一线伊匹单抗联合纳武利尤单抗和诺加彭德金阿尔法因巴基塞普(N-803)治疗IV期或复发性非小细胞肺癌患者 (FLINN)
一项II期、单中心、开放标签研究:一线伊匹单抗联合纳武利尤单抗及Nogapendekin Alfa Inbakicept(N-803)治疗IV期或复发性非小细胞肺癌患者(FLINN)
研究概览
研究类型
注册 (估计的)
阶段
- 阶段2
- 阶段1
联系人和位置
学习联系方式
- 姓名:Giordano Fabricio Cittolin Santos, MD, PhD
- 电话号码:314-273-4731
- 邮箱:cgiordano@wustl.edu
学习地点
-
-
Missouri
-
St Louis、Missouri、美国、63110
- 招聘中
- Washington University School of Medicine
-
副研究员:
- Danielle Turlington, PharmD, BCOP
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接触:
- Giordano Fabricio Cittolin Santos, MD, PhD
- 电话号码:314-273-4731
- 邮箱:cgiordano@wustl.edu
-
首席研究员:
- Giordano Fabricio Cittolin Santos, MD, PhD
-
副研究员:
- Daniel Morgensztern, MD
-
副研究员:
- Maria Q Baggstrom, MD
-
副研究员:
- Brett Herzog, MD, PhD
-
副研究员:
- Anjali Rohatgi, MD
-
副研究员:
- Saiama N Waqar, MD
-
副研究员:
- Jeffrey Ward, MD, PhD
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副研究员:
- Ningying Wu, PhD
-
-
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
入选标准:
- 经组织学或细胞学确诊、既往未治疗或复发性转移性非小细胞肺癌。
- 能够提供存档活检组织,或愿意在C1D1前接受活检用于生物标志物分析,包括通过CLIA认证检测进行的PD-L1免疫组化检测。入组不要求PD-L1检测结果。
- 根据RECIST 1.1标准具有可测量病灶。
- 年龄至少18岁。
- ECOG体能状态≤1
具备足够的器官和骨髓功能,定义如下:
- 绝对中性粒细胞计数≥1.5 K/cumm
- 血小板计数≥100 K/cumm
- 血红蛋白≥9.0 g/dL
- AST(SGOT)/ALT(SGPT) ≤2.5倍正常值上限(无肝转移)且≤5倍正常值上限(有肝转移)
- 总胆红素≤2倍正常值上限(吉尔伯特综合征患者除外,其总胆红素必须<3.0 mg/dL)
- 通过Cockcroft-Gault公式计算的肌酐清除率>30 mL/min
- INR≤1.5(除非正在接受治疗性抗凝)
- PTT/aPTT<1.5倍正常值上限(除非正在接受治疗性抗凝)
- 脑转移患者符合条件,前提是既往接受过手术或放疗、洗脱期至少2周后神经系统状况稳定,且在C1D1时未接受高于10 mg泼尼松或等效剂量的皮质类固醇治疗。
- 治疗方案对发育中人类胎儿的影响未知。因此,有生育潜力的患者及有生育能力的男性必须同意按照方案要求,从签署知情同意书至末次研究治疗给药后6个月内,使用高效避孕措施。
- 有能力理解并愿意签署机构审查委员会批准的书面知情同意书。法定授权代表可代表研究参与者签署并给予知情同意。
排除标准:
- 包含小细胞肺癌的混合组织学类型。
- 肿瘤携带EGFR突变、HER2突变、ALK融合、ROS1融合或RET融合。
- C1D1前28天内使用过任何活疫苗。
- 入组前12个月内,在辅助治疗期间或局部晚期疾病同步放疗期间接受过化疗。若末次治疗间隔≥12个月,则患者符合条件。
- C1D1前14天内接受过放疗。
- C1D1前14天内有重大手术史。
研究者认为可能使研究治疗给药存在风险的潜在医学状况,包括但不限于:
- 间质性肺病或非感染性肺炎病史,
- C1D1前14天内需要肠外治疗的活跃病毒、细菌或真菌感染,
- 具有临床意义的心血管疾病,
- 可能影响毒性判定或不良事件解读的病症,
- 既往实体器官移植史。
- 需要超生理剂量皮质类固醇(>10 mg/天口服泼尼松或等效剂量)或免疫抑制药物治疗的合并医学状况(可吸收的局部皮质类固醇不排除)。
- HIV感染且未接受有效抗逆转录病毒治疗达6个月以上或病毒载量可检测。接受抗逆转录病毒治疗且病毒载量持续不可检测至少6个月的HIV患者符合条件。无已知感染史时无需进行HIV检测。
- 慢性乙型肝炎(HBV)证据且在抑制治疗期间可检测到病毒。慢性HBV感染证据但抑制治疗期间HBV病毒载量不可检测的患者符合条件。无已知感染史时无需进行HBV检测。
- 未治愈或病毒载量可检测的丙型肝炎病毒(HCV)感染史。已治疗且治愈的HCV病史患者符合条件。当前正在接受治疗且HCV病毒载量不可检测的HCV感染患者符合条件。无已知感染史时无需进行HCV检测。
- 已知可能干扰试验配合要求的精神疾病或药物滥用障碍。
任何活跃的自身免疫性疾病,或过去2年内需要全身治疗(即使用疾病修饰剂、皮质类固醇或免疫抑制药物)的自身免疫性疾病或综合征记录史(白癜风或已缓解的儿童期哮喘/特应性疾病除外)。
- 替代疗法(如甲状腺素、胰岛素,或用于肾上腺/垂体功能不全的生理性皮质类固醇替代治疗)不视为全身治疗。
- 需要间歇使用支气管扩张剂、吸入性皮质类固醇或局部皮质类固醇注射的哮喘患者不会被排除。
- 长期使用全身性皮质类固醇的患者将被排除。
- 既往或并发的恶性肿瘤,其自然病程可能干扰研究方案的安全性或有效性评估。不符合该定义的既往或并发恶性肿瘤患者符合本试验条件。
- C1D1前28天或5个半衰期(以较长者为准)内使用过其他研究性药物(未获批任何适应症的药品)。
- 对研究中任何药物类似化学或生物成分有过敏反应史,或已知对重组蛋白或试验制剂中任何辅料过敏。
- 妊娠及/或哺乳期。有生育潜力的患者必须在研究入组7天内妊娠检测阴性。
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:非随机化
- 介入模型:顺序分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的:Phase Ib Dose Level 1: Ipilimumab plus Nivolumab and Nogapendekin alfa inbakicept (N-803)
Consenting and eligible patients will receive nivolumab intravenously (IV) on Days 1 and 22, ipilimumab IV on Day 1, and the assigned dose of nogapendekin alfa inbakicept subcutaneously (SC) on Days 1 and 22 of each cycle for Cycles 1 through 4; ipilimumab will be discontinued after Cycle 4 and patients will continue to receive nivolumab and nogapendekin alfa inbakicept on the same schedule for up to 2 years.
Cycles are 42 days (6 weeks).
|
伊匹单抗将以1毫克/千克的剂量静脉注射给药。
其他名称:
Nivolumab将以360mg的剂量静脉注射给药。
其他名称:
Nogapendekin alfa inbakicept will be given subcutaneously at the assigned dose level.
其他名称:
|
|
实验性的:Phase Ib Dose Level -1: Ipilimumab plus Nivolumab and Nogapendekin alfa inbakicept (N-803)
Consenting and eligible patients will receive nivolumab intravenously (IV) on Days 1 and 22, ipilimumab IV on Day 1, and the assigned dose of nogapendekin alfa inbakicept subcutaneously (SC) on Days 1 and 22 of each cycle for Cycles 1 through 4; ipilimumab will be discontinued after Cycle 4 and patients will continue to receive nivolumab and nogapendekin alfa inbakicept on the same schedule for up to 2 years.
Cycles are 42 days (6 weeks).
|
伊匹单抗将以1毫克/千克的剂量静脉注射给药。
其他名称:
Nivolumab将以360mg的剂量静脉注射给药。
其他名称:
Nogapendekin alfa inbakicept will be given subcutaneously at the assigned dose level.
其他名称:
|
|
实验性的:Phase II: Ipilimumab plus Nivolumab and Nogapendekin alfa inbakicept (N-803)
Consenting and eligible patients will receive nivolumab intravenously (IV) on Days 1 and 22, ipilimumab IV on Day 1, and the assigned dose of nogapendekin alfa inbakicept subcutaneously (SC) on Days 1 and 22 of each cycle for Cycles 1 through 4; ipilimumab will be discontinued after Cycle 4 and patients will continue to receive nivolumab and nogapendekin alfa inbakicept on the same schedule for up to 2 years.
Cycles are 42 days (6 weeks).
|
伊匹单抗将以1毫克/千克的剂量静脉注射给药。
其他名称:
Nivolumab将以360mg的剂量静脉注射给药。
其他名称:
Nogapendekin alfa inbakicept will be given subcutaneously at the assigned dose level.
其他名称:
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Progression-free survival (PFS) (Phase Ib acceptable dose participants and Phase II participants)
大体时间:Start of treatment through 2 years after end of treatment (up to 4 years)
|
PFS is defined as the duration of time from the start date of study treatment to the date of earliest progression or death, whichever occurs first.
Patients who neither progress nor die by the data cutoff date will be censored at the last follow up date.
|
Start of treatment through 2 years after end of treatment (up to 4 years)
|
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Incidence of dose-limiting toxicities (DLTs) (Phase Ib participants)
大体时间:From start of treatment through completion of cycle 1 (each cycle is 42 days)
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DLTs are defined in the protocol.
|
From start of treatment through completion of cycle 1 (each cycle is 42 days)
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Adverse event effect rate (All participants)
大体时间:Start of treatment through 100 days after discontinuation of therapy (up to 2 years and 100 days)
|
Defined as the number of study treatment related adverse events (AEs) and discontinuations due to treatment-related AEs.
Adverse events will be assessed using the CTCAE v5.0 criteria.
|
Start of treatment through 100 days after discontinuation of therapy (up to 2 years and 100 days)
|
|
Disease control rate (DCR) (Phase Ib acceptable dose participants and Phase II participants)
大体时间:Start of treatment through 2 years after end of treatment (up to 4 years)
|
DCR is defined as the proportion of patients achieving either a complete response (CR), partial response (PR), or stable disease (SD), according to RECIST 1.1. Complete Response (CR): Disappearance of all target lesions. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10 mm short axis). Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD), taking as reference the smallest sum diameters while on study. |
Start of treatment through 2 years after end of treatment (up to 4 years)
|
|
Duration of response (DoR) (Phase Ib acceptable dose participants and Phase II participants) (Phase Ib acceptable dose participants and Phase II participants)
大体时间:Start of treatment through 2 years after end of treatment (up to 4 years)
|
DoR is defined as the time from the confirmation of a CR of PR according to RECIST 1.1 until the first date that recurrent or progressive disease is objectively documented or death from any cause. Complete Response (CR): Disappearance of all target lesions. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10 mm short axis). Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. |
Start of treatment through 2 years after end of treatment (up to 4 years)
|
|
Objective response rate (ORR) (Phase Ib acceptable dose participants and Phase II participants)
大体时间:Start of treatment through completion of treatment or progression (up to 2 years)
|
ORR is defined as the proportion of patients achieving CR or PR measured according to RECIST 1.1. Complete Response (CR): Disappearance of all target lesions. Disappearance of all non-target lesions and normalization of tumor marker level. All lymph nodes must be non-pathological in size (<10 mm short axis). Partial Response (PR): At least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline sum diameters. |
Start of treatment through completion of treatment or progression (up to 2 years)
|
|
Immune-related best overall response (iBOR) (Phase Ib acceptable dose participants and Phase II participants)
大体时间:Start of study treatment to up to 2 years after the end of treatment (up to 4 years)
|
iBOR is defined as the proportion of the best confirmed immune-related response recorded from the start of the study treatment until disease progression, the end of treatment, or death, whichever comes first, according to iRECIST guideline.
|
Start of study treatment to up to 2 years after the end of treatment (up to 4 years)
|
|
Immune-related progression-free survival (iPFS) (Phase Ib acceptable dose participants and Phase II participants)
大体时间:Start of study treatment up to 2 years after treatment is completed (up to 4 years)
|
iPFS is defined as the time from the start date of study treatment to date of confirmed immune-related progressive disease by investigator's assessment or death from any cause, whichever occurs first. Immune unconfirmed progressive disease (iUPD) is defined according to iRECIST guidelines. |
Start of study treatment up to 2 years after treatment is completed (up to 4 years)
|
|
Overall survival (OS) (Phase Ib acceptable dose participants and Phase II participants)
大体时间:Start of study treatment up to 2 years after treatment is completed (total 4 years)
|
OS is defined as the duration of time from the start date of study treatment to death from any cause.
|
Start of study treatment up to 2 years after treatment is completed (total 4 years)
|
合作者和调查者
调查人员
- 首席研究员:Giordano Fabricio Cittolin Santos, MD, PhD、Washington University School of Medicine
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- 202602160
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
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