A Prospective, Phase II Study of Bevacizumab Combined With Fractionated Stereotactic Radiotherapy in Patients With 1 to 10 Brain Metastases From Non-small Cell Lung Cancer
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Non-small Cell Lung Cancer
- Sponsor
- Sun Yat-sen University
- Enrollment
- 100
- Locations
- 1
- Primary Endpoint
- Intracranial progression-free survival
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
This Phase II randomized study is to determine the efficacy and safety of Bevacizumab combined with fractionated stereotactic radiation therapy(FSRT) in patients with 1 to 10 brain metastases in non-small cell lung cancer by assessing the treatment response, perilesional edema, neurological symptoms and quality of life.
Detailed Description
This Phase II randomized study is to determine the efficacy and safety of Bevacizumab combined with fractionated stereotactic radiation therapy(FSRT) in patients with 1 to 10 brain metastases in non-small cell lung cancer by assessing the treatment response, neurological symptoms and quality of life. Patients will receive Bevacizumab(7.5mg/kg, q3w, i.v.) before and after FSRT(40Gy in 10 fractions or 30Gy in 5 fractions) to the brain metastases. The primary endpoint was intra-cranial progression-free survival (IPFS). Secondary endpoints included overall survival (OS), progression-free survival (PFS), quality of life (QOL) scores, and toxicities.
Investigators
Hui Liu
Professor
Sun Yat-sen University
Eligibility Criteria
Inclusion Criteria
- •aged ≥18 years old;
- •histologically confirmed NSCLC;
- •1-10 BMs on contrast-enhanced MRI;
- •stable extracranial disease status at the time of enrollment;
- •Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2;
- •Normal function of organs and bone marrow within 14 days: Total bilirubin 1.5 times or less the upper limits of normal (ULN); AST and ALT 1.5 times or less the ULN; absolute neutrophil count≥ 500 cells/mm3; creatinine clearance rate(CCR) ≥45 mL/min; Platelet count≥50,000 cells/mm3; international normalized ratio(INR) ≤1.5，Prothrombin Time (PT)≤ 1.5 × ULN
- •Informed-consent
Exclusion Criteria
- •Intracranial metastases needed surgical decompression
- •Patients with contraindications for MRI
- •Previous radiotherapy or excision for intracranial metastases
- •The tumor has completely approached, encircled, or invaded the intravascular space of the great vessels (e.g., the pulmonary artery or the superior vena cava)
- •A cavity over 2cm in diameter of primary tumor or metastasis
- •Bleeding tendency or coagulation disorder
- •Hemoptysis (1/2 teaspoon blood/day) happened within 1 month
- •The use of full-dose anticoagulation within the past 1 month
- •Severe vascular disease occurred within 6 months
- •Gastrointestinal fistula, perforation or abdominal abscess occurred within 6 months
Outcomes
Primary Outcomes
Intracranial progression-free survival
Time Frame: 1 year
IPFS was calculated from the completion of radiotherapy until the first occurrence of either intracranial progression or death.
Secondary Outcomes
- overall survival (OS)(1 year)
- progression-free survival (PFS)(1 year)
- Rate of patients with treatment-related adverse events evaluated by CTCAE v5.0(1 year)
- Rate of participants with perilesional edema of brain metastases evaluated by T2-weighted MRI(1 year)
- Quality of life evaluated by EORTC quality of life questionnaire(6 months)