- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04073745
Single Fraction Stereotactic Body Radiation Therapy After Surgery in Treating Patients With Non-small Cell Lung Cancer
A Feasibility and Toxicity Analysis of Single Fraction Stereotactic Body Radiation Therapy for Post-Operative Non-Small Cell Lung Cancer
Study Overview
Status
Conditions
Detailed Description
PRIMARY OBJECTIVES:
I. Assess feasibility and toxicity of single-fraction stereotactic body radiation therapy (SBRT) in the post-operative setting.
SECONDARY OBJECTIVES:
I. Assess quality of life following post-operative single-fraction SBRT. II. Assess rate of in-field failures.
TERTIARY OBJECTIVES:
I. Assess progression free survival and overall survival following post-operative SBRT for stage III/IV non-small cell lung cancer (NSCLC).
EXPLORATORY OBJECTIVES:
I. Changes in the inflammatory markers.
OUTLINE:
Beginning at least 2 weeks after surgical resection, patients undergo 1 fraction (or 5 fractions every other day if R2 resection of central tumor) of SBRT.
After completion of study treatment, patients are followed up at 5 and 12 weeks and then periodically for up to 5 years.
Study Type
Enrollment (Estimated)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
New York
-
Buffalo, New York, United States, 14263
- Recruiting
- Roswell Park Cancer Institute
-
Contact:
- Anurag K. Singh
- Phone Number: 716-845-3218
- Email: Anurag.Singh@roswellpark.org
-
Principal Investigator:
- Anurag K. Singh
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Have an Eastern Cooperative Oncology Group (ECOG) performance status =< 2
Has completed curative-intent surgical resection of lung primary with pathologic diagnosis of NSCLC disease, with pathology to include at least 1 of the following:
- Close (<=2 mm) or Positive surgical margin (R1/R2) or pathologic N2 disease (with or without extracapsular extension [ECE])
- Anatomic pulmonary resection (lobectomy or pneumonectomy) preferred, although sublobar resection is allowed at the discretion of the treating surgeon. Systemic lobe-specific nodal sampling is required. A minimum of 3 N2 stations must be sampled. Selective lymph node dissection should be completed for patients with known N2 disease
- Women of child-bearing potential must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence)
- Patient or legal representative must be willing and able to participate in protocol requirements, including pre- and post-treatment survey evaluations and clinical assessments
- Patient or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure
Exclusion Criteria:
Contraindication to SBRT
- This includes the inability to cooperate with any aspect of SBRT such as the inability to lie still and breath reproducibly
- Prior radiation therapy targeting the same area for which radiation treatment is being planned
- Pregnant or nursing female patients
- Unwilling or unable to follow protocol requirements
- Any condition which, in the investigator?s opinion, deems the patient unable to participate in enrollment
- Patients who undergo sublobar resection but are unable to undergo appropriate N1 and N2 lymph node sampling
Study Plan
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: Treatment (SBRT)
Beginning at least 2 weeks after surgical resection, patients undergo 1 fraction (or 5 fractions every other day if R2 resection of central tumor) of SBRT.
|
Ancillary studies
Other Names:
Ancillary studies
Undergo SBRT
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of grade 3 or greater toxicities
Time Frame: Up to 5 years
|
Hospitalization resulting from radiation treatment will be recorded.
Any acute (=< 180 days after the end of radiation therapy [RT]) and late (> 180 days after the end of RT) toxicities will be documented using the Cancer Therapy Evaluation Program (CTEP) National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Toxicity rates will be presented with Clopper-Pearson 90% confidence intervals (alpha = 0.10).
|
Up to 5 years
|
Feasibility of single fraction SBRT
Time Frame: Up to 5 years
|
Feasibility will be assessed by the median time to initiation of systemic treatment (TST) following the combination of surgery and stereotactic body radiation therapy (SBRT), as this interval will reflect the probability of completing intended treatment.
|
Up to 5 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to initiation of systemic treatment (TST)
Time Frame: From the date of surgery until the date of systemic treatment initiation, assessed up to 5 years
|
The proportion of patients who have TST < 8 weeks will be recorded.
The median time will be presented with a 90% confidence interval (CI).
|
From the date of surgery until the date of systemic treatment initiation, assessed up to 5 years
|
Quality of life (QoL)
Time Frame: Up to 5 years
|
The QoL scores, from European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and EORTC QLQ Lung Cancer?Specific Module, and cumulative toxicity rates will be compared be at each time-point (starting 5 weeks after SBRT) between tumor locations using the Mann-Whitney U and Fishers exact tests, respectively.
Comparisons of QoL scores between time-points will be made using the Wilcoxon signed rank test.
All secondary analysis will be conducted at the 10% significance level.
The QoL scores will also be examined for time trends and effects of patient characteristics using regression analysis.
|
Up to 5 years
|
In-field failure (IFF) rate
Time Frame: Up to 5 years
|
IFF rate will be reported for the total cohort and at 3- and 5-years.
The IFF will be monitored using a Bayesian approach.
The monitoring will start after 3 patients have received treatment.
|
Up to 5 years
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Progression free survival (PFS)
Time Frame: Up to 5 years
|
The PFS will be described using standard Kaplan-Meier methodologies.
The median survival time, 3-year survival rate, and 5-year survival rate will be estimated and presented with 90% CI.
|
Up to 5 years
|
Overall survival (OS)
Time Frame: From SBRT completion until death (event) or end of study/lost to follow-up (censored), assessed up to 5 years
|
The OS will be described using standard Kaplan-Meier methodologies.
The median survival time, 3-year survival rate, and 5-year survival rate will be estimated and presented with 90% CI.
|
From SBRT completion until death (event) or end of study/lost to follow-up (censored), assessed up to 5 years
|
Change in immune markers
Time Frame: Baseline up to 5 weeks post-SBRT
|
Changes in the mediators of tumor antigen presentation, costimulatory molecules, immune effector cell populations, such as CD4+ and CD8+ T-cells, T regulatory cells (CD4+CD25+FoxP3+), natural killer (NK) cells, monocytes, macrophages, dendritic cells (DCs) and myeloid derived suppressor cells (MDSCs) will be measured.
|
Baseline up to 5 weeks post-SBRT
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Anurag K Singh, Roswell Park Cancer Institute
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- I 81919 (Other Identifier: Roswell Park Cancer Institute)
- NCI-2019-04325 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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