Lung Cancer
Conditions
Keywords
stage I non-small cell lung cancer, stage II non-small cell lung cancer, stage IIIA non-small cell lung cancer
Brief summary
RATIONALE: Studying samples of tissue, blood, and urine from patients with cancer in the laboratory may help doctors learn more about changes that occur in DNA and identify biomarkers related to cancer. PURPOSE: This clinical trial is studying celecoxib in treating patients with stage I, stage II, or stage IIIA non-small cell lung cancer.
Detailed description
OBJECTIVES: * To assess cyclo-oxygenase-2 (COX-2) activity in patients with early-stage non-small cell lung cancer (NSCLC) and correlate the results with serum vascular endothelial growth factor (VEGF) levels, tumor microvessel density score, tumor prostaglandin E2 (PGE\_2) and matrix metalloproteinases (MMP) levels, and the major urinary metabolite of PGE\_2, PGE-M. * To assess the effect of specific COX-2 inhibitors (celecoxib) on COX-2 expression within the primary tumor, serum VEGF levels and tumor microvascular density, tumor PGE\_2 and MMP levels, and urinary PGE-M in a cohort of patients with early-stage NSCLC. OUTLINE: Patients receive oral celecoxib 400 mg twice a day for 5 days in the absence of disease progression or unaccepted toxicity. Patients with early-stage disease then undergo surgery. Biopsy, serum, and urine samples are obtained at baseline and after celecoxib treatment. The biopsy specimen are examined for the expression of cyclo-oxygenase-2 (COX-2), PGE\_2, and selected MMPs by immunohistochemistry, western blotting, and northern blotting. Serum and urine samples are analyzed for VEGF and PGE-M expression. COX-2 tumor expression is correlated with serum VEGF levels; tumor MMP-2, MMP-9, and PGE\_2 expression; urinary PGE-M and microvessel density scores.
Interventions
DRUGcelecoxib
400 mg P.O. BID for five days prior to obtaining second serum/urine collection (starting after initial biopsy, serum and urine collection)
PROCEDUREbiopsy
in patients with newly diagnosed NSCLC, a pretreatment excision of a small amount of tumor tissue
PROCEDUREtherapeutic conventional surgery
surgery to remove the lung tumor
Sponsors
National Cancer Institute (NCI)
Vanderbilt-Ingram Cancer Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Presumed histological or cytological diagnosis of non-small cell lung cancer * Diagnosis to be confirmed upon study entry to collect biopsy material for correlative studies * Stage I-IIIA disease PATIENT CHARACTERISTICS: * ECOG performance status of 0-2 * Serum creatinine ≤ 1.5 mg/dL * Granulocytes ≥ 1,500/mm\^3 * Platelets ≥ 100,000/mm\^3 * AST ≤ 3 times normal * Bilirubin ≤ 1.5 mg/dL * Not pregnant or nursing * Fertile patients must use effective contraception * No active unresolved infection PRIOR CONCURRENT THERAPY: * At least 7 days since prior and no concurrent non-steroidal anti-inflammatory agents or other cyclo-oxygenase-2 inhibitors * At least 7 days since prior parenteral antibiotics * No prior systemic chemotherapy or radiotherapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation of expression of cyclo-oxygenase-2 (COX-2) activity with serum VEGF levels, tumor microvessel density score, tumor PEG2 and MMP levels, and urinary PGE-M | Date of pretreatment biopsy surgery (tissue) and day 1 (blood) | COX-2 will be measured in pre-treatment tumor biopsy tissue as well as tumor microvessel density, MMP-2 and PGE2. VEGF will be measured in pre-treatment blood. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Effect of Celecoxib on COX-2 expression and microvascular density in tumor, PGE2 and MMP levels in tumor, serum VEGF levels and urinary PGE-M | After day 5 of 5 days of treatment | Patients with early-stage NSCLC will undergo tumor resection after 5 days of treatment with celecoxib. Tumor tissue will be examined. Post-treatment blood and urine will also be collected and examined. |
Outcome results
None listed