The standard treatment for patients with advanced lung cancer is a combination of chemotherapy and radiation therapy. New ways to combine these two treatments are being developed to more effectively treat cancer. To help determine what treatment is best for a patient, researchers are investigating how imaging tests can provide information about the effectiveness of a specific treatment as soon as possible.

The goal of this study is to see if positron emission tomography (PET) imaging can be useful for evaluating the effectiveness of specific chemotherapy and radiation therapy treatments. It is hoped that the results of this study will give researchers the information they need to predict how well lung cancer will respond to specific treatment combinations. About 250 people will take part in this nationwide research study.

Most insurance companies cover PET scans for lung cancer, however participants will need to check about their individual coverage. Joining this study is entirely voluntary. The study is funded by the National Cancer Institute and coordinated by the American College of Radiology Imagining Network and the Radiation Therapy Oncology Group.

The American College of Radiology Imaging Network (ACRIN) and the Radiation Therapy Oncology Group (RTOG) are national cancer research organizations funded by the National Cancer Institute. They include investigators at over 300 leading medical facilities in North America and abroad.

The goal of ACRIN is to increase the longevity and improve the quality of life of cancer patients by conducting clinical trials that evaluate diagnostic imaging and image-guided treatment procedures.

RTOG has played a key role in the development of new treatments for cancer for over 30 years. The goal of the RTOG is to increase survival and improve quality of life for patients diagnosed with cancer.

Who can join this study?
You may be eligible for this study if:
• you have inoperable non-small cell lung cancer
• you are scheduled to be treated with both chemotherapy and radiotherapy
• you are able to tolerate PET imaging.

Who cannot participate?
You cannot participate if:
• you are under 18 years of age
• you are being treated on a Phase I clinical research study that uses investigational drug therapy
• you have had prior radiation therapy to the lung
• you had cancer (other than skin cancer – except melanoma) and have not been disease-free for more than three years
• you are pregnant
• you are sexually active and are not willing to use birth control devices.

What if I choose to join this study?
After you and your doctor decide the best treatment plan for you, you will undergo the standard medical screening procedures that are part of regular cancer care. In addition, before starting your chemotherapy and radiation therapy you will have a PET scan.

Prior to your PET scan a small sample of blood will be taken. Approximately 45 minutes before the scan, you will be injected in a vein in your hand or arm with a small amount of a chemical called radionuclide which is similar to sugar. You will then rest quietly until your scan time. During the PET scan you will lie still on a partially enclosed scanning table for 20-60 minutes.

After your pre-treatment PET scan you will begin your planned course of chemotherapy and radiation therapy. About three months after your radiation treatments are finished you will have a second PET scan.

What is PET imaging?
Positron emission tomography (PET) imaging, also called a PET scan, is a test that images the function of cells to show differences between healthy tissue and diseased tissue. PET scans use a small amount of a chemical called radionuclide combined with a sugar that is injected into patient. The radionuclide emits positrons, tiny particles given off by a radioactive substance. A PET scanner rotates around the patient to detect the positron emissions given off by the radionuclide. Because cancer grows at a faster rate than healthy tissue, cancer cells use up more of the sugar that has the radionuclide attached. A computer evaluates the rate that the sugar is used and produces a colorcoded picture.

How long will I be on the study?
Your planned treatment will be about seven months and you will see your doctor(s) for follow-up visits for the next three years. This follow-up visit schedule is the same for many patients who are not part of a clinical study.

Protocol Principal Investigator
Mitchell Machtay, MD
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania

Administrative Headquarters
1818 Market Street, Suite 1600
Philadelphia, PA 19103
(215) 574-3183