NCT05671887

Brief Summary

This is a prospective observational registration trial for patients who undergo lung transplantation for the treatment of the select groups of medically refractory cancers affecting the lungs alone without extrapulmonary nodal and distant metastasis.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
125

participants targeted

Target at P50-P75 for all trials

Timeline
79mo left

Started Nov 2022

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress35%
Nov 2022Nov 2032

Study Start

First participant enrolled

November 16, 2022

Completed
1 month until next milestone

First Submitted

Initial submission to the registry

December 19, 2022

Completed
17 days until next milestone

First Posted

Study publicly available on registry

January 5, 2023

Completed
9.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2032

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2032

Last Updated

November 14, 2024

Status Verified

November 1, 2024

Enrollment Period

10 years

First QC Date

December 19, 2022

Last Update Submit

November 12, 2024

Conditions

Keywords

CancerLung CancerBilateral CancerLung TransplantDouble Lung TransplantBronchioloalveolar Carcinoma (BAC)LepidicMucinous

Outcome Measures

Primary Outcomes (8)

  • overall survival (OS) rate

    30-day

  • overall survival (OS) rate

    90-day

  • disease-free survival (DFS) rate

    30-day

  • disease-free survival (DFS) rate

    90-day

  • allograft rejection (AR) rate

    30-day

  • allograft rejection (AR) rate

    90-day

  • allograft survival (AS) rate

    30-day

  • allograft survival (AS) rate

    90-day

Secondary Outcomes (5)

  • overall survival (OS) rate

    6-month, 1-year, 3-year, and 5-year

  • disease-free survival (DFS) rate

    6-month, 1-year, 3-year, and 5-year

  • allograft rejection (AR) rate

    6-month, 1-year, 3-year, and 5-year

  • allograft survival (AS) rate

    6-month, 1-year, 3-year, and 5-year

  • Major post-transplantation morbidity (MPTM)

    6-month, 1-year, 3-year, and 5-year

Study Arms (3)

Cohort A: Primary lung cancers

\- Examples include invasive mucinous/non-mucinous non-small cell lung cancers and multifocal carcinomas

Procedure: Double Lung Transplantation

Cohort B: Metastatic cancers to the lung only

\- Examples include germ cell tumors, head \& neck tumors, colorectal tumors, renal cell tumors

Procedure: Double Lung Transplantation

Cohort C: Respiratory failure with a history of cancer in the last 5 years

\- Examples include, but not limited to interstitial lung disease (ILD), pulmonary fibrosis (idiopathic or secondary), advanced chronic obstructive pulmonary disease (COPD), bronchiectasis, emphysema, cystic fibrosis (CF), emphysema due to alpha-1 antitrypsin deficiency, and pulmonary arterial hypertension (PAH)

Procedure: Double Lung Transplantation

Interventions

To evaluate outcomes among patients who undergo lung transplantation for treatment of a select group of medically refractory cancers affecting the lungs alone without extrapulmonary nodal and distant metastasis.

Also known as: Lung Transplantation
Cohort A: Primary lung cancersCohort B: Metastatic cancers to the lung onlyCohort C: Respiratory failure with a history of cancer in the last 5 years

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

This is a prospective observational registration trial for patients who undergo lung transplantation using cadaveric organs for medically refractory cancers affecting the lungs alone and without extrapulmonary metastasis after meeting the inclusion criteria of the clinical program at Northwestern Medicine and participating centers. Essential Clinical Criteria: 1. The tumor should be without any extrapulmonary metastasis as determined by standard of care diagnostic and staging workup. 2. All standard of care or experimental oncological treatments known to improve survival should have failed or deemed infeasible 3. Patients should meet the general criteria for lung transplant evaluation and listing

You may qualify if:

  • Any patient who is undergoing double lung transplantation as part of the clinical program, consents for this prospective observational trial, and has one of the following conditions will be eligible.
  • Adults of Age ≦ 80
  • Resistant or refractory to or without available standard of care treatment options or experimental treatment options that are known to increase survival outcome
  • Patients without any extrapulmonary disease
  • Patients with good general health with an ability to withstand physiologic stressors and undergo psychosocial evaluation by the Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) or other assessment tools
  • Patients to meet all other criteria for lung transplantation including insurance approval and United Network for Organ Sharing (UNOS) registration
  • Histologically confirmed selected lung non-small cell lung cancer including but not limited to:
  • o according to the International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) classification
  • \- Lepidic dominant pattern
  • Adenocarcinoma in situ
  • Minimally invasive adenocarcinoma
  • Non mucinous lepidic predominant invasive adenocarcinoma
  • o based on 2015 World Health Organization (WHO) classification of lung tumors including
  • \- Invasive mucinous adenocarcinoma
  • Mixed invasive mucinous and mucinous adenocarcinoma
  • +21 more criteria

You may not qualify if:

  • Adults unable or unwilling to consent
  • Individuals who are not yet adults (infants, children, teenagers)
  • Pregnant women
  • Prisoners
  • Vulnerable Populations
  • Presence of extrapulmonary disease or mediastinal nodal disease at the time of transplant referral
  • Small Cell Cancers
  • Unidentified primary site of cancer for Cohort A
  • Progression of disease or confirmed distant metastases or mediastinal nodal disease at any point during transplantation work-up
  • Medical ineligibility for lung transplantation after multidisciplinary assessment
  • Not a suitable candidate according to the lung transplantation protocol for treatment of lung confined primary or metastatic tumors
  • Body mass index more than 35 kg/m2
  • Evidence of co-existing malignancies for Cohort A
  • Untreatable significant dysfunction of another major organ system including heart, liver, kidney, or brain unless combined organ transplantation can be performed
  • Uncorrected atherosclerotic disease with suspected or confirmed end-organ ischemia or dysfunction and/or coronary artery disease not amenable to revascularization
  • +3 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Thoracic Surgery, Canning Thoracic Institute (Northwestern Memorial Hospital)

Chicago, Illinois, 60611, United States

RECRUITING

Related Publications (13)

  • Bharat A, Machuca TN, Querrey M, Kurihara C, Garza-Castillon R Jr, Kim S, Manerikar A, Pelaez A, Pipkin M, Shahmohammadi A, Rackauskas M, Kg SR, Balakrishnan KR, Jindal A, Schaheen L, Hashimi S, Buddhdev B, Arjuna A, Rosso L, Palleschi A, Lang C, Jaksch P, Budinger GRS, Nosotti M, Hoetzenecker K. Early outcomes after lung transplantation for severe COVID-19: a series of the first consecutive cases from four countries. Lancet Respir Med. 2021 May;9(5):487-497. doi: 10.1016/S2213-2600(21)00077-1. Epub 2021 Mar 31.

    PMID: 33811829BACKGROUND
  • Van Raemdonck D, Vos R, Yserbyt J, Decaluwe H, De Leyn P, Verleden GM. Lung cancer: a rare indication for, but frequent complication after lung transplantation. J Thorac Dis. 2016 Nov;8(Suppl 11):S915-S924. doi: 10.21037/jtd.2016.11.05.

    PMID: 27942415BACKGROUND
  • Glanville AR, Wilson BE. Lung transplantation for non-small cell lung cancer and multifocal bronchioalveolar cell carcinoma. Lancet Oncol. 2018 Jul;19(7):e351-e358. doi: 10.1016/S1470-2045(18)30297-3. Epub 2018 Jun 29.

    PMID: 30084382BACKGROUND
  • Feldman ER, Eagan RT, Schaid DJ. Metastatic bronchioloalveolar carcinoma and metastatic adenocarcinoma of the lung: comparison of clinical manifestations, chemotherapeutic responses, and prognosis. Mayo Clin Proc. 1992 Jan;67(1):27-32. doi: 10.1016/s0025-6196(12)60273-0.

    PMID: 1310129BACKGROUND
  • Grover FL, Piantadosi S. Recurrence and survival following resection of bronchioloalveolar carcinoma of the lung--The Lung Cancer Study Group experience. Ann Surg. 1989 Jun;209(6):779-90. doi: 10.1097/00000658-198906000-00016.

    PMID: 2543339BACKGROUND
  • Ahmad U, Wang Z, Bryant AS, Kim AW, Kukreja J, Mason DP, Bermudez CA, Detterbeck FC, Boffa DJ. Outcomes for lung transplantation for lung cancer in the United Network for Organ Sharing Registry. Ann Thorac Surg. 2012 Sep;94(3):935-40; discussion 940-1. doi: 10.1016/j.athoracsur.2012.04.069. Epub 2012 Jul 25.

    PMID: 22835555BACKGROUND
  • Garver RI Jr, Zorn GL, Wu X, McGiffin DC, Young KR Jr, Pinkard NB. Recurrence of bronchioloalveolar carcinoma in transplanted lungs. N Engl J Med. 1999 Apr 8;340(14):1071-4. doi: 10.1056/NEJM199904083401403.

    PMID: 10194236BACKGROUND
  • Paloyan EB, Swinnen LJ, Montoya A, Lonchyna V, Sullivan HJ, Garrity E. Lung transplantation for advanced bronchioloalveolar carcinoma confined to the lungs. Transplantation. 2000 Jun 15;69(11):2446-8. doi: 10.1097/00007890-200006150-00041.

    PMID: 10868657BACKGROUND
  • Zorn GL Jr, McGiffin DC, Young KR Jr, Alexander CB, Weill D, Kirklin JK. Pulmonary transplantation for advanced bronchioloalveolar carcinoma. J Thorac Cardiovasc Surg. 2003 Jan;125(1):45-8. doi: 10.1067/mtc.2003.72.

    PMID: 12538984BACKGROUND
  • de Perrot M, Chernenko S, Waddell TK, Shargall Y, Pierre AF, Hutcheon M, Keshavjee S. Role of lung transplantation in the treatment of bronchogenic carcinomas for patients with end-stage pulmonary disease. J Clin Oncol. 2004 Nov 1;22(21):4351-6. doi: 10.1200/JCO.2004.12.188.

    PMID: 15514376BACKGROUND
  • Weill D, Benden C, Corris PA, Dark JH, Davis RD, Keshavjee S, Lederer DJ, Mulligan MJ, Patterson GA, Singer LG, Snell GI, Verleden GM, Zamora MR, Glanville AR. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2015 Jan;34(1):1-15. doi: 10.1016/j.healun.2014.06.014. Epub 2014 Jun 26.

    PMID: 25085497BACKGROUND
  • Dueland S, Grut H, Syversveen T, Hagness M, Line PD. Selection criteria related to long-term survival following liver transplantation for colorectal liver metastasis. Am J Transplant. 2020 Feb;20(2):530-537. doi: 10.1111/ajt.15682. Epub 2019 Nov 28.

    PMID: 31674105BACKGROUND
  • Hernandez-Alejandro R, Ruffolo LI, Sasaki K, Tomiyama K, Orloff MS, Pineda-Solis K, Nair A, Errigo J, Dokus MK, Cattral M, McGilvray ID, Ghanekar A, Gallinger S, Selzner N, Claasen MPAW, Burkes R, Hashimoto K, Fujiki M, Quintini C, Estfan BN, Kwon CHD, Menon KVN, Aucejo F, Sapisochin G. Recipient and Donor Outcomes After Living-Donor Liver Transplant for Unresectable Colorectal Liver Metastases. JAMA Surg. 2022 Jun 1;157(6):524-530. doi: 10.1001/jamasurg.2022.0300.

    PMID: 35353121BACKGROUND

MeSH Terms

Conditions

Lung NeoplasmsNeoplasmsAdenocarcinoma, Bronchiolo-Alveolar

Interventions

Lung Transplantation

Condition Hierarchy (Ancestors)

Respiratory Tract NeoplasmsThoracic NeoplasmsNeoplasms by SiteLung DiseasesRespiratory Tract DiseasesAdenocarcinoma of LungAdenocarcinomaCarcinomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic Type

Intervention Hierarchy (Ancestors)

Pulmonary Surgical ProceduresThoracic Surgical ProceduresSurgical Procedures, OperativeOrgan TransplantationTransplantation

Study Officials

  • Young Chae, MD MPH MBA

    Northwestern University

    PRINCIPAL INVESTIGATOR
  • Ankit Bharat, MD

    Northwestern University

    PRINCIPAL INVESTIGATOR
  • Rade Tomic, MD

    Northwestern University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Lung Transplant Thoracic Surgery, Canning Thoracic Institute (Northwestern Memorial Hospital)

CONTACT

Liam Il-Young Chung, MD MPH

CONTACT

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Target Duration
5 Years
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

December 19, 2022

First Posted

January 5, 2023

Study Start

November 16, 2022

Primary Completion (Estimated)

November 1, 2032

Study Completion (Estimated)

November 1, 2032

Last Updated

November 14, 2024

Record last verified: 2024-11

Data Sharing

IPD Sharing
Will not share

Locations