GEMINI NSCLC Study is a non-interventional study that will be collecting clinical and molecular health information from patients with NSCLC who will receive longitudinal blood collection in addition to their standard of care therapy and disease surveillance with the goals of identifying the molecular evolution of lung cancer with standard of care therapy, and determining the utility of ctDNA dynamics to predict risk of recurrence and therapeutic outcomes.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
For Cohort 1 Inclusion, the participant has/is:
* A known or suspected NSCLC treated with curative intent -(surgery with or without perioperative (neoadjuvant or adjuvant) therapy).
* Suspected NSCLC - Patients with a high index of suspicion for the diagnosis of NSCLC that is resectable may sign informed consent prior to undergoing diagnostic procedure at the discretion of the physician. NCCN Guidelines allow for clinical stage IA cancers to proceed directly to definitive surgery. Per NCCN Guidelines, if a preoperative tissue diagnosis has not been obtained, then an intraoperative diagnosis will be obtained. If a diagnosis of NSCLC is not confirmed and/or the tumor is not resectable, then the patient will be a screen failure.
* Undergone or planning to undergo a surgical resection - (Patients with stages I-IIIB who are resectable - per NCCN guidelines of resectability)
* Both patients who lack molecular abnormalities and those with identified molecular abnormalities may enroll. Choice of perioperative therapy is to follow SOC therapeutic guidelines for the participant's molecular and PD-L1 profile.
* 18 years old or older
* Willing and able to provide informed consent
* Willing to have additional blood samples collected during routine surveillance visits
* Must submit tumor sample representative of current disease
For Cohort 1 Exclusion, the participant has/is:
* Patients with superior sulcus tumors who are candidates for preoperative concurrent chemoradiation.
* Stage III locally advanced and unresectable patients who are candidates for chemoradiation followed by immunotherapy.
* It is expected that all patients on the cohort will be treated with a definitive surgical resection. Thus, clinical stage IIIB and IIIC patients who subsequently demonstrate pathologically confirmed N3 nodal disease or T4 N2 or 3 per any confirmatory procedure listed in NCCN guidelines for which definitive chemoradiotherapy rather than surgery is recommended per NCCN Guidelines are not eligible.
* Patients who receive primary radiation (in lieu of surgery if they are not surgical candidates).
For Cohort 2 Inclusion, the participant has/is:
* Histologically documented Stage IV NSCLC (de novo metastatic or relapse setting) not amenable to curative surgery or radiation therapy. Palliative radiation (for instance for impending bony fracture or to control pain) is allowed at any time during the protocol at the physician's discretion.
* Intended to receive first line immunotherapy (as monotherapy or in combination with chemotherapy). Patients who have had previous exposure to immunotherapy in the neoadjuvant or adjuvant setting are allowed to enroll as long as 12 months have elapsed since the prior exposure.
* Patients in surveillance on Cohort 1 are eligible to roll over to Cohort 2 at the time of recurrence as long as they have had histologic confirmation of recurrence and have been off immunotherapy for 12 months or greater and meet all other inclusion/exclusion criteria.
* Tumors that lack activating EGFR mutations (e.g., exon 19 deletion or exon 21 L858R, exon 21 L861Q, exon 18 G719X, or exon 20 S768I mutation) and ALK fusions. Also, per NCCN Guideline recommended testing, tumors must also lack ROS1, BRAF, NTRK 1/2/3, METex14 skipping mutations, and RET for which there is available front-line targeted therapy. Only those patients with KRAS G12C mutations and ERBB2 (HER2) mutations with no contraindications to immunotherapy (PD-L1 1) for which there are no approved front-line targeted therapies and for whom immunotherapy would be the preferred front-line therapy are eligible.
* Patients may be enrolled with local molecular testing and those results will be provided.
* Patients may be enrolled with local molecular testing and those results will be provided.
* 18 years and older
* Willing and able to provide informed consent
* Willing to have additional blood samples collected during routine surveillance visits
* Must submit tumor sample representative of current disease
Exclusion Criteria (both Cohorts):
* Patients without a known or suspected NSCLC diagnosis, or other disease processes such as sarcoidosis, lymphoma, or metastatic cancer from other sites.
* Not willing to have additional blood samples collected
* Patients with a secondary malignancy must have been both diagnosed \> 2 years from the lung cancer of interest and have completed all therapy for that malignancy (including extended adjuvant therapy) \> 2 years prior to diagnosis of the lung cancer of interest with the exception of the following:
* Patients with superficial basal cell carcinoma of low-risk histology per NCCN Guidelines (Low-risk histologic subtypes include nodular, superficial, and other non-aggressive growth patterns such as keratotic, infundibulocystic, and fibroepithelioma of Pinkus) and low-risk for recurrence per NCCN Guidelines (location on trunk or extremities, size \< 2 cm, primary (not recurrent), with well-defined borders) can be included even if they are diagnosed \< 2 years from the lung cancer of interest.
* Patients with superficial squamous cell carcinoma of low-risk pathology per NCCN Guidelines (verrucous, keratoacanthomatous) and low-risk for recurrence per NCCN Guidelines (located on trunk or extremities; 2 cm in size; primary lesion (vs. recurrent); well to moderately differentiated; \< 2 mm thick and no invasion beyond subcutaneous fat; negative for perineural invasion; and negative for lymphatic or vascular involvement) can be included even if they are diagnosed \< 2 years from the lung cancer of interest.
Primary outcome measure(s)
Real-World Disease Free Survival (rwDFS) — 5 years
Real-World Overall Survival (rwOS) — 3 years
Trial sites (58)
Facility
City
Region
Status
Alabama Oncology
Birmingham
Alabama
Recruiting
Mercy Clinic Oncology - Fort Smith
Fort Smith
Arkansas
Recruiting
MemorialCare
Fountain Valley
California
Recruiting
Cancer and Blood Specialty Clinic
Los Alamitos
California
Active Not Recruiting
UCLA
Los Angeles
California
Recruiting
Eastern CT and Hematology and Oncology Associates
Norwich
Connecticut
Recruiting
Clermont Oncology Center
Clermont
Florida
Recruiting
Woodlands Medical Specialists
Pensacola
Florida
Withdrawn
Morehouse School of Medicine (MSM)
Atlanta
Georgia
Recruiting
Piedmont Healthcare
Atlanta
Georgia
Recruiting
Hawaii Cancer Care
Honolulu
Hawaii
Recruiting
Southern Illinois Hospital Services
Carterville
Illinois
Recruiting
Cancer Care Specialists of Illinois
Decatur
Illinois
Recruiting
Northwestern University
Evanston
Illinois
Recruiting
Hope and Healing Cancer Services
Hinsdale
Illinois
Recruiting
OSF Saint Anthony Medical Center
Rockford
Illinois
Recruiting
Community Health Network
Indianapolis
Indiana
Recruiting
University of Iowa
Iowa City
Iowa
Recruiting
University of Maryland
Baltimore
Maryland
Recruiting
Johns Hopkins University
Baltimore
Maryland
Recruiting
The Center for Cancer and Blood Disorder
Bethesda
Maryland
Recruiting
Frederick Health Regional System
Frederick
Maryland
Recruiting
Mercy Clinic Oncology and Hematology - Joplin
Joplin
Missouri
Recruiting
Lake Regional Health System
Osage Beach
Missouri
Recruiting
Mercy Clinic Cancer and Hematology - Chub O'Reilly Cancer Center
Springfield
Missouri
Recruiting
Oncology Hematology Associates
Springfield
Missouri
Recruiting
Mercy Clinic Oncology and Hematology - Sindelar Cancer Center
St Louis
Missouri
Recruiting
Mercy Clinic Oncology and Hematology - David C. Pratt Cancer Center
St Louis
Missouri
Recruiting
Nebraska Cancer Specialists
Omaha
Nebraska
Recruiting
OptumCare Cancer Care
Las Vegas
Nevada
Recruiting
Hope Cancer Care of Nevada
Las Vegas
Nevada
Recruiting
Cancer Care Specialists Reno
Reno
Nevada
Recruiting
New Jersey Cancer Center
Belleville
New Jersey
Recruiting
New York Oncology Hematology
Albany
New York
Recruiting
Hematology Oncology Associates of Central New York
East Syracuse
New York
Recruiting
Cayuga Medical Center
Ithaca
New York
Recruiting
Icahn School of Medicine at Mount Sinai
New York
New York
Recruiting
White Plains Hospital
White Plains
New York
Recruiting
UNC
Chapel Hill
North Carolina
Recruiting
Duke University
Durham
North Carolina
Recruiting
+ 18 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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