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Non-small Cell Lung Cancer (NSCLC)NCT01463423

Individualized Lung Tumor Stereotactic Ablative Radiotherapy (iSABR)

A study testing iSABR, 25 Gray in 1 fraction for small peripheral tumors, iSABR, 50 Gray in 4 fractions for medium peripheral tumors and iSABR, 54 Gray in 3 fractions for large peripheral tumors in people with Non-small Cell Lung Cancer (NSCLC), run by Stanford University at 4 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A research study of a procedure to treating lung cancer with focused radiation called Stereotactic Ablative Radiotherapy (SABR). The purpose of this study is to evaluate the effectiveness of individualizing the dose of radiation used to treat lung tumors with SABR based on tumor-specific factors. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non-small Cell Lung Cancer (NSCLC)
What is being tested?
iSABR, 25 Gray in 1 fraction for small peripheral tumors, iSABR, 50 Gray in 4 fractions for medium peripheral tumors and iSABR, 54 Gray in 3 fractions for large peripheral tumors
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
256 participants
Where
4 sitesin 3 countries
Study dates
21 Oct 2011to 7 Feb 2022
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Limited primary non-small cell lung cancers (NSCLC) (ie, graded as T1aN0M0, T1bN0M0, T2aN0M0, T2bN0M0, or T3N0M0), or metastatic lung tumors with no evidence of uncontrolled extrathoracic metastases.
  • Up to 4 lesions may be considered.
  • For a single lesion, the sum of three orthogonal diameters can be no more than 20 cm.
  • For multiple lesions, no lesion can have a sum of orthogonal diameters greater than 15 cm.
  • Both peripheral and central tumors are accepted for this trial.
  • Age ≥ 18 years old
  • Patients may be enrolled more than once (eg, for a new tumor lesion)

Who cannot join

  • Contraindication for radiotherapy
  • Pregnant and breastfeeding women are excluded
  • If prior radiation therapy, there is no overlap with the prior high dose regions (EXCEPTION: by approval of the investigators).

Trial locations and contacts

4 sites in 3 countries.

4 sites in 3 countries

United States2 sites
  • Swedish Cancer Institute

    Seattle, Washington, 98104

  • Stanford University Cancer Institute

    Stanford, California, 94305

Other trials in United States

Canada1 site
  • Princess Margaret Cancer Center

    Toronto, Ontario, ON M5G 2M9

Other trials in Canada

Japan1 site
  • Hokkaido University Hospital

    Sapporo, Hokkaido

Other trials in Japan

About this study

Official title: Trial of Individualized Lung Tumor Stereotactic Ablative Radiotherapy (iSABR)

A research study of a procedure to treating lung cancer with focused radiation called Stereotactic Ablative Radiotherapy (SABR). The purpose of this study is to evaluate the effectiveness of individualizing the dose of radiation used to treat lung tumors with SABR based on tumor-specific factors.

While recent research has identified SABR as a promising method to increase local control (LC) of lung cancer, further research has indicated that tumor volume is a prognostic factor, with increased size/volume of tumor being associated with poorer outcomes. This study explores if a volume-adapted strategy for the radiologic exposure (dose) will improve efficacy in larger tumors (ie, > 10 cc).

This is a study of the procedure stereotactic ablative radiotherapy (SABR). It is not a study of a specific drug or device.

Being tested
iSABR, 25 Gray in 1 fraction for small peripheral tumors, iSABR, 50 Gray in 4 fractions for medium peripheral tumors, iSABR, 54 Gray in 3 fractions for large peripheral tumors, iSABR, 40 Gray in 4 fractions for small central tumors, iSABR, 50 Gray in 4 fractions for medium central tumors
Medical subject headings
Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • iSABR, 25 Gray in 1 fraction for small peripheral tumorsRadiation

    Also called Individualized Stereotactic Ablative Radiotherapy (iSABR)

    Radiotherapy procedure for participants with small peripheral tumors ≤ 10 cc.

  • iSABR, 50 Gray in 4 fractions for medium peripheral tumorsRadiation

    Also called Individualized Stereotactic Ablative Radiotherapy (iSABR)

    Radiotherapy procedure for participants with medium peripheral tumors > 10 cc and ≤ 30 cc.

  • iSABR, 54 Gray in 3 fractions for large peripheral tumorsRadiation

    Also called Individualized Stereotactic Ablative Radiotherapy (iSABR)

    Radiotherapy procedure for participants with large peripheral tumors > 30 cc.

  • iSABR, 40 Gray in 4 fractions for small central tumorsRadiation

    Also called Individualized Stereotactic Ablative Radiotherapy (iSABR)

    Radiotherapy procedure for participants with small central tumors ≤ 10 cc.

  • iSABR, 50 Gray in 4 fractions for medium central tumorsRadiation

    Also called Individualized Stereotactic Ablative Radiotherapy (iSABR)

    Radiotherapy procedure for participants with medium central tumors > 10 cc and ≤ 30 cc.

  • iSABR, 60 Gray in 8 fractions for large central tumorsRadiation

    Also called Individualized Stereotactic Ablative Radiotherapy (iSABR)

    Radiotherapy procedure for participants with large central tumors > 30 cc.

Study groups in NCT01463423
Study groupRoleWhat they receive
Limited Primary Non-small Cell Lung Cancer (NSCLC)ExperimentalParticipants with limited primary NSCLCs (graded as T1aN0M0, T1bN0M0, T2aN0M0, T2bN0M0, or T3N0M0)
Receives: Radiation: iSABR, 25 Gray in 1 fraction for small peripheral tumors; Radiation: iSABR, 50 Gray in 4 fractions for medium peripheral tumors; Radiation: iSABR, 54 Gray in 3 fractions for large peripheral tumors; Radiation: iSABR, 40 Gray in 4 fractions for small central tumors; Radiation: iSABR, 50 Gray in 4 fractions for medium central tumors; Radiation: iSABR, 60 Gray in 8 fractions for large central tumors
History of NSCLCExperimentalParticipants with prior history of NSCLC and new limited primary NSCLC lesion(s)
Receives: Radiation: iSABR, 25 Gray in 1 fraction for small peripheral tumors; Radiation: iSABR, 50 Gray in 4 fractions for medium peripheral tumors; Radiation: iSABR, 54 Gray in 3 fractions for large peripheral tumors; Radiation: iSABR, 40 Gray in 4 fractions for small central tumors; Radiation: iSABR, 50 Gray in 4 fractions for medium central tumors; Radiation: iSABR, 60 Gray in 8 fractions for large central tumors
Advanced Lung Cancer Including Metastatic Lung CancerExperimentalParticipants with more advanced lung cancer or lung metastases from a variety of different cancers.
Receives: Radiation: iSABR, 25 Gray in 1 fraction for small peripheral tumors; Radiation: iSABR, 50 Gray in 4 fractions for medium peripheral tumors; Radiation: iSABR, 54 Gray in 3 fractions for large peripheral tumors; Radiation: iSABR, 40 Gray in 4 fractions for small central tumors; Radiation: iSABR, 50 Gray in 4 fractions for medium central tumors; Radiation: iSABR, 60 Gray in 8 fractions for large central tumors

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Evaluate Local Tumor Control With Individually-optimized Stereotactic Ablative Radiotherapy (SABR) for Lung Tumors.

    Local tumor control was assessed by CT, PET-CT, and, if appropriate, biopsy. The outcome was reported as the number of lesions that maintained tumor control for 1 year from the completion of Stereotactic Ablative Radiotherapy (SABR) treatment.

    Measured: 1 year

Secondary outcomes (6)
  1. Number of Participants With Treatment-Related Toxicity Following Individually-Optimized Stereotactic Ablative Radiotherapy (SABR) for Lung Tumors

    In concept, toxicity refers to adverse events caused by an intervention, ie, related adverse events. Toxicity will be assessed on the basis of related pulmonary; esophageal; chest wall; skin; vascular; cardiac/pericardial; and neurologic adverse events. Such events may have a number of different preferred terms for the adverse effect. The outcome will be reported as the number of Grade 3 or higher adverse effect events (toxicities), by Common Terminology Criteria for Adverse Events (CTCAE) Body System. The following exceptions apply.

    • Gastrointestinal Disorders, Grade 4-5 only
    • Atelectasis (collapse of the lung or lobe), Grade 4-5 only
    • Grade 3 Hypoxia, only if worse than baseline All deaths related to treatment will be included. The outcome is numbers without dispersion.

    Measured: 1 year

  2. Number of Participants Successfully Using an Optimized Breath-hold Technique During Stereotactic Ablative Radiotherapy (SABR) to Treat Lung Tumors

    Radiotherapeutic dose levels to the tumor lesion may be limited by the proximity of critical organs. Reduced dose levels is believed to be associated with reduced therapeutic effect. This study will assess an anatomically-optimized audio-visual biofeedback (AVB)-coached breath-hold technique assisted by fast radiotherapy delivery. Holding breath at a particular point in the breathing cycle may minimize proximity between tumor lesions and critical organs. In summary, participants will be coached to breath-hold at a certain point in their normal breathing cycle, and radiation will be quickly administered in bursts for several seconds. Up to 12 to 15 cycles of breath-hold may be needed to administer the desired dose level. Feasibility of this technique will be assessed as the number of patients able to reproduce the optimized breath-hold. The outcome is a number without dispersion.

    Measured: up to 2 years

  3. Number of Participants With a Difference in Treatment Delivery Time Using an Optimized Breath-hold Technique During Stereotactic Ablative Radiotherapy (SABR)

    Radiotherapeutic dose levels to the tumor lesion may be limited by the proximity of critical organs. Reduced dose levels is believed to be associated with reduced therapeutic effect. This study will assess an anatomically-optimized audio-visual biofeedback (AVB)-coached breath-hold technique assisted by fast radiotherapy delivery. Holding breath at a particular point in the breathing cycle may minimize proximity between tumor lesions and critical organs. In summary, participants will be coached to breath-hold at a certain point in their normal breathing cycle, and radiation will be quickly administered in bursts for several seconds. Up to 12 to 15 cycles of breath-hold may be needed to administer the desired dose level. Utility of this technique will be assessed as the difference in treatment delivery time compared to free-breathing treatment, reported as the median with standard deviation.

    Measured: up to 2 years

  4. Number of Participants With Progression-free Survival (PFS)

    Progression-free survival (PFS) is a measure of participant survival without disease recurrence, relapse, metastasis, or progression. The outcome is reported as the number of participants who were alive 2 years after the completion of Stereotactic Ablative Radiotherapy (SABR) treatment, and without disease progression during that time. The outcome is a number without dispersion.

    Measured: up to 2 years

  5. Number of Participants With Metastasis-free Survival (MFS)

    Metastasis refers to the ability of cancer cells to break free of a tumor, and migrate to another location in the body and start a new tumor lesion. Metastasis-free survival (MFS) is a measure of participant survival without disease metastasis. The outcome is reported as the number of participants who were alive 2 years after the completion of Stereotactic Ablative Radiotherapy (SABR) treatment, and without documented metastasis in that time. The outcome is a number without dispersion.

    Measured: 2 years

  6. Number of Participants With Overall Survival (OS)

    Overall survival (OS) is a measure of participant survival without regard to disease status. The outcome is reported as the number of participants who were documented as alive 2 years after the completion of Stereotactic Ablative Radiotherapy (SABR) treatment. The outcome is a number without dispersion.

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Nov 2011 (estimated)
  2. Study start21 Oct 2011
  3. Primary completion2 Jan 2020
  4. Study completion7 Feb 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Sequential
Masking
None (open label)
Enrolment
256 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01463423
Sponsor's protocol ID
IRB-22600
Other IDs
SU-10202011-8537, LUN0048
Status last verified
Nov 2024
First submitted
25 Oct 2011
Last updated
19 Dec 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Gensheimer MF, Gee H, Shirato H, Taguchi H, Snyder JM, Chin AL, Vitzthum LK, Maxim PG, Wakelee HA, Neal J, Das M, Chang DT, Kidd E, Hancock SL, Shultz DB, Horst KC, Le QT, Wong S, Brown E, Nguyen N, Liang R, Loo BW Jr, Diehn M. Individualized Stereotactic Ablative Radiotherapy for Lung Tumors: The iSABR Phase 2 Nonrandomized Controlled Trial. JAMA Oncol. 2023 Nov 1;9(11):1525-1534. doi: 10.1001/jamaoncol.2023.3495.

    PubMed 37707820

Questions about this trial

What is this clinical trial studying?

A study testing iSABR, 25 Gray in 1 fraction for small peripheral tumors, iSABR, 50 Gray in 4 fractions for medium peripheral tumors and iSABR, 54 Gray in 3 fractions for large peripheral tumors in people with Non-small Cell Lung Cancer (NSCLC), run by Stanford University at 4 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States, Canada, Japan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Dec 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Evaluate Local Tumor Control With Individually-optimized Stereotactic Ablative Radiotherapy (SABR) for Lung Tumors. (time frame: 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01463423, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Dec 2024.

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