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SBRT Combination With rhGM-CSF and Tα1 for Stage IV NSCLC Patients Who Failed in Second-line Chemotherapy

Primary Purpose

Lung Cancer Metastatic

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
SBRT
Immunological Agent
Immunological Factors
Sponsored by
The First Affiliated Hospital of Xiamen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Cancer Metastatic focused on measuring lung cancer, SBRT, rhGM-CSF, Thymosin Alpha 1

Eligibility Criteria

17 Years - 70 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:Inclusion Criteria:

  1. Histologically proven non-small-cell lung cancer.
  2. Stage IV according to UICC stage system(version 7,2009).
  3. Progression after standard second-line chemotherapy.
  4. At least Three evaluable lesions among which at least two must be suitable for SBRT.
  5. ECOG performance status 0-2.
  6. Expected lifespan ≥3 months.
  7. Stable lab values:

    Hematological: Absolute neutrophil count (ANC) ≥1.5×109/L, Platelets ≥100×109/L, Hemoglobin ≥9 g/dL Renal: Creatinine OR Measured or calculated creatinine clearance (CrCl) (glomerular filtration rate [GFR] can also be used in place of creatinine or CrCl) ≤1.5× the upper limit of normal (ULN) OR ≥60 mL/min for patient with creatinine levels >1.5× institutional ULN Hepatic: Total bilirubin ≤1.5×ULN OR Direct bilirubin ≤ULN for patients with total bilirubin levels >1.5×ULN, Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5×ULN OR ≤5×ULN for patients with liver metastases ,globulin≥20 g/L, albumin≥30 g/L.

  8. Female subjects must have a negative urine or serum pregnancy test within 72 hours prior to taking study drug if of childbearing potential.
  9. Able to understand and give written informed consent and comply with study procedures.

Exclusion Criteria:

  1. Any unstable systemic disease, including active infection, uncontrolled high blood pressure, unstable angina, newly observed angina pectoris within the past 3 months, congestive heart failure (New York heart association (NYHA) class II or higher), myocardial infarction onset six months before included into the group, and severe arrhythmia, liver, kidney, or metabolic disease in need of drug therapy, Including diabetes.
  2. Any clinical evidence suggests moderately severe chronic obstructive pulmonary disease (COPD) - [With COPD history or related risk factors, FEV1 / FVC < 70%, FEV1 < 80% estimated value, with or without chronic cough, sputum, dyspnea symptoms), active interstitial lung disease - ILD (FEV1 / FVC < 70%, FEV1 < 80% estimated value, carbon monoxide diffusion capacity in lung - DLCO < 40%, and high resolution CT (HRCT) confirmed as the diffuse pulmonary interstitial lesions] and other active pulmonary disease.
  3. Previously diagnosed with autoimmune diseases, including but not limited to systemic lupus erythematous, rheumatoid arthritis, systemic vasculitis, scleroderma, dermatomyositis, autoimmune hemolytic anemia and autoimmune liver disease, autoimmune thyroiditis.
  4. Human immunodeficiency virus (HIV) infection.
  5. Women in pregnancy or lactation .
  6. Medicine abusers(including alcohol, drugs or other addictive drugs abusers).
  7. Patients with mental illness, considered as "can't fully understand the issues of this research".
  8. Cancer history within 5 years apart from NSCLC before enrollment.
  9. Histologically confirmed small cell carcinoma or other non NSCLC compositions in the cancer tissue.
  10. Cancer treatment within 4 weeks, including but not limited to palliative surgery ,radiotherapy, chemotherapy and target therapy.
  11. Tumor related immunotherapy within 1 year, including but not limited to immune cell therapy, tumor vaccine therapy, immune check-point monoclonal antibody related treatment, and cytokines treatment except for GM-CSF.
  12. Allergy of rhGM-CSF/Tα1 and its accessories.
  13. Contraindications to GM-CSF/Tα1 treatment.
  14. Patients with unilateral lung.

Sites / Locations

  • First affiliated Hospital of Xiamen UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SBRT+GM-CSF+Tα1

Arm Description

Metastasis lesion will be treated with a SBRT of 50Gy/4-10F from day 1 to day 10 . Subcutaneous injection of Immunological Agent- human recombined granulocyte-macrophage colony stimulating factor (125ug/m² per day) will be executed from day 1 to day 14 in this cycle. Another metastasis lesion will be treated likewise concurrently with rhGM-CSF in a consecutive cycle. Subcutaneous injection of another Immunological Factors Thymosin Alpha 1(1.6mg Biw)will be executed from the fist WEEK to the 12th Weeks.

Outcomes

Primary Outcome Measures

abscopal effect rate

Secondary Outcome Measures

overall survival
Incidence of Adverse events
objective response rate
Incidence of immune-related adverse events

Full Information

First Posted
November 25, 2016
Last Updated
November 28, 2016
Sponsor
The First Affiliated Hospital of Xiamen University
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1. Study Identification

Unique Protocol Identification Number
NCT02976740
Brief Title
SBRT Combination With rhGM-CSF and Tα1 for Stage IV NSCLC Patients Who Failed in Second-line Chemotherapy
Official Title
A Prospective Multi-center Phase II Study: Assessment of the Safety and Abscopal Effects of SBRT Combination With rhGM-CSF and Thymosin Alpha 1 for Stage IV NSCLC Patients Who Failed in Second-line Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Unknown status
Study Start Date
November 2016 (undefined)
Primary Completion Date
June 2019 (Anticipated)
Study Completion Date
December 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The First Affiliated Hospital of Xiamen University

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether stereotactic body radiotherapy (SBRT) combined with recombined human granulocyte-macrophage colony stimulating factor(rhGM-CSF) and Thymosin Alpha 1 is safe, effective in the treatment of stage IV NSCLC patients who failed in second-line chemotherapy.
Detailed Description
Metastasis lesion of stage IV NSCLC will be treated with a SBRT of 50Gy/4-10F from day 1 to day 14 in one cycle. Subcutaneous injection of human recombined granulocyte-macrophage colony stimulating factor (125ug/m² per day) will be executed from day 1 to day 14 in this cycle. Another metastasis lesion will be treated likewise concurrently with rhGM-CSF in a consecutive cycle.Thymosin Alpha 1(1.6mg Biw) will be Subcutaneous injection from the fist week to the 12th weeks, Efficacy evaluation, especially abscopal effect evaluation, will be conducted at the end of therapy and every month after that. Adverse events will be recorded according to NCI-CTC version 4.03.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Cancer Metastatic
Keywords
lung cancer, SBRT, rhGM-CSF, Thymosin Alpha 1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SBRT+GM-CSF+Tα1
Arm Type
Experimental
Arm Description
Metastasis lesion will be treated with a SBRT of 50Gy/4-10F from day 1 to day 10 . Subcutaneous injection of Immunological Agent- human recombined granulocyte-macrophage colony stimulating factor (125ug/m² per day) will be executed from day 1 to day 14 in this cycle. Another metastasis lesion will be treated likewise concurrently with rhGM-CSF in a consecutive cycle. Subcutaneous injection of another Immunological Factors Thymosin Alpha 1(1.6mg Biw)will be executed from the fist WEEK to the 12th Weeks.
Intervention Type
Radiation
Intervention Name(s)
SBRT
Other Intervention Name(s)
SABR
Intervention Description
Stereotactic body radiotherapy A type of radiation therapy to the Metastasis lesion
Intervention Type
Drug
Intervention Name(s)
Immunological Agent
Other Intervention Name(s)
rh GM-CSF
Intervention Description
Subcutaneous injection of human recombined granulocyte-macrophage colony stimulating factor (125ug/m² per day) will be executed from day 1 to day 14 in this cycle. Another metastasis lesion will be treated likewise concurrently with rhGM-CSF in a consecutive cycle.
Intervention Type
Drug
Intervention Name(s)
Immunological Factors
Other Intervention Name(s)
Tα1
Intervention Description
Thymosin Alpha 1(1.6mg Biw)will be executed from the fist Week to the 12th Weeks.
Primary Outcome Measure Information:
Title
abscopal effect rate
Time Frame
at the time point of 4 weeks after completion of the combined treatment
Secondary Outcome Measure Information:
Title
overall survival
Time Frame
1 year after completion of the combined treatment
Title
Incidence of Adverse events
Time Frame
1 year after completion of the combined treatment
Title
objective response rate
Time Frame
4 weeks after completion of the combined treatment
Title
Incidence of immune-related adverse events
Time Frame
1 year after completion of the combined treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
17 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:Inclusion Criteria: Histologically proven non-small-cell lung cancer. Stage IV according to UICC stage system(version 7,2009). Progression after standard second-line chemotherapy. At least Three evaluable lesions among which at least two must be suitable for SBRT. ECOG performance status 0-2. Expected lifespan ≥3 months. Stable lab values: Hematological: Absolute neutrophil count (ANC) ≥1.5×109/L, Platelets ≥100×109/L, Hemoglobin ≥9 g/dL Renal: Creatinine OR Measured or calculated creatinine clearance (CrCl) (glomerular filtration rate [GFR] can also be used in place of creatinine or CrCl) ≤1.5× the upper limit of normal (ULN) OR ≥60 mL/min for patient with creatinine levels >1.5× institutional ULN Hepatic: Total bilirubin ≤1.5×ULN OR Direct bilirubin ≤ULN for patients with total bilirubin levels >1.5×ULN, Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5×ULN OR ≤5×ULN for patients with liver metastases ,globulin≥20 g/L, albumin≥30 g/L. Female subjects must have a negative urine or serum pregnancy test within 72 hours prior to taking study drug if of childbearing potential. Able to understand and give written informed consent and comply with study procedures. Exclusion Criteria: Any unstable systemic disease, including active infection, uncontrolled high blood pressure, unstable angina, newly observed angina pectoris within the past 3 months, congestive heart failure (New York heart association (NYHA) class II or higher), myocardial infarction onset six months before included into the group, and severe arrhythmia, liver, kidney, or metabolic disease in need of drug therapy, Including diabetes. Any clinical evidence suggests moderately severe chronic obstructive pulmonary disease (COPD) - [With COPD history or related risk factors, FEV1 / FVC < 70%, FEV1 < 80% estimated value, with or without chronic cough, sputum, dyspnea symptoms), active interstitial lung disease - ILD (FEV1 / FVC < 70%, FEV1 < 80% estimated value, carbon monoxide diffusion capacity in lung - DLCO < 40%, and high resolution CT (HRCT) confirmed as the diffuse pulmonary interstitial lesions] and other active pulmonary disease. Previously diagnosed with autoimmune diseases, including but not limited to systemic lupus erythematous, rheumatoid arthritis, systemic vasculitis, scleroderma, dermatomyositis, autoimmune hemolytic anemia and autoimmune liver disease, autoimmune thyroiditis. Human immunodeficiency virus (HIV) infection. Women in pregnancy or lactation . Medicine abusers(including alcohol, drugs or other addictive drugs abusers). Patients with mental illness, considered as "can't fully understand the issues of this research". Cancer history within 5 years apart from NSCLC before enrollment. Histologically confirmed small cell carcinoma or other non NSCLC compositions in the cancer tissue. Cancer treatment within 4 weeks, including but not limited to palliative surgery ,radiotherapy, chemotherapy and target therapy. Tumor related immunotherapy within 1 year, including but not limited to immune cell therapy, tumor vaccine therapy, immune check-point monoclonal antibody related treatment, and cytokines treatment except for GM-CSF. Allergy of rhGM-CSF/Tα1 and its accessories. Contraindications to GM-CSF/Tα1 treatment. Patients with unilateral lung.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Deng Chong, MD
Phone
86-05922139531
Email
dengchongxm@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Lin Qin, MD/PhD
Phone
86-05922139531
Email
linqin03@163.com
Facility Information:
Facility Name
First affiliated Hospital of Xiamen University
City
Xiamen
State/Province
Fujian
ZIP/Postal Code
361000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Deng Chong, MD
Phone
8605922139531
Email
dengchongxm@163.com
First Name & Middle Initial & Last Name & Degree
Lin Qin, MD/PhD
Phone
8605922139531
Email
linqin06@163.com
First Name & Middle Initial & Last Name & Degree
Deng Chong, MD
First Name & Middle Initial & Last Name & Degree
Lin Qin, MD/PhD
First Name & Middle Initial & Last Name & Degree
Ye Feng, MD
First Name & Middle Initial & Last Name & Degree
An Hanxiang, MD/PhD
First Name & Middle Initial & Last Name & Degree
Liu Qun, MD

12. IPD Sharing Statement

Plan to Share IPD
No
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SBRT Combination With rhGM-CSF and Tα1 for Stage IV NSCLC Patients Who Failed in Second-line Chemotherapy

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