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Stereotactic Radiosurgery Combination With Anlotinib for Limited Brain Metastases With Perilesional Edema in NSCLC (Rvision-001)

Primary Purpose

Stereotactic Body Radiation Therapy

Status
Unknown status
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Anlotinib
Stereotactic Radiosurgery
Sponsored by
Peking University Third Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stereotactic Body Radiation Therapy

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients voluntarily participate in this study, signed informed consent.
  2. Patients pathologically diagnosed as non-small cell lung cancer, with brain metastases and measurable lesions;
  3. Patients aged between 18 -80 years; with expected survival time>3 months.
  4. Patients with no more than 5 brain metastases
  5. Patients with normal organ function within 7 days prior to treatment, the following criteria are met:

    a) blood routine examination criteria : i) hemoglobin (HB) ≥90g/L; ii) absolute neutrophil count (ANC) ≥1.5×10e9/L; iii) platelet (PLT) ≥80×10e9/L; b) biochemical tests meet the following criteria: i) total bilirubin (TBIL) ≤1.5 times of upper limit of normal (ULN); ii) alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 ULN, if liver metastasis occurred, ALT and AST ≤5 ULN; iii) serum creatinine (Cr) ≤1.5 ULN or creatinine clearance (CCr) ≥60mL/min;

  6. Female patients should agree to use contraceptives during and within 6 months after the study.

Exclusion Criteria:

  1. Patients who had previously used antiangiogenic agents within 1 month;
  2. Patients with small cell lung cancer (including small cell carcinoma and non-small cell carcinoma mixed lung cancer);
  3. Patient with lung squamous cell carcinoma that involved pulmonary hilar, or non-small cell lung cancer with hemoptysis;
  4. Patients with cerebral infarction and cerebral hemorrhage;
  5. Patients without perilesional edema;
  6. Patients with more than grade 2 (NCI-CTCAE v4.0) acute toxicity reaction due to any previous treatment.
  7. Patients with factors that affect oral medication (such as cannot swallow, chronic diarrhea and intestinal obstruction, etc.);
  8. Patients with visceral dissemination or severe symptoms, which could cause death in short term;
  9. Patients with any other severe and/or uncontrolled disease;
  10. Patients who received a surgery, a biopsy or a significant traumatic injury within 1 month;
  11. Patients with any signs or medical history of bleeding, unhealed wounds, ulcers or fractures, regardless of the severity;
  12. Patients underwent artery or venous thrombotic events within 2 months, such as deep vein thrombosis and pulmonary embolism;
  13. Patients with a history of psychotropic medicine abuse and cannot quit or have mental disorders;
  14. Patients with disease which will severely endanger their security and could not complete this study, according to the judgement of researchers;
  15. Patients who still can't tolerate SRS after anlotinib treatment, even after adding mannitol, and have to receive steroid treatment.

Sites / Locations

  • Department of Radiation Oncology Cancer Center, Peking University Third Hospital 49# North Garden Rd.,Haidian Dist.Recruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SRS Combination With Anlotinib

Arm Description

Stereotactic Radiosurgery Combination With Anlotinib

Outcomes

Primary Outcome Measures

EI
Edema Index. The "Edema index (EI)" is calculated per the equation of "edema index= (peri-tumoral edema volume+ tumor volume)/tumor volume.

Secondary Outcome Measures

PFS
Progression-free Survival
OS
Overall Survival
ORR
Objective Response Rate
DCR
Disease Control Rate
iORR
intracranial objective response rate
iPFS
intracranial progression-free survival
SRS rate
the rate of SRS after anlotinib treatment

Full Information

First Posted
October 30, 2019
Last Updated
March 1, 2020
Sponsor
Peking University Third Hospital
Collaborators
Huashan Hospital, Tianjin Medical University
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1. Study Identification

Unique Protocol Identification Number
NCT04147728
Brief Title
Stereotactic Radiosurgery Combination With Anlotinib for Limited Brain Metastases With Perilesional Edema in NSCLC
Acronym
Rvision-001
Official Title
Stereotactic Radiosurgery Combination With Anlotinib for Limited Brain Metastases With Perilesional Edema in Non-small Cell Lung Cancer:An Exploratory Single-Arm Phase II Clinical Trail
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Unknown status
Study Start Date
December 24, 2019 (Actual)
Primary Completion Date
December 15, 2021 (Anticipated)
Study Completion Date
December 15, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Peking University Third Hospital
Collaborators
Huashan Hospital, Tianjin Medical University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether stereotactic radiosurgery combination with Anlotinib is safe, effective in the treatment of limited brain metastases with Perilesional edema in non-small cell lung cancer.
Detailed Description
The purpose of this study is to determine whether stereotactic radiosurgery combination with Anlotinib is safe, effective in the treatment of limited brain metastases with perilesional edema in non-small cell lung cancer. The sample size is 50. Patients start to take Anlotinib 1 week before the MRI-based simulation,12mg/d QD,day1~14, day22~36.Edema index will be used to evaluate the effectiveness of Anlotinib. The "Edema index (EI)" is calculated per the equation of "edema index= (peri-tumoral edema volume+ tumor volume)/tumor volume.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stereotactic Body Radiation Therapy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
SRS Combination With Anlotinib
Arm Type
Experimental
Arm Description
Stereotactic Radiosurgery Combination With Anlotinib
Intervention Type
Drug
Intervention Name(s)
Anlotinib
Other Intervention Name(s)
Antiangiogenic agents
Intervention Description
Anlotinib is a novel multi-target tyrosine Kinase inhibitor that inhibits VEGFR2/3, FGFR1-4, PDGFD α/β, c-Kit and Ret.
Intervention Type
Radiation
Intervention Name(s)
Stereotactic Radiosurgery
Intervention Description
Stereotactic Radiosurgery as the initial treatment of non small cell lung cancer patients with limited brain metastases
Primary Outcome Measure Information:
Title
EI
Description
Edema Index. The "Edema index (EI)" is calculated per the equation of "edema index= (peri-tumoral edema volume+ tumor volume)/tumor volume.
Time Frame
1 month
Secondary Outcome Measure Information:
Title
PFS
Description
Progression-free Survival
Time Frame
1 year
Title
OS
Description
Overall Survival
Time Frame
1 year
Title
ORR
Description
Objective Response Rate
Time Frame
3 months
Title
DCR
Description
Disease Control Rate
Time Frame
3 months
Title
iORR
Description
intracranial objective response rate
Time Frame
3 months
Title
iPFS
Description
intracranial progression-free survival
Time Frame
3 months
Title
SRS rate
Description
the rate of SRS after anlotinib treatment
Time Frame
1 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients voluntarily participate in this study, signed informed consent. Patients pathologically diagnosed as non-small cell lung cancer, with brain metastases and measurable lesions; Patients aged between 18 -80 years; with expected survival time>3 months. Patients with no more than 5 brain metastases Patients with normal organ function within 7 days prior to treatment, the following criteria are met: a) blood routine examination criteria : i) hemoglobin (HB) ≥90g/L; ii) absolute neutrophil count (ANC) ≥1.5×10e9/L; iii) platelet (PLT) ≥80×10e9/L; b) biochemical tests meet the following criteria: i) total bilirubin (TBIL) ≤1.5 times of upper limit of normal (ULN); ii) alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 ULN, if liver metastasis occurred, ALT and AST ≤5 ULN; iii) serum creatinine (Cr) ≤1.5 ULN or creatinine clearance (CCr) ≥60mL/min; Female patients should agree to use contraceptives during and within 6 months after the study. Exclusion Criteria: Patients who had previously used antiangiogenic agents within 1 month; Patients with small cell lung cancer (including small cell carcinoma and non-small cell carcinoma mixed lung cancer); Patient with lung squamous cell carcinoma that involved pulmonary hilar, or non-small cell lung cancer with hemoptysis; Patients with cerebral infarction and cerebral hemorrhage; Patients without perilesional edema; Patients with more than grade 2 (NCI-CTCAE v4.0) acute toxicity reaction due to any previous treatment. Patients with factors that affect oral medication (such as cannot swallow, chronic diarrhea and intestinal obstruction, etc.); Patients with visceral dissemination or severe symptoms, which could cause death in short term; Patients with any other severe and/or uncontrolled disease; Patients who received a surgery, a biopsy or a significant traumatic injury within 1 month; Patients with any signs or medical history of bleeding, unhealed wounds, ulcers or fractures, regardless of the severity; Patients underwent artery or venous thrombotic events within 2 months, such as deep vein thrombosis and pulmonary embolism; Patients with a history of psychotropic medicine abuse and cannot quit or have mental disorders; Patients with disease which will severely endanger their security and could not complete this study, according to the judgement of researchers; Patients who still can't tolerate SRS after anlotinib treatment, even after adding mannitol, and have to receive steroid treatment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hongqing Zhuang, doctor
Phone
13051776232
Email
hongqingzhuang@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yuxia Wang, doctor
Phone
15001292991
Email
lily31415926@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hongqing Zhuang, doctor
Organizational Affiliation
Peking University Third Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Department of Radiation Oncology Cancer Center, Peking University Third Hospital 49# North Garden Rd.,Haidian Dist.
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100191
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hongqing Zhuang, Doctor
Phone
13051776232
Email
hongqingzhuang@163.com
First Name & Middle Initial & Last Name & Degree
Yuxia Wang, Doctor
Phone
15001292991
Email
lily31415926@126.com
First Name & Middle Initial & Last Name & Degree
Enmin Wang
First Name & Middle Initial & Last Name & Degree
Yongchun Song
First Name & Middle Initial & Last Name & Degree
Xin Wang
First Name & Middle Initial & Last Name & Degree
Yun Guan

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33294918
Citation
Zhuang H, Wang Y, Cheng C, Shi S. The efficacy of anlotinib instead of glucocorticoids for edema induced by brain metastases in NSCLC patients with anti-PD1/PDL-1 immunotherapy. Neuro Oncol. 2021 Jan 30;23(1):169-171. doi: 10.1093/neuonc/noaa236. No abstract available.
Results Reference
derived

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Stereotactic Radiosurgery Combination With Anlotinib for Limited Brain Metastases With Perilesional Edema in NSCLC

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