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临床试验/NCT04767009
NCT04767009招募中2 期

An Open-label, Multicenter, Phase II Single Arm Trial of Stereotactic Body Radiotherapy for Oligo-residual Disease After Effective Treatment With PD-1/PD-L1 Inhibitors Among Metastatic Non-small Cell Lung Cancer

Fudan University1 个研究点 分布在 1 个国家目标入组 59 人开始时间: 2021年1月1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
59
试验地点
1
主要终点
Progression-free survival

研究概览

简要总结

Despite the impressive response rate to PD-1/PD-L1 immune checkpoint inhibitors, resistance inevitably develops in most patients. Stereotactic body radiation therapy (SBRT) plays a growing role in the management of oligometastatic disease. This study aims to evaluate the efficacy and safety of SBRT for oligo-residual NSCLC after effective treatment with PD-1/PD-L1 inhibitors.

研究设计

研究类型
Interventional
分配方式
Na
干预模型
Single Group
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

  • Age at least 18 years.
  • ECOG PS 0-
  • Patients with pathologically confirmed stage IV NSCLC by tumor biopsy and/or fine-needle aspiration.
  • Negative for driver genes including EGFR, ALK, and ROS-
  • Oligo-residual disease after effective treatment with PD-1/PD-L1 inhibitors that would be amenable to SBRT in the opinion of the investigator.
  • Patients with brain metastasis are eligible if they are asymptomatic, neurologically stable, and off corticosteroids.
  • Patients with a history of radiotherapy are eligible if they satisfy the following criteria:
  • Radiotherapy administered more than 4 weeks before study entry.
  • At least one measurable lesion outside the radiation field.
  • Patients with no indications for palliative radiotherapy in the opinion of the investigator.
  • Patients with a prior history of surgery are eligible if they have sufficiently recovered from the toxicity and/or complications of surgery.
  • Signed informed consent for the use of fresh tumor biopsies before and during the treatment.
  • Women of childbearing age and men must agree to use effective contraception during the trial.
  • Life expectancy of more than 3 months.
  • Adequate organ function within 1 week prior to enrollment:
  • Adequate bone marrow function: hemoglobin ≥80g/L, white blood cell (WBC) count ≥ 4.0 * 10 ^ 9/L or neutrophil count ≥ 1.5 * 10 ^ 9/L, and platelet count ≥ 100 * 10 ^ 9/L;
  • Adequate hepatic function: total bilirubin < 1.5 x upper limit of normal (ULN). Note: If total bilirubin is > 1.5 x ULN, direct bilirubin must ≤ ULN, Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤2.5 ULN;
  • Adequate renal function: serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 50 mL/min;
  • Ability to understand and willingness to provide the informed consent.

排除标准

  • Severe autoimmune disease: inflammatory bowel disease (including Crohn's disease and ulcerative colitis), rheumatoid arthritis, scleroderma, systemic lupus erythematosus, Wegener's granulomatosis and related vasculitides.
  • Symptomatic interstitial lung disease or clinically active infectious/non-infectious pneumonitis.
  • History of another malignancy or concurrent malignancy.
  • Active infection, congestive heart failure, or any evidence of myocardial infarction, unstable angina pectoris or cardiac arrhythmia within 6 months prior to enrollment.
  • Any evidence of severe or uncontrolled systemic diseases, which in the investigator's opinion makes it undesirable for the patient to participate in the trial or which would jeopardize compliance with the protocol. Screening for chronic conditions is not required.
  • Patients in whom palliative radiotherapy is indicated in the opinion of the investigator.
  • Mixed small cell with non-small cell lung cancer histology.
  • The patient is pregnant (confirmed by serum b-HCG if applicable) or is breastfeeding.
  • Patients who have received tumor vaccine; or administration of live, attenuated vaccine within 4 weeks before the start of treatment. Note: Influenza vaccination is permitted only during influenza season, while live, attenuated influenza vaccine such as FluMist is not allowed.
  • Patients receiving immunosuppressive agents, or other investigational treatment. Long-term corticosteroid users are also excluded.
  • Mental disorders, drug abuse, and social condition that may negatively impact compliance in the investigator's opinion.
  • Prior allergic reaction or contraindications to PD-1/PD-L1 inhibitors.

研究组 & 干预措施

SBRT for oligo-residual NSCLC

Experimental

干预措施: PD-1/PD-L1 inhibitors (alone or in combination with chemotherapy) (Drug)

SBRT for oligo-residual NSCLC

Experimental

干预措施: SBRT (Radiation)

结局指标

主要结局

Progression-free survival

时间窗: Two years

PFS was measured from the date of the initiation of treatment with PD-1/PD-L1 inhibitors to the date of disease progression as defined by Response Evaluation Criteria in Solid Tumor (RECIST) Version 1.1 or death.

次要结局

  • Percentage of Participants With Adverse Events(Two year)
  • Overall Survival(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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