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ERICA-02 Study : Impact of Physical Exercise on the Tumor Immune Microenvironment in Patients Treated With Neoadjuvant Chemoimmunotherapy for Non-small Cell Lung Cancer (ERICA-02)

25 août 2026 mis à jour par: Centre Leon Berard
Recent advances combining chemotherapy and immunotherapy before surgery have significantly improved outcomes for patients with resectable non-small cell lung cancer (NSCLC). However, a substantial proportion of patients still do not respond optimally to these treatments. Researchers believe that physical activity may help strengthen the immune system and favorably modify the tumor microenvironment, potentially improving treatment effectiveness. ERICA-02 aims to investigate this hypothesis.The primary objective of ERICA-02 is to evaluate whether a structured exercise program performed during neoadjuvant chemo-immunotherapy can increase the presence of CD8+ cytotoxic T lymphocytes within the tumor. These immune cells play a key role in recognizing and destroying cancer cells and are considered an important marker of anti-tumor immune response.The study is designed for adults with locally advanced, resectable non-small cell lung cancer who are eligible for neoadjuvant chemo-immunotherapy followed by surgery. Participants must be medically fit to engage in physical activity, able to comply with study procedures, and provide informed consent before enrollment.ERICA-02 is a multicenter, randomized phase II pilot trial involving approximately 40 patients. Participants will be randomly assigned to one of two groups : intervention group and control group. Each participant will be involved in the study for approximately six months, including three months of exercise intervention for patients assigned to the exercise group.

Aperçu de l'étude

Type d'étude

Interventionnel

Inscription (Estimé)

40

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Sauvegarde des contacts de l'étude

Lieux d'étude

      • Villefranche-sur-Saône, France
        • Hopitaux Nord Ouest
        • Sous-enquêteur:
          • Camille SIMON
        • Contact:
          • HUET
          • Numéro de téléphone: +33 474092385
          • E-mail: ahuet@hno.fr
        • Sous-enquêteur:
          • Luc Odier
        • Sous-enquêteur:
          • Christine Dussopt
        • Sous-enquêteur:
          • Lionel Falchero
    • Rhône
      • Lyon, Rhône, France, 69373
        • Centre Léon Berard (CLB)
        • Chercheur principal:
          • Aurelie Swalduz, MD
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

Patients with locally advanced, resectable non-small cell lung cancer (NSCLC), stage IIA (≥ 4 cm) to IIIA according to the TNM classification (American Joint Committee on Cancer, 9th edition)

  • PD-L1 positive
  • ECOG performance status of 0 or 1 at diagnosis
  • Sufficient tumor material for the analyses planned by the study Note: The amount of available material must be validated by the coordinating center before patient enrollment
  • With measurable disease according to RECIST version 1.1 criteria
  • Recently diagnosed and eligible for neoadjuvant chemotherapy-immunotherapy, as decided by the multidisciplinary tumor board (MTB)
  • Having obtained medical certification of fitness to engage in physical activity, issued by the referring oncologist or the principal investigator
  • Willing and deemed likely to comply with the intervention and visit schedule and follow-up examinations throughout the duration of the study
  • Able to understand, read, and speak French
  • Affiliated with a social security scheme
  • Having been informed about the study and having signed an informed consent form

Exclusion Criteria:

  • Activating EGFR mutations or ALK translocations, as well as those who have received prior chemotherapy, immunotherapy, or radiotherapy for their current lung cancer
  • History of cancer within the last 5 years
  • Uncontrolled cardiovascular disease, including heart failure, unstable coronary artery disease, severe arrhythmias, or uncontrolled hypertension that could limit participation in physical activity, according to the investigator
  • Uncontrolled type 2 diabetes despite appropriate treatment
  • Severe limiting pulmonary disease such as GOLD stage IV chronic obstructive pulmonary disease, or severe restrictive lung disease
  • Major neuropsychiatric disorders that could hinder participation in the program (e.g., dementia, Alzheimer's disease, advanced Parkinson's disease)
  • Severe physical disability or any other medical condition that contraindicates participation in an exercise program • Concurrent participation in another physical activity study
  • Pregnant woman
  • Person deprived of liberty by judicial or administrative decision, or adult protected by law

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Soins de soutien
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: Physical Activity Recommendations
Au départ, tous les participants recevront les recommandations internationales en termes d'activité physique pour la promotion de la santé dans la population générale.
Expérimental: Supervised Physical Activity Program
Au départ, tous les participants recevront les recommandations internationales en termes d'activité physique pour la promotion de la santé dans la population générale.

The exercise programme is carried out during the neoadjuvant period (9 to 12 weeks), alongside the three cycles of chemo-immunotherapy. Participants are provided with an exercise bike and a heart rate monitor.

The programme is structured in three progressive phases: adaptation (weeks 1 to 3, light to moderate intensity), progression (weeks 4 to 6, increased intensity and introduction of interval training) and maintenance/optimisation (from week 7 until surgery, stabilisation of the training load).

Outside the treatment weeks, participants undertake one supervised strength training session each week via videoconference and two independent aerobic sessions on an exercise bike. During each treatment session (C1, C2, C3), a supervised session combining aerobic exercise and strength training is carried out whilst the infusion is in progress.A weekly telephone follow-up allows the programme to be adjusted and enables the collection of assessments of fatigue and perceived exertion.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Evaluate the effect of a structured exercise program on immune pathological response (irPR)
Délai: T2 (pre-surgery):
Impact of structured exercise on the tumor immune microenvironment in patients receiving neoadjuvant chemo-immunotherapy. The primary endpoint is the density of CD8+ cytotoxic T lymphocytes (cells/mm²) within the tumor on the surgical specimen.
T2 (pre-surgery):

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Evaluate changes in the tumor immune microenvironment
Délai: Mainly pre surgery (T2), compared with baseline biopsy collected at inclusion (T1).
Assessment of stromal CD8+ CTL density, plasma cells (CD138/MUM1), mature tertiary lymphoid structures (CD20/CD23), and CTL/Treg (FOXP3) ratio.
Mainly pre surgery (T2), compared with baseline biopsy collected at inclusion (T1).
Objective Response Rate (ORR)
Délai: From study inclusion until completion of the 3 planned neoadjuvant chemotherapy cycles, prior to surgery
Evaluate tumor response to neoadjuvant treatment.
From study inclusion until completion of the 3 planned neoadjuvant chemotherapy cycles, prior to surgery
Pathological Complete Response (pCR)
Délai: T2 (surgery)
Assess the absence of viable tumor cells in the surgical specimen.
T2 (surgery)
Major Pathological Response (MPR)
Délai: T2 (surgery).
Evaluate residual tumor burden following neoadjuvant therapy.
T2 (surgery).
Disease-Free Survival (DFS)
Délai: T3 (6 weeks post-surgery) and T4 (3 months post-surgery).
Evaluate recurrence-free survival following treatment.
T3 (6 weeks post-surgery) and T4 (3 months post-surgery).
Treatment-Related Toxicities
Délai: During the first, second, and third cycles of neoadjuvant chemotherapy ( Each cycle is separated by 21 days).
Incidence, nature, and severity of adverse events according to CTCAE v5.0.
During the first, second, and third cycles of neoadjuvant chemotherapy ( Each cycle is separated by 21 days).
Postoperative Complications
Délai: T3 (6 weeks post-surgery).
Incidence and severity of postoperative complications according to Clavien-Dindo classification.
T3 (6 weeks post-surgery).
Length of Postoperative Hospital Stay
Délai: Assessed 6 weeks after surgery (T3)
Number of hospital days following surgery.
Assessed 6 weeks after surgery (T3)
90-Day Postoperative Mortality
Délai: T4 (3 months post-surgery).
Mortality occurring within 90 days after surgery.
T4 (3 months post-surgery).
Change in Aerobic Capacity
Délai: at study inclusion and at the pre-surgery visit.
Measurement of submaximal oxygen consumption.
at study inclusion and at the pre-surgery visit.
Change in Peripheral Muscle Strength
Délai: at study inclusion and at the pre-surgery visit.
Assessment of quadriceps isometric strength and core endurance (plank test).
at study inclusion and at the pre-surgery visit.
Change in Functional Capacity
Délai: at study inclusion and at the pre-surgery visit.
Six-Minute Walk Test (6MWT) and handgrip strength.
at study inclusion and at the pre-surgery visit.
Change in Functionnal capacity
Délai: at study inclusion and at the pre-surgery visit.
Handgrip test strength.
at study inclusion and at the pre-surgery visit.
Change in Lean and Fat Mass
Délai: at study inclusion and at the pre-surgery visit.
Body composition analysis using (CT-scan) imaging at the L3 vertebral level and bioimpedance assessment
at study inclusion and at the pre-surgery visit.
Level of physical activity
Délai: at study inclusion and at the pre-surgery visit.
International Physical Activity Questionnaire (IPAQ) score. The IPAQ assesses physical activity levels based on self-reported frequency and duration of physical activities. Higher scores indicate higher levels of physical activity.
at study inclusion and at the pre-surgery visit.
Change in Quality of Life
Délai: at study inclusion and at the pre-surgery visit.
Evaluation using EORTC QLQ-F17
at study inclusion and at the pre-surgery visit.
Change of quality of life
Délai: at study inclusion and at the pre-surgery visit.
Evaluation using EORTC QLQ-LC13 questionnaires.
at study inclusion and at the pre-surgery visit.
Change in Cancer-Related Fatigue
Délai: at study inclusion and at the pre-surgery visit.
Assessment using the FACT-Fatigue questionnaire.
at study inclusion and at the pre-surgery visit.
Change in Circulating Immune and Inflammatory Biomarkers
Délai: At study inclusion, during the second cycle of neoadjuvant chemotherapy(Each cycle is separated by 21 days) and before surgery
Analysis of cytokines and myeloid/lymphoid cell populations using flow cytometry and MSD technology.
At study inclusion, during the second cycle of neoadjuvant chemotherapy(Each cycle is separated by 21 days) and before surgery
Participation Rate
Délai: At screening and 6 months
Proportion of eligible patients enrolled in the study.
At screening and 6 months
Exercise Program Adherence
Délai: Assessed at study inclusion, during the first, second, and third cycles of neoadjuvant chemotherapy (each cycle is separated by 21 days), and at the pre-surgery visit
Exercise adherence measured as the percentage of prescribed exercise sessions completed. Values range from 0% to 100%, with higher percentages indicating greater adherence.
Assessed at study inclusion, during the first, second, and third cycles of neoadjuvant chemotherapy (each cycle is separated by 21 days), and at the pre-surgery visit
Attrition Rate
Délai: 6 months
Proportion of participants withdrawing from the study.
6 months
Program Acceptability and Satisfaction
Délai: pre-surgery (T2) : intervention arm only
Participant satisfaction with the exercise intervention, assessed using a self-administered questionnaire developed specifically for this study
pre-surgery (T2) : intervention arm only

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Ancillary - Characterize Exercise-Induced Changes in the Tumor Immune Microenvironment
Délai: Comparison of tumor samples collected at baseline from the pre-treatment biopsy and at surgery
To identify immune signatures, molecular pathways (immune response, angiogenesis, metabolism), and cellular populations modulated by exercise through RNA sequencing and high-dimensional spatial imaging (Akoya Phenocycler™).
Comparison of tumor samples collected at baseline from the pre-treatment biopsy and at surgery

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

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Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

30 juillet 2026

Achèvement primaire (Estimé)

30 juin 2029

Achèvement de l'étude (Estimé)

31 décembre 2029

Dates d'inscription aux études

Première soumission

10 août 2026

Première soumission répondant aux critères de contrôle qualité

25 août 2026

Première publication (Réel)

26 août 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

26 août 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

25 août 2026

Dernière vérification

1 juin 2026

Plus d'information

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