stage III non-small cell lung cancer
Conditions
Interventions
intervention group:Neoadjuvant chemoradiotherapy combined with PD-1 inhibitors
control group:Neoadjuvant chemotherapy combined with PD-1 inhibitors
Sponsors
Department of Oncology, Affiliated Hospital of Southwest Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Patients with stage III NSCLC who have not previously received antitumor therapy, as demonstrated by histology or cytology, such as chest enhanced CT, liver and adrenal CT, skull magnetic resonance, PET-CT/ whole body bone imaging and other definite stages; 2. Patients aged 18-75 years old, able to give informed consent and sign informed consent, able to comply with research protocols and follow-up procedures; 3. NSCLC subjects considered by the attending thoracic surgeon to be operable for lobectomy; 4. Life expectancy greater than 6 months; 5. ECOG score of the Eastern United States Cancer Cooperative Group 0-2; 6. Willing to provide tissue from tumor lesions; 7. Adequate lung function, requirements: the first second forced breathing volume (FEV1) =1.2 l/s or =50% of the predicted value, postoperative expectation (FEV1) = 30%; 8. No history of other lung malignancies and no anti-tumor therapy for lung cancer; 9. Patients who received hormone therapy more than 4 weeks ago, and all adverse events caused by previous treatment have recovered to = grade I (CTCAE 4.0); 10. The following laboratory tests performed within 7 days prior to the first dose confirmed that the bone marrow, liver and kidney function of the patient met the requirements for participation in the study: hemoglobin =9.0 g/dL (this level can be maintained or exceeded by transfusion); Red blood cell count =2.0×109/L Absolute neutrophil count (ANC) =1.0× 109/L; Platelet count =90×109/L; Total bilirubin =2.0 times the upper limit of normal value; Glutamic pyruvic transaminase, glutamic oxalacetic transaminase, alkaline phosphatase =2.5 times the upper limit of normal value; Creatinine =2.0 mg/dL Creatinine clearance =60ml/min; The International normalized ratio of prothrombin time (INR)=1.5 and partial thromboplastin time (APTT)=1.5 times the upper limit of normal for patients who did not receive anticoagulant therapy. Patients receiving full or parenteral anticoagulant therapy could be enrolled as long as the anticoagulant dose was stable for at least 2 weeks before entering the clinical study and coagulation function was within the limits of local treatment. Laboratory test values for the rest of the screening must meet the relevant standards; 11. Urine and serum HCG tests should be negative for women of childbearing age within 7 days before the start of treatment; Eligible men and women must use a reliable method of contraception before entering the trial and during the study until 30 days after stopping the drug. Reliable methods of contraception will be determined by the principal investigator or designated person.
Exclusion criteria
Exclusion criteria: 1. Patients with known ALK translocation, EGFR or BRAF mutation, and ROS1 gene rearrangement were excluded; 2. Any unstable systemic disease (including active infection, uncontrolled hypertension, unstable angina pectoris, angina pectoris onset within the last 3 months, congestive heart failure (= New York Heart Association Class II), heart infarction (6 months prior to enrollment), severe arrhythmia requiring medication, liver, kidney, or metabolic disease; 3. Patients with uncontrolled neuropathy (grade 2 or above) or psychosis; Have an active, known or suspected autoimmune disease; Subjects with the following conditions may be enrolled: vitiligo, type I diabetes, residual hypothyroidism due to autoimmune thyroiditis; 4. Those who have previously failed or progressed after treatment with anti-PD-1 antibodies, anti-PD-L1 antibodies, anti-PD-L2 antibodies, or anti-CTLA-4 antibodies (or any other antibodies that act on T-cell co-stimulation or checkpoint pathways); 5. Chest X-ray examination, sputum examination and nucleic acid-PCR considered active tuberculosis; A history of active tuberculosis treatment within 1 year; The patients with more than 1 year history of active pulmonary tuberculosis were controlled for more than 1 year and the efficacy of anti-tuberculosis treatment was positive. 6. Known human immunodeficiency virus (HIV) test positive history or known to have acquired immunodeficiency syndrome (AIDS); If the first-line standard treatment is ineffective, the patients can be enrolled after full communication and clear death risk. 7. Comorbidities requiring treatment with immunosuppressive drugs, or comorbidities requiring systemic or local use of corticosteroids at immunosuppressive doses; 8. Patients who have previously received radiotherapy in the chest region can no longer be evaluated for large segment radiotherapy; 9. Pregnant or lactating women, as well as men and women who refuse to use appropriate contraceptive methods; 10. Previously received or expected to undergo an organ or bone marrow transplant during the study period; 11. Patients with interstitial pneumonia, pneumoconiosis, radiation pneumonia, drug-induced pneumonia, and severe impairment of lung function; 12. Allergies to study drugs. 13. Situations deemed unsuitable for inclusion by other researchers after comprehensive evaluation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Major pathological remissions, MPR; | — |
Secondary
| Measure | Time frame |
|---|---|
| Radical resection rate;Objective remission rate, ORR;Overall survival, OS; | — |
Countries
China
Contacts
Public ContactLin sheng
Department of Oncology, Affiliated Hospital of Southwest Medical University
Outcome results
None listed