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A Randomized Trial of Standard vs. Hypofractionated Accelerated Radiotherapy for Progression in Limited-Stage Small Cell Lung Cancer (SHARP SCLC)

2 november 2026 uppdaterad av: Melody Qu, London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

A Randomized Trial of Standard vs. Hypofractionated Accelerated Radiotherapy for Progression in Limited-Stage Small Cell Lung Cancer (SHARP-SCLC)

This study aims to determine whether an abbreviated course of thoracic radiotherapy, delivered in five fractions over one week between chemotherapy cycles, improves progression-free survival compared with standard radiotherapy delivered concurrently with chemotherapy in patients with newly diagnosed limited-stage small cell lung cancer (LS-SCLC).

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

This is a multicentre, randomized clinical trial comparing two thoracic radiation therapy (RT) approaches for patients with newly diagnosed limited-stage small cell lung cancer (LS-SCLC).

Standard treatment for LS-SCLC involves chemotherapy combined with thoracic radiation therapy. Conventional radiation schedules require daily or twice-daily treatments over several weeks. This study will investigate whether a shorter, accelerated course of radiotherapy can improve progression-free survival while reducing treatment burden.

The primary outcome is progression-free survival, defined as the time from randomization to disease progression or death. Secondary outcomes include overall survival, treatment-related toxicity, patient-reported quality of life, and treatment burden.

The study also includes exploratory translational research involving blood samples and radiation dosimetric analyses to better understand the biological effects of different radiation schedules.

Participants will be followed for up to five years after randomization to assess short- and long-term outcomes.

Studietyp

Interventionell

Inskrivning (Beräknad)

150

Fas

  • Fas 2
  • Fas 3

Kontakter och platser

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

Studiekontakt

Studieorter

  • Kanada
    • Ontario
      • London, Ontario, Kanada, N6A 5W9
        • London Health Sciences Centre, Verspeeten Family Cancer Centre
        • Kontakt:
        • Huvudutredare:
          • Melody Qu, MD

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

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • New diagnosis of Limited-stage small cell lung cancer (LS-SCLC), eligible for curative intent concurrent chemoradiotherapy

    -- Planned for immunotherapy and prophylactic cranial irradiation is allowed and encouraged

  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2

  • Age 18 years or older

  • Life expectancy > 3 months

  • Willingness and ability to provide informed consent

Exclusion Criteria:

  • Prior thoracic radiation therapy (RT) which, in the opinion of the treating radiation oncologist, precludes the delivery of further thoracic RT

    • If there has been prior thoracic RT, a composite of all RT plans must be created, and the dose constraints herein must still be met
    • An allowance for 10% repair is permitted if at least 12 months have passed between the prior RT and the trial protocol specified RT

  • Serious medical comorbidities which, in the opinion of the treating radiation oncologist, preclude the delivery of RT

    -- This includes interstitial lung disease

  • Patients who have started systemic treatment for LS-SCLC but are unable to start radiation with cycle 3 or earlier (delaying scheduled chemotherapy without clinical indication) is not permitted

  • Pregnant or lactating women

  • Inability to attend the full course of RT or planed follow-up visits

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: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Standard Thoracic Radiotherapy
Strålning: Radiation Therapy

Standard RT using VMAT or IMRT. Accepted standard-of-care fractionation schedules include:

  • 60-66 Gy in 30-33 daily fractions
  • 40-45 Gy in 15 daily fractions
  • 45 Gy in 30 twice-daily fractions Radiotherapy will begin as early as feasible, preferably during chemotherapy cycle 1 or 2, and no later than cycle 3.
Läkemedel: Chemotherapy

4-6 cycles of intravenous (IV) cisplatin (75 mg/m2) or carboplatin (area under the curve of 5-6 mg/mL × min) given on day 1 or day 1-3 and etoposide (100 mg/m2) on days 1 to 3 every 3 weeks. Oral etoposide (200 mg/m²) is permitted in urgent situations and/or when IV etoposide is not feasible, at the treating clinician's discretion.
Experimentell: Hypofractionated Accelerated Thoracic Radiotherapy
Läkemedel: Chemotherapy

4-6 cycles of intravenous (IV) cisplatin (75 mg/m2) or carboplatin (area under the curve of 5-6 mg/mL × min) given on day 1 or day 1-3 and etoposide (100 mg/m2) on days 1 to 3 every 3 weeks. Oral etoposide (200 mg/m²) is permitted in urgent situations and/or when IV etoposide is not feasible, at the treating clinician's discretion.

Strålning: Hypofractionated Radiation Therapy

Hypofractionated radiotherapy using VMAT or IMRT, prescribed to a total dose of 35 Gy in 5 fractions, with a SIB to 40 Gy for GTV where feasible. Radiotherapy will begin as early as feasible, preferably during chemotherapy cycle 1 or 2, and no later than cycle 3. Radiation will be delivered between chemotherapy cycles, ideally on days 15-20 of the respective cycle to avoid the anticipated chemotherapy nadir, and will not be administered on chemotherapy treatment days.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Progression-free survival
Tidsram: From randomization to disease progression or death, assessed for up to 60 months.

Progression-free survival (PFS) is defined as the time from randomization to the first occurrence of disease progression or death from any cause, whichever occurs first. Disease progression will be assessed using RECIST version 1.1 criteria. Participants without documented progression or death will be censored at the date of their last adequate disease assessment.
From randomization to disease progression or death, assessed for up to 60 months.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Changes in Quality of Life Measured by the Functional Assessment of Cancer Therapy: Lung (FACT-L), and EuroQol 5-Dimension 5-Level (EQ-5D-5L) Questionnaires
Tidsram: From randomization to 60 months post-randomization

Changes in quality of life as reported by the participant on the Functional Assessment of Cancer Therapy: Lung (FACT-L) and EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaires
From randomization to 60 months post-randomization
Acute and Chronic Physician-Reported Toxicity Using Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0
Tidsram: From randomization to 60 months post-randomization

Severity and grade of side effects of treatment as reported by the physician as grade 2 or greater, using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
From randomization to 60 months post-randomization
Overall Survival
Tidsram: From randomization to 60 months post-randomization

Overall survival defined as time from randomization to death from any cause, or last follow-up, whichever occurs first
From randomization to 60 months post-randomization
Freedom From Intrathoracic Progression
Tidsram: From randomization to 60 months post-enrollment

Freedom From Intrathoracic Progression defined as time from randomization to disease progression with the thorax, or last follow-up, whichever occurs first.
From randomization to 60 months post-enrollment
Freedom From Intracranial Progression
Tidsram: From randomization to 60 months post-randomization

Freedom From Intracranial Progression defined as time from randomization to disease progression intracranially, or last follow-up, whichever occurs first.
From randomization to 60 months post-randomization
Cost-Effectiveness Analysis
Tidsram: From randomization to 60 months post-randomization

Patient-level data on survival, disease progression, treatment-related toxicity, healthcare utilization, and health-related quality of life (EQ-5D-5L) will inform a cost-effectiveness analysis, based on modelled costs and quality-adjusted life years.
From randomization to 60 months post-randomization

Samarbetspartners och utredare

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

Sponsor

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

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 november 2026

Primärt slutförande (Beräknad)

1 september 2036

Avslutad studie (Beräknad)

1 september 2036

Studieregistreringsdatum

Först inskickad

13 oktober 2026

Först inskickad som uppfyllde QC-kriterierna

2 november 2026

Första postat (Faktisk)

5 november 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

5 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

2 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • ReDA 17092

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Nej

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