Safety and Tolerability of LDRT+Sugemalimab+Chemotherapy+Olaparib for First-Line Treatment of SLFN-11 Positive ES-SCLC

NCT06217757 | Recruiting Phase 1

• 1 other identifier: SCS-Lung01
• Study Type: interventional
• Target: 45
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study was to evaluate the safety and efficacy of low-dose radiotherapy (LDRT) combined with sugemalimab, olaparib, chemotherapy in the first-line treatment of SLFN-11 positive extensive stage small cell lung cancer.

Conditions

Lung Cancer; Extensive-stage Small-cell Lung Cancer

Outcome Measures

Primary Outcomes (1)

• RDE

  To determine the RDE of olaparib in subjects with Extensive Stage-SCLC when combined with low-Dose Radiotherapy, chemotherapy and sugemalimab.

  3 weeks after initiation of treatment.

Secondary Outcomes (5)

• Progression-free survival (PFS)

  Baseline up to approximately 24 months

• PFS Rate at 6 Months and 1 Year

  Baseline up to 1 year

• Overall Survival (OS)

  Baseline up to approximately 24 months

• OS Rate at 1 Year, 1.5 Years and 2 Years

  Baseline to 2 years or death, whichever occurs first.

• Objective response rate (ORR)

  Baseline to 2 years

Study Arms (1)

Low-dose radiotherapy combined with sugemalimab, olaparib, etoposide and cisplatin

EXPERIMENTAL

Participants will receive the following treatment regimens: LDRT cisplatin + etoposide + sugemalimab+olaparib. Induction treatment will be administered on a 21-day cycle for four cycles. LDRT will be conducted from Day 1 - Day 5 in the first cycle. Following the induction phase, participants will continue maintenance therapy with sugemalimab and olaparib. Participants will be treated until loss of clinical benefit, or unaccepted toxicity, or withdrawal of consent, or death (whichever occurs first).

Radiation: Low-dose radiotherapy; Drug: Etoposide; Drug: Cisplatin; Drug: Sugemalimab; Drug: Olaparib

Interventions

Low-dose radiotherapy RADIATION

The LDRT deals with primary tumour in a 15 Gy of 5fractions over five days, starting from Day 1 in the first cycle.

Also known as: LDRT

Low-dose radiotherapy combined with sugemalimab, olaparib, etoposide and cisplatin

Etoposide DRUG

Etoposide will be administered intravenously at a dose of 100 mg/m\^2 on Days 1, 2 and 3 of each 21-day cycle during the induction phase (Cycles 1-4).

Also known as: One of the standard chemotherapy regimens

Low-dose radiotherapy combined with sugemalimab, olaparib, etoposide and cisplatin

Cisplatin DRUG

Cisplatin will be administered as intravenous infusion at a dose of 25 mg/m\^2 on Days 1, 2 and 3 of each 21-day cycle during the induction phase (Cycles 1-4).

Also known as: One of the standard chemotherapy regimens

Low-dose radiotherapy combined with sugemalimab, olaparib, etoposide and cisplatin

Sugemalimab DRUG

Sugemalimab will be administered by intravenous infusion at a dose of 1200mg on Day 1 of each 21-day cycle for a maximum of 2 years or progressive disease or intolerable toxicity.

Also known as: Programmed Death Ligand-1 (PD-L1) Inhibitor

Low-dose radiotherapy combined with sugemalimab, olaparib, etoposide and cisplatin

Olaparib DRUG

Olaparib will be administered orally at a dose of 150mg qod Day 1,3,5,7 or 150 mg qd/150 mg bid/300mg in the morning and 150mg in the evening/300 mg bid on Day 1-7 of each 21-day cycle for a maximum of 2 years or progressive disease or intolerable toxicity.

Also known as: poly ADP-ribose polymerase (PARP) inhibitor

Low-dose radiotherapy combined with sugemalimab, olaparib, etoposide and cisplatin

Eligibility Criteria

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

You may qualify if:

• Men or women aged more than or equal to (≥) 18 years old and less than or equal to (≤) 75 years old
• Histologically or cytologically confirmed ES-SCLC
• No prior treatment for ES-SCLC
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
• Five white slides (unstained paraffin sections) were available for immunohistochemical SLFN-11 detection and SLFN-11 was positive
• Extensive clinical stage. American Joint Committee on Cancer (AJCC) 8th edition Stage IV with lesions exceeding one side of the chest and including malignant pleural and pericardial effusions or hematogenous metastases (any T, any N, M1a/b/c); or T3-4 due to multiple nodules in the lung or tumor/nodule size too large to be included in a T3-4 disease within a tolerable radiotherapy schedule
• The subjects were considered suitable for combining etoposide with cisplatin chemotherapy and low-dose radiotherapy as first-line treatment for extensive -stage small cell lung cancer
• Have measurable lesions as defined by RECIST1.1, with at least one lesion (never previously treated with radiation) of ≥10 mm longest diameter accurately measured by computed tomography (CT) or magnetic resonance imaging (MRI) at baseline (except for lymph nodes, which must have a short axis of ≥15 mm) and the lesion is suitable for repeat and accurate measurements
• Patients with brain metastases must be asymptomatic or stable on steroids and anticonvulsants for at least 1 month prior to study treatment. Participants with suspected brain metastases during screening should have a CT/MRI of the brain prior to study
• No previous treatment with immune checkpoint inhibitors and PARP inhibitors, including but not limited to other anti-PD-1, anti-PD-L1 and anti-programmed cell death ligand 2 (anti-PD-L2) antibodies, with the exception of therapeutic anti-tumor vaccines. No prior chemotherapy or radiation therapy to the chest lesion
• Weight over 30 Kg
• Life expectancy ≥ 12 weeks
• Have adequate organ and bone marrow functional reserve and normal major organ function
• Patients were compliant, voluntarily enrolled in the study and signed an informed consent form
• For women or men with childbearing potential: use effective contraception to avoid conception or embryonic drug exposure during treatment and for 5 months after the last dose of sugemalimab and for 6 months after the last dose of cisplatin or etoposide. Female subjects are prohibited from donating eggs during this period and males are prohibited from donating sperm during this period

You may not qualify if:

• Histopathologic or cytopathologic diagnosis of mixed small cell lung cancer or non-small cell lung cancer
• Limited stage small cell lung cancer
• Combination of poorly controlled malignant pleural or pericardial effusions requiring continuous drainage
• Presence of active or symptomatic brain metastases or Leptomeningeal metastases
• Prior systemic antitumor therapy (chemotherapy, targeted agents such as PARP inhibitors) or immune checkpoint inhibitors for SCLC
• Presence of active, unstable systemic disease such as active infection, autoimmune disease, inflammatory disease (uncontrolled hypertension, heart failure (NYHA classification \>= Class II), unstable angina, acute coronary syndrome, severe arrhythmia, severe hepatic, renal or metabolic disease, human immunodeficiency virus (HIV) immunodeficiency virus (HIV) infected patients
• Previous allogeneic stem cell or solid organ transplantation
• Patients with prior interstitial lung disease, drug-induced interstitial lung disease, or active interstitial pneumonia requiring systemic glucocorticoid or immunosuppressive therapy; Patients with pulmonary interstitial fibrosis or active pulmonary tuberculosis
• Severe infection within 4 weeks prior to the start of study treatment, including but not limited to hospitalization for infection, bacteremia, or severe pneumonia
• Received therapeutic oral or intravenous infusion of antibiotics within 2 weeks prior to the start of study treatment
• Been diagnosed or treated for another malignancy (excluding resected basal cell carcinoma of the skin or other carcinoma in situ) within 5 years prior to randomization to this study
• For pregnant or lactating females or male or female subjects of reproductive potential who refuse to use effective contraception during treatment and within 5 months of the last dose of sugemalimab and within 6 months of the last dose of cisplatin or etoposide
• Allergic to the study drug or its components
• The investigator believes that the patients may not be able to complete the study or comply with the requirements of the study
• Inadequate bone marrow function and vital organ function reserve

Sponsors & Collaborators

• Sichuan University: lead

Study Sites (1)

West China Hospital of Sichuan University

Chengdu, Sichuan, 610044, China

RECRUITING

Related Publications (1)

• Kaczorowski M, Ylaya K, Chlopek M, Taniyama D, Pommier Y, Lasota J, Miettinen M. Immunohistochemical Evaluation of Schlafen 11 (SLFN11) Expression in Cancer in the Search of Biomarker-Informed Treatment Targets: A Study of 127 Entities Represented by 6658 Tumors. Am J Surg Pathol. 2024 Dec 1;48(12):1512-1521. doi: 10.1097/PAS.0000000000002299. Epub 2024 Aug 26.

  PMID: 39185596 DERIVED

MeSH Terms

Conditions

Lung Neoplasms; Small Cell Lung Carcinoma

Interventions

Radiotherapy; Etoposide; Cisplatin; sugemalimab; olaparib; ADP Ribose Transferases

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Therapeutics; Podophyllotoxin; Tetrahydronaphthalenes; Naphthalenes; Polycyclic Aromatic Hydrocarbons; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons; Organic Chemicals; Polycyclic Compounds; Glucosides; Glycosides; Carbohydrates; Chlorine Compounds; Inorganic Chemicals; Nitrogen Compounds; Platinum Compounds; Pentosyltransferases; Glycosyltransferases; Transferases; Enzymes; Enzymes and Coenzymes

Study Officials

• You Lu, MD

  West China Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Min, Yu, MD

CONTACT

02885423571; yuminisagoodgirl@163.com

You, Lu, MD

CONTACT

02885423571; radyoulu@hotmail.com

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Chief of Thoracic Cancer Ward

Study Record Dates

• First Submitted: January 11, 2024
• First Posted: January 22, 2024
• Study Start: April 18, 2024
• Primary Completion (Estimated): October 31, 2027
• Study Completion (Estimated): October 31, 2028
• Last Updated: May 5, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)