Patient case: 52-year-old male with Lung cancer. Genetic variant: EML4-ALK Fusion transcript. Other conditions: Hypertension, Osteoarthritis.

Clinical trial: Fluorescent Light Bronchoscopy Plus White Light Bronchoscopy for Early Detection of Lung Cancer

Summary: RATIONALE: Fluorescent bronchoscopy, when used in combination with conventional white light bronchoscopy, may improve the ability to detect early lung cancer.
  PURPOSE: A pilot study to evaluate fluorescent light bronchoscopy plus conventional bronchoscopy as a tool for screening and detecting lung cancer in persons with completely resected head and neck cancer or successfully treated early-stage lung cancer.

Detailed description: OBJECTIVES:
  -  Evaluate the efficacy of autofluorescence bronchoscopy using the Lung Imaging Fluorescence Endoscopic System with conventional white-light bronchoscopy for the early detection of lung cancer in selected patients with known or suspected bronchogenic carcinoma, completely resected head and neck cancer, and successfully treated early-stage lung cancer.
  -  Determine the number of areas of moderate dysplasia, severe dysplasia, and carcinoma in situ in patients treated with surgery for lung cancer compared with patients treated with combined modality therapy.
  -  Determine the ability of immunohistochemistry to predict whether lesions of moderate to severe dysplasia will progress to cancer.
  OUTLINE: If possible, patients produce a 3-day pooled sputum sample prior to bronchoscopy. Patients then undergo tracheobronchial white-light bronchoscopy followed by autofluorescence bronchoscopy using the Lung Imaging Fluorescence Endoscopic (LIFE) Device attached to a computerized video camera. Visualized tissue is classified as either normal, abnormal, or suspicious. Abnormal or suspicious tissue is biopsied, as is tissue from 1 or 2 randomly chosen normal sites. Immunohistochemical analysis of the biopsy material is conducted without knowledge of the bronchoscopic results. Patients unable to produce a sputum sample prior to bronchoscopy are required to do so after bronchoscopy.
  PROJECTED ACCRUAL: A total of 70 patients will be entered.

Eligibility: DISEASE CHARACTERISTICS:
  -  The following diagnoses are eligible:
  -  Known or suspected bronchogenic carcinoma scheduled for bronchoscopy as part of standard diagnostic or staging work-up
  -  Completely resected stage I/II non-small cell lung cancer with no evidence of metastasis
  -  Stage III non-small cell lung cancer with no evidence of disease for at least 2 years following treatment
  -  Small cell lung cancer with no evidence of disease for at least 2 years following treatment
  -  Completely resected head and neck cancer with no evidence of metastasis
  -  Ability to produce sputum samples required
  PATIENT CHARACTERISTICS:
  Age:
  -  18 and over
  Performance status:
  -  ECOG 0-2
  Hematopoietic:
  -  WBC 2,000-20,000
  -  Platelets at least 50,000
  Hepatic:
  -  Not specified
  Renal:
  -  Not specified
  Cardiovascular:
  -  No uncontrolled hypertension (i.e., systolic pressure greater than 200 mm Hg or diastolic pressure greater than 120 mm Hg)
  -  No unstable angina
  Other:
  -  No bleeding disorder
  -  No allergic reaction to topical lidocaine
  -  No pregnant women
  PRIOR CONCURRENT THERAPY:
  Biologic therapy
  -  Not specified
  Chemotherapy
  -  Not specified
  Endocrine therapy
  -  Not specified
  Radiotherapy
  -  At least 18 months since ionizing radiotherapy to the chest
  Surgery
  -  See Disease Characteristics
  Other
  -  At least 1 month since yttrium-aluminum-garnet (YAG) laser therapy to the lung
  -  At least 3 months since fluorescent photosensitizing drugs (e.g., Photofrin)

Relevance to patient case: not relevant