Stereotactic Body Radiotherapy for the Treatment of OPD

NCT ID: NCT03256981

Last Updated: 2023-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

113 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-27

Study Completion Date

2025-06-30

Brief Summary

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HALT is a phase II, randomised multi-centre study with integrated seamless continuation to phase III trial following acceptable safety and feasibility assessment.

HALT aims to recruit 110 patients with mutation positive advanced NSCLC with oligoprogressive disease (OPD) following initial response to a Tyrosine Kinase Inhibitor (TKI).

Detailed Description

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Eligible patients will be randomised to receive either SBRT or no SBRT at a ratio of 2:1 (SBRT : no SBRT), with all patients continuing to receive background treatment with TKI therapy as clinically indicated and as per standard care. Patients randomised to receive SBRT will receive a dose and fractionation schedule dependent on OPD lesion site and proximity to critical normal tissues. All patients will be seen 8 weeks post randomisation, then 3 monthly in line with routine care.

HALT aims to assess whether in patients with mutation positive advanced NSCLC the use of SBRT to ≤ 3 sites of OPD with continuation of TKI improves progression-free survival (PFS) compared with continuation of TKI alone.

Conditions

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NSCLC

Keywords

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SBRT Oligoprogressive disease NSCLC TKI

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SBRT and continued TKI therapy

Patients will continue to receive background TKI treatment as prior to trial entry.

Simultaneous administration (SBRT \& TKI) or break in TKI during SBRT will be by centre preference and determined prior to commencing recruitment.

Repeat SBRT will be permissible upon development of subsequent OPD lesions dependent on SBRT suitability and total progression lesion number at any one point remaining ≤ 5.

Group Type EXPERIMENTAL

SBRT

Intervention Type RADIATION

SBRT dose and fractionation dependent on site of metastasis and proximity to critical normal tissues.

Continued TKI therapy alone

Continuation on the same background TKI treatment as prior to trial entry

Group Type ACTIVE_COMPARATOR

TKI

Intervention Type DRUG

Continued background TKI alone

Interventions

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SBRT

SBRT dose and fractionation dependent on site of metastasis and proximity to critical normal tissues.

Intervention Type RADIATION

TKI

Continued background TKI alone

Intervention Type DRUG

Other Intervention Names

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Stereotactic body radiotherapy SABR Tyrosine Kinase Inhibitor

Eligibility Criteria

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Inclusion Criteria

1. Male or female, ≥ 16 years of age
2. Established histological diagnosis of advanced NSCLC, not suitable for radical treatment, with defined actionable mutation receiving targeted TKI therapy
3. Clinical and/or radiologically confirmed response to TKI therapy (assessed locally usually 2-3 months post commencing TKI)
4. Confirmed OPD defined as ≤ 5 extracranial sites of progressive disease. All sites must be visible, imaging defined targets and suitable for treatment with SBRT as determined by the virtual multi-disciplinary team (MDT) and in accordance with the HALT Radiotherapy planning and delivery guidance document.
5. Adequate baseline organ function to allow SBRT to all relevant targets
6. Predicted life expectancy ≥ 6 months
7. Karnofsky Index ≥ 60% and ECOG 0-2
8. Provision of written informed consent

Exclusion Criteria

1. \> 5 extracranial sites of progressive disease
2. Progressing or newly diagnosed brain metastases identified at the time of trial entry, not amenable to radical surgery or SRS. Previously treated brain metastases (i.e palliative radiotherapy or systemic therapy) which have remained clinically and radiologically stable for ≥ 6 months are permissible.
3. Prior radiotherapy near the oligoprogressive lesion precluding ablative SBRT. Suitability of lesions for ablative SBRT as part of the trial defined in section 4.1 of this document and will be determined by the HALT virtual MDT
4. Co-morbidities considered clinically precluding the safe use of SBRT (as detailed in the HALT radiotherapy planning and delivery guidelines).
5. Any psychological, sociological or geographical issue potentially hampering compliance with the study
6. Pregnancy
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute of Cancer Research, United Kingdom

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fiona McDonald, MD

Role: PRINCIPAL_INVESTIGATOR

Royal Marsden NHS Foundation Trust

Locations

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Institut Gustave Roussy

Paris, , France

Site Status

Institut Claudius Régaud

Toulouse, , France

Site Status

Policlinico Universitario Campus Bio-Medico

Roma, , Italy

Site Status

Ospedale San Luigi Gonzaga - Universita Di Torino

Torino, , Italy

Site Status

Hospital Clinic Universitari de Barcelona

Barcelona, , Spain

Site Status

Institut Català d'Oncologia

Barcelona, , Spain

Site Status

University Hospital Virgen del Rocio

Seville, , Spain

Site Status

Oncology Institute of Southern Switzerland

Bellinzona, , Switzerland

Site Status

Hopital Cantonal Universitaire De Geneve

Geneva, , Switzerland

Site Status

Kantonsspital St. Gallen

Sankt Gallen, , Switzerland

Site Status

UniversitatsSpital Zurich

Zurich, , Switzerland

Site Status

Royal Marsden Hosital

Sutton, England, United Kingdom

Site Status

Royal Marsden Hospital

Chelsea, London, United Kingdom

Site Status

Royal Surrey County Hospital

Guildford, Surrey, United Kingdom

Site Status

Belfast City Hospital

Belfast, , United Kingdom

Site Status

Bristol Haematology and Oncology Centre

Bristol, , United Kingdom

Site Status

Western General Hospital

Edinburgh, , United Kingdom

Site Status

Beatson West of Scotland Cancer Centre

Glasgow, , United Kingdom

Site Status

Castle Hill Hospital

Hull, , United Kingdom

Site Status

Leicester Royal Infirmary

Leicester, , United Kingdom

Site Status

St Bartholomew's Hospital

London, , United Kingdom

Site Status

University College London Hospital

London, , United Kingdom

Site Status

Guy's Hospital

London, , United Kingdom

Site Status

The Christie Hospital

Manchester, , United Kingdom

Site Status

Clatterbridge Cancer Centre

Metropolitan Borough of Wirral, , United Kingdom

Site Status

Nottingham City Hospital

Nottingham, , United Kingdom

Site Status

Churchill Hospital

Oxford, , United Kingdom

Site Status

Weston Park Hospital

Sheffield, , United Kingdom

Site Status

Southampton University Hospital

Southampton, , United Kingdom

Site Status

Countries

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France Italy Spain Switzerland United Kingdom

References

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Lee J, Koom WS, Byun HK, Yang G, Kim MS, Park EJ, Ahn JB, Beom SH, Kim HS, Shin SJ, Kim K, Chang JS. Metastasis-Directed Radiotherapy for Oligoprogressive or Oligopersistent Metastatic Colorectal Cancer. Clin Colorectal Cancer. 2022 Jun;21(2):e78-e86. doi: 10.1016/j.clcc.2021.10.009. Epub 2021 Nov 18.

Reference Type DERIVED
PMID: 34903471 (View on PubMed)

Other Identifiers

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ICR-CTSU/2016/10061

Identifier Type: -

Identifier Source: org_study_id