Phase 1b/2 Study of LDRT in Combination With AK104 Plus Chemotherapy as First-line Treatment for ES-SCLC
- Conditions
- SCLC, Extensive Stage
- Interventions
- Registration Number
- NCT06477523
- Lead Sponsor
- Sichuan University
- Brief Summary
Phase Ib/II, open-label, multicentre study to evaluate the efficacy and safety of low-dose radiotherapy (LDRT) combined with AK104 and chemotherapy as first-line treatment for patients with ES-SCLC.
- Detailed Description
This trial aims to assess the safety and efficacy of a new therapeutic strategy that combines to low-dose radiotherapy combination With AK104 plus etoposide and carboplatin/cisplatin.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 57
- 18 to 80 years old.
- Be able and willing to provide written informed consent and to comply with all requirements of study participation (including all study procedures).
- Histologically or cytologically confirmed diagnosis of ES-SCLC per the Veterans Administration Lung Study Group (VALG) staging system.
- No prior treatment for ES-SCLC.
- Measurable disease, as defined by RECIST v1.1.
- Eastern Cooperative Oncology Group performance status ≤ 1.
- Life expectancy ≥ 3 months.
- Adequate hematologic and end-organ function.
- All female and male subjects of reproductive potential must agree to use an effective method of contraception, as determined by the Investigator, during and for 120 days after the last dose of study treatment.
- Symptomatic or actively progressing Central nervous system metastases.
- Uncontrolled carcinomatous meningitis.
- Uncontrolled severe cancer pain
- Uncontrolled pleural effusion, pericardial effusion or ascites requiring recurrent drainage procedures (once a month or more frequently).
- Uncontrolled or symptomatic hypercalcemia.
- History of autoimmune disease.
- History of idiopathic pulmonary fibrosis, organizing pneumonia (such as bronchiolitis obliterans), drug-induced pneumonia, or idiopathic pneumonia, or evidence of active pneumonia on chest computed tomography (CT) during screening.
- Active Tuberculosis infection.
- Significant cardiovascular disease.
- Major surgical procedure within 28 days prior to enrollment or anticipation of need for major surgical procedure during the course of the study.
- Known additional malignancy that is progressing or requires active treatment.
- Active infection requiring systemic therapy
- Prior allogenic bone marrow transplantation or solid organ transplant.
- Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the participant at high risk for treatment complications.
- Receipt of live attenuated vaccination within 4 weeks prior to the first dose of study treatment, or plan to receive live attenuated vaccine during the study.
- Currently receiving the treatment of hepatitis B virus infection..
- Received approved or under development systematic anti-tumor therapy within 28 days before enrollment
- Previously received immune checkpoint agonists (antibodies to CD137 targets) or immune checkpoint inhibitors (such as anti-PD-1 antibodies, anti-PD-L1 antibodies, anti-CTLA-4 antibodies, etc.) , immune cell therapy and other treatment of any immune mechanism for tumors
- Treatment with systemic immunosuppressive medications within 1 week prior to enrollment..
- Known allergies or intolerant to test drugs or their excipients; or a known history of severe hypersensitivity reactions to other antibodies.
- Women who are pregnant (positive pregnancy test before medication) or breastfeeding.
- Received chest radiation therapy prior to the first dose.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description LDRT+AK104+chemotherapy Etoposide AK104(IV, D1) + Cisplatin (IV, D1)/Carboplatin (IV, D1) +Etoposide (IV, D1-D3) were administrated on a 21-day cycle for four cycles. Concurrent LDRT (15 Gy/5f) were conducted from D1-D5 in the first cycle. Then pts received LDRT and AK104 maintenance until loss of clinical benefit or unacceptable toxicity. LDRT+AK104+chemotherapy AK104 AK104(IV, D1) + Cisplatin (IV, D1)/Carboplatin (IV, D1) +Etoposide (IV, D1-D3) were administrated on a 21-day cycle for four cycles. Concurrent LDRT (15 Gy/5f) were conducted from D1-D5 in the first cycle. Then pts received LDRT and AK104 maintenance until loss of clinical benefit or unacceptable toxicity. LDRT+AK104+chemotherapy low-dose radiotherapy AK104(IV, D1) + Cisplatin (IV, D1)/Carboplatin (IV, D1) +Etoposide (IV, D1-D3) were administrated on a 21-day cycle for four cycles. Concurrent LDRT (15 Gy/5f) were conducted from D1-D5 in the first cycle. Then pts received LDRT and AK104 maintenance until loss of clinical benefit or unacceptable toxicity. LDRT+AK104+chemotherapy Carboplatin AK104(IV, D1) + Cisplatin (IV, D1)/Carboplatin (IV, D1) +Etoposide (IV, D1-D3) were administrated on a 21-day cycle for four cycles. Concurrent LDRT (15 Gy/5f) were conducted from D1-D5 in the first cycle. Then pts received LDRT and AK104 maintenance until loss of clinical benefit or unacceptable toxicity.
- Primary Outcome Measures
Name Time Method Progression free survival at 6 months (PFS-6) 6 months PFS-6 is defined as patient outcomes were evaluated at diagnosis and in the subsets of patients achieving progression-free status at 6 months from diagnosis.
Incidence of treatment-related adverse events 48 months The incidence of treatment-related adverse events were measured for determining tolerability and safety. Adverse events (AEs) are evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE, version 5.0). Events of grade 3-5 are defined as moderate and severe adverse events.
- Secondary Outcome Measures
Name Time Method Progression free survival (PFS) Interval between the date of enrollment and the date of progressive disease, or death due to any cause (whichever occurs first), up to a maximum of 24 months. PFS is defined as the time from the date of first dosing till the first documentation of disease progression (per RECIST v1.1) assessed by the investigator or death due to any cause (whichever occurs first)
Overall survival (OS) Interval between the date of enrollment and the date of progressive disease, or death due to any cause (whichever occurs first), up to a maximum of 24 months. OS is defined as the time from randomization to death.
OS Rates at 12 Months (OS-12) 12 months OS-12 is defined as patient outcomes were evaluated at diagnosis and in the subsets of patients survival at 12 months from diagnosis.
OS Rates at 24 Months ( OS-24) 24 months OS-24 is defined as patient outcomes were evaluated at diagnosis and in the subsets of patients survival at 24 months from diagnosis.
Objective Response Rate (ORR) Interval between the date of enrollment and the date of death from any cause, up to a maximum of 18 months. ORR is proportion of subjects with complete response(CR) or partial response(PR). Tumor responses will be evaluated according to RECIST 1.1 criteria. Patients with no tumor assessment after baseline will be classified as non-responders.
Disease control rate (DCR) Interval between the date of enrollment and the date of death due to any cause , up to a maximum of approximately 2 years DCR is defined as the proportion of subjects with CR, PR, or SD (subjects achieving SD will be included in the DCR if they maintain SD for ≥8 weeks) based on RECIST V1.1
PFS Rates at 12 months (PFS-12) 12 months. PFS-6 is defined as patient outcomes were evaluated at diagnosis and in the subsets of patients achieving progression-free status at 12 months from diagnosis.
Number of participants with adverse events (AEs) From the subject signs the Informed Consent Form to 90 days after the last dose of study treatment or initiation of other anti-tumor therapy An AE is defined as any untoward medical occurrence in a participant administered a pharmaceutical product.
temporally associated with the use of study treatment, whether or not considered related to the study treatment
Trial Locations
- Locations (2)
China West Hospital
🇨🇳Chengdu, Sichuan, China
West China Hospital, Sichuan University
🇨🇳Chengdu, Sichuan, China