Collection of Blood, Bone Marrow, Tumor, or Tissue Samples From Patients With Cancer to Study Drug Resistance



Status:Recruiting
Conditions:Lung Cancer, Cancer, Women's Studies
Therapuetic Areas:Oncology, Reproductive
Healthy:No
Age Range:18 - 100
Updated:4/6/2019
Start Date:August 9, 2000
Contact:Julie C Barnes, R.N.
Email:barnesjk@mail.nih.gov
Phone:(240) 760-6044

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Collection of Blood, Fluid, Bone Marrow, Tumor, or Tissue Samples From Patients With Cancer or Normal Volunteers

This study will examine blood, bone marrow, tumor and tissue samples from patients with
cancer to study tumor resistance to chemotherapy (drug treatment). Many patients with cancer
improve initially with chemotherapy, but then have a disease relapse, after which their tumor
no longer responds to treatment. Other patients tumors are drug-resistant from the start. The
study will look for "resistance factors" substances in blood and tissues that render tumors
resistant to chemotherapy. The findings may provide information needed to develop methods of
combating drug resistance.

Patients with cancer who are 18 years or older may be eligible for this study. Participants
will have 40 milliliters (3 tablespoons) of blood drawn at the beginning of the study;
additional samples will be obtained periodically during the course of treatment. A small
sample of tumor or normal tissue will be taken from patients who undergo surgery or tumor
biopsy (removal of a small piece of tumor) for medical reasons or as part of a research
treatment protocol. Patients who do not require surgery or biopsy may be asked permission to
obtain a tumor sample. Depending on the location of the tumor, this may be done by: 1)
withdrawing bone marrow through a small needle; 2) removing fluid from the chest or abdomen;
3) removing a small tumor sample through a needle; or 4) removing the sample with a small
incision into or around the tumor. These procedures will be done only if they are of low risk
to the patient.

Background:

Ongoing research in the Experimental and Molecular Therapeutics Sections, NCI, requires the
availability of blood, serum, tumor, hair follicle and tissue samples from patients with
cancer.

Resistance is the underlying cause of treatment failure, and may present as acquired or
intrinsic drug resistance. Patients with cancer frequently present with
chemotherapy-responsive disease, and undergo tumor response, only to eventually experience
relapse, at which time the tumor may be refractory to further treatment. This is termed
acquired drug resistance; while intrinsic resistance implies a cancer that is refractory from
the outset. Diverse mechanisms of drug resistance have been described and are often dependent
upon the particular drug under study.

Objectives:

To obtain blood, serum, tumor, hair follicle or normal tissue samples that would allow
development of assays for use in subsequent clinical trials

Eligibility:

Patients with a prior diagnosis of malignancy, with advanced or refractory cancer will be
evaluated in the Medical Oncology Clinic, NCI.

Blood samples or hair follicle samples may be collected at the initial visit, and at follow
up visits.

Tumor samples may be obtained by fine needle aspirate, by removal of pleural or peritoneal
fluid, or by excisional biopsy, providing the tumor is accessible with a minimal risk to the
patient.

Patients may be on, or in the process of being evaluated for a research protocol.

Patients may receive treatment on the standard care protocol.

Normal volunteers may enroll in the study for collection of blood or hair follicle samples.

Design:

Acquired samples will be recorded in the computerized data bank currently existing in the
Molecular Therapeutics Section. No germline testing will be performed on any of the samples
collected. Tests will be pilot studies relating to the Section s work on the biology of drug
resistance and cell survival in cancer. If any research tests are considered to be themselves
of more than minimal risk to the patient, separate permission will be requested from the IRB
to perform that test, and a new consent will be obtained.

Examples of the types of studies to be performed with biopsies will be drug resistance gene
expression assays, with the goal of demonstrating the utility of the assay in patient
samples.

Evaluation of methods to detect drug resistance proteins and genes will be explored,
including Northern blot, immunoblot, polymerase chain reaction assay, and RNA in situ
hybridization. With whole blood, we may evaluate the presence of dye transport in an ex vivo
assay, for example, using inhibitors of ABCG2. Evidence of drug accumulation or DNA damage
may be sought in patient mononuclear cells or in hair follicle samples.

- INCLUSION CRITERIA:

1. Patients 18 years of age and older are eligible.

2. Patients must have a performance status of ECOG 0, 1, 2, or 3 for admission to
this protocol.

3. Patients with malignancy are eligible.

4. Patients requiring a surgical procedure for any medical indication can be
included on study.

5. Patients requiring biopsy or any procedure for any medical indication can be
included on study.

6. Patients not requiring biopsy for a medical indication can be included on the
study solely for the purpose of obtaining research samples, including blood,
pleural fluid, or peritoneal fluid, or biopsy samples, providing the biopsy or
aspiration procedure is of minimal risk, i.e. fine needle aspirate, bone marrow
aspirate, or excisional biopsy. No radiology tests will be used in the procedure
to collect a sample that would not be otherwise used for an appropriate medical
indication.

7. Normal volunteers 18 years of age and older are eligible to enroll. Normal
volunteers must be willing to sign informed consent and must be willing to
provide samples to be used for research.

EXCLUSION CRITERIA:

1. Pregnant individuals will not be eligible due to potential risks to the fetus
associated with radiologic procedures required for biopsy.

2. Children will not be eligible because of potential risks from complications due to
procedures involved in obtaining the biopsies.

3. Normal volunteers with a history of a clotting disorder may not enroll.
We found this trial at
1
site
9000 Rockville Pike
Bethesda, Maryland 20892
Phone: (888) NCI-1937
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Bethesda, MD
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