This pilot clinical trials studies azacitidine and entinostat in treating patients with newly diagnosed stage IA-IIIIA non-small cell lung undergoing surgery. Drugs used in chemotherapy, such as azacitidine, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Entinostat may stop the growth of cancer tumor cells by blocking some of the enzymes needed for cell growth. Giving azacitidine with entinostat may be an effective treatment for non-small cell lung cancer.
PRIMARY OBJECTIVES: I. To measure reversal of aberrant genome-wide promoter methylation and gene re-expression in paired, pre- and post- treatment lung tumor tissue pairs from patients with newly diagnosed, surgically resectable non-small cell lung cancer before and after exposure to a single neoadjuvant cycle of 5-azacytidine (azacitidine) and entinostat. SECONDARY OBJECTIVES: I. To measure the 3-year disease-free survival of operable non-small cell lung cancer (NSCLC) patients who receive 1 cycle of preoperative epigenetic treatment. II. To determine any potential toxicities, and reversibility of toxicities, of a single pre-operative cycle of 5-azacytidine and entinostat. OUTLINE: Patients receive azacitidine subcutaneously (SC) on days 1-6 and 8-10 and entinostat orally (PO) on days 3 and 10. Patients undergo surgery between days 11-20 (this period can be extended 10 more days if adverse events from therapy impose a surgical risk). After completion of study treatment, patients are followed up at 4 weeks, every 3 months for 2 years and then every 6 months for 1 year.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Given SC
Given PO
Correlative studies
Correlative studies
Undergo surgery
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, United States
University of New Mexico
Albuquerque, New Mexico, United States
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Change in aberrant genome-wide promoter methylation
Genome-wide DNA methylation and gene expression profiles of each pre- and post-treatment tumor will be assessed using validated DNA methylation and gene expression arrays. Response will be measured based on the degree of epigenomic reprogramming (i.e., number of genes affected, degree of demethylation, and class of genes \[e.g., PRC2\]) and pathways affected.
Time frame: Baseline up to day 20
Change in gene expression
Genome-wide DNA methylation and gene expression profiles of each pre- and post-treatment tumor will be assessed using validated DNA methylation and gene expression arrays. Response will be measured based on the degree of epigenomic reprogramming (i.e., number of genes affected, degree of demethylation, and class of genes \[e.g., PRC2\]) and pathways affected.
Time frame: Baseline up to day 20
Disease-free survival
Time frame: Up to 3 years
Reversibility of toxicities
Time frame: Up to 4 weeks after surgery
Toxicities, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.02
Time frame: Up to 4 weeks after surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.