Limited-stage Small Cell Lung Cancer (LS-SCLC)
Conditions
Keywords
Limited-stage small cell lung cancer, benmelstobart, anlotinib, chemotherapy
Brief summary
This is a single-arm, single-center, exploratory clinical study conducted at Shanghai Pulmonary Hospital, Tongji University. The study evaluates the effectiveness and safety of first-line treatment with benmelstobart (an immunotherapy), anlotinib (an anti-angiogenic drug), platinum-etoposide chemotherapy, and concurrent thoracic radiotherapy in participants with previously untreated, unresectable limited-stage small cell lung cancer (LS-SCLC). Eligible participants are aged 18 to 75 years, with histologically or cytologically confirmed limited-stage SCLC (VALG staging), no prior systemic treatment for lung cancer, measurable lesions by RECIST 1.1, ECOG performance status 0-1, and adequate organ function. Participants receive 4 cycles of induction therapy (21 days per cycle), including benmelstobart intravenously every 3 weeks, anlotinib orally for 2 weeks on / 1 week off, and chemotherapy with carboplatin or cisplatin plus etoposide. Thoracic radiotherapy (60-70 Gy in 30-35 fractions) is given concurrently with chemotherapy cycles 1-3. After induction, participants receive maintenance therapy with benmelstobart plus anlotinib for up to 2 years or until disease progression or unacceptable side effects. The primary objective is to assess the Objective Response Rate (ORR) as evaluated by investigators using RECIST 1.1. Secondary objectives include progression-free survival (PFS), overall survival (OS), disease control rate (DCR), duration of response (DOR), and safety assessments of adverse events graded by CTCAE 5.0. A total of 27 participants will be enrolled. The study is expected to start in March 2026, complete enrollment by September 2027, and end in March 2029. All participants will be regularly followed for efficacy and safety.
Interventions
DRUGBenmelstobart
Anti-PD-L1 monoclonal antibody, immunotherapy.1200 mg/dose, Q21D (1 cycle), IV infusion.
DRUGAnlotinib
Small molecule multi-target anti-angiogenic agent.12 mg/day, oral (2 weeks on/1 week off, repeated Q3W), taken with water at fixed time.
Chemotherapy agent.Carboplatin: Day 1, AUC 5 mg/mL/min (max 750 mg), IV infusion; Cisplatin: Day 1, 75-80 mg/m², IV infusion.
DRUGEtoposide
Chemotherapy agent. Days 1-3, 100 mg/m², IV infusion.
RADIATIONThoracic Radiation Therapy
External beam intensity-modulated radiotherapy (IMRT) targeting the primary thoracic tumor, ipsilateral hilum, and mediastinal lymph node stations (per LS-SCLC staging guidelines). Initiated with Cycle 1 of chemotherapy; IMRT, 60-70 Gy in 30-35 fractions (1.8-2.0 Gy/fraction, once daily); target volumes: primary tumor + lymph nodes delineated on post-chemotherapy CT, investigator-adjusted individually.
Sponsors
Yayi He
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: Histologically or cytologically confirmed inoperable limited-stage small cell lung cancer (LS-SCLC) (per VALG staging). 2: No prior systemic therapy for limited-stage small cell lung cancer 3: Presence of measurable lesions as defined by RECIST 1.1. A previously irradiated lesion may be considered measurable only if it has demonstrated clear progression after radiotherapy and is not the sole lesion 4: Age ≥ 18 and ≤ 75 years 5: ECOG performance status: 0-1 6: Expected survival ≥ 3 months 7: Adequate hematologic and organ function, defined as meeting the following criteria: a) Hematologic function (no transfusion of blood or blood products, no G-CSF or other hematopoietic growth factors within 14 days): i. Absolute neutrophil count (ANC) ≥ 1.5 × 10⁹/L (1,500/mm³); ii. Platelet count (PLT) ≥ 100 × 10⁹/L (100,000/mm³); iii. Hemoglobin (HB) ≥ 80 g/L. b) Renal function: i. Calculated creatinine clearance (CrCl) ≥ 50 mL/min; ii. Urine protein \< 2+ or 24-hour urine protein quantification \< 1.0 g. c) Hepatic function: i. Serum total bilirubin (TBil) ≤ 1.5 × ULN; ii. AST and ALT ≤ 2.5 × ULN; iii. Serum albumin (ALB) ≥ 28 g/L. d) Coagulation function: i. International normalized ratio (INR) and activated partial thromboplastin time (APTT) ≤ 1.5 × ULN. e) Cardiac function: i. Left ventricular ejection fraction (LVEF) ≥ 50%. 8: Subjects voluntarily participate in this study, provide written informed consent, demonstrate good compliance, and agree to comply with follow-up procedures.
Exclusion criteria
* 1: Prior use of anti-angiogenic agents such as anlotinib, apatinib, bevacizumab, or related immunotherapeutic agents targeting PD-1, PD-L1, etc 2: Presence of multiple factors affecting oral medication absorption (e.g., inability to swallow, status post gastrointestinal resection, chronic diarrhea, intestinal obstruction, etc.). 3: Uncontrolled pleural effusion, pericardial effusion, or ascites requiring repeated drainage. 4: Patients with imaging evidence of tumor invasion adjacent to major blood vessels, or judged by the investigator to have a high risk of fatal massive hemorrhage due to tumor invasion of major blood vessels during the subsequent study period. 5: History of severe bleeding tendency or coagulopathy, including but not limited to: clinically significant hemoptysis (more than one tablespoon per day) within 3 months prior to enrollment; or clinically significant bleeding symptoms or bleeding diathesis within 4 weeks prior to randomization, such as gastrointestinal bleeding, hemorrhagic gastric ulcer (including gastrointestinal perforation and/or fistula; however, patients with surgically repaired gastrointestinal perforation or fistula may be eligible), unhealed wounds, ulcers, or fractures, etc. 6: Undergoing major surgical treatment, incisional biopsy, or significant traumatic injury within 28 days prior to randomization. 7: History of arterial/venous thrombotic events within 6 months prior to randomization, such as cerebrovascular accident (including transient ischemic attack), deep vein thrombosis, and pulmonary embolism. 8: Development of active autoimmune disease requiring systemic therapy (e.g., disease-modifying agents, corticosteroids, or immunosuppressants) within 2 years prior to the first dose. 9: Any other conditions that, in the judgment of the investigator, would render the patient ineligible for study enrollment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Investigator-Assessed Objective Response Rate | Baseline at screening, after every 2 treatment cycles (each cycle is 21 days), end of treatment, up to disease progression, assessed up to approximately 24 months | According to RECIST 1.1 criteria, investigator assesses target lesion changes via imaging; calculates the proportion of subjects achieving complete response (CR) or partial response (PR) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Serious Adverse Event (SAE) | from date of first study drug administration, follow-up until resolution or stabilization, assessed up to approximately 24 months | Collect SAEs resulting in death, life-threatening condition, hospitalization, disability per CTCAE 5.0 and ICH-GCP, document and report |
| 6-Month Progression-Free Survival Rate | 6-month time point after first treatment, follow-up cutoff | Estimated proportion of subjects without progression and alive at 6 months after first treatment using Kaplan-Meier method |
| Immune-Related Adverse Event (irAE) | From date of first study drug administration through 90 days after the last dose of study drug; assessed at baseline, each cycle visit, and unscheduled visits for suspected irAEs; graded per CTCAE 5.0 and irAE-specific criteria. | Identify and grade organ-specific immune-related adverse events according to CTCAE 5.0 and irAE criteria |
| Progression-Free Survival (PFS) | From date of first study drug administration until the date of first documented disease progression (per RECIST v1.1) or death from any cause, whichever occurs first; assessed up to 24 months (maximum follow-up period). | Time from first treatment to disease progression or death from any cause, whichever occurs first |
| 18-Month Overall Survival Rate | 18-month time point after first treatment, follow-up cutoff | Estimated proportion of alive subjects at 18 months after first treatment via Kaplan-Meier method |
| 12-Month Overall Survival Rate | 12-month time point after first treatment, follow-up cutoff | Estimated proportion of alive subjects at 12 months after first treatment using Kaplan-Meier method |
| 12-Month Progression-Free Survival Rate | 12-month time point after first treatment, follow-up cutoff | Estimated proportion of progression-free and alive subjects at 12 months via Kaplan-Meier method |
| Overall Survival (OS) | From date of first study treatment to date of death from any cause or last follow-up, whichever occurs first, assessed up to approximately 24 months | Time from first study treatment to death from any cause; censored at last follow-up for alive subjects |
| Disease Control Rate (DCR) | Time Frame: Baseline and after every 2 treatment cycles (each cycle is 21 days), up to disease progression, death, or study withdrawal, whichever occurs first，assessed up to approximately 24 months | According to RECIST 1.1, proportion of subjects achieving CR, PR, or stable disease (SD) in total enrolled population |
| Duration of Response (DOR) | From date of first confirmed objective response (CR/PR) until date of disease progression, death from any cause, or initiation of new antitumor therapy, whichever occurs first, assessed up to approximately 24 months | Time from first confirmed CR/PR to disease progression, death from any cause, or initiation of new antitumor therapy |
| Adverse Event (AE) | From signing informed consent through study completion and safety follow-up, assessed up to approximately 24 months | Record all new or worsening unfavorable medical events, grade and calculate incidence according to CTCAE 5.0 |
Contacts
CONTACTYayi He, MD
Outcome results
None listed