Minimal Residual Disease Guiding Adjuvant Therapy in Stage I NSCLC

NCT ID: NCT06709274

Last Updated: 2024-11-29

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

342 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-30

Study Completion Date

2032-01-31

Brief Summary

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This investigator-initiated study aims to evaluate the effectiveness of minimal residual disease (MRD) as a biomarker for guiding adjuvant therapy decisions in patients with Stage I non-small-cell lung cancer (NSCLC). The study will compare outcomes between an MRD-guided management group and a standard-of-care group, focusing on whether the use of MRD information can improve the 3-year disease-free survival rate compared to existing treatment protocols. Participants in the MRD-guided management group will receive targeted therapy, immunotherapy, or observation based on their postoperative MRD status, while those in the standard-of-care group will receive treatments or observation according to current clinical guidelines.

Detailed Description

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Conditions

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Non-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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MRD-guided management

Patients who are MRD-positive after surgery in the MRD-guided management group receive adjuvant therapy. Patients who are MRD-negative in the MRD-guided management group are monitored through observation.

Group Type EXPERIMENTAL

Osimertinib

Intervention Type DRUG

80mg daily, for EGFR-positive patients

Alectinib

Intervention Type DRUG

600mg BID, for ALK-rearranged patients

TORIPALIMAB INJECTION (JS001 ) combine with chemotherapy

Intervention Type DRUG

Toripalimab 240mg + Platinum-based chemotherapy (Q3W for 4 cycles), followed by Toripalimab maintenance therapy (240mg Q3W for one year), for EGFR/ALK wildtype patients

Standard of care

Adjuvant therapy is not recommended. However, if the physician and patient decide on adjuvant therapy, the treatment regimen and cycle must be documented. Researchers are strongly advised to follow the medication guidelines laid out in the Chinese Society of Clinical Oncology (CSCO) Clinical Practice Guidelines.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Osimertinib

80mg daily, for EGFR-positive patients

Intervention Type DRUG

Alectinib

600mg BID, for ALK-rearranged patients

Intervention Type DRUG

TORIPALIMAB INJECTION (JS001 ) combine with chemotherapy

Toripalimab 240mg + Platinum-based chemotherapy (Q3W for 4 cycles), followed by Toripalimab maintenance therapy (240mg Q3W for one year), for EGFR/ALK wildtype patients

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Non-small cell lung cancer (NSCLC) confirmed by histological and/or cytological examination. Invasive subtypes are required for adenocarcinomas.
2. Stage IA or IB after surgery based on pathological TNM8 staging criteria established by the International Union Against Cancer/American Joint Committee on Cancer (8th Edition).
3. Completely surgical resection (R0) of the primary NSCLC via lobectomy, segmentectomy, or sleeve lobectomy. The gross tumor must be entirely removed, and all surgical margins of the excised tumor must be negative.
4. Complete recovery from surgery with no evidence of disease progression within 2 weeks prior to the first treatment decision.
5. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1.
6. Minimum life expectancy of ≥12 weeks.
7. Demonstrate adequate organ function, including:

Hematological parameters:
* Absolute neutrophil count ≥1.5×10\^9/L
* Platelet count ≥100×10\^9/L
* Hemoglobin ≥90 g/L

Liver function:
* ALT ≤2.5× upper limit of normal (ULN)
* AST ≤2.5×ULN
* Total Bilirubin (TBL) ≤1.5×ULN Renal function: Creatinine level ≤1.25×ULN, or creatinine clearance ≥60 mL/min (measured or calculated using the Cockcroft-Gault formula).
8. Male or female, age between 18 and 75 years.
9. Written informed consent must be obtained from the subject or their legal representative.
10. Participants regardless of sex must agree to use effective contraception during the study period and for 3 months following treatment completion.
11. Willingness and ability to comply with visit schedules, treatment plans, and laboratory assessments.

Exclusion Criteria

1. Histopathologically confirmed small cell carcinoma components.
2. Presence of multiple pulmonary nodules.
3. Incomplete resections (R1/R2) or resections via bilateral lobectomy, pneumonectomy, or wedge resection.
4. A history of any systemic anti-tumor treatment, including but not limited to surgery, neoadjuvant chemotherapy, radiotherapy, targeted therapy, or immunotherapy.
5. Significant allergies to any targeted drugs, immunotherapies, or chemotherapy agents used in the study.
6. Previous use of any traditional Chinese medicine with anti-tumor properties, or use of such medicine within 2 weeks prior to surgery.
7. History of other malignancies within the past 5 years, with the exception of the following:

* Other malignancies fully cured by surgery with a disease-free survival of more than 10 years
* Curable basal cell carcinoma of the skin
* Bladder carcinoma in situ
* Cervical carcinoma in situ
8. History of interstitial lung disease, drug-induced interstitial lung disease, radiation-induced pneumonia requiring steroid treatment, or any evidence of clinically active interstitial lung disease.
9. Active hepatitis B, defined as HBsAg positive with an HBV-DNA copy number exceeding the ULN established by the study center, accompanied by abnormal liver function, or requiring treatment as evaluated by the investigator.
10. Presence of any unstable systemic disease, including but not limited to active infection, uncontrolled hypertension, unstable angina, congestive heart failure, myocardial infarction within the past 3 months, serious arrhythmias that requires medication, liver disease, kidney disease, or metabolic disorders.
11. Evidence of any other diseases, neurological or metabolic disorders, or physical exam or laboratory findings that may suggest contraindications for the investigational drug, or a high risk for treatment-related complications.
12. Any of the following cardiac conditions:

* Resting ECG QT interval (QTc) \> 470 msec.
* Significant abnormalities in rhythm, conduction, or morphology on resting ECG, including complete left bundle branch block, third-degree atrioventricular block, or second-degree atrioventricular block
* Factors increasing the risk of QTc prolongation or arrhythmic events, such as heart failure, hypokalemia, congenital long QT syndrome, family history of long QT syndrome, unexplained sudden death in a first-degree relative under the age of 40, or use of medications known to prolong QT interval.
13. Blood transfusion within 2 weeks prior to and during the surgery.
14. History of alcohol or drug abuse.
15. Pregnant or breastfeeding females.
16. Any other factors that the investigator deems may affect the progress of the study or compromise the trial data
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nanjing Geneseeq Technology Inc.

INDUSTRY

Sponsor Role collaborator

Guangdong Association of Clinical Trials

OTHER

Sponsor Role lead

Responsible Party

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Xue-Ning Yang

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yi-Long Wu, M.D.

Role: PRINCIPAL_INVESTIGATOR

Guangdong Provincial People's Hospital

Xue-Ning Yang, M.D.

Role: PRINCIPAL_INVESTIGATOR

Guangdong Provincial People's Hospital

Locations

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Dongguan People's Hospital

Dongguan, Guangdong, China

Site Status

The First People's Hospital of Foshan

Foshan, Guangdong, China

Site Status

Guangdong Provincial People's Hostpital

Guangzhou, Guangdong, China

Site Status

ZhuJiang Hospital of Southern Medical University

Guangzhou, Guangdong, China

Site Status

Peking University Shenzhen Hospital

Shenzhen, Guangdong, China

Site Status

Shenzhen People's Hospital

Shenzhen, Guangdong, China

Site Status

The Second Affiliated Hospital of Guangxi Medical University

Nanning, Guangxi, China

Site Status

Guizhou Provincial People's Hospital

Guiyang, Guizhou, China

Site Status

Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science & Technology

Wuhan, Hubei, China

Site Status

Hunan Cancer Hospital

Changsha, Hunan, China

Site Status

Xiangya Hospital of Central South University

Changsha, Hunan, China

Site Status

Jiangsu Cancer Hospital

Nanjing, Jiangsu, China

Site Status

Affiliated Hospital of Nantong University

Nantong, Jiangsu, China

Site Status

Sichuan Provincial People's Hospital

Chengdu, Sichuan, China

Site Status

The Third People's Hospital of Chengdu

Chengdu, Sichuan, China

Site Status

Countries

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China

Central Contacts

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Xue-Ning Yang, M.D.

Role: CONTACT

020-83827812

Facility Contacts

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Jianping Zhou, MD

Role: primary

+8613332673999

Weiquan Gu, MD

Role: primary

+8618038865071

Xuening Yang, MD

Role: primary

+8620-83827812

Guibin Qiao, MD

Role: primary

+8613602749153

Xiaoqiang Li, MD

Role: primary

+8613480978588

Lin Yang, MD

Role: primary

+8613798314779

Lei Xian, MD

Role: primary

+8613977182059

Chuan Xu, MD

Role: primary

+8613985520269

Ni Zhang, MD

Role: primary

+8613871288490

Wenxiang Wang, MD

Role: primary

+8613808454225

Yang Gao, MD

Role: primary

+8613973171096

Rong Yin, MD

Role: primary

+8618305185629

Jianle Chen, MD

Role: primary

+8615950806806

Gang Feng, MD

Role: primary

+8618981838656

Yi Yang, MD

Role: primary

+8613980013944

Other Identifiers

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CTONG2301

Identifier Type: -

Identifier Source: org_study_id