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Non-small Cell Lung CancerNCT06534489

Surgical Strategy of NSCLC Patients After Neo-adjuvant or Induction Treatment

An observational study of Non-small Cell Lung Cancer and Surgery, run by Ruijin Hospital at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Lung cancer is one of the most common malignant tumors worldwide and has the highest mortality rate among malignant tumors. In recent years, with the gradual development of therapeutic modalities such as targeted therapy and immunotherapy, the overall survival of lung cancer patients has improved significantly. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Non-small Cell Lung Cancer, Surgery
What is being tested?
neoadjuvant immuno-chemotherapy and surgery
Type of treatment
Surgery or procedure
How many people
50 participants
Where
1 siteChina
Study dates
31 Aug 2023to 31 Aug 2029
How long will I take part?
3 Years
Phase
Observational
Are there results?
Not yet: the study is under way

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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Source of study subjects: outpatients Recruitment location: Thoracic Surgery and Respiratory Medicine Clinic of participant centers. Recruitment method:Through WeChat public number, departmental website and other online channels to publish recruitment information. The researchers conducted a study on the lungs of patients attending outpatient clinics. After preliminary evaluation of lung cancer patients in the outpatient clinic of Ruijin Hospital and identification of those who are potentially eligible for enrollment, as well as improvement of chest CT, PET-CT(optional), cardiac ultrasound, lung function and other auxiliary examinations, and after it is clear that they are eligible for enrollment, subjects will be informed of the study and will sign an informed consent form.

Who may be able to join

  • The patients voluntarily participate in the study, have good compliance, can cooperate with the requirements of the experiment to complete the observation and follow-up, and sign the informed consent form.
  • Aged over 18 years old, under 75 years old; male and female are not limited;
  • Pathologically confirmed non-small cell lung cancer with clinical stage T2-4N0-2, resectable non-small cell lung cancer, potentially needing pneumonectomy and receiving neoadjuvant or induction therapy.
  • ASA score: Grade I-III;
  • The cardiopulmonary function evaluation can meet the requirements for radical lung cancer surgery, and the liver and kidney functions are normal.

Who cannot join

  • Those with serious cardiac, pulmonary, hepatic, and renal dysfunctions, unable to tolerate the surgery;
  • Those with uncontrollable neurological or psychiatric diseases or mental disorders, poor compliance, and being unable to cooperate and describe the treatment response.
  • Those who are going to undergo emergency surgery or palliative surgery due to lung abscess or hemoptysis.
  • Those who have been treated, or are undergoing neoadjuvant or induction radiotherapy or targeted therapy.
  • Those who have a combined history of other malignant tumors
  • Those who have a history of thoracic surgery
  • Those who are pregnant or breastfeeding women
  • Patients of childbearing age who refuse to use contraception.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

China1 site, 1 recruiting
  • Ruijin hospital

    Shanghai, 200025

    Hecheng Li, Medical Doctor, 13917113402, lihecheng2000@hotmail.com

    Zhengxin Yin, Medical Doctor, 13601615676, hunterfh1@163.com

    Recruiting

Other trials in China

About this study

Lung cancer is one of the most common malignant tumors worldwide and has the highest mortality rate among malignant tumors. In recent years, with the gradual development of therapeutic modalities such as targeted therapy and immunotherapy, the overall survival of lung cancer patients has improved significantly. However, late tumor staging at the time of diagnosis often leaves patients with only pneumonectomy, which affects the prognosis with a higher rate of postoperative complications than lobectomy, poorer quality of life and the possible loss of the opportunity to continue adjuvant therapy. Our group proposes to conduct this single-arm prospective clinical study to investigate the feasibility, safety and prognosis of the conversion from pneumonectomy to lobectomy after neoadjuvant or induction therapy in patients with operable non-small cell lung cancer.

Read the detailed description

We propose to conduct a multicenter, single-arm prospective clinical study to investigate the feasibility, safety and prognosis of the conversion from pneumonectomy to lobectomy after neoadjuvant or induction therapy in patients with operable non-small cell lung cancer. The anticipated sample size is 50 patients. Study will last 5 years.

After the patients were enrolled in the group, further relevant examinations (chest enhancement CT, PET-CT (optional), cranial MR, bronchoscopy, cardiac ultrasound, pulmonary function, electrocardiogram, blood tests) were completed, contraindications to surgery were ruled out, and the patients were evaluated to receive neoadjuvant or induction chemo-immunotherapy after multidisciplinary discussion (thoracic surgery, respiratory medicine, radiology). After the patients completed these treatments, systemic preoperative examinations should be underwent (chest enhancement CT, PET-CT (optional), cranial MR, bronchoscopy, cardiac ultrasound, pulmonary function, electrocardiogram, blood tests) and open or minimally invasive radical lung cancer surgery and systematic lymph node dissection were performed. The perioperative complications, lymph node dissection, R0 clearance rate, 3-year event-free survival rate, overall and disease-free survival rate, quality of life, and pulmonary function were recorded and evaluated.

The surgical strategies include pneumonectomy, double lobectomy, sleeve lobectomy and lobectomy.

The patients will be followed up in one and three months after surgery. Then every three months in first year, every six months after one year of operation, with blood routine, biochemistry, tumor indexes, and chest CT examination at each visit. Within one year after surgery, head MR was performed every six months and PET-CT was performed at one year, and after one year after surgery, head MR was performed every six months and PET-CT was performed every year.

The researchers will contact the study participants or their families via the Internet or telephone to inform them of the treatment schedule and remind them of follow-up visits.

Being tested
neoadjuvant immuno-chemotherapy and surgery
Keywords
lung cancer, Neo-adjuvant treatment, pneumonectomy
Medical subject headings
Carcinoma, Non-Small-Cell Lung, Lung Neoplasms

What participants receive

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

  • neoadjuvant immuno-chemotherapy and surgeryProcedure or surgery

    After enrolled, patients should receive neo-adjuvant immuno-chemotherapy and a re-evaluation will be performed after treatment to decide surgery strategy.

Study groups in NCT06534489
Study groupRoleWhat they receive
Enrolled patientsAfter the patients were enrolled in the group, further relevant examinations (chest enhancement CT, PET-CT (optional), cranial MR, bronchoscopy, cardiac ultrasound, pulmonary function, electrocardiogram, blood tests) were completed, contraindications to surgery were ruled out, and the patients were evaluated to receive neo-adjuvant immuno-chemotherapy. After treatment, patients should be re-evaluated and amenable to surgical treatment after multidisciplinary discussion (thoracic surgery, respiratory medicine, radiology), and open or minimally invasive radical lung cancer surgery and systematic lymph node dissection were performed, including pneumonectomy, lobectomy, double lobectomy, extended lobectomy or sleeve lobectomy. The perioperative complications, lymph node dissection, R0 clearance rate, 3-year event-free survival rate, overall and disease-free survival rate, quality of life, and pulmonary function were recorded and evaluated.
Receives: Procedure: neoadjuvant immuno-chemotherapy and surgery

What is being measured

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

  1. Tumor R0 resection rate (lobectomy)

    the proportion of patients with complete tumor removal by lobectomy, as evaluated by the pathologic findings of postoperative lung cancer specimens

    Measured: Two weeks after surgery according to Frozen pathologic test and Paraffin pathologic test

Secondary outcomes (8)
  1. Lymph node dissection

    Record the total number of lymph node dissection, the number of stations of lymph node dissection, and the number of lymph node dissection at each station during the operation,and evaluate them according to the pathologic results.

    Measured: Two weeks after surgery according to Paraffin pathologic test

  2. Duration of surgery

    Record the duration of surgery in minute(min),evaluated by surgical records and perioperative clinical manifestations, laboratory tests, physical examination

    Measured: 1 month after surgery

  3. Intraoperative bleeding

    Record intraoperative bleeding in milliliter (ml), evaluated by surgical records and perioperative clinical manifestations, laboratory tests, physical examination

    Measured: 1 month after surgery

  4. Incidence of intraoperative accidents

    Record the incidence of intraoperative accidents in rate(%), including bleeding,injury to normal tissue or organ, evaluated by surgical records and perioperative clinical manifestations, laboratory tests, physical examination

    Measured: 1 month after surgery

  5. Postoperative short-term efficacy indicators

    record the length of postoperative hospitalization (days), survival within 30 days after surgery, and evaluate through postoperative follow-up

    Measured: 1 month after surgery

  6. Perioperative complication rate

    Evaluated by clinical manifestations, laboratory tests, and physical examination

    Measured: 1 month after surgery

  7. 3-year disease-free survival rate

    defined as the proportion of patients without tumor recurrence or metastasis 3 years after surgery, evaluated by postoperative follow-up

    Measured: When all enrolled patients complete 3-year follow-up

  8. 3-year overall survival rate

    defined as the proportion of patients who are still alive 3 years after surgery, and evaluated by postoperative follow-up.

    Measured: When all enrolled patients complete 3-year follow-up

Timeline

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

  1. First posted2 Aug 2024
  2. Study start31 Aug 2023
  3. Primary completion31 Aug 2026 (estimated)
  4. Study completion31 Aug 2029 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
50 participants (estimated)
Target duration
3 Years
IDs, dates and publications
ClinicalTrials.gov ID
NCT06534489
Sponsor's protocol ID
RTS-021
Status last verified
May 2024
First submitted
22 May 2024
Last updated
2 Aug 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Global Burden of Disease Cancer Collaboration; Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, Allen C, Alsharif U, Alvis-Guzman N, Amini E, Anderson BO, Aremu O, Artaman A, Asgedom SW, Assadi R, Atey TM, Avila-Burgos L, Awasthi A, Ba Saleem HO, Barac A, Bennett JR, Bensenor IM, Bhakta N, Brenner H, Cahuana-Hurtado L, Castaneda-Orjuela CA, Catala-Lopez F, Choi JJ, Christopher DJ, Chung SC, Curado MP, Dandona L, Dandona R, das Neves J, Dey S, Dharmaratne SD, Doku DT, Driscoll TR, Dubey M, Ebrahimi H, Edessa D, El-Khatib Z, Endries AY, Fischer F, Force LM, Foreman KJ, Gebrehiwot SW, Gopalani SV, Grosso G, Gupta R, Gyawali B, Hamadeh RR, Hamidi S, Harvey J, Hassen HY, Hay RJ, Hay SI, Heibati B, Hiluf MK, Horita N, Hosgood HD, Ilesanmi OS, Innos K, Islami F, Jakovljevic MB, Johnson SC, Jonas JB, Kasaeian A, Kassa TD, Khader YS, Khan EA, Khan G, Khang YH, Khosravi MH, Khubchandani J, Kopec JA, Kumar GA, Kutz M, Lad DP, Lafranconi A, Lan Q, Legesse Y, Leigh J, Linn S, Lunevicius R, Majeed A, Malekzadeh R, Malta DC, Mantovani LG, McMahon BJ, Meier T, Melaku YA, Melku M, Memiah P, Mendoza W, Meretoja TJ, Mezgebe HB, Miller TR, Mohammed S, Mokdad AH, Moosazadeh M, Moraga P, Mousavi SM, Nangia V, Nguyen CT, Nong VM, Ogbo FA, Olagunju AT, Pa M, Park EK, Patel T, Pereira DM, Pishgar F, Postma MJ, Pourmalek F, Qorbani M, Rafay A, Rawaf S, Rawaf DL, Roshandel G, Safiri S, Salimzadeh H, Sanabria JR, Santric Milicevic MM, Sartorius B, Satpathy M, Sepanlou SG, Shackelford KA, Shaikh MA, Sharif-Alhoseini M, She J, Shin MJ, Shiue I, Shrime MG, Sinke AH, Sisay M, Sligar A, Sufiyan MB, Sykes BL, Tabares-Seisdedos R, Tessema GA, Topor-Madry R, Tran TT, Tran BX, Ukwaja KN, Vlassov VV, Vollset SE, Weiderpass E, Williams HC, Yimer NB, Yonemoto N, Younis MZ, Murray CJL, Naghavi M. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study. JAMA Oncol. 2018 Nov 1;4(11):1553-1568. doi: 10.1001/jamaoncol.2018.2706.

    PubMed 29860482
  • Saji H, Okada M, Tsuboi M, Nakajima R, Suzuki K, Aokage K, Aoki T, Okami J, Yoshino I, Ito H, Okumura N, Yamaguchi M, Ikeda N, Wakabayashi M, Nakamura K, Fukuda H, Nakamura S, Mitsudomi T, Watanabe SI, Asamura H; West Japan Oncology Group and Japan Clinical Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022 Apr 23;399(10335):1607-1617. doi: 10.1016/S0140-6736(21)02333-3.

    PubMed 35461558
  • Altorki N, Wang X, Kozono D, Watt C, Landrenau R, Wigle D, Port J, Jones DR, Conti M, Ashrafi AS, Liberman M, Yasufuku K, Yang S, Mitchell JD, Pass H, Keenan R, Bauer T, Miller D, Kohman LJ, Stinchcombe TE, Vokes E. Lobar or Sublobar Resection for Peripheral Stage IA Non-Small-Cell Lung Cancer. N Engl J Med. 2023 Feb 9;388(6):489-498. doi: 10.1056/NEJMoa2212083.

    PubMed 36780674
  • Jones GD, Tan KS, Caso R, Dycoco J, Park BJ, Bott MJ, Molena D, Huang J, Isbell JM, Bains MS, Jones DR, Rocco G. Time-varying analysis of readmission and mortality during the first year after pneumonectomy. J Thorac Cardiovasc Surg. 2020 Jul;160(1):247-255.e5. doi: 10.1016/j.jtcvs.2020.02.086. Epub 2020 Mar 7.

    PubMed 32249082
  • Shapiro M, Swanson SJ, Wright CD, Chin C, Sheng S, Wisnivesky J, Weiser TS. Predictors of major morbidity and mortality after pneumonectomy utilizing the Society for Thoracic Surgeons General Thoracic Surgery Database. Ann Thorac Surg. 2010 Sep;90(3):927-34; discussion 934-5. doi: 10.1016/j.athoracsur.2010.05.041.

    PubMed 20732520
  • Yang J, Xia Y, Yang Y, Ni ZZ, He WX, Wang HF, Xu XX, Yang YL, Fei K, Jiang GN. Risk factors for major adverse events of video-assisted thoracic surgery lobectomy for lung cancer. Int J Med Sci. 2014 Jun 11;11(9):863-9. doi: 10.7150/ijms.8912. eCollection 2014.

    PubMed 25013365
  • Kozower BD, Sheng S, O'Brien SM, Liptay MJ, Lau CL, Jones DR, Shahian DM, Wright CD. STS database risk models: predictors of mortality and major morbidity for lung cancer resection. Ann Thorac Surg. 2010 Sep;90(3):875-81; discussion 881-3. doi: 10.1016/j.athoracsur.2010.03.115.

    PubMed 20732512
  • Pricopi C, Mordant P, Rivera C, Arame A, Foucault C, Dujon A, Le Pimpec Barthes F, Riquet M. Postoperative morbidity and mortality after pneumonectomy: a 30-year experience of 2064 consecutive patients. Interact Cardiovasc Thorac Surg. 2015 Mar;20(3):316-21. doi: 10.1093/icvts/ivu417. Epub 2014 Dec 8.

    PubMed 25487232
  • Schneider L, Farrokhyar F, Schieman C, Shargall Y, D'Souza J, Camposilvan I, Hanna WC, Finley CJ. Pneumonectomy: the burden of death after discharge and predictors of surgical mortality. Ann Thorac Surg. 2014 Dec;98(6):1976-81; discussion 1981-2. doi: 10.1016/j.athoracsur.2014.06.068. Epub 2014 Oct 3.

    PubMed 25282164
  • Kim AW, Boffa DJ, Wang Z, Detterbeck FC. An analysis, systematic review, and meta-analysis of the perioperative mortality after neoadjuvant therapy and pneumonectomy for non-small cell lung cancer. J Thorac Cardiovasc Surg. 2012 Jan;143(1):55-63. doi: 10.1016/j.jtcvs.2011.09.002. Epub 2011 Nov 4.

    PubMed 22056364
  • Jones GD, Caso R, Tan KS, Dycoco J, Adusumilli PS, Bains MS, Downey RJ, Huang J, Isbell JM, Molena D, Park BJ, Rocco G, Rusch VW, Sihag S, Jones DR, Bott MJ. Propensity-matched Analysis Demonstrates Long-term Risk of Respiratory and Cardiac Mortality After Pneumonectomy Compared With Lobectomy for Lung Cancer. Ann Surg. 2022 Apr 1;275(4):793-799. doi: 10.1097/SLA.0000000000004065.

    PubMed 32541218
  • Riquet M, Mordant P, Pricopi C, Legras A, Foucault C, Dujon A, Arame A, Le Pimpec-Barthes F. A review of 250 ten-year survivors after pneumonectomy for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014 May;45(5):876-81. doi: 10.1093/ejcts/ezt494. Epub 2013 Oct 16.

    PubMed 24132299
  • Sartipy U. Prospective population-based study comparing quality of life after pneumonectomy and lobectomy. Eur J Cardiothorac Surg. 2009 Dec;36(6):1069-74. doi: 10.1016/j.ejcts.2009.05.011. Epub 2009 Jul 5.

    PubMed 19581107
  • Balduyck B, Hendriks J, Lauwers P, Van Schil P. Quality of life after lung cancer surgery: a prospective pilot study comparing bronchial sleeve lobectomy with pneumonectomy. J Thorac Oncol. 2008 Jun;3(6):604-8. doi: 10.1097/JTO.0b013e318170fca4.

    PubMed 18520798
  • Lococo F, Sassorossi C, Nachira D, Chiappetta M, Petracca Ciavarella L, Vita E, Boldrini L, Evangelista J, Cesario A, Bria E, Margaritora S. Prognostic Factors and Long-Term Survival in Locally Advanced NSCLC with Pathological Complete Response after Surgical Resection Following Neoadjuvant Therapy. Cancers (Basel). 2020 Nov 30;12(12):3572. doi: 10.3390/cancers12123572.

    PubMed 33265905

Questions about this trial

What is this clinical trial studying?

An observational study of Non-small Cell Lung Cancer and Surgery, run by Ruijin Hospital at 1 site in China.

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 5 inclusion and 8 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: looking for participants now, as of the sponsor's last update on 2 Aug 2024. 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 China. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Hecheng Li (13917113402, lihecheng2000@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Tumor R0 resection rate (lobectomy) (time frame: Two weeks after surgery according to Frozen pathologic test and Paraffin pathologic test). 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 NCT06534489, which also lists 17 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 2 Aug 2024.

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