Vanguard Study Characterizing Occurrence of Recurrent or Second Primary Tumors in Patients With Prior History of Definitively Treated Stage I/II Head and Neck or Non-Small Cell Lung Cancer Who Are Current or Former Smokers
This study is known as the Vanguard Trial. When you enter this study, you will have a
complete medical history (including smoking history) and physical exam, including
measurement of height, weight, and vital signs (including blood pressure, heart rate, and
temperature). You will have a performance status evaluation (a test looking at the ability
to perform every day activities). You will have blood samples drawn for routine blood tests
(about 3 teaspoons), to check your blood clotting function (about 1-2 teaspoons), and for
research purposes (about 4 teaspoons). You will have a chest x-ray and a CT scan of your
chest. Women who are able to have children must have a negative blood or urine pregnancy
test. If you are currently a smoker, you will be given information on programs to help you
quit smoking. Although you will be encouraged to quit smoking, you do not have to quit
smoking or participate in these programs to be a part of this study.
You will also have a bronchoscopy (tissue sample from the lung) at the beginning of this
study for lab analysis. For this procedure, you will be given drugs to relax. Then, a
local anesthetic will be sprayed in your nose and throat to numb those areas. A slim,
flexible tube with a light will be placed through your nose or mouth and into your lungs.
Tweezers will be fed through the tube to collect lung tissue (biopsy) samples from 6
different places in your lungs. During the bronchoscopy procedure, a complete inspection of
the airways will be performed. Any suspicious areas that are seen under the white-light and
autofluorescence bronchoscopy will be identified and more biopsies and brushings will be
performed to evaluate whether any pre-cancerous tissue is present. You will also have a
bronchial brushing next to each biopsy site. In a bronchial brushing, a small brush is fed
through the tube into your lungs and a sample of lung tissue is gently scraped off. When
the biopsies and brushings are done, you will have a bronchial lavage (bronchial washing).
In the bronchial lavage, a small amount of water (about 4 tablespoons) is sprayed into your
lungs and then suctioned out through the tube. This fluid is used to collect additional
tissue and mucous samples. In addition, a sputum (saliva) sample will be taken and the
inside of your cheek will be scraped (buccal sample).
If you have had HNSCC, you will also have a laryngoscopy. In a laryngoscopy, a lighted tube
is placed down your throat and the larynx is checked. The back of your throat will be
sprayed with an anesthetic before this procedure to make the procedure more comfortable.
While on study, you will return to the clinic for at least 3 years and for up to a total of
6 years. At Months 6, 12, 18, 24, 30, and 36, your complete medical history will be
recorded, and you will have a physical exam by either a doctor or a nurse. At each of these
visits, you will also have blood drawn for routine tests (about 3 teaspoons) and for
research purposes (about 4 teaspoons). You will also have a chest x-ray and a chest CT at
these visits. At Months 12, 24 and 36, you will have blood drawn (about 1-2 teaspoons) to
check your blood-clotting function. If you think you may be pregnant, you will also have a
urine or blood pregnancy test. In addition, you will have a bronchoscopy and provide sputum
and buccal smear samples at your 12 month visit. If you have been treated for HNSCC you
will have a laryngoscopy at 12 months.
You have the right to leave the study at any time. If you choose to stop participating in
this study, you will be asked to return to the clinic for a final clinic visit. At this
visit, your complete medical history will be recorded, and you will have a physical exam and
blood drawn for routine tests (about 3 teaspoons) and for research purposes (about 4
teaspoons). Your study doctor will also ask you about your current smoking use, any
medications you are taking, and how you are feeling (symptoms).
This research study includes two bronchoscopies done one year apart. These bronchoscopies
are being done primarily for research purposes and are unlikely to provide information
useful in your individual treatment. These bronchoscopies do have risks associated with
them. These risks are described in section 4 of this informed consent document.
Recent research on early stage NSCLC indicates that adjuvant chemotherapy after surgery
increases the length of time a person may survive and the length of time before cancer
recurs. However, this adjuvant chemotherapy also has side effects that can be severe and in
rare cases fatal. If you have had surgery for NSCLC and wish to receive adjuvant
chemotherapy, you may only enroll in the Vanguard study after you have completed the
As part of this study you will provide samples of your lung tissue, saliva, blood, and
scrapings from the inside of your cheek. Fluid and mucous collected during the
bronchoscopies will also collected. These samples will be studied by scientists to learn
about genes and proteins in people who have been treated for early NSCLC or HNSCC. The
samples will also be used to grow cells and cultures that will be used to test chemotherapy
drugs. These cells and cultures will also be used to learn about genes and proteins.
All M. D. Anderson researchers are trained in the importance of maintaining patient privacy.
Your privacy will be protected by assigning you a number that will be used in place of your
name on documents that are part of this study. A list that links your name with your study
number will be stored in a restricted file that may be accessed only with a password. Only
a few essential research personnel have access to this password.
At the end of the study you will not be automatically notified of the research findings. If
you wish to learn about the results, however, you may request them from the principal
Principal Investigator: Waun Ki Hong, MD 1515 Holcombe Blvd., Unit 432 MD Anderson Cancer
Center Houston, TX 77030
This is an investigational study. A total of about 50 individuals will take part in this
study. Participants will be enrolled at M. D. Anderson and several other sites around the
Observational Model: Case-Only, Time Perspective: Prospective
To look at how long individuals who have been treated for early stage NSCLC or HNSCC live without developing lung cancer.
Waun K. Hong, MD
M.D. Anderson Cancer Center
United States: Institutional Review Board
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