Patient case: 67-year-old male with esophageal cancer; genetic feature: EGFR

Clinical trial: Feasibility Study of Using Navigational Bronchoscopy to Perform PDT-Photofrin® in Unresectable Peripheral Lung Cancer

Summary: This research study is being conducted to assess the safety and feasibility of using a new developed bronchoscopic technology called electronavigational bronchoscopy to treat subjects with peripheral stage T1A non-small cell lung cancer (NSCLC), who are inoperable or refused surgery, and are not candidates or refused radiation therapy. It will involve 10 sites in USA and Canada. Participation will last 6 months.

Detailed description: Lung cancer accounts for almost one-third of cancer deaths. Cancer screening strategies have the potential to achieve a 20% reduction in death rates. Newly developed bronchoscopic technologies (such as navigational bronchoscopy) have shown to enable physicians to safely reach lesions in peripheral regions of the lung and obtain diagnosis. This new technology may now potentially offer bronchoscopic therapeutic interventions, such as photodynamic therapy, to tumors that were previously unreachable due to their peripheral anatomic location.
  Photodynamic therapy (PDT) uses a combination of a photosensitizing drug (a drug that is activated by light), called porfimer sodium (Photofrin®), and a light from a laser that emits no heat. This technique works to allow the medical doctor to specifically target and destroy abnormal or cancer cells while limiting damage to surrounding healthy tissue. The activation of the drug is done by lighting the abnormal area using a fiber optic device (very fine fiber [like a fishing line] that permits light transmission) inserted into a flexible tube called bronchoscope. The light activates the porfimer sodium, which is concentrated in the abnormal tissue, leading to its destruction.
  The purpose of this study is to determine if physicians can reach the tumors in the periphery of the lung via electronavigational bronchoscopy and deliver the photodynamic therapy by placing the optical fiber into the tumor.

Eligibility: Inclusion Criteria:
  -  Male or female aged 18 or older
  -  Diagnosed with histologically confirmed Stage TIA (T1aN0M0) NSCLC located in the peripheral lung
  -  Not candidate for curative surgery, is unfit for surgery, or does not wish to undergo curative surgery
  -  Not candidate for curative concurrent chemo/radiation therapy or does not wish to undergo curative chemo/radiation therapy
  -  The tumor is ≤ 2 cm in size and clearly observable in computerized tomography (CT scan) with contrast
  -  Able to sign an informed consent
  Exclusion Criteria:
  -  Diagnostic of small cell lung cancer
  -  NSCLC located in central lung
  -  Presence of concurrent non-solid malignancy
  -  Abnormal blood results
  -  Tumor invades a major blood vessel
  -  Porphyria or known hypersensitivity to Photofrin® or porphyrin-like compounds or to any of its excipients
  -  Planned surgical procedure within the next 90 days
  -  Coexisting ophthalmic disease likely to require slit-lamp examination within the next 90 days
  -  Acute or chronic medical or psychological illnesses that prevent endoscopy procedures
  -  Pregnant or intend to become pregnant, breastfeeding or intend to breastfeed during the study
  -  Received PDT during the past 3 months
  -  Known sensitivity to contrast agent used in CT scan
  -  Severe impairment of your kidney or liver function
  -  Participates or intends to participate in another drug study during the study

Relevance to patient case: not relevant