Two thirds of non small cell lung cancer patients present with locally advanced tumours
(stage III) or metastatic disease (stage IV) and radiotherapy plays a major role in their
treatment. Treatment (radiotherapy and chemotherapy) can be given with curative intent to
selected patients with locally advanced, stage III disease. Patients with stage III tumours
associated with a pleural effusion, and patients who present with advanced, metastatic
disease (stage IV) are treated palliatively with no prospect of cure. In the latter,
radiotherapy (RT) is offered with the aim of improving symptoms, achieving tumour control and
optimising quality of life. It is generally believed that a plateau has been reached for
combination of chemotherapy with radiotherapy lung cancer. There is a strong rationale for
combining molecular targeted agents with irradiation. AZD6244 is a potent, selective,
uncompetitive inhibitor of MEK that has been tested in early phase clinical trials either
alone or in combination with chemotherapy in a variety of cancers including lung cancer.
Preclinical studies have shown that AZD6244 enhances the effect of radiation. AZD6244 has not
yet been combined with radiotherapy in clinical trials. In this study, a maximum of 18
patients will be allocated to one of 3 doses of AZD6244 in combination with a standard dose
of RT in a Phase 1 dose escalation/ de-escalation design to determine the recommended dose
for Phase 2 trials (RP2D). An expanded cohort of 15 patients will be treated at the RP2D to
obtain additional safety and preliminary response data. Patients will undergo 3 FLT positron
emission tomogram (PET) scans, the first scan before treatment, second scan during AZD6244
treatment and third scan during RT. All patients will also have tissue/blood samples
collected for biomarkers. Biomarkers and FLTPET imaging will be examined to obtain
information that may predict for response, resistance or toxicity to radiation and AZD6244.