Non Small Cell Lung Cancer
Conditions
Brief summary
Offering an early-initiated supportive care program to stage III NSCLC patients to prevent deterioration of performance status and increase compliance of patients that complete chemoradiation as well as the patients receiving 12 months of durvalumab.
Detailed description
In inoperable Stage III Non-Small Cell Lung Cancer (NSCLC), consolidation immune checkpoint inhibition with the PD-L1 inhibitor durvalumab, given within 6 weeks after completion of concurrent platinum-based chemoradiotherapy (CCRT) for 12 months results in remarkable improvement of 3-year overall survival rates (57% vs 43.5%). This tri-modal therapy has become the new standard of care. Unfortunately, the tri-modal therapy frequently causes adverse events such as fatigue and, to a much lesser degree, cough, dyspnea and pneumonitis, resulting in treatment cessation in 15% - 53% of the patients (15%) (53%). For the most optimal overall survival (OS) and disease-free survival (DFS), compliance to the full treatment regimen, i.e. in the ideal situation 100% of patients completing their full course of CCRT and receiving durvalumab for one year, is expected to have significant and relevant beneficial effects. Optimizing patients' fitness is essential in order to handle the tough full treatment regimen.
Interventions
BEHAVIORALLifestyle advice
Patients will receive lifestyle advice regarding nutricion and exercise and will be monitored with regard to exercise and vital signs.
Sponsors
Maastricht Radiation Oncology
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Pathological diagnosis of adequately staged (according to standard practice using chest-CT, FDG-PET, brain imaging MRI/CT) NSCLC * Participant is willing and able to give informed consent for participation in the trial * Aged 18 years or above * Scheduled to receive one of the following two therapeutic strategies: * Concurrent chemotherapy and radiotherapy with photons (60 Gy in 30 fractions of 2 Gy) followed by durvalumab in patients with stage III NSCLC * Concurrent chemotherapy and radiotherapy with protons (60 Gy in 30 fractions of 2 Gy) followed by durvalumab in patients with stage III NSCLC * Able and willing to comply with all trial requirements
Exclusion criteria
* Mixed non-small cell lung cancer with other histology such as small cell lung cancer * Not able to comply with the study protocol * Less than 18 years old * Pregnancy or not able to comply with adequate contraception in women with child baring potential * Previous radiotherapy to the chest for benign or malignant conditions, including radiation for breast cancer * Previous malignancy treated with chemotherapy, immune therapy or radiotherapy (irrespective of when this happened) * Previous malignancies treated with surgery only are allowed if 2 years or more before inclusion in the present study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Compliance | 12 months | Compliance to CCRT and durvalumab treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage hospitalization | 12 months | Improving standard of care lifestyle support by measuring % hospitalization for (treatment-related) complications + specification (from start until 6 weeks after radiotherapy) |
| Standard of care lifestyle support | 12 months | Measuring match between lifestyle advice and personal circumstances by questionnaire |
| Percentage adhering advice | 12 months | Improving standard of care lifestyle support by measuring % patients successfully adhering to the dietary, exercise, smoking advice |
| Perctenage use of watch | 12 months | Improving standard of care lifestyle support by measuring % use of the watch (and app) |
| Barriers | 12 months | Measuring adherence of barriers and facilitators in lifestyle support by questionnaire |
| Percentage dyspnea | 12 months | Improving standard of care lifestyle support by measuring % grade 2 dyspnea |
| Proton/photon | 12 months | Improving standard of care lifestyle support by measuring the difference between proton and photon therapy i the above mentioned outcome |
| Durvalumab | 12 months | Improving standard of care lifestyle support by measuring % patients receiving durvalumab |
| Quality of life questionnaire | 12 months | Improving standard of care lifestyle support by measuring the quality of life by EORTC QLQ-C30/-LC13 |
| Percentage dysphagia | 12 months | Improving standard of care lifestyle support by measuring % grade 3 dysphagia and odynophagia |
Outcome results
None listed