A Study of Camrelizumab Plus Apatinib as Consolidation Therapy in Non-Small Cell Lung Cancer Patients Treated With Chemoradiotherapy
Primary Purpose
Locally Advanced Non-Small Cell Lung Cancer
Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Camrelizumab, PD-1 monoclonal antibody
Apatinib, VEGFR2 antibody
Sponsored by
About this trial
This is an interventional treatment trial for Locally Advanced Non-Small Cell Lung Cancer focused on measuring Non-Small Cell Lung Cancer, Programmed cell death 1 (PD-1, PD1), Anti VEGF, Chemoradiotherapy
Eligibility Criteria
Inclusion Criteria:
- Patients aged ≥18 years, male and female are not limited;
- Patients with ECOG score of 0-1;
- Life expectancy ≥12 weeks;
- Patients must have histologically or cytologicallyproved NSCLC, and present with locally advanced, unresectable Stage III disease(according to 8th AJCC/UICC Classification);
- Receipt of concurrent or sequential chemoradiation therapy which must have been completed within 42 days prior to first dose administration of the study; Consolidation chemotherapy is not permitted.
- No progression following definitive, platinum-based, concurrent or sequential chemoradiation therapy;
- Subject with prior anti-cancer treatment can only be enrolled when all toxicities of prior anti-cancer treatment has recovered to baseline or ≤ Grade 1, except for hearing loss, alopecia and fatigue. (according to National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] V5.0);
- No prior exposure to any anti-CTLA-4, anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-VEGF treatments, as well as therapeutic anticancer vaccines;
- Agreement to provide tumor histological specimens required for this study;
- Adequate organ and marrow function required;
- Fertile female were required to have a negative serum or urine pregnancy test within 72 days before the start dose of study medication; If female of childbearing potential, is willing to use adequate contraception for the course of the study through 90 days after the last dose of study medication; if male with a female partner(s) of child-bearing potential, he must agree to use adequate contraception starting with the first dose of study medication through 90 days after the last dose of study medication or have been surgically sterilized;
- Provision of signed ICF.
Exclusion Criteria:
- Mixed small cell lung cancer histology;
- Disease progression after concurrent/sequential chemoradiotherapy;
- Major surgical procedure (as defined by the Investigator) within 28 days prior to the first dose of treatment;
- Receipt of live attenuated vaccine within 28 days prior to the first dose of treatment;
- Previous enrolment of another study and receiving any study drug within 28 days prior to the first dose of treatment;
- Patients with ≥Grade 2 pneumonitis from the prior anti-cancerchemoradiation therapy;
- Imaging (CT or MRI) shows the tumor invading large vessels or blurring the boundary with vessels;
- History of organ transplant or allogeneic hematopoietic stem cell transplantation;
- Patients with any active autoimmune disease or history of autoimmune disease;
- Patients with innate or acquired immune deficiency, such as human immunodeficiency virus (HIV) infection;
- Uuntreated active hepatitis B or, hepatitis C or active tuberculosis or currently receiving anti-tuberculosis treatment co-infection with hepatitis B and hepatitis C;
- Subjects receiving systemic treatment with corticosteroids (>10mg/day of prednisone or its equivalent) or other immunosuppressants within 14 days prior to the first administration;
- History of another primary malignancy within 5 years prior to enrollment, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ and the disease under study;
- Pulmonary function test: FEV1< 1.2L or DLCO < 50% of predicted value;
- Patients with cardiac insufficiencyheart diseases including: 1) NYHA III-IV; 2)Acute coronary syndrome; 3) Supraventricular or ventricular arrhythmias requiring clinical intervention; 4) Pericardial and myocardial diseases; 5) Echocardiography indicates that the left ventricular ejection fraction (LVEF) is < 50%;
- Patients with uncontrollable hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, despite the best drug treatment);
- Patients who have had arteriovenous thrombosis events within 6 months, such as cerebrovascular accident (including cerebral embolism, deep vein thrombosis, pulmonary embolismcerebral hemorrhage, cerebral infarction, transient ischemic attack, etc.);
- Patients with hemoptysis, active bleeding, ulcer, intestinal perforation and intestinal obstruction within 3 months before administration;
- Significant hemoptysis symptoms or daily amount of hemoptysis up to 2.5mL or more within 30 days before the first administration;
- Known hereditary or acquired bleeding and thrombosis tendency (such as hemophilia, coagulation dysfunction, thrombocytopenia, hypersplenism, etc.);
- Routine urine test indicated that urine protein was ≥ (++), or 24-hour urine protein was ≥ 1g, or severe liver and kidney dysfunction;
- Patients with severe infection or fever of unknown origin > 38.5 degrees C within 24 weeks before medication;
- Pregnant or lactating women; those with fertility who are unwilling or unable to take effective contraceptive measures;
- Known allergies, hypersensitivity, or intolerance to camrelizumab or its excipients, apatinib and chemotherapy drugs;
- Any conditions, judged by investigators, that may impair the subject or cause the subject to be unable to meet or perform the study requirements.
Sites / Locations
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Experimental Arm
Arm Description
Camrelizumab plus apatinib as consolidation therapy
Outcomes
Primary Outcome Measures
Progression-free Survival (PFS)
PFS is determined by the investigator using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1).
Secondary Outcome Measures
Overall Survival (OS)
OS is defined as the first date of treatment to date of death from any causes.
PFS at 12 months (PFS12)
PFS will be calculated using Kaplan-Meier product limit methods.
PFS at 18 months (PFS18)
PFS will be calculated using Kaplan-Meier product limit methods.
OS at 12 months (OS12)
OS will be calculated using Kaplan-Meier product limit methods.
OS at 24 months (OS24)
OS will be calculated using Kaplan-Meier product limit methods.
OS at 36 months (OS36)
OS will be calculated using Kaplan-Meier product limit methods.
Objective response rate (ORR)
ORR is defined as the percentage of participants in the analysis population who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 by investigator.
Duration of Response (DoR)
DoR is defined as the first date of treatment to the progression, or the last evaluable assessment in the absence of progression.
TTDM
TTDM is defined as the first date of treatment to the first date of distant metastasis or death in the absence of distant metastasis.
Number of participants with AEs, SAEs, Treatment-related Adverse Events (TRAEs).
Full Information
NCT ID
NCT04749394
First Posted
February 5, 2021
Last Updated
August 15, 2022
Sponsor
Chinese Academy of Medical Sciences
1. Study Identification
Unique Protocol Identification Number
NCT04749394
Brief Title
A Study of Camrelizumab Plus Apatinib as Consolidation Therapy in Non-Small Cell Lung Cancer Patients Treated With Chemoradiotherapy
Official Title
A Phase II, Open-Label, Multi-Centre Study of Camrelizumab Plus Apatinib As Consolidation Therapy in Patients With Locally Advanced, Unresectable NSCLC, Who Have Not Progressed Following Definitive, Platinum-Based Chemoradiation Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
March 17, 2021 (Actual)
Primary Completion Date
January 2025 (Anticipated)
Study Completion Date
June 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Chinese Academy of Medical Sciences
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
This is a phase II, open-Label, multi-centre study to determine the efficacy and safety of Camrelizumab plus apatinib in participants with unresectable Stage III Non-Small Cell Lung Cancer (NSCLC), who have not progressed following platinum-based concurrent chemoradiation therapy (cCRT) or sequential chemoradiation therapy (sCRT). This study will be conducted in China mainland.
Detailed Description
This trial will evaluate the efficacy and safety of camrelizumab plus apatinib in participants with unresectable stage III NSCLC who have not progressed following definitive, platinum-based cCRT or sCRT. The primary endpoint is progression free survival (PFS) in the intent-to-treat (ITT) population. The secondary endpoints are as follows: 1) Overall survival (OS); 2) 1, 2, 3-year OS rates; 3) PFS rates at 12-monthand 18-month; 4) Objective response rate (ORR), 5) Duration of response (DoR); 6) Time to death or distant metastasis (TTDM); 7) Adverse effects (AEs) and severe adverse effects (SAEs) ;8) Quality of life (QoL).Exploratory objective is to explore potential biomarkers associated with efficacy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Locally Advanced Non-Small Cell Lung Cancer
Keywords
Non-Small Cell Lung Cancer, Programmed cell death 1 (PD-1, PD1), Anti VEGF, Chemoradiotherapy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
42 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Experimental Arm
Arm Type
Experimental
Arm Description
Camrelizumab plus apatinib as consolidation therapy
Intervention Type
Drug
Intervention Name(s)
Camrelizumab, PD-1 monoclonal antibody
Other Intervention Name(s)
SHR-1210
Intervention Description
Camrelizumab 200mg IV, Q3W, until clinical progression/deterioration or confirmed radiological progression, or up to 1 year.
Intervention Type
Drug
Intervention Name(s)
Apatinib, VEGFR2 antibody
Other Intervention Name(s)
Apatinib Mesylate
Intervention Description
Apatinib 250mg PO, QD, until clinical progression/deterioration or confirmed radiological progression, or up to 1 year.
Primary Outcome Measure Information:
Title
Progression-free Survival (PFS)
Description
PFS is determined by the investigator using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1).
Time Frame
From the first date of treatment until the date of objective disease progression or death (up to maximum 24 months)
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
OS is defined as the first date of treatment to date of death from any causes.
Time Frame
up to approximately 36 months
Title
PFS at 12 months (PFS12)
Description
PFS will be calculated using Kaplan-Meier product limit methods.
Time Frame
up to maximum 12 months
Title
PFS at 18 months (PFS18)
Description
PFS will be calculated using Kaplan-Meier product limit methods.
Time Frame
up to maximum 18 months
Title
OS at 12 months (OS12)
Description
OS will be calculated using Kaplan-Meier product limit methods.
Time Frame
up to maximum 12 months
Title
OS at 24 months (OS24)
Description
OS will be calculated using Kaplan-Meier product limit methods.
Time Frame
up to maximum 24 months
Title
OS at 36 months (OS36)
Description
OS will be calculated using Kaplan-Meier product limit methods.
Time Frame
up to maximum 36 months
Title
Objective response rate (ORR)
Description
ORR is defined as the percentage of participants in the analysis population who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 by investigator.
Time Frame
up to approximately 24 months
Title
Duration of Response (DoR)
Description
DoR is defined as the first date of treatment to the progression, or the last evaluable assessment in the absence of progression.
Time Frame
up to approximately 24 months
Title
TTDM
Description
TTDM is defined as the first date of treatment to the first date of distant metastasis or death in the absence of distant metastasis.
Time Frame
up to approximately 36 months
Title
Number of participants with AEs, SAEs, Treatment-related Adverse Events (TRAEs).
Time Frame
From screening (Day -28) till final visit (up to a maximum of 24 months)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients aged ≥18 years, male and female are not limited;
Patients with ECOG score of 0-1;
Life expectancy ≥12 weeks;
Patients must have histologically or cytologicallyproved NSCLC, and present with locally advanced, unresectable Stage III disease(according to 8th AJCC/UICC Classification);
Receipt of concurrent or sequential chemoradiation therapy which must have been completed within 42 days prior to first dose administration of the study; Consolidation chemotherapy is not permitted.
No progression following definitive, platinum-based, concurrent or sequential chemoradiation therapy;
Subject with prior anti-cancer treatment can only be enrolled when all toxicities of prior anti-cancer treatment has recovered to baseline or ≤ Grade 1, except for hearing loss, alopecia and fatigue. (according to National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE] V5.0);
No prior exposure to any anti-CTLA-4, anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-VEGF treatments, as well as therapeutic anticancer vaccines;
Agreement to provide tumor histological specimens required for this study;
Adequate organ and marrow function required;
Fertile female were required to have a negative serum or urine pregnancy test within 72 days before the start dose of study medication; If female of childbearing potential, is willing to use adequate contraception for the course of the study through 90 days after the last dose of study medication; if male with a female partner(s) of child-bearing potential, he must agree to use adequate contraception starting with the first dose of study medication through 90 days after the last dose of study medication or have been surgically sterilized;
Provision of signed ICF.
Exclusion Criteria:
Mixed small cell lung cancer histology;
Disease progression after concurrent/sequential chemoradiotherapy;
Major surgical procedure (as defined by the Investigator) within 28 days prior to the first dose of treatment;
Receipt of live attenuated vaccine within 28 days prior to the first dose of treatment;
Previous enrolment of another study and receiving any study drug within 28 days prior to the first dose of treatment;
Patients with ≥Grade 2 pneumonitis from the prior anti-cancerchemoradiation therapy;
Imaging (CT or MRI) shows the tumor invading large vessels or blurring the boundary with vessels;
History of organ transplant or allogeneic hematopoietic stem cell transplantation;
Patients with any active autoimmune disease or history of autoimmune disease;
Patients with innate or acquired immune deficiency, such as human immunodeficiency virus (HIV) infection;
Uuntreated active hepatitis B or, hepatitis C or active tuberculosis or currently receiving anti-tuberculosis treatment co-infection with hepatitis B and hepatitis C;
Subjects receiving systemic treatment with corticosteroids (>10mg/day of prednisone or its equivalent) or other immunosuppressants within 14 days prior to the first administration;
History of another primary malignancy within 5 years prior to enrollment, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ and the disease under study;
Pulmonary function test: FEV1< 1.2L or DLCO < 50% of predicted value;
Patients with cardiac insufficiencyheart diseases including: 1) NYHA III-IV; 2)Acute coronary syndrome; 3) Supraventricular or ventricular arrhythmias requiring clinical intervention; 4) Pericardial and myocardial diseases; 5) Echocardiography indicates that the left ventricular ejection fraction (LVEF) is < 50%;
Patients with uncontrollable hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, despite the best drug treatment);
Patients who have had arteriovenous thrombosis events within 6 months, such as cerebrovascular accident (including cerebral embolism, deep vein thrombosis, pulmonary embolismcerebral hemorrhage, cerebral infarction, transient ischemic attack, etc.);
Patients with hemoptysis, active bleeding, ulcer, intestinal perforation and intestinal obstruction within 3 months before administration;
Significant hemoptysis symptoms or daily amount of hemoptysis up to 2.5mL or more within 30 days before the first administration;
Known hereditary or acquired bleeding and thrombosis tendency (such as hemophilia, coagulation dysfunction, thrombocytopenia, hypersplenism, etc.);
Routine urine test indicated that urine protein was ≥ (++), or 24-hour urine protein was ≥ 1g, or severe liver and kidney dysfunction;
Patients with severe infection or fever of unknown origin > 38.5 degrees C within 24 weeks before medication;
Pregnant or lactating women; those with fertility who are unwilling or unable to take effective contraceptive measures;
Known allergies, hypersensitivity, or intolerance to camrelizumab or its excipients, apatinib and chemotherapy drugs;
Any conditions, judged by investigators, that may impair the subject or cause the subject to be unable to meet or perform the study requirements.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhouguang Hui
Phone
18611876792
Email
drhuizg@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Yirui Zhai
Phone
18610168510
Email
januarywind@163.com
Facility Information:
Facility Name
National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
City
Beijing
ZIP/Postal Code
100021
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhouguang Hui, M.D.
Phone
8610-87787230
Email
drhuizg@163.com
First Name & Middle Initial & Last Name & Degree
Zhouguang Hui, M.D.
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Study of Camrelizumab Plus Apatinib as Consolidation Therapy in Non-Small Cell Lung Cancer Patients Treated With Chemoradiotherapy
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