Multicentre Phase II Trial Evaluating Stereotactic Body Radiotherapy on Ultra-central Lung Tumors on MR-Linac (LIN-LUNG-2504)
28 de julho de 2026 atualizado por: Centre Oscar Lambret
Multicentre Phase II Trial Evaluating Stereotactic Body Radiotherapy (SBRT) on Ultra-central Lung Tumors on MR-Linac (Magnetic Resonance Image-Guided Radiotherapy)
Phase II multicenter trial evaluating the safety, tolerability, and feasibility of MRI-guided stereotactic radiotherapy using MRI-LINAC in patients with ultracentral lung tumors or lymphadenopathy in the context of controlled oligometastatic disease.
The study investigates the potential of this innovative technology, which enables real-time treatment adaptation, with the goal of optimizing the benefit-risk ratio in a population at high risk of radiotherapy-related toxicity
Visão geral do estudo
Status
Ainda não está recrutando
Condições
Intervenção / Tratamento
Descrição detalhada
This interventional, prospective, multicenter, non-randomized Phase II study primarily aims to evaluate the safety of MRI-guided stereotactic radiotherapy delivered with an MRI-LINAC, particularly in terms of late toxicity of grade ≥3.
Ultracentral lung tumors represent a major therapeutic challenge due to their immediate proximity to critical structures such as the tracheobronchial tree, oesophagus, and pericardium. This location exposes patients to an increased risk of severe complications (haemorrhage, fistula, stenosis, pneumonitis), limiting the doses that can be delivered with conventional radiotherapy and potentially compromising tumor control.
The use of an MRI-LINAC enables real-time visualization of anatomical structures and adaptation of the treatment plan at each session (adaptive radiotherapy). This technology also incorporates respiratory motion management systems (gating), allowing for reduced treatment margins and improved sparing of organs at risk.
Enrolled patients will receive stereotactic radiotherapy delivered in 8 fractions, with extended clinical, radiological, and functional follow-up.
In addition to assessing late toxicity, the study will also evaluate the feasibility of the technique, early adverse events, overall survival, progression-free survival, tumor control, and changes in respiratory function.
The overall objective is to demonstrate that MRI-LINAC-guided radiotherapy can reduce toxicity while maintaining satisfactory tumor control in this high-risk population, thereby improving the management of ultracentral lung tumors.
Tipo de estudo
Intervencional
Inscrição (Estimado)
59
Estágio
- Não aplicável
Contactos e Locais
Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.
Contato de estudo
- Nome: Florence LE TINIER, MD
Estude backup de contato
- Nome: Alicia PROBST, PhD
- Número de telefone: +33 (0)3 20 29 59 18
- E-mail: promotion@o-lambret.fr
Critérios de participação
Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Não
Descrição
Inclusion Criteria:
- Age ≥ 18 year-old
Clinical status:
- Primary lung tumour T1-T2 N0, confirmed histologically by bronchoscopic examination, or meeting the criteria set out in the Aura 2026 and ASTRO guidelines for the indication of stereotactic radiotherapy (tumor growth of at least 2 mm between two CT scans performed 3 months apart, metabolic hyper-intensity on PET, and no pathological evidence), OR
- Metachronous oligometastatic disease: isolated mediastinal or non-central pulmonary lymph node recurrence occurring sometimes after initial cancer treatments for an initially localised, locally advanced or oligometastatic cancer that has been treated OR
- Synchronous oligometastatic disease: all metastatic sites and the primary tumour must be amenable to local debulking treatment following systemic treatment. Systemic treatment (chemotherapy or targeted therapy) must not be administered concurrently with radiotherapy OR
- Metachronous oligoprogression: isolated metastatic recurrence in the mediastinal or ultra-central lung lymph nodes, with the primary tumour and metastatic sites under control (no change observed on two consecutive imaging scans and a complete metabolic response on PET) and not requiring continued treatment with chemotherapy or targeted therapy to ensure disease control (hormone therapy is, however, permitted)
- Patient unsuitable for surgery, and treatment with stereotactic RT validated by multidisciplinary tumor board (including the radiation oncologist and medical physician)
- Ultracentral lesion defined by a GTV less than 1 cm of the PBT (proximal bronchial trachea, including the main bronchi, trachea and intermediate bronchi), oesophagus, or pericardum
- ECOG performance status ≤2 (for all patients)
- Patient covered by a health insurance system
- Patient agreed to take part in the study, and signed an informed consent form
- Use of a method of contraception (for female patients of childbearing age)
Exclusion Criteria:
- Tumour with intrabronchial or intratracheal invasion identified by fibroscopy, bronchoscopy or localisation MRI
- Prior RT overlapping the intended treatment field
- Patients with oligoprogression requiring continued systemic treatment during RT
- Uncontrolled intercurrent diseases
- Contraindication to radiotherapy due to a comorbidity such as pulmonary fibrosis or scleroderma
- Respiratory contraindications (FEV1 < 20%)
- Need of oncologic systemic treatment during RT
- Contraindication to MRI (e.g. severe claustrophobia unmanageable)
- Pregnancy or breastfeeding patient
- Patient under guardianship or curatorship
Plano de estudo
Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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Experimental: MR-guided stereotactic radiotherapy (MR-LINAC)
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Stereotactic body radiotherapy (SBRT) is delivered using an MRI-guided linear accelerator (MR-LINAC), at a total dose of 60 Gy in 8 fractions (7.5 Gy per fraction) over 17 days.
Treatment is performed using MR-guided adaptive radiotherapy with real-time imaging and respiratory motion management (gating).
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Incidence of late treatment-related toxicity
Prazo: from 90 days post-radiotherapy to 36 months after end of treatment
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Treatment-related toxicity is assessed according to NCI-CTCAE v6.0 and defined as grade ≥ 3 adverse events such as: pneumonitis, bronchopulmonary haemorrhage, fibrosis, airway obstruction, fistula, or oesophageal toxicity, or other severe toxicity. Death possibly related to radiotherapy within 36 months is also considered as an event. |
from 90 days post-radiotherapy to 36 months after end of treatment
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Early and late adverse events (all grades)
Prazo: From radiotherapy simulation up to 36 months post-radiotherapy
|
Early and late adverse events are assessed according to NCI-CTCAE v6.0.
Adverse events that are definitively linked to the underlying disease, the progression of the underlying disease, or systemic treatment are excluded.
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From radiotherapy simulation up to 36 months post-radiotherapy
|
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Feasibility of MR-guided radiotherapy
Prazo: from treatment initiation up to 3 months after completion of radiotherapy
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Feasibility of MR-guided radiotherapy is evaluated considering occurrence of primary failures (patient who dindn't start treatment) or secondary failures (incomplete treatment, or significant interruption of more than one week).
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from treatment initiation up to 3 months after completion of radiotherapy
|
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Progression-Free Survival (PFS)
Prazo: from treatment initiation to progression or death, assessed up to 36 months
|
Time from treatment initiation to disease progression (local, regional, or distant) or death from any cause
|
from treatment initiation to progression or death, assessed up to 36 months
|
|
Overall Survival (OS)
Prazo: from treatment initiation up to 36 months
|
Time from treatment initiation to death from any cause.
|
from treatment initiation up to 36 months
|
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Local, regional, and distant disease control
Prazo: at 6, 12, 24, and 36 months after treatment
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Assessed using imaging-based evaluation and cumulative incidence of progression.
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at 6, 12, 24, and 36 months after treatment
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FEV1 lung test
Prazo: at baseline, and at 6, 18, and 30 months post-treatment
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This test evaluates forced expiratory volume in one second
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at baseline, and at 6, 18, and 30 months post-treatment
|
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Dosimetric parameters related to target coverage (GTV, CTV, PTV)
Prazo: During treatment planning (less than 30 days after enrollment), and then at each radiotherapy session (8 sessions spaced 2 days apart over a period of 17 days). Radiotherapy should start no later than 30 days after enrollment. .
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Gross Tumor Volume (GTV), Clinical Target Volume (CTV), and Planning Target Volume (PTV) are evaluated, and recorded during treatment planning, and at each adaptive fraction to document the benefit of online plan adaptation enabled by the MR-LINAC technology.
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During treatment planning (less than 30 days after enrollment), and then at each radiotherapy session (8 sessions spaced 2 days apart over a period of 17 days). Radiotherapy should start no later than 30 days after enrollment. .
|
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Radiation dose delivered to CTV and OAR
Prazo: During treatment planning (less than 30 days after enrollment), and then at each radiotherapy session (8 sessions spaced 2 days apart over a period of 17 days). Radiotherapy should start no later than 30 days after enrollment.
|
The radiation dose delivered (Gy) to the clinical target volume (CTV) and healthy nearby tissues (OAR, Organs at Risk) is evaluated, and recorded during treatment planning, and at each adaptive fraction, to document the benefit of online plan adaptation enabled by the MR-LINAC technology.
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During treatment planning (less than 30 days after enrollment), and then at each radiotherapy session (8 sessions spaced 2 days apart over a period of 17 days). Radiotherapy should start no later than 30 days after enrollment.
|
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Lung diffusion test (DLCO)
Prazo: at baseline, and at 6, 18, and 30 months post-treatment
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The DLCO test measures how effectively the lungs transfer oxygen from inhaled air to the blood
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at baseline, and at 6, 18, and 30 months post-treatment
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Colaboradores e Investigadores
É aqui que você encontrará pessoas e organizações envolvidas com este estudo.
Patrocinador
Investigadores
- Diretor de estudo: Florence LE TINIER, MD, Centre Oscar Lambret, Lille
- Diretor de estudo: David PASQUIER, MD, PhD, Centre Oscar Lambret, Lille
Datas de registro do estudo
Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.
Datas Principais do Estudo
Início do estudo (Estimado)
1 de setembro de 2026
Conclusão Primária (Estimado)
1 de novembro de 2031
Conclusão do estudo (Estimado)
1 de novembro de 2031
Datas de inscrição no estudo
Enviado pela primeira vez
29 de junho de 2026
Enviado pela primeira vez que atendeu aos critérios de CQ
28 de julho de 2026
Primeira postagem (Real)
29 de julho de 2026
Atualizações de registro de estudo
Última Atualização Postada (Real)
29 de julho de 2026
Última atualização enviada que atendeu aos critérios de controle de qualidade
28 de julho de 2026
Última verificação
1 de julho de 2026
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- LIN-LUNG-2504
- 2026-A00128-43 (Outro identificador: IDRCB)
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
NÃO
Informações sobre medicamentos e dispositivos, documentos de estudo
Estuda um medicamento regulamentado pela FDA dos EUA
Não
Estuda um produto de dispositivo regulamentado pela FDA dos EUA
Não
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