Predictive Biomarkers for Pneumonitis After Chemoradiotherapy and Immunotherapy in Patients With Non-small Cell Lung Cancer

NCT ID: NCT04913311

Last Updated: 2025-08-14

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

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-01-21

Study Completion Date

2027-02-02

Brief Summary

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This study looks at the side effects of chemotherapy and radiation (chemoradiation) followed by immunotherapy in patients with non-small cell lung cancer, with a particular focus on lung inflammation (pneumonitis). By collecting blood, stool and saliva samples, and data from lung function tests, researchers may be able to create a database of information about treatment and side effects in patients with non-small cell lung cancer who are receiving chemoradiation followed by immunotherapy. The information gained from this study may also help researchers find signs of problems with lung function earlier rather than later, since lung function is checked more often than routine care. This may improve how quickly these issues can be treated, and future patients may benefit from what is learned.

Detailed Description

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PRIMARY OBJECTIVE:

I. To assess the association between the incidence of concurrent chemoradiation and subsequent immunotherapy-related adverse events, particularly radiation and immune-related pneumonitis, in patients with non-small cell lung cancer (NSCLC), and various clinicopathologic, radiologic, tumor, and demographic covariates of interest.

SECONDARY OBJECTIVES:

I. To correlate clinicopathologic, radiologic data and tumor characteristics with systemic longitudinal assessments of blood biomarkers for toxicity and response to therapy.

II. To monitor home spirometry and symptoms to identify early pneumonitis. III. To collect blood and microbiome samples from patients on immunotherapy and biopsy samples from toxicity sites at the time of toxicity to evaluate predictive markers for therapy related adverse events.

IV. To determine the effect of concurrent chemotherapy followed by immunotherapy on sleep quality.

V. To determine the impact of sleep disturbance on gut and oral dysbiosis. VI. To characterize longitudinal changes in fatigue and financial toxicity with concurrent chemotherapy followed by immunotherapy.

OUTLINE:

Patients undergo collection of blood, stool and saliva samples at baseline. Patients receive standard of care treatment consisting of concurrent chemoradiation from baseline up to week 62 and immune checkpoint inhibitors from week 10-62. Patients also undergo the collection of blood, stool, saliva and samples at week 10. During the course of treatment, patients also complete routine tests and procedures to monitor for side effects per standard of care including computed tomography (CT) within 4 weeks, lung function tests including home spirometry three times a week (TIW) from week 10-62, bronchoscopy and/or a nasal wash to check for viral infection. Patients also complete questionnaires about symptoms and quality of life once a week (QW) for weeks 1-9, twice a week (BIW) during weeks 5-54, and once a month until week 62.

Conditions

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Lung Non-Small Cell Carcinoma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Observational (biospecimen collection, standard treatment)

Patients undergo collection of blood, stool and saliva samples at baseline. Patients will also have a 6 minute walk and standard of care pulmonary function test at baseline. Patients receive standard of care treatment consisting of concurrent chemoradiation from baseline up to week 10 and immune checkpoint inhibitors from week 10-62. Patients also undergo the collection of blood, stool, saliva and No BAL sample is collected at week 10. During the course of treatment, patients also complete routine tests and procedures to monitor for side effects per standard of care including CT within 4 weeks, lung function tests including home spirometry TIW from week 10-62, bronchoscopy and/or a nasal wash to check for viral infection. Patients also complete questionnaires about symptoms and quality of life QW for weeks 1-10, BIW during weeks 10-62.

Biospecimen Collection

Intervention Type PROCEDURE

Undergo collection of blood, saliva, stool, and bronchoalveolar lavage samples

Bronchoscopy with Bronchoalveolar Lavage

Intervention Type PROCEDURE

Undergo bronchoscopy with BAL

Chemoradiotherapy

Intervention Type OTHER

Undergo concurrent chemoradiation per standard of care

Computed Tomography

Intervention Type PROCEDURE

Undergo computed tomography scan

Diagnostic Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Immune Checkpoint Inhibitor

Intervention Type DRUG

Receive CPI per standard of care

Nasal Wash and Collection

Intervention Type PROCEDURE

Undergo nasal wash

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Spirometry

Intervention Type PROCEDURE

Under lung spirometry tests

Interventions

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Biospecimen Collection

Undergo collection of blood, saliva, stool, and bronchoalveolar lavage samples

Intervention Type PROCEDURE

Bronchoscopy with Bronchoalveolar Lavage

Undergo bronchoscopy with BAL

Intervention Type PROCEDURE

Chemoradiotherapy

Undergo concurrent chemoradiation per standard of care

Intervention Type OTHER

Computed Tomography

Undergo computed tomography scan

Intervention Type PROCEDURE

Diagnostic Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Immune Checkpoint Inhibitor

Receive CPI per standard of care

Intervention Type DRUG

Nasal Wash and Collection

Undergo nasal wash

Intervention Type PROCEDURE

Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Spirometry

Under lung spirometry tests

Intervention Type PROCEDURE

Other Intervention Names

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bronchial washing Bronchoscopy/Lavage Chemoradiation CRT CRTx Radiochemotherapy RCTx RT-CT CAT CAT Scan Computerized Axial Tomography Computerized Tomography CT CT Scan tomography Nasal Lavage Nasal Wash Nasopharyngeal Lavage Nasopharyngeal Wash Quality of Life Assessment

Eligibility Criteria

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Inclusion Criteria

* Newly-diagnosed NSCLC patients who will be undergoing concurrent chemotherapy and radiotherapy (XRT) followed by immune checkpoint inhibitors (CPI) therapy with durvalumab, as per the PACIFIC trial
* Willing to undergo all treatment and evaluation at MD Anderson Cancer Center (MDACC)
* Has access to a smartphone with the ability to transmit data via wireless connection or through their personal cellular plan
* Able and willing to perform home spirometry (HS) weekly without absolute contraindications to performing spirometry
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ajay Sheshadri

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

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M D Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Ajay Sheshadri, MD

Role: primary

713-792-6238

Related Links

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http://www.mdanderson.org

MD Anderson Cancer Center

Other Identifiers

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NCI-2021-01136

Identifier Type: REGISTRY

Identifier Source: secondary_id

2020-0889

Identifier Type: OTHER

Identifier Source: secondary_id

2020-0889

Identifier Type: -

Identifier Source: org_study_id

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