Chemo-immunotherapy Plus Thoracic Radiotherapy in Extensive Stage Small-cell Lung Cancer

NCT ID: NCT05223647

Last Updated: 2025-06-06

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

PHASE3

Total Enrollment

302 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-11

Study Completion Date

2029-10-31

Brief Summary

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Studies have shown that combining chemotherapy and immune checkpoint inhibitors (ICI) prolongs survival compared with chemotherapy alone in extensive stage small-cell lung cancer (ES SCLC), but the survival benefit is modest. The main aim of this trial is to investigate whether there is a synergistic/additive effect of concurrent thoracic radiotherapy in ES SCLC patients receiving carboplatin/etoposide/durvalumab.

Detailed Description

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Studies show that adding ICI therapy to standard chemotherapy prolongs survival in ES SCLC. The survival benefit, however, is modest, and there is a need for more effective therapy. It has been hypothesized that there is a synergistic effect of combining ICI with radiotherapy. In this randomized phase III study, the main aim is to investigate whether concurrent thoracic radiotherapy of 30 Gy/10 fractions improves survival in ES SCLC patients receiving carboplatin/etoposide/durvalumab.

It is currently not possible to classify the patients who benefit from ICIs in SCLC. In this study, biological material (tissue, blood, feces) which will be analyzed for potential predictive and prognostic biomarkers.

Prophylactic cranial irradiation in ES SCLC is debated, mainly due to the potentially detrimental effect on cognition. Thus, frequency and timing of brain metastases and cognitive function will be assessed before, during and after study treatment.

Conditions

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Small-cell Lung Cancer

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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Chemo-immunotherapy plus thoracic radiotherapy

Four courses of carboplatin/etoposide/durvalumab every 3 weeks followed by durvalumab every 4 weeks until intolerable toxicity, progressive disease leading to a need for other treatment, or until the patient no longer wishes to continue treatment.

Thoracic radiotherapy of 30 Gy/10 fractions between 2nd and 3rd carboplatin/etoposide/durvalumab course.

Group Type EXPERIMENTAL

Thoracic radiotherapy

Intervention Type PROCEDURE

30Gy/10 fractions thoracic radiotherapy given between 2nd and 3rd course of chemo-immunotherapy.

Chemo-immunotherapy

Intervention Type DRUG

Four courses of carboplatin/etoposide/durvalumab every 3 weeks followed by durvalumab every 4 weeks until intolerable toxicity, progressive disease leading to a need for other treatment, or until the patient no longer wishes to continue treatment.

Chemo-immunotherapy

Four courses of carboplatin/etoposide/durvalumab every 3 weeks followed by durvalumab every 4 weeks until intolerable toxicity, progressive disease leading to a need for other treatment, or until the patient no longer wishes to continue treatment.

Group Type ACTIVE_COMPARATOR

Chemo-immunotherapy

Intervention Type DRUG

Four courses of carboplatin/etoposide/durvalumab every 3 weeks followed by durvalumab every 4 weeks until intolerable toxicity, progressive disease leading to a need for other treatment, or until the patient no longer wishes to continue treatment.

Interventions

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Thoracic radiotherapy

30Gy/10 fractions thoracic radiotherapy given between 2nd and 3rd course of chemo-immunotherapy.

Intervention Type PROCEDURE

Chemo-immunotherapy

Four courses of carboplatin/etoposide/durvalumab every 3 weeks followed by durvalumab every 4 weeks until intolerable toxicity, progressive disease leading to a need for other treatment, or until the patient no longer wishes to continue treatment.

Intervention Type DRUG

Other Intervention Names

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carboplatin/etoposide/durvalumab

Eligibility Criteria

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Inclusion Criteria

1. Age \> 18 years at time of study entry
2. ECOG performance status of 0 or 1
3. Body weight \>30 kg
4. Adequate bone marrow, liver and kidney function
5. Life expectancy of at least 3 months
6. At least one measurable (RECIST 1.1), thoracic lesion that can be irradiated with 30 Gy/10 fractions
7. Histologically or cytologically confirmed SCLC
8. Stage III-IV disease (TNM v8)
9. FEV1 \>1 L or \>30 % of predicted value and DLCO \>30 % of predicted value
10. Patients with brain metastases are eligible provided they are asymptomatic or treated and stable on steroids and/or anticonvulsants prior to the start of treatment

Exclusion Criteria

1. Previous chemo-, immuno- or radiotherapy for SCLC
2. Major surgical procedure last 28 days
3. History of allogenic organ transplantation, autoimmune disease, immunodeficiency, hepatitis or HIV
4. Uncontrolled intercurrent illness
5. Other active malignancy
6. Leptomeningeal carcinomatosis
7. Immunosuppressive medication
8. Pregnant or breastfeeding women
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Olavs Hospital

OTHER

Sponsor Role collaborator

Haukeland University Hospital

OTHER

Sponsor Role collaborator

University Hospital of North Norway

OTHER

Sponsor Role collaborator

Alesund Hospital

OTHER

Sponsor Role collaborator

Helse Stavanger HF

OTHER_GOV

Sponsor Role collaborator

Oslo University Hospital

OTHER

Sponsor Role collaborator

Helse Nord-Trøndelag HF

OTHER

Sponsor Role collaborator

Helse Fonna

OTHER

Sponsor Role collaborator

Drammen sykehus

OTHER

Sponsor Role collaborator

University Hospital, Akershus

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role collaborator

Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Karolinska University Hospital

OTHER

Sponsor Role collaborator

Gävle Hospital

OTHER

Sponsor Role collaborator

Sykehuset Innlandet HF

OTHER

Sponsor Role collaborator

North Estonia Medical Centre

OTHER

Sponsor Role collaborator

Nordlandssykehuset HF

OTHER

Sponsor Role collaborator

Landspitali University Hospital

OTHER

Sponsor Role collaborator

Lund University Hospital

OTHER

Sponsor Role collaborator

University Hospital, Linkoeping

OTHER

Sponsor Role collaborator

Norwegian University of Science and Technology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Magnus Steigedal, PhD

Role: STUDY_DIRECTOR

Department of Clinical and Molecular Medicine, NTNU

Locations

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North Estonia Medical Centre

Tallinn, , Estonia

Site Status RECRUITING

Landspitali University Hospital

Reykjavik, , Iceland

Site Status RECRUITING

Erasmus MC

Rotterdam, , Netherlands

Site Status RECRUITING

Ålesund Hospital

Ålesund, , Norway

Site Status RECRUITING

Haukeland Universitetssykehus

Bergen, , Norway

Site Status RECRUITING

Nordlandssykehuset HF

Bodø, , Norway

Site Status RECRUITING

Drammen sykehus - Vestre Viken

Drammen, , Norway

Site Status RECRUITING

Innlandet hospital Gjøvik

Gjøvik, , Norway

Site Status RECRUITING

Haugesund hospital

Haugesund, , Norway

Site Status RECRUITING

Sykehuset Levanger

Levanger, , Norway

Site Status RECRUITING

Akershus Universitetssykehus AHUS

Oslo, , Norway

Site Status RECRUITING

Oslo University Hospital Ullevål

Oslo, , Norway

Site Status RECRUITING

Stavanger University Hospital

Stavanger, , Norway

Site Status RECRUITING

University Hospital of North Norway, Pulmonology Department

Tromsø, , Norway

Site Status RECRUITING

Cancer Clinic at St. Olavs Hospital

Trondheim, , Norway

Site Status RECRUITING

Gävle hospital

Gävle, , Sweden

Site Status RECRUITING

Sahlgrenska Sjukehuset

Gothenburg, , Sweden

Site Status RECRUITING

Linköping University Hospital

Linköping, , Sweden

Site Status RECRUITING

Lund University Hospital

Skåne, , Sweden

Site Status RECRUITING

Karolinska University Hospital

Stockholm, , Sweden

Site Status RECRUITING

Countries

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Estonia Iceland Netherlands Norway Sweden

Central Contacts

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Bjørn H Grønberg, MD, PhD

Role: CONTACT

47297878 ext. +47

Trude C Frøseth, MSc

Role: CONTACT

Facility Contacts

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Kersti Oselin

Role: primary

Örvar Gunnarsson

Role: primary

Joachim Aerts

Role: primary

Øyvind Yksnøy

Role: primary

Marianne Aanerud

Role: primary

Luka Stanisavljevic, MD

Role: primary

Odd Terje Brustugun

Role: primary

Daniel Heinrich

Role: primary

Sverre Fluge

Role: primary

Hanne Sorger

Role: primary

Kirill Neumann

Role: primary

Maria Moksnes Bjaanes

Role: primary

Madebo Tesfaye

Role: primary

Nina Helbekkmo

Role: primary

Bjørn H Grønberg

Role: primary

Johan Isaksson

Role: primary

Jan Nyman

Role: primary

Anders Vikström

Role: primary

Emelie Gezelius

Role: primary

Georgios Tsakonas

Role: primary

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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2020203

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

EC#230766

Identifier Type: -

Identifier Source: org_study_id

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