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Non-small Cell Lung CancerNCT04758481

Consolidation Conventional Radiotherapy + Stereotactic Body Radiotherapy at 3 Months After First-line Chemotherapy in Stage IV Oligometastatic Non-small Cell Lung Cancer

A study testing primary tumour radiotherapy, stereotactic body radiotherapy and maintenance radiotherapy in people with Non-small Cell Lung Cancer, run by University Hospital Ostrava at 1 site in Czechia.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Lung cancer is the main cause of death among cancer diseases, in the Czech Republic, as well as worldwide. Non-small cell lung cancer (NSCLC) is responsible for more than 80% of deaths among cancer patients. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non-small Cell Lung Cancer
What is being tested?
primary tumour radiotherapy, stereotactic body radiotherapy and maintenance radiotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteCzechia
Study dates
4 May 2021to 31 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

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

  • Patients with previously untreated, non-resectable, stage IV NSCLC verified with histology or cytology (according to American Joint Committee on Cancer Version 8).
  • Patients must undergo 2-4 cycles of first-line chemotherapy, with the effect of disease stabilization or partial response.
  • Patients over 18 years of age.
  • Patients with measureable disease (on CT, PET/CT, MRI).
  • Patients with 3-10 extracranial/intracranial lesions confirmed on CT, PET/CT, MRI, max. 4 weeks prior to start of SBRT.
  • Max. 10 irradiated volumes (primary tumour + lymphadenopathy in one volume, if technically feasible).
Show all 13Show fewer
  • Performance status (PS) 0-2 according to ECOG. Assessment of PS max. 7 days prior to start of treatment.
  • AST, ALT \& ALP ≤ 2.5x norm. Total bilirubin must be within the normal range. 9. Normal function of bone marrow - Adiponectin ≥ 1.5, Haemoglobin ≥ 100, thrombo ≥ 100.
  • Serum creatinine ≤1.5x norm.
  • The entry laboratory tests must not be older than 14 days prior to start of treatment.
  • Negative pregnancy test and use of contraception in women of childbearing age.
  • Patients undergoing SBRT for pulmonary nidi must undergo entry spirometry with the value FEV1 (forced expiratory volume in 1 second) ≥ 1L.
  • Patients must sign informed consent.

Who cannot join

  • Patients with small-cell lung cancer or with mixed aetiology with SCLC.
  • Serious ongoing infections.
  • Patients with a history of haematopoiesis disorders.
  • Weight loss exceeding 10% within the last 3 months.
  • Patients with skin metastases of NSCLC.
  • Patients treated for other malignity within the last 5 years
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  • Patients with more than 10 extracranial/intracranial metastases.
  • Malignant fluidothorax > 1 cm prior to start of treatment.
  • Patients treated with targeted treatment for EGFR mutation or EML-4-ALK translocation in the 1st-line (Erlotinib, Gefitinib, Afatinib, Crizotinib, …).
  • Patients treated with immunotherapy (anti-PD-1, anti-PD-L1 or anti-PD-L2, anti CTLA-4, …).
  • Participation in another clinical trial within the last month before the start of NSCLC treatment.
  • Inability to cooperate or comply with the study protocol.
  • Decision of the patient to discontinue participation in the study.
  • Pregnant women.

Trial locations and contacts

1 site in 1 country.

Czechia1 site, 1 recruiting
  • University Hospital Ostrava

    Ostrava, Moravian-Silesian Region, 70852

    Jiří Hynčica, 0042059773 ext. 2587, jiri.hyncica@fno.cz

    Tereza Paračková, MD

    Recruiting

Other trials in Czechia

About this study

Official title: Consolidation Conventional Radiotherapy + Stereotactic Body Radiotherapy of All Body Locations With the Disease at 3 Months After First Line Chemotherapy in Stage IV Oligometastatic Non-small Cell Lung Cancer, Prior to Maintenance Therapy

Lung cancer is the main cause of death among cancer diseases, in the Czech Republic, as well as worldwide. Non-small cell lung cancer (NSCLC) is responsible for more than 80% of deaths among cancer patients. Bronchogenic carcinoma is the reason of death of almost 5.500 cases every year in the Czech Republic, the mortality/incidence ration varies around 85%. The main cause for these unfavorable findings is the late detection of the carcinoma in late stages only (III and IV), when a long-term control of the disease is exceptional. Chemotherapy is able to prolong the life of patients with NSCLC by less than one year on average, that is why new treatment approaches are being examined.

Read the detailed description

The basic treatment modality of lung cancer is radiotherapy, which has a proven therapeutic benefit in radical and palliative indications in up to 76% of all patients. Stereotactic robotic radiotherapy reaches maximum precision due to the precise definition of the target volume. In some localities, management with images has been solved using modern software instruments, which are able to visualize the tumor and monitor it during the whole course of respiratory cycle. This is directly associated with minimizing radiation of healthy tissues, especially the healthy lung parenchyma. In order to define predictive factors of survival of cancer patients, it is necessary to use molecular markers.

The aim of the study is to verify the feasibility of consolidation SBRT (Stereotactic Body RadioTherapy) - CyberKnife, with subsequent maintenance chemotherapy in patients with stage IV NSCLC, with max. 10 metastatic nidi. The main focus of the study will be on assessment of combination treatment toxicity.

The project is a phase I/II non-randomized clinical trial. Patients with stage IV NSCLC will be treated with 2-4 cycles of chemotherapy - platinum doublet (cisplatinum - cDDP/carboplatinum - CBDCA + Pemetrexed/navelibne - NVB). In cases when disease stabilization (SD)/partial resection (PR) will be achieved, based upon restaging examinations (CT), radiotherapy (RT) of the primary tumour will follow, with lymphadenopathy and SBRT of all metastatic nidi (max. 10 intra- or extracranial metastases). Standard fractionation schemes for RT and SBRT will be used (RT 40-50 Gy/16-20 fractions, SBRT 30 Gy/1 fractionation, 50-60 Gy/3-5 fractionations). At 3-6 weeks after the end of RT, maintenance treatment will be initiated in all patients treated with Peterexed. Regular restaging examinations are planned every 3 months.

Being tested
primary tumour radiotherapy, stereotactic body radiotherapy, maintenance radiotherapy
Keywords
non-small cell lung cancer, stereotactic body radiotherapy, CyberKnife, maintenance radiotherapy
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.

  • primary tumour radiotherapyRadiation

    The study subjects will undergo primary tumour radiotherapy.

  • stereotactic body radiotherapyRadiation

    The study subjects will undergo stereotactic body radiotherapy.

  • maintenance radiotherapyRadiation

    The study subjects will undergo maintenance radiotherapy.

Study groups in NCT04758481
Study groupRoleWhat they receive
Primary tumour radiotherapy + stereotactic body radiotherapy + maintenance radiotherapyExperimentalThe patients, in whom disease stabilisation/partial regression will be achieved, will undergo primary tumour radiotherapy and stereotactic body radiotherapy, followed with maintenance radiotherapy.
Receives: Radiation: primary tumour radiotherapy; Radiation: stereotactic body radiotherapy; Radiation: maintenance radiotherapy

What is being measured

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

  1. Acute and late toxicity

    Acute and late toxicity of the combination therapy will be observed (according to Common Terminology for Clinical Adverse Event (CTCAE, version 5)

    Measured: every 3 months, throughout the study duration, up to 32 months in total

  2. Progression-free survival

    Progression-free survival will be observed

    Measured: every 3 months

Secondary outcomes (4)
  1. Overall survival

    Overall survival will be observed

    Measured: every 3 months, throughout the study duration, up to 32 months in total

  2. Share of nidi under local control

    The share of nidi under local control will be observed (in per cent/total number of nidi)

    Measured: every 3 months, throughout the study duration, up to 32 months in total

  3. Time to new nidus formation

    The time to new nidus formation will be observed

    Measured: every 3 months, throughout the study duration, up to 32 months in total

  4. Duration of maintenance chemotherapy

    The duration of maintenance chemotherapy will be observed.

    Measured: every 3 months, throughout the study duration, up to 32 months in total

Timeline

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

  1. First posted17 Feb 2021
  2. Study start4 May 2021
  3. Primary completion31 Dec 2023 (estimated)
  4. Study completion31 Dec 2023 (estimated)

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
Not applicable
Intervention model
Single group
Model description
This is a non-randomised study with the primary intent to treat patients with NSCLC
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04758481
Sponsor's protocol ID
RVO-FNOs/2020-22
Status last verified
Dec 2022
First submitted
4 Feb 2021
Last updated
7 Dec 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is no plan to share the individual participant data with other researchers; the data may be provided upon request.

Publications

  • Siva S, MacManus M, Ball D. Stereotactic radiotherapy for pulmonary oligometastases: a systematic review. J Thorac Oncol. 2010 Jul;5(7):1091-9. doi: 10.1097/JTO.0b013e3181de7143.

    PubMed 20479693
  • Onishi H, Shirato H, Nagata Y, Hiraoka M, Fujino M, Gomi K, Karasawa K, Hayakawa K, Niibe Y, Takai Y, Kimura T, Takeda A, Ouchi A, Hareyama M, Kokubo M, Kozuka T, Arimoto T, Hara R, Itami J, Araki T. Stereotactic body radiotherapy (SBRT) for operable stage I non-small-cell lung cancer: can SBRT be comparable to surgery? Int J Radiat Oncol Biol Phys. 2011 Dec 1;81(5):1352-8. doi: 10.1016/j.ijrobp.2009.07.1751. Epub 2010 Jul 16.

    PubMed 20638194
  • Takeda A, Kunieda E, Ohashi T, Aoki Y, Koike N, Takeda T. Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer. Radiother Oncol. 2011 Nov;101(2):255-9. doi: 10.1016/j.radonc.2011.05.033.

    PubMed 21641064
  • Collen C, Christian N, Schallier D, Meysman M, Duchateau M, Storme G, De Ridder M. Phase II study of stereotactic body radiotherapy to primary tumor and metastatic locations in oligometastatic nonsmall-cell lung cancer patients. Ann Oncol. 2014 Oct;25(10):1954-1959. doi: 10.1093/annonc/mdu370. Epub 2014 Aug 11.

    PubMed 25114022
  • Norihisa Y, Nagata Y, Takayama K, Matsuo Y, Sakamoto T, Sakamoto M, Mizowaki T, Yano S, Hiraoka M. Stereotactic body radiotherapy for oligometastatic lung tumors. Int J Radiat Oncol Biol Phys. 2008 Oct 1;72(2):398-403. doi: 10.1016/j.ijrobp.2008.01.002. Epub 2008 Apr 18.

    PubMed 18374506
  • Guerrero E, Ahmed M. The role of stereotactic ablative radiotherapy (SBRT) in the management of oligometastatic non small cell lung cancer. Lung Cancer. 2016 Feb;92:22-8. doi: 10.1016/j.lungcan.2015.11.015. Epub 2015 Dec 2.

    PubMed 26775592
  • Oh D, Ahn YC, Seo JM, Shin EH, Park HC, Lim DH, Pyo H. Potentially curative stereotactic body radiation therapy (SBRT) for single or oligometastasis to the lung. Acta Oncol. 2012 May;51(5):596-602. doi: 10.3109/0284186X.2012.681698. Epub 2012 May 1.

    PubMed 22548366
  • Singh D, Chen Y, Hare MZ, Usuki KY, Zhang H, Lundquist T, Joyce N, Schell MC, Milano MT. Local control rates with five-fraction stereotactic body radiotherapy for oligometastatic cancer to the lung. J Thorac Dis. 2014 Apr;6(4):369-74. doi: 10.3978/j.issn.2072-1439.2013.12.03.

    PubMed 24688781
  • Lussier YA, Xing HR, Salama JK, Khodarev NN, Huang Y, Zhang Q, Khan SA, Yang X, Hasselle MD, Darga TE, Malik R, Fan H, Perakis S, Filippo M, Corbin K, Lee Y, Posner MC, Chmura SJ, Hellman S, Weichselbaum RR. MicroRNA expression characterizes oligometastasis(es). PLoS One. 2011;6(12):e28650. doi: 10.1371/journal.pone.0028650. Epub 2011 Dec 13.

    PubMed 22174856
  • Wong AC, Watson SP, Pitroda SP, Son CH, Das LC, Stack ME, Uppal A, Oshima G, Khodarev NN, Salama JK, Weichselbaum RR, Chmura SJ. Clinical and molecular markers of long-term survival after oligometastasis-directed stereotactic body radiotherapy (SBRT). Cancer. 2016 Jul 15;122(14):2242-50. doi: 10.1002/cncr.30058. Epub 2016 May 20.

    PubMed 27206146

Questions about this trial

What is this clinical trial studying?

A study testing primary tumour radiotherapy, stereotactic body radiotherapy and maintenance radiotherapy in people with Non-small Cell Lung Cancer, run by University Hospital Ostrava at 1 site in Czechia.

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 13 inclusion and 14 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: status not confirmed, as of the sponsor's last update on 7 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Czechia. 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?

Results are not available in the source record.

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

Contact Jiří Hynčica (0042059737 ext. 2587, jiri.hyncica@fno.cz), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Acute and late toxicity (time frame: every 3 months, throughout the study duration, up to 32 months in total). The study lists 2 primary outcomes in all. 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 NCT04758481, which also lists 10 linked publications.

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 7 Dec 2022.

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