Toripalimab as Maintenance Therapy in Patients With Driver-gene Negative Advanced NSCLC After First-line Chemotherapy

NCT04613804 | Unknown Phase 2

• 1 other identifier: SCOG001
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

Lung cancer is the malignant tumor with the highest incidence and mortality in China. Non-small cell lung cancer (NSCLC) ,which includes non-squamous cell carcinoma (including adenocarcinoma, large cell carcinoma, and other cell types) and squamous cell carcinoma, accounts for about 80% of lung cancer. Platinum-based two-drug chemotherapy is the first-line standard treatment for driver-gene negative advanced NSCLC, but most patients experience disease progression after 4 to 6 months. To extend the efficacy of first-line treatment, maintenance therapy is a logical clinical option for patients who are effective after 4 to 6 cycles of standard treatment. There is currently no standard regimen for maintenance treatment of NSCLC. We evaluated the effectiveness and safety of maintenance therapy with the anti-PD-1 monoclonal antibody (Toripalimab injection) followed by the first-line standard regimen in advanced NSCLC patients who are effective after standard treatment. With a view to exploring treatment methods that are effective for the maintenance treatment of driver-gene negative advanced NSCLC and have little toxic and side effects,thereby improving the survival prognosis of these patients.

Conditions

NSCLC Stage IV

Keywords

driver-gene negative advanced NSCLC; maintenance treatment

Outcome Measures

Primary Outcomes (1)

• Progression-free survival (PFS)

  PFS by investigator-reported measurements according to CT image. PFS was calculated from date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months.PD was defined as Overall Response by RECIST criteria v1.1 according to CT image.

  up to 12 months

Secondary Outcomes (4)

• Overall survival time

  Up to 36 months

• Objective response rate

  up to 12 months

• Disease control rate

  up to 12 months

• Adverse events rate

  up to 12 months

Other Outcomes (1)

• Changes in immune environment

  up to 12 months

Study Arms (1)

Toripalimab group

EXPERIMENTAL

Toripalimab 240mg ivgtt Q21d

Drug: Toripalimab Injection

Interventions

Toripalimab Injection DRUG

Qualified subjects will be treated with "toripalimab 240mg q21d" as a treatment cycle.

Also known as: PD-1 inhibitor

Toripalimab group

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Fully understand the research and voluntarily sign the informed consent form (ICF)
• Age 18 to 75 years
• Histological or cytological documentation of non-small cell lung cance.
• Diagnosed as stage IV by imaging (staging according to AJCC eighth edition).
• Gene test is negative for EGFR, ALK, ROS1 confirmed by molecular pathology (tissue, ARMS method or NGS).
• Previously received first-line standard chemotherapy for non-small cell lung cancer (platinum combined with third-generation chemotherapy drugs in a two-drug combination regimen: pemetrexed or paclitaxel or docetaxel or gemcitabine or vinorelbine combined with cisplatin or carboplatin), and which were assessed the effectiveness by imaging(SD, PR or CR).
• At least one measurable lesion according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria measured within 4 weeks prior to registration.
• ECOG performance status 0-1
• Expected overall survival time≥3 months
• Adequate bone marrow, Coagulation function，hepatic and renal function should be assessed by the following laboratory requirements conducted within 7 days before starting study treatment:
• Leukocytes ≥ 3.0 x109/ L, absolute neutrophil count (ANC) ≥ 1.5 x109/ L, platelet count ≥ 100 x109/ L, hemoglobin (Hb) ≥9g/ dL.
• Total bilirubin ≤ 1.5 x the upper limit of normal (ULN).
• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 x ULN.
• Serum creatinine ≤ 1.5 x the ULN.
• Calculated creatinine clearance or 24 hour creatinine clearance ≥ 40 mL/ min.

You may not qualify if:

• Tumor histology or cytology pathology confirmed with small cell lung cancer components or sarcomatoid lesions.
• Previously received any T-cell co-stimulation or immune checkpoint therapy, including but not limited to CTLA-4 inhibitors, PD-1 inhibitors, PD-L1 / 2 inhibitors or other drugs that target T cells.
• Major autoimmune diseases.
• Subjects who were vaccinated or planned to be vaccinated within 4 weeks before the first time using the study drug.
• LD, drug-induced pneumonia, radiation pneumonitis requiring steroid therapy, or clinically active pneumonia or severe pulmonary dysfunction.
• TB or subjects with a history of active tuberculosis infection ≤ 48 weeks before screening, whether or not treated.
• Symptomatic cardiac disease, such as: heart failure above NYHA level 2, unstable angina pectoris, myocardial infarction occurred within 24 weeks, clinically significant supraventricular or ventricular arrhythmias require treatment or intervention.
• Acquired immunosuppression (AIDS or major immunosuppressive agents)
• Suffering from active viral hepatitis. Defined as: Hepatitis B virus (HBV) infection and HBV DNA ≥ 2500 copies / ml; or Hepatitis C virus (HCV) infection (quantitative test results of anti-HCV positive and HCV RNA are greater than the lower limit of detection) .
• Mental illness, alcohol, drug or substance abuse
• Pregnant or lactating women.

Sponsors & Collaborators

• Fujian Cancer Hospital: lead

Study Sites (1)

Fujian cancer hospital

Fuzhou, Fujian, China

Location

MeSH Terms

Conditions

Carcinoma, Non-Small-Cell Lung

Interventions

toripalimab; Immune Checkpoint Inhibitors

Condition Hierarchy (Ancestors)

Carcinoma, Bronchogenic; Bronchial Neoplasms; Lung Neoplasms; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases

Intervention Hierarchy (Ancestors)

Molecular Mechanisms of Pharmacological Action; Pharmacologic Actions; Chemical Actions and Uses; Antineoplastic Agents, Immunological; Antineoplastic Agents; Therapeutic Uses

Study Officials

• Zhiyong He, master

  Fujian Cancer Hospital

  STUDY CHAIR

Central Study Contacts

Zhiyong He, master

CONTACT

13805086391; heyong1015@163.com

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Model Details: This study is a single-center, single-arm Phase II study. Qualified subjects will be treated with toripalimab every three weeks as a treatment cycle. After every two cycles, they will be evaluated the efficacy of tumor treatment by imaging and the safety of treatment.

Study Record Dates

• First Submitted: September 5, 2020
• First Posted: November 3, 2020
• Study Start: December 1, 2020
• Primary Completion: November 30, 2022
• Study Completion: November 30, 2023
• Last Updated: November 3, 2020

Record last verified: 2020-09

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)