Addition of Radiotherapy to Standard Medical Treatment for Stage IV NSCLC

NCT ID: NCT04530708

Last Updated: 2020-08-28

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

RECRUITING

Clinical Phase

NA

Total Enrollment

162 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-01

Study Completion Date

2026-02-01

Brief Summary

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The hypothesis for this study is that addition of a moderate dose of radiotherapy to the primary tumor and mediastinal nodes after three months of medical treatment could reduce the tumor burden, partly as an abscopal effect, and thereby improving quality of life and possible also prolonging survival for stage IV NSCLC.

Detailed Description

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Primary objective: To assess whether the addition of radiotherapy to the remaining thoracic tumor burden following standard medical treatment results in a superior quality of life measured with lung cancer symptom scale (LCSS) in patients with stage IV non-small cell lung cancer. The comparison will be made at three months after randomization.

Secondary objectives: Overall survival, progression-free survival, toxicity and longitudinal quality of life measurements.

Design: Multicentre, randomized, phase III trial. Patients will be registered for the study up-front but randomization will be performed after evaluation of response, three months after initiating medical treatment with chemotherapy/ chemo-immunotherapy or immunotherapy. Randomization will be to thoracic radiotherapy or follow-up (1:1).

Conditions

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Radiotherapy Non Small Cell Lung Cancer Stage IV Non-small Cell Lung Cancer Quality of Life

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Multicentre randomized phase 3 trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A: Standard of care

Normal standard of care and follow-up.

Group Type NO_INTERVENTION

No interventions assigned to this group

B: Thoracic radiotherapy

Addition of thoracic radiotherapy to 36 Gy after medical treatment.

Group Type EXPERIMENTAL

Thoracic radiotherapy

Intervention Type RADIATION

36 Gy to the primary lung tumor and present mediastinal node metastases after three months of medical treatment.

Interventions

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Thoracic radiotherapy

36 Gy to the primary lung tumor and present mediastinal node metastases after three months of medical treatment.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Histological or cytological confirmed non-small cell lung cancer (NSCLC)
* Stage IV disease
* Previously untreated disease (before first line treatment)
* No symptomatic brain metastases
* Performance status (WHO) 0-2
* FEV1 (forced expiratory volume one second) ≥ 1 L or \>40% of predicted
* Written informed consent
* Life expectancy ≥ 12 weeks
* Platelet count ≥ 100,00/mm3
* Hemoglobin ≥ 10 g/dl
* WBC (White blod cells) ≥ 3,000/mm3
* Kidney function allowing chemotherapy
* Patients scheduled for standard platinum based chemotherapy, chemo-immunotherapy or immunotherapy
* Willing and able to comply with study treatment

Exclusion Criteria

* Requirement for daily supplemental oxygen
* Second primary malignancy within 3 years, except for any of the following which can be included even if diagnosed within the past 3 years: Carcinoma in situ of the cervix, nonmelanoma skin cancer, history of low-grade (Gleason score ≤ 6) localized prostate cancer, definitely treated stage I breast cancer, other malignancy that was diagnosed and definitely treated ≥ 3 years ago with no subsequent evidence of recurrence
* Concurrent severe and/or uncontrolled medical condition, including any of the following:
* Angina pectoris
* Congestive heart failure within the past 3 months, unless LVEF (left ventricular ejection fraction) \> 40%
* Myocardial infarction within the past 6 months
* Clinically significant infection
* Psychiatric illness or social situation that would limit compliance with study requirements
* EGFR (epidermal growth factor receptor) mutation or ALK (anaplastic lymphoma kinas) - rearrangement detected
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Swedish Lung Cancer Study Group

NETWORK

Sponsor Role lead

Responsible Party

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Ass. Prof. Jan Nyman

Head of Swedish Lung Cancer Study Group, Ass. Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jan Nyman, Ass.prof

Role: PRINCIPAL_INVESTIGATOR

Sahlgrenska University Hospital

Thomas Björk-Eriksson, Prof.

Role: STUDY_DIRECTOR

Regionalt Cancercentrum Väst

Locations

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Department of Oncology, Norrlands Universitetssjukhus

Umeå, Norrland, Sweden

Site Status RECRUITING

Department of Oncology, Karolinska University Hospital

Stockholm, Stockholm County, Sweden

Site Status NOT_YET_RECRUITING

Department of Oncology, Sahlgrenska University Hospital

Gothenburg, Västra Götaland County, Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Jan Nyman, Ass.prof.

Role: CONTACT

0046313421000 ext. 27927

Andreas Hallqvist, MD, PhD

Role: CONTACT

0046739845114

Facility Contacts

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Mikael Johansson, MD PhD

Role: primary

0046703711414

Signe Friesland, MD PhD

Role: primary

Gunnar Wagenius, MD PhD

Role: backup

Jan Nyman, Ass prof

Role: primary

0046313427927

Bengt Bergman, Ass.prof.

Role: backup

0046706187880

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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MARS

Identifier Type: -

Identifier Source: org_study_id

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