A Study of SBRT in Combination With rhGM-CSF for Stage IV NSCLC Patients Who Failed in Second-line Chemotherapy

October 10, 2018 updated by: Conghua Xie,MD,PhD, Wuhan University

A Prospective Single-arm Multi-center Phase II Study: Assessment of the Safety and Abscopal Effects of SBRT in Combination With rhGM-CSF for Stage IV NSCLC Patients Who Failed in Second-line Chemotherapy

The purpose of this study is to determine whether stereotactic body radiotherapy (SBRT) combined with recombined human granulocyte-macrophage colony stimulating factor(rhGM-CSF) is safe, effective in the treatment of stage IV NSCLC patients who failed in second-line chemotherapy.

Study Overview

Status

Withdrawn

Conditions

Intervention / Treatment

Detailed Description

Metastasis lesion will be treated with a SBRT of 50Gy/5F from day 1 to day 5 in one cycle.Subcutaneous injection of human recombined granulocyte-macrophage colony stimulating factor (125ug/m² per day) will be executed from day 1 to day 14 in this cycle. Another metastasis lesion will be treated likewise concurrently with rhGM-CSF in a consecutive cycle. Efficacy evaluation,especially abscopal effect evaluation, will be conducted at the end of therapy and every month after that. Adverse events will be recorded according to NCI-CTC version 4.03.

Study Type

Interventional

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Hubei
      • Wuhan, Hubei, China, 430071
        • Zhongnan Hospital of Wuhan University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Histologically proven non-small-cell lung cancer.
  2. Stage IV according to UICC stage system(version 7,2009).
  3. Progression after standard second-line chemotherapy.
  4. At least Three evaluable lesions among which at least two must be suitable for SBRT.
  5. ECOG performance status 0-2.
  6. Expected lifespan ≥3 months.

  7. Stable lab values:

    Hematological: Absolute neutrophil count (ANC) ≥1.5×109/L, Platelets ≥100×109/L, Hemoglobin ≥9 g/dL Renal: Creatinine OR Measured or calculated creatinine clearance (CrCl) (glomerular filtration rate [GFR] can also be used in place of creatinine or CrCl) ≤1.5× the upper limit of normal (ULN) OR ≥60 mL/min for patient with creatinine levels >1.5× institutional ULN Hepatic: Total bilirubin ≤1.5×ULN OR Direct bilirubin ≤ULN for patients with total bilirubin levels >1.5×ULN, Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤2.5×ULN OR ≤5×ULN for patients with liver metastases ,globulin≥20 g/L, albumin≥30 g/L.

  8. Female subjects must have a negative urine or serum pregnancy test within 72 hours prior to taking study drug if of childbearing potential.
  9. Able to understand and give written informed consent and comply with study procedures.

Exclusion criteria:

  1. Any unstable systemic disease, including active infection, uncontrolled high blood pressure, unstable angina, newly observed angina pectoris within the past 3 months, congestive heart failure (New York heart association (NYHA) class II or higher), myocardial infarction onset six months before included into the group, and severe arrhythmia, liver, kidney, or metabolic disease in need of drug therapy.
  2. Any clinical evidence suggests moderately severe chronic obstructive pulmonary disease (COPD) - [With COPD history or related risk factors, FEV1 / FVC < 70%, FEV1 < 80% estimated value, with or without chronic cough, sputum, dyspnea symptoms), active interstitial lung disease - ILD (FEV1 / FVC < 70%, FEV1 < 80% estimated value, carbon monoxide diffusion capacity in lung - DLCO < 40%, and high resolution CT (HRCT) confirmed as the diffuse pulmonary interstitial lesions] and other active pulmonary disease.
  3. Previously diagnosed with autoimmune diseases, including but not limited to systemic lupus erythematous, rheumatoid arthritis, systemic vasculitis, scleroderma, dermatomyositis, autoimmune hemolytic anemia and autoimmune liver disease, autoimmune thyroiditis.
  4. Human immunodeficiency virus (HIV) infection.
  5. Women in pregnancy or lactation .
  6. Medicine abusers(including alcohol, drugs or other addictive drugs abusers).
  7. Patients with mental illness, considered as "can't fully understand the issues of this research".
  8. Cancer history within 5 years apart from NSCLC before enrollment.
  9. Histologically confirmed small cell carcinoma or other non NSCLC compositions in the cancer tissue.
  10. Cancer treatment within 4 weeks, including but not limited to palliative surgery ,radiotherapy, chemotherapy and target therapy.
  11. Tumor related immunotherapy within 1 year, including but not limited to immune cell therapy, tumor vaccine therapy, immune check-point monoclonal antibody related treatment, and cytokines treatment except for GM-CSF.
  12. Allergy of rhGM-CSF and its accessories.
  13. Contraindications to GM-CSF treatment.
  14. Patients with unilateral lung.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: SBRT+GM-CSF
Metastasis lesion will be treated with a SBRT of 50Gy/5F from day 1 to day 5 in a cycle of 21 days.Subcutaneous injection of human recombined granulocyte-macrophage colony stimulating factor (125ug/m² per day) will be executed from day 1 to day 14 in this cycle. Another metastasis lesion will be treated likewise concurrently with rhGM-CSF in a consecutive cycle.
Radiation: Stereotactic body radiotherapy
A type of radiation therapy
Other Names:
  • SBRT
  • SABR
Drug: rhGM-CSF
Immune modulating agents
Other Names:
  • Recombined human granulocyte-macrophage colony stimulating factor

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
abscopal effect rate
Time Frame: at the time point of 4 weeks after completion of rhGM-CSF
at the time point of 4 weeks after completion of rhGM-CSF

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
overall survival
Time Frame: 2 years
2 years
objective response rate
Time Frame: 2 years
2 years
Incidence of Adverse events
Time Frame: 2 years
All adverse events will be recorded
2 years
progression free survival
Time Frame: 2 years
2 years
abscopal effect rate
Time Frame: at the time point of 2 months after completion of rhGM-CSF
at the time point of 2 months after completion of rhGM-CSF
Incidence of treatment-related adverse events
Time Frame: 2 years
All treatment-related adverse events will be recorded
2 years
Incidence of immune-related adverse events
Time Frame: 2 years
All Immune-related adverse events will be recorded
2 years

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total T cells count in peripheral blood
Time Frame: pre-treatment,1, 2, 3, 6, 12 months after completion of rhGM-CSF
To assess the absolute number of T cells in per milliliter peripheral blood pre- and post-therapy.
pre-treatment,1, 2, 3, 6, 12 months after completion of rhGM-CSF
Absolute number of CD4+T, CD8+T and regulatory T cells
Time Frame: pre-treatment,1, 2, 3, 6, 12 months after completion of rhGM-CSF
To assess ratio of effector T cells: regulatory T cells in per milliliter peripheral blood pre- and post-therapy.
pre-treatment,1, 2, 3, 6, 12 months after completion of rhGM-CSF

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Wuhan University

Collaborators

Tongji Hospital
Hubei Cancer Hospital

Investigators

  • Principal Investigator: Conghua Xie, MD, PhD, Wuhan University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2016

Primary Completion (Anticipated)

May 1, 2019

Study Completion (Anticipated)

November 1, 2019

Study Registration Dates

First Submitted

November 23, 2015

First Submitted That Met QC Criteria

December 4, 2015

First Posted (Estimate)

December 7, 2015

Study Record Updates

Last Update Posted (Actual)

October 15, 2018

Last Update Submitted That Met QC Criteria

October 10, 2018

Last Verified

October 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CHX-65

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Yes

IPD Plan Description

Data of tumor response, abscopal effect rate and survival time will be available within 4 months of study completion

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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