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Xuan Yin Ning Plus Bevacizumab for Malignant Pleural Effusion (XYN-Bev MPE)

29 juni 2026 uppdaterad av: Zhang Ming, Shanghai Chest Hospital

A Prospective, Multicenter, Randomized, Double-blind, Placebo-controlled Clinical Study of Xuan Yin Ning Formula Combined With Intrapleural Injection of Bevacizumab for the Treatment of Malignant Pleural Effusion.

The goal of this clinical trial is to determine whether the Xuanyin Ning Formula combined with intrapleural injection of bevacizumab via chest tube drainage is effective in treating malignant pleural effusion. It will also evaluate the safety of this combination therapy. The main questions it aims to answer include:

Does the Xuanyin Ning Formula combined with intrapleural injection of bevacizumab via chest tube drainage improve the objective response rate (ORR) of pleural effusion in patients with malignant pleural effusion? Does this combination therapy affect the duration of response (DoR), progression-free survival (PFS), overall survival (OS), degree of dyspnea, quality of life, and Traditional Chinese Medicine (TCM) pattern/syndrome evaluation in patients with malignant pleural effusion?

Participants will:

Receive intrapleural injection of bevacizumab via chest tube drainage, and take either Xuanyin Ning Formula or placebo granules daily for 8 weeks.

Undergo ultrasound assessment of pleural effusion at 2, 4, 8, and 12 weeks after the first intrapleural injection during closed chest drainage, followed by ultrasound assessments every 3 months (±7 days) until pleural effusion progression.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Studietyp

Interventionell

Inskrivning (Beräknad)

308

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

  • Kina
    • Hebei
      • Wuhan, Hebei, Kina, 430022
        • Wuhan First Hospital
        • Kontakt:
    • Henan
      • Xinxiang, Henan, Kina, 453100
        • The First Affiliated Hospital of Xinxiang Medical University
        • Kontakt:
    • Shandong
      • Weifang, Shandong, Kina, 261041
        • Weifang Traditional Chinese Medicine Hospital 或 Weifang Traditional Chinese Hospital
        • Kontakt:
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, Kina, 200030
        • Shanghai Chest Hospital
        • Kontakt:
      • Shanghai, Shanghai Municipality, Kina, 200437
        • Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
        • Kontakt:
      • Shanghai, Shanghai Municipality, Kina, 200032
        • Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine
        • Kontakt:
      • Shanghai, Shanghai Municipality, Kina, 202157
        • Shanghai Tenth People's Hospital Chongming Branch
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • Patients with advanced non-squamous non-small cell lung cancer who have failed at least first-line systemic therapy;
  • Presence of unilateral pleural effusion confirmed as malignant by pathology or cytology, with at least moderate volume requiring drainage (moderate pleural effusion defined as: supine ultrasound examination showing pleural effusion ≥3 cm, or sitting ultrasound examination showing pleural effusion ≥4 cm,accompanied by clinical symptoms such as chest tightness and dyspnea);
  • Age 18-75 years;
  • ECOG performance status 0-2;
  • Traditional Chinese Medicine (TCM) syndrome differentiation classified as Xuanyin (suspension fluid) with fluid retention in the chest and hypochondrium;
  • Expected survival of at least 3 months;
  • Voluntarily signed informed consent before treatment;
  • No contraindications to chest tube placement for drainage;

  • Adequate major organ function, including:

    1. Complete blood count:

      White blood cell count ≥ 4.0×10⁹/L Absolute neutrophil count ≥ 1.5×10⁹/L Platelet count ≥ 100×10⁹/L Hemoglobin ≥ 90 g/L

    2. Blood biochemistry:

      Total bilirubin ≤ 1.5×ULN ALT ≤ 2.5×ULN, AST ≤ 2.5×ULN Serum creatinine ≤ 1.5×ULN, or creatinine clearance ≥ 50 mL/min (Cockcroft-Gault formula)

    3. Coagulation function:

      International normalized ratio (INR) ≤ 1.5×ULN Activated partial thromboplastin time (APTT) ≤ 1.5×ULN

    4. Blood glucose: within normal range, or diabetic patients under treatment with stable blood glucose control;
  • Female subjects of childbearing potential must have a negative serum pregnancy test within 72 hours before starting study drug administration, and must use effective contraception (e.g., intrauterine device, contraceptive pills, or condoms) during the study period and for at least 3 months after the last dose. -Male subjects with a partner of childbearing potential must use effective contraception during the study period and for 3 months after the last dose;
  • Good subject compliance, able to follow up for efficacy and adverse events/reactions as required by the protocol.

Exclusion Criteria:

  • The location of pleural effusion is unsuitable for drainage, or the patient would not benefit from intrapleural drug administration (e.g., severe loculation/septation);
  • Other contraindications to indwelling chest tube placement;
  • Pleural effusion with active infection;
  • Prior history of ipsilateral chest tube drainage and intrapleural anti-tumor drug therapy or pleurodesis;
  • Prior history of empyema or chylothorax;
  • Participation in another clinical trial within 4 weeks before signing informed consent;
  • Known allergy to any component of the study drugs;
  • Severe bleeding tendency or active bleeding;
  • Uncontrolled severe hypertension;
  • Recent (within 3 months) thromboembolic events, such as deep vein thrombosis, pulmonary embolism, cerebral infarction, etc.;
  • Prior severe adverse reactions to intravenous bevacizumab, such as severe proteinuria, gastrointestinal perforation, hypertensive crisis, etc.;
  • Severe cardiac, hepatic, or renal insufficiency;
  • Pregnant or breastfeeding women;
  • Subjects with other active infectious diseases in the acute phase;
  • Any other factors that, in the investigator's judgment, may lead to premature termination of the study, such as other serious diseases (including psychiatric disorders) requiring concomitant treatment, alcoholism, drug abuse, family or social factors that may affect the subject's safety or compliance.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Dubbel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: experimentgrupp
Övrig: Treatment with Xuanyin Ning Formula combined with intrapleural injection of bevacizumab via chest tube drainage
After chest tube drainage, bevacizumab 300 mg per dose, dissolved in 50 ml of normal saline, is injected intrapleurally. The injection may be repeated after 2 weeks depending on the control of pleural effusion. Xuanyin Ning is taken as 2 sachets per day, one sachet dissolved in water and taken orally in the morning and one in the evening. Each treatment cycle is 4 weeks, and at least 2 cycles are required.
Placebo-jämförare: kontrollgrupp
Läkemedel: Placebo granules plus chest tube drainage and intrapleural bevacizumab injection
After chest tube drainage, bevacizumab 300 mg per dose, dissolved in 50 ml of normal saline, is injected intrapleurally. The injection may be repeated after 2 weeks depending on the control of pleural effusion. Placebo granules are taken as 2 sachets per day, one sachet dissolved in water and taken orally in the morning and one in the evening. Each treatment cycle is 4 weeks, and at least 2 cycles are required.

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
Objective Response Rate of pleural effusion (ORR)
Tidsram: Before treatment and at 4 weeks, 8 weeks, and 12 weeks after treatment
Before treatment and at 4 weeks, 8 weeks, and 12 weeks after treatment

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Duration of Response (DoR)
Tidsram: At 2, 4, 8, and 12 weeks after treatment
At 2, 4, 8, and 12 weeks after treatment
Progression-Free Survival (PFS)
Tidsram: From date of treatment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months
From date of treatment until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months
Overall Survival (OS)
Tidsram: From date of treatment until the date of death from any cause, assessed up to 100 months
From date of treatment until the date of death from any cause, assessed up to 100 months
Degree of dyspnea
Tidsram: At 2, 4, 8, and 12 weeks after treatment
At 2, 4, 8, and 12 weeks after treatment
ECOG score
Tidsram: At 2, 4, 8, and 12 weeks after treatment
The ECOG score is a widely used clinical tool for quantifying a cancer patient's general well-being and functional capacity in daily life. It is primarily employed in oncology trials, treatment planning, and prognosis assessment. The scale ranges from 0 to 5, with higher numbers indicating greater disability
At 2, 4, 8, and 12 weeks after treatment
Traditional Chinese Medicine (TCM) syndrome evaluation
Tidsram: At 2, 4, 8, and 12 weeks after treatment

Quantification: The scale standardizes the evaluation of clinical symptoms, signs, and tongue/pulse findings, which are traditionally assessed through the four examinations (inspection, hearing/smelling, inquiry, and palpation).

Objectivity: It aims to improve the objectivity and standardization of TCM diagnosis and treatment evaluation.

Efficacy Evaluation: It is frequently used to calculate a "total effective rate" based on the reduction in syndrome scores after treatment.

Scoring: Symptoms are typically graded on a scale (e.g., 0 for normal, 2 for mild, 4 for moderate, 6 for severe), and the total score reflects the overall severity of the syndrome
At 2, 4, 8, and 12 weeks after treatment

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Shanghai Chest Hospital

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

1 juni 2026

Primärt slutförande (Beräknad)

1 september 2028

Avslutad studie (Beräknad)

1 september 2028

Studieregistreringsdatum

Först inskickad

4 juni 2026

Först inskickad som uppfyllde QC-kriterierna

24 juni 2026

Första postat (Faktisk)

26 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

1 juli 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

29 juni 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • ZDYN-2024-A-147

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