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Study to Confirm Efficacy and Feasibility of Tarlatamab Treatment in Patients With Extensive Stage Small-cell Lung Cancer With Poor Performance Status (SPACE-T)

31. srpna 2026 aktualizováno: AIO-Studien-gGmbH

A Single-arm Phase II-study to Confirm Efficacy and Feasibility of Tarlatamab Treatment in Patients With Extensive Stage Small-cell Lung Cancer With Poor Performance Status

The SPACE-T study is a clinical trial for people with advanced small-cell lung cancer (SCLC) whose cancer has returned or spread despite previous treatment and whose general health is reduced (ECOG performance status 2). The study will include 57 participants at about 15 sites in Germany.

The study is testing tarlatamab, a treatment that helps the immune system recognize and attack cancer cells. Participants will receive tarlatamab through a vein, starting with a lower dose of 1 mg, followed by doses of 10 mg. Treatment will then generally be given every two weeks.

The main purpose of the study is to find out how effective tarlatamab is in this group of patients by assessing how many participants are alive 12 months after starting the study. The study will also examine how well the treatment controls the cancer, including cancer that has spread to the brain, how well participants tolerate the treatment, its side effects, and its impact on quality of life.

Patients with poorer general health are often not included in clinical trials, even though they represent an important part of the people treated for SCLC in everyday clinical practice. The SPACE-T study aims to provide more information about whether tarlatamab is effective and feasible for these patients.

Přehled studie

Postavení

Nábor

Podmínky

Intervence / Léčba

Detailní popis

The SPACE-T study is a phase II clinical trial investigating the treatment tarlatamab in people with advanced small-cell lung cancer (SCLC). The study focuses specifically on patients whose cancer has returned or spread after previous treatment and whose general health and ability to carry out everyday activities are reduced (ECOG performance status 2). This patient group is often underrepresented in clinical trials, although it represents an important part of patients treated for SCLC in routine clinical practice.

A total of 57 patients are planned to participate at approximately 15 study sites in Germany. To take part, patients must be at least 18 years old and have confirmed small-cell lung cancer that has returned or spread to other parts of the body. They must have received at least one previous treatment for recurrent or metastatic disease. In general, previous treatment should have included platinum-based chemotherapy, etoposide and a PD-L1 inhibitor. Patients must also have cancer that can be measured on imaging examinations.

Patients with brain metastases may also participate in the study. However, patients cannot take part if brain metastases are causing new or worsening neurological symptoms. There are also other eligibility requirements relating, for example, to blood counts, liver and kidney function, breathing problems and previous cancer treatments. Patients who have previously received a treatment targeting DLL3 cannot participate.

All participants in the study will receive tarlatamab; there is no placebo or comparison group. Tarlatamab is a type of immunotherapy designed to bring the body's T cells into contact with cancer cells that carry a protein called DLL3. This is intended to help the immune system recognize and attack the cancer cells.

Tarlatamab is given through a vein. To reduce the risks associated with starting treatment, patients first receive a lower dose of 1 mg on the first day of treatment. They then receive the full 10 mg dose one week later and again one week after that. Afterwards, tarlatamab is generally given every two weeks.

The main aim of the SPACE-T study is to determine how effective tarlatamab is in this patient population. The main measure used for this assessment is the proportion of patients who are alive 12 months after starting the study. Other assessments will look at how long patients live overall, how long the cancer remains under control, how many patients have a reduction in the size of their cancer, and how long it takes before another cancer treatment is needed. For patients with brain metastases, the study will also examine how well the treatment controls cancer in the brain.

Another important aim is to understand whether tarlatamab can be given safely and practically to patients whose general health is reduced. The study will therefore closely assess side effects and how well patients tolerate treatment. It will also evaluate patients' quality of life and symptoms using questionnaires completed by the patients themselves. In addition, the study will investigate whether palliative radiotherapy, for example for symptomatic cancer lesions, can be incorporated into treatment with tarlatamab.

Blood samples and, where available as part of routine care, tumor tissue samples will also be collected for research. These samples will be used to study changes in the immune system during treatment and to investigate whether early immune responses may be related to how well a patient's cancer responds to tarlatamab.

Tarlatamab can cause specific immune-related side effects. These include cytokine release syndrome (CRS), an inflammatory reaction caused by activation of the immune system, and neurological side effects such as immune effector cell-associated neurotoxicity syndrome (ICANS). One reason for conducting the SPACE-T study is to obtain more information about the feasibility, safety and effectiveness of tarlatamab in patients with poorer general health, for whom there is currently limited clinical evidence.

Overall, the SPACE-T study aims to determine whether tarlatamab is an effective and feasible treatment option for patients with advanced small-cell lung cancer and reduced performance status, a population that more closely reflects many patients seen in everyday clinical practice.

Typ studie

Intervenční

Zápis (Odhadovaný)

57

Fáze

  • Fáze 2

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní záloha kontaktů

Studijní místa

      • Berlin, Německo, 13125
        • Nábor
        • Evangelische Lungenklinik Berlin
        • Kontakt:
          • Christian Grohé, MD
      • Dresden, Německo, 01307
        • Nábor
        • Universitatsklinikum Carl Gustav Carus
        • Kontakt:
          • Martin Wermke, MD
      • Essen, Německo, 45147
        • Nábor
        • Universitätsklinikum Essen
        • Kontakt:
          • Marcel Wiesweg, MD
      • Flensburg, Německo, 24939
        • Nábor
        • Malteser Krankenhaus St. Franziskus-Hospital
        • Kontakt:
          • Nicolai Faber, MD
      • Frankfurt, Německo, 60590
        • Nábor
        • Universitätsklinikum Frankfurt
        • Kontakt:
          • Friederike Althoff, MD
      • Minden, Německo, 32429
        • Nábor
        • Johannes Wesling Klinikum Minden
        • Kontakt:
          • Parvis Sadjadian, MD
      • München, Německo, 80336
        • Nábor
        • Klinikum der Universität München
        • Kontakt:
          • Amanda Tufman, MD
      • Stuttgart, Německo, 70174
        • Nábor
        • Klinikum Stuttgart
        • Kontakt:
          • Cornelia Kropf-Sanchen, MD

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

  1. Written informed consent obtained from the subject prior to performing any protocol-related procedures.
  2. Age ≥ 18 years
  3. ECOG performance status 2
  4. Histologically confirmed small-cell lung cancer (initial mixed histology / combined SCLC permitted if re-biopsy of current progression shows SCLC)
  5. Recurrent or metastatic disease. In case of local-only recurrence, availability of local treatment options must have been excluded
  6. Has received at least one prior line of treatment in the recurrent or metastatic setting
  7. Has received a prior treatment line with platinum, etoposide, and a PD-L1 antibody. Treatment with chemotherapy only is acceptable if the patient had a contraindication for CPI treatment
  8. Measurable disease according to RECIST v1.1

Exclusion Criteria:

  1. ECOG performance status 0, 1, 3 or 4
  2. Life expectancy less than three months
  3. Active brain metastases with unstable symptoms (new or progressive neurological symptoms within the last 3 weeks)
  4. Bone marrow insufficiency:

    1. neutrophil count < 1.5/nl or
    2. hemoglobin <8 mg/dl or
    3. platelets <100/nl
  5. Advanced liver disease:

    1. Subjects with pre-existing chronic liver disease:

      iii. Total bilirubin > 1.5xULN or iv. ALT or AST > 3xULN

    2. Subjects with no relevant prior chronic liver disease and elevated liver parameters due to liver metastases:

    v. Total bilirubin > 3xULN or vi. ALT or AST > 10xULN c. International normalized ratio (INR) > 2.0 and partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) ≥ 1.5 x ULN, except for subjects undergoing new class anticoagulant therapy (eg, Apixaban, Rivaroxaban, Edoxaban) with stable dose for 2 weeks prior to enrollment

  6. Advanced kidney disease:

    CKD-EPI GFR <20 ml/min/1.73m²

  7. Heart failure with reduced ejection fraction (EF < 40%, assessed by echochardiography performed within 3 months prior to C1D1)
  8. Hemodynamically significant pericardial effusion
  9. Clinically significant pleural effusion (Clinically significant pleural effusions must be managed by drainage. Re-check within 3 days prior to initiation of treatment.)
  10. Respiratory compromise leading to an unjustifiable risk in case of higher-grade CRS, in the judgment of the investigator (possible criteria leading to such judgment: oxygen support at rest >2l/min, active pneumonia or pneumonitis)
  11. Prior DLL3-directed treatment
  12. Prior systemic therapy (chemotherapy, CPI) within 14 days prior to first dose of study treatment
  13. Previous treatment in the present study (does not include screening failure)
  14. History of immune-mediated encephalitis
  15. Concurrent malignancy other than SCLC requiring active treatment
  16. HIV infection not on stable antiviral treatment
  17. Women of childbearing potential or men with partners of childbearing potential who are not adhering to contraceptive measures
  18. Female subjects of childbearing potential

    1. unwilling to use appropriate method(s) of contraception. WOCBP should use an adequate method to avoid pregnancy for 60 days after the last dose of tarlatamab
    2. who are breastfeeding or who plan to breastfeed while on study through 60 days after the last dose of tarlatamab
    3. planning to become pregnant or donate eggs while on study through 60 days after the last dose of tarlatamab
    4. with a positive pregnancy test at screening
  19. Male subjects

    1. with a female partner of childbearing potential who are unwilling to practice sexual abstinence (refrain from heterosexual intercourse) or use contraception during treatment and for an additional 60 days after the last dose of tarlatamab
    2. with a pregnant partner who are unwilling to practice abstinence or use a condom during treatment and for an additional 60 days after the last dose of tarlatamab
    3. unwilling to abstain from donating sperm during treatment and for an additional 60 days after the last dose of tarlatamab
  20. Patient who has been incarcerated or involuntarily institutionalized by court order or by the authorities [§ 40 Abs. 1 S. 3 Nr. 4 AMG].
  21. Patients who are unable to consent because they do not understand the nature, significance and implications of the clinical trial and therefore cannot form a rational intention in the light of the facts [§ 40 Abs. 1 S. 3 Nr. 3a AMG].

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: N/A
  • Intervenční model: Přiřazení jedné skupiny
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Tarlatamab
Participants receive tarlatamab intravenously at a step dose of 1 mg on Cycle 1 Day 1, followed by the target dose of 10 mg on Cycle 1 Day 8 and Cycle 1 Day 15, and every two weeks thereafter.
Tarlatamab is administered intravenously at a step dose of 1 mg on Cycle 1 Day 1, followed by a target dose of 10 mg on Cycle 1 Day 8 and Cycle 1 Day 15, and every two weeks thereafter.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Overall Survival Rate at 12 Months
Časové okno: 12 months
Percentage of participants who are alive 12 months after initiation of study treatment.
12 months

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Overall Survival (OS)
Časové okno: From initiation of study treatment until death from any cause, assessed up to 48 months
Time from initiation of study treatment to death from any cause.
From initiation of study treatment until death from any cause, assessed up to 48 months
Progression-Free Survival (PFS)
Časové okno: From initiation of study treatment until the date of first documented disease progression or death from any cause, whichever occurs first, assessed up to 48 months
(PFS) Time from initiation of study treatment to disease progression or death from any cause, whichever occurs first.
From initiation of study treatment until the date of first documented disease progression or death from any cause, whichever occurs first, assessed up to 48 months
Objective Response Rate (ORR)
Časové okno: From initiation of study treatment until documented disease progression, assessed up to 48 months
Percentage of participants with an objective tumor response according to RECIST v1.1.
From initiation of study treatment until documented disease progression, assessed up to 48 months
Intracranial Objective Response Rate (iORR)
Časové okno: From initiation of study treatment until documented intracranial disease progression, assessed up to 48 months
Percentage of participants with brain metastases who achieve an objective intracranial tumor response.
From initiation of study treatment until documented intracranial disease progression, assessed up to 48 months
Rate of Participants Tolerating Tarlatamab Until First Disease Assessment
Časové okno: From first dose until first scheduled disease assessment after 2 months
percentage of participants who are able to continue tarlatamab treatment until the first scheduled disease assessment
From first dose until first scheduled disease assessment after 2 months
Safety and Tolerability of Tarlatamab
Časové okno: rom first dose of tarlatamab through the protocol-defined safety follow-up period, assessed up to 48 months
Incidence and severity of adverse events during treatment with tarlatamab.
rom first dose of tarlatamab through the protocol-defined safety follow-up period, assessed up to 48 months
Time to Next-Line Systemic Therapy
Časové okno: From initiation of study treatment until initiation of the next-line systemic anticancer therapy, assessed up to 48 months
Time from initiation of study treatment to initiation of the next systemic anticancer therapy.
From initiation of study treatment until initiation of the next-line systemic anticancer therapy, assessed up to 48 months
Quality of Life - EORTC QLQ-C30
Časové okno: From baseline through treatment and follow-up, assessed up to 48 months
Changes in patient-reported quality of life as assessed using the EORTC QLQ-C30 questionnaire.
From baseline through treatment and follow-up, assessed up to 48 months
Patient-Reported Symptoms - PRO-CTCAE
Časové okno: From baseline through treatment and follow-up, assessed up to 48 months
Patient-reported symptomatic adverse events assessed using the PRO-CTCAE questionnaire.
From baseline through treatment and follow-up, assessed up to 48 months

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

1. ledna 2025

Primární dokončení (Odhadovaný)

31. prosince 2027

Dokončení studie (Odhadovaný)

31. prosince 2028

Termíny zápisu do studia

První předloženo

19. srpna 2026

První předloženo, které splnilo kritéria kontroly kvality

31. srpna 2026

První zveřejněno (Aktuální)

4. září 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

4. září 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

31. srpna 2026

Naposledy ověřeno

1. srpna 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • AIO-TRK-0624
  • 2025 (Grant/smlouva NIH USA: Faculty of Social Sciences Scientific Grant at the University of Gdańsk)
  • 2025-522437-65-00 (Ctis)

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .