Neoadjuvant PD-1 Antibody Plus Apatinib or Chemotherapy for Non-small Cell Lung Cancer

  • STATUS
    Recruiting
  • End date
    Dec 30, 2026
  • participants needed
    99
  • sponsor
    Shanghai Pulmonary Hospital, Shanghai, China
Updated on 19 February 2024
blood transfusion
platelet count
measurable disease
metastasis
platinum-based chemotherapy
neutrophil count
anticoagulation therapy
anticoagulants
pulmonary function test
aptt
ros1
pd-1 inhibitor
angiogenesis inhibitor
apatinib
proto-oncogene tyrosine-protein kinase ros
kidney function test
endobronchial ultrasound
cancer immunotherapy
camrelizumab
blockade
oral contraceptives
small cell lung cancer

Summary

Immunotherapy with anti-programmed death 1 (PD-1) antibodies has revolutionized the treatment of metastatic and advanced NSCLC, but its application in neoadjuvant setting has not been well established. Results from a pilot clinical study reported the safety and feasibility of neoadjuvant PD-1 blockade. There are several neoadjuvant immunotherapy (NEOSTAR, LCMC3, NADIM, IMpower131) ongoing, and the preliminary results are reported in 2019 American Society of Clinical Oncology, which show promising therapeutic prospect. However, the therapeutic response rate (major pathologic response [MPR]) are not so good (20% - 45%) for PD-1 inhibitor monotherapy. To improve the therapeutic response, the investigators design a multiple-canter, open-label, phase II trial for stage II-IIIA resectable NSCLC. The participants will receive neoadjuvant PD-1 inhibitor (camrelizumab) combined with antiangiogenic drug (apatinib) or platinum-based chemotherapy.

Description

Detailed Description:

This is a multiple-canter, open-label, phase II trial, 2-4 cycles treatment will be planned as neo-adjuvant therapy for NSCLC participants in stage II-IIIA.

Study design:

Participants: Newly diagnosed Resectable II-IIIA NSCLC without EGFR/ALK/ROS1/BRAF mutation.

Treatment

Group Acamrelizumab 200 mg q3w i.v. for 2-4 cycles, apatinib 250mg pd po 3w/cycle for 2-4 cycles before surgery; Group Bcamrelizumab 200 mg q3w i.v. for 2-4 cycles, platinum-based chemotherapy q3w i.v for 2-4 cycles before surgery.

Endpoints

Primary objectives are to assess MPR and safety. Secondary objective is to assess 2-year overall survival (OS), disease-free survival (DFS), OS etc.

Exploratory end point is to explore biomarkers.

Details
Condition Non-Small Cell Lung Cancer, Non-Small Cell Lung Cancer
Age 18-75 years
Treatment Camrelizumab
Clinical Study IdentifierNCT04379739
SponsorShanghai Pulmonary Hospital, Shanghai, China
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Aged 18-75 years
Eastern Cooperative Oncology Group (ECOG) performance-status score of 0 or 1
Histological or cytological diagnosis of NSCLC by needle biopsy, and clinical stage II-IIIA (N2 single lymph node station) according to the TNM classification (8th edition) validated by radiological examination or EBUS
Without EGFR, ALK, ROS1 or BRAF gene mutation
At least 1 measurable lesion according to RECIST 1.1
Life expectancy is at least 12 weeks
Adequate hematological function, liver function and renal function: Hemoglobin greater than or equal to 9.0 g/dL (which can be maintained or exceeded by blood transfusion); Red blood cell count greater than or equal to 2.0 x 10^12/L; Absolute neutrophil count (ANC) greater than or equal to 1.0x10^9/L; Platelet count greater than or equal to 100 x 10^9/L; Total bilirubin within the normal limit; Upper limit of normal value of alanine glutamate transaminase, straw glutamate transaminase and alkaline phosphatase less than 2.5 times; Creatinine less than or equal to 2.0 mg/dL;Creatinine clearance rate greater than or equal to 60ml/min; The international standardized ratio of prothrombin time (INR) is less than or equal to 1.5 in patients who have not received anticoagulation therapy, and the upper limit of partial thrombin time (APTT) is less than or equal to 1.5 times the normal value. Patients receiving full or extra-gastrointestinal anticoagulant therapy can enter the clinical trial as long as the dose of anticoagulant is stable for at least 2 weeks before entering the clinical study, and the results of the coagulation test test are within the limits of local treatment
Without systemic metastasis
With the feasibility of radical surgery therapy
Patients with normal lung function can tolerate surgery
The child-bearing female must undergo pregnancy test within 7 days before starting the treatment and the result shall be negative. Reliable contraceptive measures, such as intrauterine device, contraceptive pill and condom, shall be adopted during the trial and within 30 days after completion of the trial. The child-bearing male shall use condom for contraception during the trial and within 30 days after completion of the trial
Signed and dated informed consent

Exclusion Criteria

The patient has undergone any systemic anti-cancer treatment for NSCLC, including surgical treatment, local radiotherapy, cytotoxic drug treatment, targeted drug treatment and experimental treatment, etc
The patient suffered from other cancers besides NSCLC (except cervical carcinoma in situ, cured basal cell carcinoma and bladder epithelial tumor [including Ta and Tis]) within 5 years before the trial
The patient suffers from any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina pectoris, angina pectoris that starts to attack within the last 3 months, congestive heart failure [ Grade II specified by New York Heart Association (NYHA)], cardiac infarction (6 months before enrollment), severe arrhythmia and liver, kidney or metabolic diseases that requires drug treatment
Any active, diagnosed or suspected autoimmune diseases
The patient is allergic to camrelizumab or its any excipients
The patient has had or is currently suffering from interstitial lung disease
The patient is a carrier of active hepatitis B, hepatitis C or HIV
The patient had undergone other major systemic operations or suffered from severe trauma within 2 months before the trial
Pregnancy or breast-feeding women
Patients with eurological or psychiatric disorders history including epilepsy or dementia were lack of treatment compliance
Other situations in which investigators thought the patients not suit to be included
Clear my responses

How to participate?

Step 1 Connect with a study center
What happens next?
  • You can expect the study team to contact you via email or phone in the next few days.
  • Sign up as volunteer  to help accelerate the development of new treatments and to get notified about similar trials.

You are contacting

Investigator Avatar

Primary Contact

site

Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

Learn more

If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

Learn more

Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

Learn more

Similar trials to consider

Loading...

Browse trials for

Not finding what you're looking for?

Every year hundreds of thousands of volunteers step forward to participate in research. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.

Sign up as volunteer

user name

Added by • 

 • 

Private

Reply by • Private
Loading...

Lorem ipsum dolor sit amet consectetur, adipisicing elit. Ipsa vel nobis alias. Quae eveniet velit voluptate quo doloribus maxime et dicta in sequi, corporis quod. Ea, dolor eius? Dolore, vel!

  The passcode will expire in None.
Loading...

No annotations made yet

Add a private note
  • abc Select a piece of text from the left.
  • Add notes visible only to you.
  • Send it to people through a passcode protected link.
Add a private note
  • abc Select a piece of text.
  • Add notes visible only to you.
  • Send it to people through a passcode protected link.