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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Withdrawn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
Zhejiang Provincial People's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

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

19 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients with histologically confirmed small cell lung cancer which is persistent and metastatic or recurrent and metastatic;
  2. Patients must have at least 3 distinct measurable metastatic sites at least 1 cm of larger in their largest diameter;
  3. Age ≥18 years;
  4. 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.
  5. ECOG performance status: 0-1;
  6. Life expectancy ≥ 3 months.
  7. 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;
  8. Signed consent forms voluntarily;

Exclusion Criteria:

  1. Patients undergoing therapy with other investigational agents.
  2. Women who are pregnant or breastfeeding;
  3. Patients with known brain metastases can be included in this clinical trial but brain lesions are not eligible as target or non target lesion;
  4. Active severe infection or known chronic infection with HIV, hepatitis B virus, or hepatitis C virus;
  5. Cardiovascular disease problems including unstable angina, therapy for life-threatening ventricular arrhythmia, myocardial infarction, stroke or congestive heart failure within the last 6 months;
  6. 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;
  7. 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;
  8. 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

    First Posted
    September 2, 2015
    Last Updated
    March 19, 2019
    Sponsor
    Zhejiang Provincial People's Hospital
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    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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