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STRATIFY: Staging by thoracoscopy in potentially radically treatable non-small cell lung cancer associated with minimal pleural effusio

Not Applicable
Conditions
ung cancer
Cancer
Registration Number
ISRCTN13584097
Lead Sponsor
HS Greater Glasgow and Clyde
Brief Summary

2023 Protocol article in https://pubmed.ncbi.nlm.nih.gov/37996118/ (added 24/11/2023)

Detailed Description

Not available

Recruitment & Eligibility

Status
Ongoing
Sex
All
Target Recruitment
50
Inclusion Criteria

Current participant inclusion criteria as of 18/08/2023:
1. Suspected or confirmed stage I-IIIA lung cancer
2. Mini-PE, defined as an ipsilateral pleural effusion, resulting in < 1/3 hemithorax opacification on erect chest radiograph which is either:
2.1. Too small to safely aspirate after US assessment (level 1 operator judgement)
2.2. Cytology-negative after diagnostic aspiration
3. Performance Status 0-2
4. Radical treatment feasible (Surgery, Radical RT or chemo-RT, +/- immunotherapy)) if OPM is excluded by thoracoscopy (local PI judgement)
5. Aged 16 or over
6. Informed written or remote consent
7. Willingness to comply with scheduled visits, study procedures and laboratory tests

Previous participant inclusion criteria:
Eligibility Criteria for the Main Study
1. Stage I-IIIA NSCLC, after completion of routine staging
2. Mini-PE, defined as an ipsilateral pleural effusion, which is = 40 mm in max depth on axial CT scan and either:
2.1 Too small to safely aspirate after US assessment (level 1 operator judgement)
2.2 Cytology-negative after diagnostic aspiration
3. Performance Status 0-2
4. Radical treatment feasible (Surgery, Radical RT or chemo-RT) if OPM excluded by LAT (MDT judgement)
5. Aged 16 or over
6. Informed written consent
7. Willingness to comply with scheduled visits, study procedures and laboratory tests

Eligibility Criteria for the MRI sub-study
1. Registered to the main STRATIFY study
2. Informed written consent
3. Willingness to comply with scheduled visits, and study procedures

Exclusion Criteria

Current Participant exclusion criteria as of 18/08/2023:
1. Any metastatic disease, including confirmed pleural metastases
2. Any contraindication to the selected thoracoscopy method when LAT is the preferred method:
2.1. Absent lung sliding or extensive fluid loculation on pleural ultrasound (not applicable to VATS) when VATS is the preferred method:
2.2. Insufficient fitness for general anaesthesia (not applicable to LAT)
3. Uncorrectable bleeding disorder (applicable to LAT and VATS)

Previous participant exclusion criteria:
Main study:
1. Any metastatic disease, including confirmed pleural metastases
2. Bilateral pleural effusions
3. Any contraindication to LAT, e.g.:
3.1 Absent lung-sliding on pleural ultrasound
3.2 Uncontrollable cough
3.3 Uncorrectable bleeding disorder

MRI Sub-study Exclusion Criteria
1. Any contraindication to MRI, including but not limited to:
1.1 Claustrophobia, pregnancy
1.2 Metallic foreign body
1.3 Pacemaker/implant
1.4 Allergy to Gadolinium contrast
1.5 eGFR <30 ml/min

Study & Design

Study Type
Observational
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
<br> Current primary outcome measure as of 18/08/2023:<br> The true prevalence of detectable OPM, as defined by the proportion of recruited patients with lung cancer cells in parietal pleural biopsies (pathology) or pleural fluid (cytology) obtained during Thoracoscopy (LAT or VATS)<br><br><br><br><br> Previous primary outcome measure:<br> The true prevalence of detectable OPM, as defined by the proportion of recruited patients with NSCLC cells in parietal pleural biopsies (pathology) or pleural fluid (cytology) obtained during Local Anaesthetic Thoracoscopy, at visit 3<br>
Secondary Outcome Measures
NameTimeMethod
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