Immune checkpoint inhibitors and Carbon iON radiotherapy In solid Cancers with stable disease (ICONIC)
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Not specified
- Sponsor
- Fondazione Centro Nazionale Di Adroterapia Oncologica
- Enrollment
- 27
- Locations
- 3
- Primary Endpoint
- Objective response rate (ORR) according to RECIST, assessed at least 8 weeks after CIRT
- Status
- Not yet recruiting
- Last Updated
- last year
Overview
Brief Summary
To estimate the effect, in terms of clinical response, of immunotherapy associating carbon ion treatment in the palliative setting across different malignancies, for which immunotherapy is currently the standard of care.
Detailed Description
This is a multicenter, open label, non-randomized phase II clinical trial aiming to assess the feasibility and the clinical activity of adding CIRT to ICIs in cancer patients that have obtained a disease stability (SD) with pembrolizumab administered as per standard of care. At study entry, hypofractionated CIRT will be delivered to one measurable lesion previously untreated with local approaches.CIRT will be performed at Fondazione CNAO, Pavia
Investigators
Federica Serra
Scientific
Fondazione Centro Nazionale Di Adroterapia Oncologica
Eligibility Criteria
Inclusion Criteria
- •Signed written informed consent
- •Histologic confirmation of malignancies under treatment with single agent anti-PD1/PDL1 immunotherapy per clinical practice (see cohort specific inclusion criteria) with immune checkpoint inhibitors approved by Italian national drug regulatory agencies (Agenzia Italiana del Farmaco, AIFA)
- •Having a disease stability as assessed by AIFA monitoring sheet
- •Presence of at least 2 measurable target lesions, of which at least one to be followed up as per RECIST and one suitable for CIRT
- •Willing and able to comply with scheduled visits, treatment schedule, laboratory testing, and other requirements of the study
- •Females and males, 18 years of age or older (no upper limit for age)
- •Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
- •Subjects must have measurable disease by CT or MRI per RECIST 1.1
Exclusion Criteria
- •Patients treated with chemo-immunotherapy associations
- •Any immune-related CTCAE grade 4 adverse event, before study entry
- •Any CTCAE grade ≥3 immune-related adverse event observed within 3 weeks prior to CIRT start
- •Presence of metal prostheses or any other condition to prevent adequate imaging for identification of the target volume and calculation of the dose
- •Loco-regional conditions not allowing hadron therapy (e.g. active infections in RT target region)
- •Prisoners or subjects who are involuntarily incarcerated
- •Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness (e.g. infectious disease)
- •Patients treated with immunotherapy combinations (e.g. subjects treated with anti-CTLA4 + anti-PD1/PDL1 are excluded)
- •Patients receiving immunotherapy within clinical trials
- •Patients receiving off-label immunotherapy or within expanded access programs or as compassionate use
Outcomes
Primary Outcomes
Objective response rate (ORR) according to RECIST, assessed at least 8 weeks after CIRT
Objective response rate (ORR) according to RECIST, assessed at least 8 weeks after CIRT
Toxicity according to CTCAE version 5.0
Toxicity according to CTCAE version 5.0
Secondary Outcomes
- progression-free survival (PFS)
- overall survival (OS)
- objective response of the metastatic lesion treated with CIRT
- disease control rate (DCR) according to RECIST, defined as ORR+SD
- objective response rate (ORR) according to irRECIST
- percentage of patients with disease progression as best response