Solid Tumor
Conditions
Brief summary
This is a phase II study to observe efficacy of combining local radiotherapy with PD-1blockade in patients with advanced solid tumors. All patients will accept at least one site of radiotherapy together with PD-1 blockade. The study will evaluate changes of unirradiated and irradiated lesions.
Interventions
All patients with more than one distant metastatic lesions will accept at least one site of radiotherapy and PD-1 blockade at the same time.
Sponsors
Ruijin Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Adult patients 18-75 years old with the right to make medical decisions 2. Signed informed consent form 3. ECOG score of 0-2 4. Clear pathological diagnosis of the primary site 5. Multiple distant metastases 6. Stable assessment of brain metastases after treatment can be enrolled (more than 6 weeks) 7. Bone metastases combined with soft tissue mass formation can be enrolled 8. imaging with ≥ 2 clearly assessable lesions (bone metastases alone without soft tissue mass formation, brain metastases not as target lesions) 9. expected survival ≥ 6 months 10. Progression after ≥ 1 prior line of therapy regimen with no standard treatment regimen or intolerable toxicities, including all three of the following: 1. Patients must have failed to respond to at least one prior standard of care regimen 2. The patient must not have a conventional treatment option that is clinically proven to provide long-term control of the disease and the patient refuses other conventional treatment options 3. The patient is intolerant to the toxic side effects of the standard treatment regimen 11. No prior immunotherapy history 12. Time to last systemic therapy (including monoclonal antibodies) ≥ 4 weeks 13. Previous radiotherapy to non-target sites with other evaluable lesions can be enrolled 14. Laboratory examination indexes meet the following requirements: WBC ≥ 3×109/L, ANC ≥ 2.0×109/L, PLT ≥ 80×109/L, Hb ≥ 80g/L (according to the normal standards of the central laboratory department); liver function: total bilirubin, ALT and AST are ≤ 1.5xUNL (upper limit of normal value); AST (SGOT)/ALT (SGPT) ≤ 2.5xUNL (upper limit of normal value) ALT (SGPT) ≤ 2.5 x IULN (upper limit of normal value); renal function: Cr≦1.5xUNL (upper limit of normal value), and creatinine clearance rate≧60ml/min; thyroid function T3, T4 within normal range (hypothyroidism can be supplemented with oral thyroxine); cardiac function: cardiac protein three and pro-BNP within normal range, no previous Adrenal function: normal cortisol secretion function or correctable by endocrine assessment 15. HBV infected patients with HBV-DNA copy number less than 500 IU/ml 16. No history of other malignancies within 5 years (except skin basal cell carcinoma)
Exclusion criteria
1. Uncontrolled brain metastases (stabilization time \<6 weeks) 2. Bone metastases alone without clear soft tissue mass formation 3. Bone marrow infiltration 4. Presence of clinical factors (e.g., bleeding, active infection, or psychiatric factors) that the investigator determines may interfere with the completion of the study process 5. Inability to administer radiotherapy due to organ-threatening or other factors as assessed by the investigator 6. Patients requiring long-term maintenance steroid therapy (including oral, intravenous use); topical use or inhalation may be included in the study 7. Prior autoimmune disease or active disease \[e.g., including but not limited to inflammatory bowel disease \[IBD\], rheumatoid arthritis, autoimmune hepatitis, systemic sclerosis (scleroderma and its variants), systemic lupus erythematosus, autoimmune vasculitis, autoimmune neuropathy (e.g., Guillain-Barre syndrome)\], vitiligo and correctable endocrine deficiencies such as thyroid hypofunction, physiological cortisol hypersecretion may be included in the study and are not considered as
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective response rate | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed at least 4 weeks | The proportion of patients with a tumor volume reduction of 30% lasting for at least 4 weeks，and is the sum of the proportion of complete remission (CR) and partial remission (PR) |
| non-irradiated lesion control rate(NRCR) | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 6 months | The percentage of non-irradiated target lesions with CR/PR or SD |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Progression free survival | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 6 months | The time from enrollment to disease progression or death from any cause |
| Overall survival | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 6 months | The time from enrollment to death from any cause |
| Rate of side effects | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 6 months | ≥ grade 3 adverse effects |
Countries
China
Contacts
Primary ContactYujie Wang, MD
Backup ContactYunsheng Gao, MD
Outcome results
None listed