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PD-1 Inhibitors Consolidation in Extensive-stage Small Cell Lung Cancer (PICARES)

Primary Purpose

Extensive-stage Small Cell Lung Cancer, Radiotherapy, Immunotherapy

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
PD-1 inhibitor JS-001
Sponsored by
Chinese Academy of Medical Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Extensive-stage Small Cell Lung Cancer focused on measuring small cell lung cancer, radiotherapy, PD-1 inhibitor

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Sign written informed consent;
  • With extensive small cell lung cancer;
  • Previously received first-line standard chemotherapy, with treatment response of CR or PR;
  • Can provide at least 5-8 pathological tissue specimens (for detecting PD-L1 expression and infiltrating lymphocytes)
  • Can tolerate the radiotherapy process;
  • Weight ≥ 40kg;
  • Life expectancy ≥ 12 weeks;
  • With the Eastern Cancer Cooperative Group (ECOG) score 0-1;
  • The interval from the previous chemotherapy is more than 4 weeks, the grade of all adverse events caused by previous treatment have been reduced to grade 1 or less evaluated by CTCAE 4.03;
  • Before the administration of the study drug, systemic drugs (such as corticosteroids) applied at an immunosuppressive dose level (prednisone > 10 mg/d or equivalent) must have been discontinued for at least 2 weeks;
  • Major surgery requiring general anesthesia must have been completed for at least 4 weeks before administration of the study drug. Surgery requiring local anesthesia/epidural anesthesia must have been completed for at least 72 hours before administration of the study drug, and the subject must have recovered. Skin biopsy with only local anesthesia has been completed for at least 1 hour before administration of the study drug.
  • Other criteria including the laboratory values meets the requirements specified in the protocol.

Exclusion Criteria:

  • Subjects with central nervous system (CNS) metastases;
  • The subject has cancerous meningitis;
  • Subjects with active, known or suspected autoimmune diseases ;
  • Previously treated with anti-PD-1 antibody, anti-PD-L1 antibody, anti-PD-L2 antibody or anti-CTLA-4 antibody (or any other antibody acting on the T cell stimulation or checkpoint pathway);
  • According to chest X-ray examination, sputum examination and clinical examination, it is determined that there is active tuberculosis (TB) infection now or before, even one year before;
  • A positive immunodeficiency virus (HIV) test or have acquired immunodeficiency syndrome (AIDS);
  • With comorbidity needs to be treated with an immunosuppressive drug;
  • Other research drugs were administrated 28 days prior to the start of study drug or although they were more than 28 days apart, still within the 5 half-life of previous study drugs;
  • Inoculated with any anti-infective vaccine (such as influenza vaccine, varicella vaccine, etc.) within 4 weeks before starting the study drug;
  • In the condition of pregnant or breastfeeding;
  • Inability to tolerate venous puncture and/or venous access;
  • Any other medical, psychotic, and/or social problems determined by the investigator;
  • Subject has interstitial lung disease;
  • Use any Chinese medicine with anti-tumor activity within 2 weeks before starting of the study drug;
  • Monoclonal antibodies have been used in the past 3 months, except for topical use;
  • Subjects who have previously had other malignancies (excluding non-melanoma skin cancer and the following carcinomas in situ: bladder, stomach, colon, endometrium, cervix/dysplasia, melanoma or breast cancer) are not allowed to participate in the study. Unless he/she has been cured at least 2 years prior to enrollment, and does not require additional treatment or other treatments during the study;
  • Subjects with chronic hepatitis B (hepatitis B surface antigen positive) or chronic hepatitis C (HCV antibody positive) blood screening positive;
  • Previously allergic to macromolecular protein preparations, or to any of the JS001 ingredients.

Sites / Locations

  • Cancer Insititute and Hosiptal of Chinese Academy of Medical Sciences

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PD-1 inhibitor JS-001 consolidation for SCLC

Arm Description

The extensive-stage SCLC patients will receive PD-1 inhibitor JS-001 treatment after standard first-line chemotherapy, chest radiotherapy ± SABR for metastasis disease, and propylactic cranial irradiation untill disease progression or death.

Outcomes

Primary Outcome Measures

Adverse events
The incidence and severity of adverse events related to treatments
Objective remission rate
Objective remission rate (ORR): refers to the proportion of subjects in the analyzed population who achieved complete remission (CR) or partial remission (PR); according to the tumor immunotherapy efficacy evaluation (irRC) and RECIST criteria (v1.1) by the evaluation of investigator.

Secondary Outcome Measures

Pharmacodynamic indicators
Pharmacodynamic indicators,such as the detection of PD-1 receptor occupancy in the blood
Continuous remission time (DOR)
DOR was defined as time since onset of CR or PR to relapse or death due to underlying cancer, whichever is earlier
Disease Control Rate (DCR)
The percentage of patients who have achieved complete response, partial response and stable disease to the therapeutic intervention
Time to response (TTR)
The time from the start of treatment to the first objective tumor response
Progression-free survival (PFS)
The length of time during and after the treatment of a disease that a patient lives with the disease but it does not get worse
Overall survival (OS)
The time from treatment to death from any cause

Full Information

First Posted
May 29, 2019
Last Updated
June 2, 2019
Sponsor
Chinese Academy of Medical Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT03971214
Brief Title
PD-1 Inhibitors Consolidation in Extensive-stage Small Cell Lung Cancer
Acronym
PICARES
Official Title
Pilot Study on PD-1 Inhibitors Consolidation After Standard First-line Chemotherapy and Radiotherapy in Extensive-stage Small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2019
Overall Recruitment Status
Unknown status
Study Start Date
June 2019 (Anticipated)
Primary Completion Date
June 2020 (Anticipated)
Study Completion Date
June 2021 (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
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The prognosis of extensive-stage small cell lung cancer is still very poor, even for those who received platinum-based chemotherapy and chest radiotherapy. 2-year survival rate of these patients is only about 10%. Therefore, this study aims to explore a comprehensive treatments with low toxicity to further improve the efficacy for these paitents with PD-1 inhibitor.
Detailed Description
The study is a prospective pilot trial. The purpose of this study is to evaluate the safety and efficacy of PD-1 inhibitor consolidation in extensive-stage small cell lung cancer paitents who received standard first-line chemotherapy and chest radiotherapy ± SABR for metastasis disease. The primary endpoint is the safety and objective response rate of treatment. The secondary objectives are progression free survival(PFS), overall survial. The exploratory end point includes the correlation of PD-1 expression on the tumor tissue, and the TMB, Immune Repertoire sequencing derived from the tumor tissue and the blood sample with the efficacy of treatent. The plan for collection of tumor tissue and blood at baseline at different stages during or after treatment was defined in the protocol. The PICCARE-trial has been designed by National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, and the hypothesis is PD-1 inhibitor consolidation was safe and effective in the treatment of extensive-stage SCLC after sandard first-line chemotherapy and radiotherapy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Extensive-stage Small Cell Lung Cancer, Radiotherapy, Immunotherapy
Keywords
small cell lung cancer, radiotherapy, PD-1 inhibitor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PD-1 inhibitor JS-001 consolidation for SCLC
Arm Type
Experimental
Arm Description
The extensive-stage SCLC patients will receive PD-1 inhibitor JS-001 treatment after standard first-line chemotherapy, chest radiotherapy ± SABR for metastasis disease, and propylactic cranial irradiation untill disease progression or death.
Intervention Type
Drug
Intervention Name(s)
PD-1 inhibitor JS-001
Other Intervention Name(s)
chemotherapy, radiotherapy, SABR, propylactic cranial irradiation
Intervention Description
The extensive-stage SCLC patients will receive PD-1 inhibitor treatment after standard first-line chemotherapy, chest radiotherapy ± SABR for metastasis disease, and propylactic cranial irradiation untill disease progression or death.
Primary Outcome Measure Information:
Title
Adverse events
Description
The incidence and severity of adverse events related to treatments
Time Frame
At least 1 year following the conclusion of immunotherapy
Title
Objective remission rate
Description
Objective remission rate (ORR): refers to the proportion of subjects in the analyzed population who achieved complete remission (CR) or partial remission (PR); according to the tumor immunotherapy efficacy evaluation (irRC) and RECIST criteria (v1.1) by the evaluation of investigator.
Time Frame
24 weeks following the conclusion of immunotherapy
Secondary Outcome Measure Information:
Title
Pharmacodynamic indicators
Description
Pharmacodynamic indicators,such as the detection of PD-1 receptor occupancy in the blood
Time Frame
During and 6 weeks after the treatment of immunotherapy
Title
Continuous remission time (DOR)
Description
DOR was defined as time since onset of CR or PR to relapse or death due to underlying cancer, whichever is earlier
Time Frame
At least 1 year following the conclusion of immunotherapy
Title
Disease Control Rate (DCR)
Description
The percentage of patients who have achieved complete response, partial response and stable disease to the therapeutic intervention
Time Frame
At least 1 year following the conclusion of immunotherapy
Title
Time to response (TTR)
Description
The time from the start of treatment to the first objective tumor response
Time Frame
24 weeks following the conclusion of immunotherapy
Title
Progression-free survival (PFS)
Description
The length of time during and after the treatment of a disease that a patient lives with the disease but it does not get worse
Time Frame
At least 1 year following the conclusion of immunotherapy
Title
Overall survival (OS)
Description
The time from treatment to death from any cause
Time Frame
At least 1 year following the conclusion of immunotherapy
Other Pre-specified Outcome Measures:
Title
Exploratory end point including biomarkers
Description
To explore the correlation of PD-L1 expression in tumor tissue , TCR, ctDNA in peripheral blood and efficacy
Time Frame
At least 1 year following the conclusion of immunotherapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Sign written informed consent; With extensive small cell lung cancer; Previously received first-line standard chemotherapy, with treatment response of CR or PR; Can provide at least 5-8 pathological tissue specimens (for detecting PD-L1 expression and infiltrating lymphocytes) Can tolerate the radiotherapy process; Weight ≥ 40kg; Life expectancy ≥ 12 weeks; With the Eastern Cancer Cooperative Group (ECOG) score 0-1; The interval from the previous chemotherapy is more than 4 weeks, the grade of all adverse events caused by previous treatment have been reduced to grade 1 or less evaluated by CTCAE 4.03; Before the administration of the study drug, systemic drugs (such as corticosteroids) applied at an immunosuppressive dose level (prednisone > 10 mg/d or equivalent) must have been discontinued for at least 2 weeks; Major surgery requiring general anesthesia must have been completed for at least 4 weeks before administration of the study drug. Surgery requiring local anesthesia/epidural anesthesia must have been completed for at least 72 hours before administration of the study drug, and the subject must have recovered. Skin biopsy with only local anesthesia has been completed for at least 1 hour before administration of the study drug. Other criteria including the laboratory values meets the requirements specified in the protocol. Exclusion Criteria: Subjects with central nervous system (CNS) metastases; The subject has cancerous meningitis; Subjects with active, known or suspected autoimmune diseases ; Previously treated with anti-PD-1 antibody, anti-PD-L1 antibody, anti-PD-L2 antibody or anti-CTLA-4 antibody (or any other antibody acting on the T cell stimulation or checkpoint pathway); According to chest X-ray examination, sputum examination and clinical examination, it is determined that there is active tuberculosis (TB) infection now or before, even one year before; A positive immunodeficiency virus (HIV) test or have acquired immunodeficiency syndrome (AIDS); With comorbidity needs to be treated with an immunosuppressive drug; Other research drugs were administrated 28 days prior to the start of study drug or although they were more than 28 days apart, still within the 5 half-life of previous study drugs; Inoculated with any anti-infective vaccine (such as influenza vaccine, varicella vaccine, etc.) within 4 weeks before starting the study drug; In the condition of pregnant or breastfeeding; Inability to tolerate venous puncture and/or venous access; Any other medical, psychotic, and/or social problems determined by the investigator; Subject has interstitial lung disease; Use any Chinese medicine with anti-tumor activity within 2 weeks before starting of the study drug; Monoclonal antibodies have been used in the past 3 months, except for topical use; Subjects who have previously had other malignancies (excluding non-melanoma skin cancer and the following carcinomas in situ: bladder, stomach, colon, endometrium, cervix/dysplasia, melanoma or breast cancer) are not allowed to participate in the study. Unless he/she has been cured at least 2 years prior to enrollment, and does not require additional treatment or other treatments during the study; Subjects with chronic hepatitis B (hepatitis B surface antigen positive) or chronic hepatitis C (HCV antibody positive) blood screening positive; Previously allergic to macromolecular protein preparations, or to any of the JS001 ingredients.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wen-Yang Liu, MD
Phone
8613810753633
Email
liuwenyang26@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nan Bi, MD
Organizational Affiliation
Cancer Hospital, CAMS and PUMC
Official's Role
Study Director
Facility Information:
Facility Name
Cancer Insititute and Hosiptal of Chinese Academy of Medical Sciences
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100021
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
LUHUA WANG, MD
First Name & Middle Initial & Last Name & Degree
Luhua Wang, MD
First Name & Middle Initial & Last Name & Degree
Nan Bi, MD

12. IPD Sharing Statement

Plan to Share IPD
Undecided
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Finkelstein SE, Timmerman R, McBride WH, Schaue D, Hoffe SE, Mantz CA, Wilson GD. The confluence of stereotactic ablative radiotherapy and tumor immunology. Clin Dev Immunol. 2011;2011:439752. doi: 10.1155/2011/439752. Epub 2011 Nov 15.
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PD-1 Inhibitors Consolidation in Extensive-stage Small Cell Lung Cancer

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