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临床试验/NCT06313541
NCT06313541招募中2 期

A Multicenter, Randomized Controlled Clinical Trial of Treatment Response Adapted Hybrid Radiotherapy in Metastatic Non-small Cell Lung Cancer Receiving First-line Immunotherapy

Fudan University1 个研究点 分布在 1 个国家目标入组 146 人开始时间: 2024年4月10日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
2 期
状态
招募中
入组人数
146
试验地点
1
主要终点
Progression Free Survival

研究概览

简要总结

This study is a multicenter, randomized controlled clinical trial to explore the preliminary efficacy and safety of treatment response adapted hybrid radiotherapy (LDRT and SBRT) in the first-line treatment of immunotherapy combined with chemotherapy for advanced driver-gene negative NSCLC, and to provide new ideas for the comprehensive treatment of advanced NSCLC

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
18 Years 至 —(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • ECOG functional status score was 0-
  • Histologically confirmed stage IV primary NSCLC;
  • Genetic testing showed that the common driver genes including EGFR, ALK and ROS-1 were negative;
  • Patients with brain metastases were eligible if they were neurologically asymptomatic and had stable disease without receiving systemic glucocorticoids;
  • According to the investigator's judgment, the patient does not need to receive palliative radiotherapy for any site at present;
  • Male/female of childbearing age agreed to use contraception (surgical ligation or oral contraceptive/intrauterine device plus condom) during the trial;
  • Life expectancy ≥3 months;
  • One week before enrollment, the organ function level met the following criteria:
  • ① Bone marrow function: hemoglobin ≥80g/L, white blood cell count ≥4.0*10^9/L or neutrophil count ≥1.5*10^9/L, platelet count ≥100*10^9/L;
  • ② Liver: serum total bilirubin level ≤1.5 times upper limit of normal, direct bilirubin level must be ≤1.5 times upper limit of normal, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5 times upper limit of normal;
  • ③ Kidney: serum creatinine < 1.5 times upper limit of normal or creatinine clearance ≥50ml/min, urea nitrogen ≤200mg/L; Serum albumin ≥30g/L;
  • Patients must be able to understand and voluntarily sign the informed consent form.

排除标准

  • The patient had severe autoimmune diseases: active inflammatory bowel disease (including Crohn's disease, ulcerative colitis), rheumatoid arthritis, scleroderma, systemic lupus erythematosus, autoimmune vasculitis (such as Wegener's granulomatosis), etc.
  • Symptomatic interstitial lung disease or active infectious/non-infectious pneumonia;
  • Patients with risk factors for intestinal perforation: active diverticulitis, intra-abdominal abscess, gastrointestinal (GI) obstruction, abdominal cancer, or other known risk factors for intestinal perforation;
  • History of other malignant tumors;
  • Patients with active infection, heart failure, myocardial infarction, unstable angina or unstable arrhythmia within the past 6 months;
  • Medical examination or clinical findings, or other uncontrollable conditions that the investigator considers may interfere with the results or increase the patient's risk of treatment complications;
  • Patients who were considered by the investigator to have lesions requiring palliative and subtractive radiotherapy;
  • Mixed with small cell lung cancer components;
  • Lactating or pregnant women;
  • Congenital or acquired immunodeficiency diseases including human immunodeficiency virus (HIV), organ transplantation or allogeneic stem cell transplantation;
  • Known HBV, HCV, active pulmonary tuberculosis infection;
  • Patients had received a cancer vaccine or received another vaccine within 4 weeks before starting treatment (note: injectable seasonal influenza vaccine is usually inactivated, so vaccination is allowed, while intranasal vaccine is usually live attenuated, so it is not allowed);
  • Patients with concurrent use of other immune agents, chemotherapy drugs, drugs in other clinical studies, and long-term use of cortisol were excluded.
  • Patients with mental disorders, substance abuse, or social problems that affect adherence were excluded from the study after physician review;
  • Patients who are allergic to or contraindicated to PD-1 monoclonal antibody or chemotherapy drugs.

研究组 & 干预措施

PD-1/PD-L1 inhibitor combined with chemotherapy

Active Comparator

干预措施: PD-1/PD-L1 inhibitor combined with platinum-based chemotherapy (Drug)

Treatment response adapted hybrid radiotherapy plus PD-1/PD-L1 inhibitor and chemotherapy

Experimental

干预措施: SBRT or LDRT (Radiation)

Treatment response adapted hybrid radiotherapy plus PD-1/PD-L1 inhibitor and chemotherapy

Experimental

干预措施: PD-1/PD-L1 inhibitor combined with platinum-based chemotherapy (Drug)

结局指标

主要结局

Progression Free Survival

时间窗: Two years

The time from enrollment to disease progression or death from any cause. Patients who were still alive at the time of analysis will have the date of their last contact as the cutoff date.

次要结局

  • Overall Survival(Two years)
  • Treatment-related adverse event(Two years)
  • Objective response rate(Two years)
  • Progression free survival 2(Two years)

研究者

申办方类型
Other
责任方
Principal Investigator
主要研究者

Zhengfei Zhu

Professor

Fudan University

研究点 (1)

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