Abscopal Effect for Metastatic Small Cell Lung Cancer
Primary Purpose
Small Cell Lung Cancer, Radiotherapy, Thymalfasin
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Radiotherapy
Thymalfasin
Sponsored by
About this trial
This is an interventional treatment trial for Small Cell Lung Cancer focused on measuring Small cell lung cancer, Metastatic small cell lung cancer, ZADAXIN, radiotherapy, Thymalfasin
Eligibility Criteria
Inclusion Criteria:
- Patients with histologically confirmed small cell lung cancer which is persistent and metastatic or recurrent and metastatic;
- Patients must have at least 3 distinct measurable metastatic sites at least 1 cm of larger in their largest diameter;
- Age ≥18 years;
- Metastatic disease measurable on a CT/MRI scan. The primary tumor is not considered measurable disease. Metastatic lesions within a prior radiation field are acceptable as long as disease has progressed in the radiation field by RECIST criteria. The same imaging modality performed at baseline (CT or MRI) will be repeated at subsequent imaging.
- ECOG performance status: 0-1;
- Life expectancy ≥ 3 months.
- Patients have adequate baseline organ and marrow function as defined by an absolute neutrophil count greater than 1500 cells per μL, platelet concentration of greater than 50 000 per μL, total bilirubin less than 1•5 times the upper limit of normal (ULN), aspartate aminotransferase and alanine aminotransferase less than 2•5 times the ULN, and serum creatinine less than 1•5 times the ULN;
- Signed consent forms voluntarily;
Exclusion Criteria:
- Patients undergoing therapy with other investigational agents.
- Women who are pregnant or breastfeeding;
- Patients with known brain metastases can be included in this clinical trial but brain lesions are not eligible as target or non target lesion;
- Active severe infection or known chronic infection with HIV, hepatitis B virus, or hepatitis C virus;
- Cardiovascular disease problems including unstable angina, therapy for life-threatening ventricular arrhythmia, myocardial infarction, stroke or congestive heart failure within the last 6 months;
- The subject has had another active malignancy within the past five years except for cervical cancer in site, in situ carcinoma of the bladder or non-melanoma carcinoma of the skin;
- Clinically significant and uncontrolled major medical conditions including but not limited to: active uncontrolled infection, symptomatic congestive heart failure, Unstable angina pectoris or cardiac arrhythmia, psychiatric illness/ social situation that would limit compliance with study requirements; any medical condition, which in the opinion of the study investigator places the subject at an unacceptably high risk for toxicities;
- Patients with any other concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for participation in the study.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Radiotherapy and Thymalfasin arm
Arm Description
Patients with metastatic lesions of small cell lung cancer receiving 3.5Gy per fraction to a total dose of 35Gy/10 fractions over 2 weeks with concurrent thymalfasin.
Outcomes
Primary Outcome Measures
The proportion of patients with an abscopal response assessed at 7-8 weeks after the initiation of treatment.
Secondary Outcome Measures
The number of participants with adverse events from the date of enrollment until 2 years from the opening of the study.
The proportion of patients alive with abscopal responses from the date of enrollment until date of death from any cause, assessed up to 2 years from the opening of the study.
Full Information
NCT ID
NCT02542137
First Posted
September 2, 2015
Last Updated
March 19, 2019
Sponsor
Zhejiang Provincial People's Hospital
1. Study Identification
Unique Protocol Identification Number
NCT02542137
Brief Title
Abscopal Effect for Metastatic Small Cell Lung Cancer
Official Title
A Phase II Study of Radiotherapy and ZADAXIN's® (Thymalfasin) Induced Abscopal Effect in Patients With Heavily Pretreated, Metastatic Small Cell Lung Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
March 2019
Overall Recruitment Status
Withdrawn
Why Stopped
No recruitment.
Study Start Date
September 2015 (undefined)
Primary Completion Date
December 2018 (Anticipated)
Study Completion Date
December 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Zhejiang Provincial People's Hospital
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Patients with small cell lung cancer that had metastatic lesions after been treated with definitive surgery or chemoradiotherapy are being asked to participate in this study.
To observe immunity-mediated tumor response outside the radiation field (abscopal effect) after chemoradiotherapy of a metastatic site in metastatic small cell lung cancer patients.
To induce the efficacy (effectiveness) of a new combination of therapy, chemoradiotherapy and thymalfasin for heavily pretreated, metastatic small cell lung cancer patients;
To explore the role of PET/CT scanning to assess tumor response/abscopal effect.
This study will help find out what abscopal effects (good or bad) the combination of radiotherapy and thymalfasin has on metastatic small cell lung cancer.
Detailed Description
To observe immunity-mediated tumor response outside the radiation field (abscopal effect) after chemoradiotherapy of a metastatic site in metastatic small cell lung cancer patients.
To induce the efficacy (effectiveness) of a new combination of therapy, chemoradiotherapy and thymalfasin for heavily pretreated, metastatic small cell lung cancer patients;
To explore the role of PET/CT scanning to assess tumor response/abscopal effect.
Eligible are patients with metastatic small cell lung cancer who have achieved stable disease or have disease progression after systemic therapy (surgery or definitive chemoradiotherapy) and have at least three separate measurable sites of metastatic lesions. Extent of metastatic disease is recorded both at CT and PET/CT scanning. Radiation is given during combined therapy to one of the lesions, 35Gy in 10 fractions over a two week interval, conformally to maximally spare normal tissue or organ. Thymalfasin treatment is given twice a week with an interval of 3-4 days each week. At day 22 radiation is re-started and the same radiation dose is delivered to a second metastatic site, again with thymalfasin. Abscopal response is evaluated by assessing clinical and PET/CT response in the non-irradiated measurable metastatic sites. A Phase II clinical trial based on an optimum two-stage Phase II Simon design is used to conduct this pilot study. Ten patients will be treated in Stage one; if there are no abscopal responses, the trial will be terminated. If there are one or more abscopal responses in Stage One, the trial will proceed to enroll an additional 19 patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Small Cell Lung Cancer, Radiotherapy, Thymalfasin
Keywords
Small cell lung cancer, Metastatic small cell lung cancer, ZADAXIN, radiotherapy, Thymalfasin
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Radiotherapy and Thymalfasin arm
Arm Type
Experimental
Arm Description
Patients with metastatic lesions of small cell lung cancer receiving 3.5Gy per fraction to a total dose of 35Gy/10 fractions over 2 weeks with concurrent thymalfasin.
Intervention Type
Radiation
Intervention Name(s)
Radiotherapy
Intervention Description
3.5Gy per fraction to a total dose of 35Gy/10 fractions over 2 weeks with concurrent thymalfasin for metastatic lesions of small cell lung cancer.
Intervention Type
Drug
Intervention Name(s)
Thymalfasin
Other Intervention Name(s)
ZADAXIN's®
Intervention Description
Patients with metastatic lesions of small cell lung cancer receiving 3.5Gy per fraction to a total dose of 35Gy/10 fractions over 2 weeks with concurrent thymalfasin ( given twice a week with an interval of 3-4 days each week).
Primary Outcome Measure Information:
Title
The proportion of patients with an abscopal response assessed at 7-8 weeks after the initiation of treatment.
Time Frame
week 7- week 8
Secondary Outcome Measure Information:
Title
The number of participants with adverse events from the date of enrollment until 2 years from the opening of the study.
Time Frame
year 0- year 2
Title
The proportion of patients alive with abscopal responses from the date of enrollment until date of death from any cause, assessed up to 2 years from the opening of the study.
Time Frame
year 0- year 2
10. Eligibility
Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with histologically confirmed small cell lung cancer which is persistent and metastatic or recurrent and metastatic;
Patients must have at least 3 distinct measurable metastatic sites at least 1 cm of larger in their largest diameter;
Age ≥18 years;
Metastatic disease measurable on a CT/MRI scan. The primary tumor is not considered measurable disease. Metastatic lesions within a prior radiation field are acceptable as long as disease has progressed in the radiation field by RECIST criteria. The same imaging modality performed at baseline (CT or MRI) will be repeated at subsequent imaging.
ECOG performance status: 0-1;
Life expectancy ≥ 3 months.
Patients have adequate baseline organ and marrow function as defined by an absolute neutrophil count greater than 1500 cells per μL, platelet concentration of greater than 50 000 per μL, total bilirubin less than 1•5 times the upper limit of normal (ULN), aspartate aminotransferase and alanine aminotransferase less than 2•5 times the ULN, and serum creatinine less than 1•5 times the ULN;
Signed consent forms voluntarily;
Exclusion Criteria:
Patients undergoing therapy with other investigational agents.
Women who are pregnant or breastfeeding;
Patients with known brain metastases can be included in this clinical trial but brain lesions are not eligible as target or non target lesion;
Active severe infection or known chronic infection with HIV, hepatitis B virus, or hepatitis C virus;
Cardiovascular disease problems including unstable angina, therapy for life-threatening ventricular arrhythmia, myocardial infarction, stroke or congestive heart failure within the last 6 months;
The subject has had another active malignancy within the past five years except for cervical cancer in site, in situ carcinoma of the bladder or non-melanoma carcinoma of the skin;
Clinically significant and uncontrolled major medical conditions including but not limited to: active uncontrolled infection, symptomatic congestive heart failure, Unstable angina pectoris or cardiac arrhythmia, psychiatric illness/ social situation that would limit compliance with study requirements; any medical condition, which in the opinion of the study investigator places the subject at an unacceptably high risk for toxicities;
Patients with any other concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for participation in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shixiu Wu, MD
Organizational Affiliation
Hangzhou Cancer Hospital
Official's Role
Study Chair
12. IPD Sharing Statement
Citations:
PubMed Identifier
26095785
Citation
Golden EB, Chhabra A, Chachoua A, Adams S, Donach M, Fenton-Kerimian M, Friedman K, Ponzo F, Babb JS, Goldberg J, Demaria S, Formenti SC. Local radiotherapy and granulocyte-macrophage colony-stimulating factor to generate abscopal responses in patients with metastatic solid tumours: a proof-of-principle trial. Lancet Oncol. 2015 Jul;16(7):795-803. doi: 10.1016/S1470-2045(15)00054-6. Epub 2015 Jun 18.
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Abscopal Effect for Metastatic Small Cell Lung Cancer
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