consistent finding was reduced hospital admissions for cardiac events. After cigarette smoking and exposure to secondhand smoke, occupational exposure to lung carcinogens, such as asbestos, arsenic, nickel, and chromium, is the most important contributor to the lung cancer burden. Consequently, the proportion of the lung cancer burden attributable to occupational exposures is declining over time in countries like the United States that have taken steps to protect the workforce from exposure to known lung carcinogens.

Subjects were randomly assigned to one of the following four groups for 5 to 8 years: beta-carotene alone, alpha-tocopherol alone, beta-carotene plus alpha-tocopherol, or placebo.

Subjects receiving beta-carotene alone or with alpha-tocopherol had a higher incidence of lung cancer RR, 1. In , the results of the U. The primary endpoint was lung cancer incidence.

The trial was terminated early by the Data Monitoring Committee and NCI because its results confirmed the ATBC finding of a harmful effect of beta-carotene over that of placebo, which increased lung cancer incidence RR, 1.

In a follow-up study of CARET participants after the intervention discontinued, these effects attenuated for a period of time. After 6 years of postintervention follow-up, the postintervention RR for lung cancer incidence was 1. During the postintervention phase a larger RR among women, rather than men, emerged for both outcomes in subgroup analyses; the reason for this observation, if reliable, is not known.

The overall findings from the ATBC [ 84 , 85 ] and CARET [ 86 , 88 ] studies, which include over 47, subjects, demonstrated that pharmacological doses of beta-carotene increase lung cancer risk in relatively high-intensity smokers.

The mechanism of this adverse effect is not known. Subsequent analyses of participants in these trials and cohorts suggest that the beneficial outcomes associated with high beta-carotene plasma levels may be due to increased dietary intake of fruits and vegetables.

These findings show the importance of randomized controlled trials RCTs to confirm epidemiologic studies. Studies have examined whether it is possible to prevent cancer development in the lung using chemopreventive agents. Chemoprevention is defined as the use of specific natural or synthetic chemical agents to reverse, suppress, or prevent carcinogenesis before the development of invasive malignancy.

So far, agents tested for efficacy in lung cancer chemoprevention have been micronutrients, such as beta-carotene and vitamin E. Two other RCTs of beta-carotene were carried out in populations that were not at excess risk of lung cancer. The PHS was designed to study the effects of beta-carotene and aspirin in cancer and cardiovascular disease. The study is a randomized, double-blind, placebo-controlled trial begun in involving 22, male physicians aged 40 to 84 years.

After 12 years of follow-up, beta-carotene was not associated with overall risk of cancer RR, 0. After a median of 2. In this randomized, placebo-controlled trial, patients aged 55 years or older with vascular disease or diabetes were assigned to IU vitamin E or placebo.

With a median follow-up of 7 years, the group randomly assigned to vitamin E had a significantly lower lung cancer incidence rate 1. In the WHS of 40, female health professionals, using IU of vitamin E every other day showed no evidence of protection against lung cancer in women RR, 1.

The trial began recruitment in , and as of the follow-up the results showed a slightly higher rate of lung cancer in the vitamin group compared with the placebo group 1. The combined evidence for vitamin E supplementation thus continues to be consistent with no effect on lung cancer risk. The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available.

This section describes the latest changes made to this summary as of the date above. Description of the Evidence. Revised text to state that the incidence rate in men declined from a high of Revised text to state that between and , the incidence rate in Black men was higher than in White men, whereas among women, the incidence rate in Black women was lower than in White women; similarly, the mortality rates among Black men were higher than among White men during the same time frame, whereas the mortality rates among Black women were lower than among White women.

Revised text to state that the overall 5-year relative survival rate from lung cancer was This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about lung cancer prevention. It is intended as a resource to inform and assist clinicians in the care of their patients.

It does not provide formal guidelines or recommendations for making health care decisions. Board members review recently published articles each month to determine whether an article should:. Changes to the summaries are made through a consensus process in which Board members evaluate the strength of the evidence in the published articles and determine how the article should be included in the summary.

Any comments or questions about the summary content should be submitted to Cancer. Do not contact the individual Board Members with questions or comments about the summaries. Board members will not respond to individual inquiries. Some of the reference citations in this summary are accompanied by a level-of-evidence designation.

These designations are intended to help readers assess the strength of the evidence supporting the use of specific interventions or approaches. The PDQ Screening and Prevention Editorial Board uses a formal evidence ranking system in developing its level-of-evidence designations. PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated.

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