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Consolidative Stereotactic Radiotherapy for Oligo-Residual Advanced EGFR-Mutant NSCLC After First-Line Third-Generation EGFR-TKI Plus Chemotherapy

10. september 2026 oppdatert av: Zhengfei Zhu, Fudan University

Consolidative Stereotactic Radiotherapy for Oligo-Residual Advanced EGFR-Mutant Non-Small Cell Lung Cancer After First-Line Treatment With Third-Generation EGFR Tyrosine Kinase Inhibitor Plus Chemotherapy: A National Multicenter, Randomized Controlled Clinical Trial

This national multicenter, randomized controlled clinical trial evaluates the safety and efficacy of consolidative stereotactic radiotherapy in patients with advanced EGFR-mutant non-small cell lung cancer who have oligo-residual disease after four cycles of first-line treatment with third-generation EGFR-TKI plus platinum-based pemetrexed chemotherapy. Eligible participants will be randomized 1:1 to continue third-generation EGFR-TKI plus pemetrexed maintenance therapy alone or to receive stereotactic radiotherapy to all oligo-residual lesions in addition to the same maintenance therapy. The primary endpoint is progression-free survival.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

374

Fase

  • Fase 2

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Histologically confirmed non-small cell lung cancer.
  • Clinical stage IV disease according to the AJCC 9th edition.
  • Sensitizing EGFR mutation: EGFR exon 19 deletion or EGFR L858R.
  • Age 18-75 years.
  • Karnofsky Performance Status score ≥70.
  • Complete whole-body imaging assessment before initiation of first-line third-generation EGFR-TKI plus chemotherapy, with at least one evaluable lesion according to RECIST version 1.1.
  • No disease progression after completion of four cycles of first-line third-generation EGFR-TKI plus chemotherapy and no unresolved grade ≥3 nonhematologic toxicity.
  • Oligo-residual disease after four treatment cycles, with all residual lesions considered suitable for stereotactic radiotherapy by the investigator.
  • Written informed consent.

Exclusion Criteria:

  • Double primary or multiple primary malignancies, except early skin cancer or cervical carcinoma in situ treated with curative intent and without recurrence or progression for at least five years.
  • Pregnancy or breastfeeding, or considered unsuitable by the investigator for PET/CT or brain MRI examination.
  • History of uncontrolled epilepsy, central nervous system disease, or psychiatric disorder that, in the investigator's judgment, may interfere with informed consent or participant compliance.
  • Residual lesions considered unsuitable for consolidative stereotactic radiotherapy after first-line third-generation EGFR-TKI plus chemotherapy.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Radiotherapy plus TKI Group
Consolidative stereotactic radiotherapy plus continued third-generation EGFR-TKI and pemetrexed maintenance therapy.
Legemiddel: Third-generation EGFR tyrosine kinase inhibitor
administered during induction and maintenance; the specific third-generation EGFR-TKI is not uniformly restricted in the protocol.
Legemiddel: Platinum plus pemetrexed chemotherapy
cisplatin or carboplatin plus pemetrexed for four 3-week cycles during induction.
Legemiddel: Pemetrexed maintenance therapy
administered with the third-generation EGFR-TKI until disease progression or unacceptable toxicity.
Stråling: Consolidative stereotactic radiotherapy
SRS/SRT/SBRT delivered to all eligible intracranial and/or extracranial oligo-residual lesions, completed as a single course or in staged courses within one month.
Aktiv komparator: TKI alone Group
Continued third-generation EGFR-TKI and pemetrexed maintenance therapy alone.
Legemiddel: Third-generation EGFR tyrosine kinase inhibitor
administered during induction and maintenance; the specific third-generation EGFR-TKI is not uniformly restricted in the protocol.
Legemiddel: Platinum plus pemetrexed chemotherapy
cisplatin or carboplatin plus pemetrexed for four 3-week cycles during induction.
Legemiddel: Pemetrexed maintenance therapy
administered with the third-generation EGFR-TKI until disease progression or unacceptable toxicity.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Progression-Free Survival (PFS)
Tidsramme: 4 years
The time from randomization to disease progression or death of the patient. Patients who have not yet progressed at the time of analysis will be censored at the date of their last contact.
4 years

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Total overlevelse (OS)
Tidsramme: 4 år
4 år
Intracranial Progression-Free Survival (iPFS)
Tidsramme: 4 years
4 years
Health-Related Quality of Life (HRQoL)
Tidsramme: 4 years
health-related quality of life assessed using the QLQ-C30 and QLQ-LC13 questionnaires
4 years
Incidence of Treatment-Related Toxicities
Tidsramme: 4 years
proportion of evaluable participants experiencing treatment-related toxicities, graded according to CTCAE version
4 years

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
peripheral blood specimens
Tidsramme: 4 years
This study requires that peripheral blood specimens be collected as much as possible at the time points specified in the study, and that they be stored and processed in accordance with standard procedures, in order to explore the clinical value of liquid biopsy for oligo-residual disease prediction, early warning of drug resistance, and prognostic assessment.
4 years

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Fudan University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. oktober 2026

Primær fullføring (Antatt)

1. september 2030

Studiet fullført (Antatt)

1. september 2030

Datoer for studieregistrering

Først innsendt

7. august 2026

Først innsendt som oppfylte QC-kriteriene

10. september 2026

Først lagt ut (Faktiske)

16. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

16. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

10. september 2026

Sist bekreftet

1. august 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • LUNG-SORT2

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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