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MRD-guided Adjuvant Tislelizumab and Chemotherapy in Resected Stage IIA-IIIB NSCLC (Seagull)

Primary Purpose

NSCLC

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
adjuvant tislelizumab and chemotherapy for MRD+ patients
adjuvant tislelizumab and chemotherapy for MRD+ patients
adjuvant chemotherapy for MRD- patients
Sponsored by
The First Affiliated Hospital of Zhengzhou University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for NSCLC focused on measuring ctDNA-MRD

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient with age ≥ 18 years old, gender is not limited.
  2. Histologically confirmed primary NSCLC, postoperative stage is IIA, IIB, IIIA or T3N2IIIB.
  3. Receiving surgery-based comprehensive treatment, that is, radical surgical resection combined with neoadjuvant chemotherapy or/and adjuvant chemotherapy recommended by the Chinese Medical Association's Lung Cancer Clinical Diagnosis and Treatment Guidelines.
  4. Paraffin-embedded sections (10-15 pieces) or fresh frozen tissue are required.
  5. ECOG score of 0 or 1.
  6. Females of childbearing age should take appropriate contraceptive measures from screening to 3 months after discontinuation of study treatment and should not breastfeed. The pregnancy test was negative before starting dosing.
  7. Male patients should use barrier contraception from screening to 3 months after discontinuation of study treatment.
  8. The subjects themselves participated voluntarily and signed the informed consent in writing.

Exclusion Criteria:

  1. The patient has received immune checkpoint inhibitors such as anti-PD-1, PD-L1 or CTLA-4, other immunotherapy or systemic immune modulators (including but not limited to interferon, IL-2 and TNF etc).
  2. Histopathology with small cell or large cell endocrine tumor component.
  3. Harboring EGFR sensitizing mutation or ALK gene translocation
  4. History of other malignant tumors, except for non-melanoma skin cancer, carcinoma in situ or other solid tumors that have been effectively treated, and no evidence of any disease for >5 years after the last treatment.
  5. At the start of the study treatment, there are residual toxicities of the previous treatment that are greater than CTCAE 1 and have not been alleviated, except for alopecia and grade 2 neurotoxicity caused by previous chemotherapy.
  6. Any serious or uncontrolled systemic disease, including uncontrolled high blood pressure, active bleeding, active infection including hepatitis B, C, HIV, etc., which the investigator considers unsuitable to participate in the study or affect the trial program compliance.
  7. History of ILD, drug-induced interstitial lung disease, radiation pneumonitis requiring steroid therapy, or any evidence of clinically active interstitial lung disease
  8. Insufficient bone marrow reserve or organ function.
  9. History of hypersensitivity reactions to any active or inactive ingredient of tislelizumab or to drugs that are chemically similar to tislelizumab or in the same class of tislelizumab.
  10. Patients who, in the judgment of the investigator, may not comply with the procedures and requirements of the study.
  11. Patients who, in the investigator's judgment, have any condition that compromises patient safety or interferes with the evaluation of the study.

Sites / Locations

  • The First Affiliated Hospital of Zhengzhou University,Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

MRD-guided adjuvant tislelizumab and chemotherapy

Non MRD-guided adjuvant tislelizumab and chemotherapy

Arm Description

MRD+: Tislelizumab 200mg Q3W + chemotherapy 1-4 cycles and followed by Tislelizumab 200mg Q3W Up to 16 cycles or until PD or intolerable toxicity or withdrawal MRD-: Adjuvant chemotherapy and surveillance the MRD status, the patient will receive treatment for MRD+ patient when MRD detected,

patients in non MRD-guided arm receive adjuvant tislelizumab and chemotherapy

Outcomes

Primary Outcome Measures

2-year PFS rate
Progression-free survival (per RECIST 1.1) is defined as the time from the starting date of study drug to the date of first documentation of disease progression or death, whichever occurs first. Subjects who do not have disease progression will be censored at their last valid tumor assessment. PFS rate at 1 year as estimated by Kaplan-Meier method.

Secondary Outcome Measures

Percentage of patients changed from MRD+ to MRD- after treatment with tislelizumab for 6 months,12 months
Percentage of patients changed from MRD+ to MRD- after treatment with Tislelizumab for 9 months,12months

Full Information

First Posted
March 1, 2022
Last Updated
March 15, 2023
Sponsor
The First Affiliated Hospital of Zhengzhou University
Collaborators
BeiGene
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1. Study Identification

Unique Protocol Identification Number
NCT05286957
Brief Title
MRD-guided Adjuvant Tislelizumab and Chemotherapy in Resected Stage IIA-IIIB NSCLC
Acronym
Seagull
Official Title
Minimal Residual Disease (MRD)-Guided Adjuvant Tislelizumab and Chemotherapy in Resected Stage IIA-IIIB Non-small Cell Lung Cancer (NSCLC): a Randomized Controlled Phase II Study (Seagull)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 20, 2022 (Actual)
Primary Completion Date
June 1, 2026 (Anticipated)
Study Completion Date
June 1, 2027 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The First Affiliated Hospital of Zhengzhou University
Collaborators
BeiGene

4. Oversight

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

5. Study Description

Brief Summary
Seagull is a phase Ⅱ study designed to investigate the efficacy and safety of MRD-guided adjuvant tislelizumab and chemotherapy vs adjuvant tislelizumab and chemotherapy in patients with resectable NSCLC
Detailed Description
In the phase II trial, the efficacy and safety of MRD-guided adjuvant tislelizumab and chemotherapy will be compared with that of standard adjuvant tislelizumab and chemotherapy in patients with resectable NSCLC.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
NSCLC
Keywords
ctDNA-MRD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
MRD-guided adjuvant tislelizumab and chemotherapy
Arm Type
Experimental
Arm Description
MRD+: Tislelizumab 200mg Q3W + chemotherapy 1-4 cycles and followed by Tislelizumab 200mg Q3W Up to 16 cycles or until PD or intolerable toxicity or withdrawal MRD-: Adjuvant chemotherapy and surveillance the MRD status, the patient will receive treatment for MRD+ patient when MRD detected,
Arm Title
Non MRD-guided adjuvant tislelizumab and chemotherapy
Arm Type
Active Comparator
Arm Description
patients in non MRD-guided arm receive adjuvant tislelizumab and chemotherapy
Intervention Type
Drug
Intervention Name(s)
adjuvant tislelizumab and chemotherapy for MRD+ patients
Intervention Description
MRD+ patients receive adjuvant tislelizumab and chemotherapy while MRD- patients just is recommended receive adjuvant chemotherapy untill be detected MRD+ adjuvant tislelizumab and chemotherapy (cisplatin/carboplatin + paclitaxel or cisplatin/carboplatin + pemetrexed,dependent on tumor histology and at investigator's discretion)
Intervention Type
Drug
Intervention Name(s)
adjuvant tislelizumab and chemotherapy for MRD+ patients
Intervention Description
patients receive adjuvant tislelizumab and chemotherapy regardless of MRD status
Intervention Type
Drug
Intervention Name(s)
adjuvant chemotherapy for MRD- patients
Intervention Description
MRD- patients just be recommended receive adjuvant chemotherapy untill be detected cisplatin/carboplatin + paclitaxel or cisplatin/carboplatin + pemetrexed,dependent on tumor histology and at investigator's discretion, limited to ≤4 cycles
Primary Outcome Measure Information:
Title
2-year PFS rate
Description
Progression-free survival (per RECIST 1.1) is defined as the time from the starting date of study drug to the date of first documentation of disease progression or death, whichever occurs first. Subjects who do not have disease progression will be censored at their last valid tumor assessment. PFS rate at 1 year as estimated by Kaplan-Meier method.
Time Frame
up to 36 months after enrollment or study close
Secondary Outcome Measure Information:
Title
Percentage of patients changed from MRD+ to MRD- after treatment with tislelizumab for 6 months,12 months
Description
Percentage of patients changed from MRD+ to MRD- after treatment with Tislelizumab for 9 months,12months
Time Frame
At the end of Cycle 8(each cycle is 21 days)、Cycle 16 (each cycle is 21 days)

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: Patient with age ≥ 18 years old, gender is not limited. Histologically confirmed primary NSCLC, postoperative stage is IIA, IIB, IIIA or T3N2IIIB. Receiving complete resection Paraffin-embedded sections (10-15 pieces) or fresh frozen tissue are required. ECOG score of 0 or 1. Females of childbearing age should take appropriate contraceptive measures from screening to 3 months after discontinuation of study treatment and should not breastfeed. The pregnancy test was negative before starting dosing. Male patients should use barrier contraception from screening to 3 months after discontinuation of study treatment. The subjects themselves participated voluntarily and signed the informed consent in writing. Exclusion Criteria: The patient has received immune checkpoint inhibitors such as anti-PD-1, PD-L1 or CTLA-4, other immunotherapy or systemic immune modulators (including but not limited to interferon, IL-2 and TNF etc). Histopathology with small cell or large cell endocrine tumor component. Harboring EGFR sensitizing mutation or ALK gene translocation History of other malignant tumors, except for non-melanoma skin cancer, carcinoma in situ or other solid tumors that have been effectively treated, and no evidence of any disease for >5 years after the last treatment. At the start of the study treatment, there are residual toxicities of the previous treatment that are greater than CTCAE 1 and have not been alleviated, except for alopecia and grade 2 neurotoxicity caused by previous chemotherapy. Any serious or uncontrolled systemic disease, including uncontrolled high blood pressure, active bleeding, active infection including hepatitis B, C, HIV, etc., which the investigator considers unsuitable to participate in the study or affect the trial program compliance. History of ILD, drug-induced interstitial lung disease, radiation pneumonitis requiring steroid therapy, or any evidence of clinically active interstitial lung disease Insufficient bone marrow reserve or organ function. History of hypersensitivity reactions to any active or inactive ingredient of tislelizumab or to drugs that are chemically similar to tislelizumab or in the same class of tislelizumab. Patients who, in the judgment of the investigator, may not comply with the procedures and requirements of the study. Patients who, in the investigator's judgment, have any condition that compromises patient safety or interferes with the evaluation of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Feng Li, MD
Phone
+8615838222689
Email
LF_0604@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yu Qi
Phone
+8613803892392
Email
qiyu@zzu.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yu Qi
Organizational Affiliation
The First Affiliated Hospital of Zhengzhou University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Affiliated Hospital of Zhengzhou University,
City
Zhengzhou
State/Province
Henan
ZIP/Postal Code
450052
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Feng Li, MD
Phone
+8615838222689
Email
LF_0604@163.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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MRD-guided Adjuvant Tislelizumab and Chemotherapy in Resected Stage IIA-IIIB NSCLC

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