Reducing Symptom Burden - Non Small Cell Lung Cancer (NSCLC)

The Study Drugs:

It is not know which study drug or combination of study drugs is better at reducing side
effects patients may experience during chemoradiation therapy. For this reason, researchers
have chosen 4 study drugs that may help to reduce side effects. The study drugs will be
tested alone and in combination with each other.

Armodafinil is designed to prevent excessive sleepiness.

Bupropion is an antidepressant with anti-inflammatory properties that may help reduce
multiple symptoms.

Curcumin is the active ingredient in the spice, turmeric. It may interfere with the
production of cytokines (which cause inflammation), which may reduce multiple symptoms.

Minocycline is an antibiotic. Minocycline has been shown to interrupt cytokine production,
which may help to reduce multiple symptoms.

Study Groups:

If you agree to take part in this study, you will be randomly assigned (as in the roll of
dice) to join 1 of 16 groups. You may be assigned to receive no study drugs, 1 study drug,
or a combination of 2, 3, or all 4 of the study drugs.

During this study, you may receive 1 or more placebos. A placebo looks like the study
drug(s) but has no active ingredients. There is a chance that you will be in a group that
does not receive any study drugs at all. However, all patients are under standard care by
their treating doctors.

Neither you nor the study staff you will see in the clinic will know if you are receiving
the study drugs and/or the placebo(s). However, if needed for your safety, the study staff
will be able to find out which study drug you are receiving.

Study Drug Administration:

You will take the study drugs/placebos every day for 10 weeks. You will take either single
or combined study drug(s) or placebos by mouth everyday as instructed by the study doctor.

If you have difficulty swallowing the study drugs/placebos, they can be crushed just before
taking them.

You will be given pamphlets with more information about how to take the study
drugs/placebos.

You will be given a daily diary to write down when you take the study drugs/placebo. You
should bring your study drug/placebo blister packs/sticks to the clinic to every study
visit. You should also bring your diary to every visit.

Completing the Symptom Questionnaire:

Throughout the study, you will be asked to complete the symptom questionnaire. You will be
asked about symptoms from therapy you may be experiencing and how they may be interfering
with your daily activities. The study staff will either meet you during your regular clinic
visit or call you at your home at a time that is convenient for you. In the clinic, you
will complete the questionnaire by paper and pen, or by entering your answers into an
electronic tablet computer. On the phone, study staff will ask you the questions and record
your answers on paper or enter them into a computer. The symptom questionnaire will take up
to 5 minutes to complete.

- During Weeks 1-10, you will complete the symptom questionnaire 2 times a week.

- During Weeks 11-16, you will complete the symptom questionnaire 1 time a week.

Study Visits:

-Before you begin chemoradiation: You will complete 4 questionnaires about pain and other
symptoms, your mood, and your quality of life. Completing all 4 of the questionnaires will
take about 15 minutes.

-Blood (about 3-4 teaspoons) will be drawn for biomarker testing. Biomarkers are markers
in the blood that may be related to your reaction to the study drug(s). This will be drawn
during a routine blood draw.

After 1 week of chemoradiation:

-Blood (about 3-4 teaspoons) will be collected during a routine blood draw for biomarker
testing.

After 4 weeks of chemoradiation:

- You will complete 1 questionnaire about your quality of life. This questionnaire will
take about 2-3 minutes to complete.

- Blood (about 3-4 teaspoons) will be drawn for biomarker testing. This will be drawn
during a routine blood draw.

During the last week of chemoradiation (about Week 7):

- You will complete 3 questionnaires about your symptoms, mood, and quality of life.
These questionnaires will take about 10 minutes total to complete.

- Blood (about 3-4 teaspoons) will be collected during a routine blood draw for biomarker
testing.

After about Week 7, the study staff will call you 1 time per week to check on you until week
10. This phone call should last only a few minutes. If you have experienced several side
effects from chemoradiation, this phone call make take longer.

About Week 12 (at a routine clinical visit):

- You will complete 3 questionnaires about your symptoms, mood, and quality of life.

- If you were smoking at the beginning of the study, you will complete a questionnaire
that asks if you stopped smoking any time during the study. This will take a few
minutes.

- You will be asked to complete another questionnaire that asks about your satisfaction
with the study drug(s). This will take a few minutes.

- Blood (about 3-4 teaspoons) will be drawn for biomarker testing. This will be drawn
during a routine blood draw.

Length of Study:

You will be on study for about 16 weeks. You will take the study drug(s) for 10 weeks and
complete the symptom survey until 16 weeks. You will be taken off study if you experience
intolerable side effects.

Additional Information:

- The information about side effects collected during this study will not be reported to
your regular doctor. You should directly report all symptoms and side effects to your
doctor and nurse during your visits to the clinic at M. D. Anderson. You should call
your regular doctor right away if any of the symptoms are severe.

- You should not take any herbal supplements while you are on this study.

This is an investigational study. Armodafinil is FDA approved and commercially available
for the treatment of excessive sleepiness. Bupropion is FDA approved and commercially
available for the treatment of depression. Minocycline is FDA approved and commercially
available for the treatment of bacterial infection. Curcumin is not FDA approved. At this
time, curcumin is only being used in research. The different possible combinations of these
drugs being used in this study is investigational.

Up to 32 patients will take part in this study. All will be enrolled at M. D. Anderson.