Clinical Study of PD-L1 Antibody (TQB2450) Plus Chemotherapy (Cisplatin and Etoposide) for Previously Untreated Small Cell Lung Cancer

• ClinicalTrials.gov Identifier: NCT04539977
• Recruitment Status: Recruiting
• First Posted: September 7, 2020
• Last Update Posted: January 28, 2021
• Sponsor: Shanghai Pulmonary Hospital, Shanghai, China
• Information provided by (Responsible Party): Peng Zhang, Shanghai Pulmonary Hospital, Shanghai, China

Study Description

Brief Summary:

This is a phase II, non-randomized, open-label, single center study to evaluate the efficacy and safety of combining TQB2450 (PD-L1 antibody) + chemotherapy (cisplatin and etoposide) followed by TQB2450 maintenance therapy as first-line treatment in patients with extensive-stage small cell lung cancer (SCLC), and neoadjuvant TQB2450 + chemotherapy (EP) followed by radical surgery and adjuvant TQB2450 immunotherapy as first-line treatment in patients limited-stage SCLC.

Condition or disease	Intervention/treatment	Phase
Small-cell Lung Cancer	Drug: TQB2450	Phase 2

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 40 participants
• Allocation: Non-Randomized
• Intervention Model: Sequential Assignment
• Intervention Model Description: There are no control group in this trial, and the experimental group will be divided into two subgroups according to the pathologic stage (extensive-stage and limited stage).
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: Clinical Study of PD-L1 Antibody (TQB2450) Plus Chemotherapy (Cisplatin and Etoposide) for Previously Untreated Small Cell Lung Cancer
• Actual Study Start Date: September 1, 2020
• Estimated Primary Completion Date: December 31, 2023
• Estimated Study Completion Date: December 31, 2028

Arms and Interventions

Arm	Intervention/treatment
Experimental: ES-SCLC; Induction therapy: TQB2450 1200mg, d1, q3w, 2-4 cycles; cisplatin 75mg/m2, d1+ etoposide 100mg/m2, d1,d2,d3, q3w, 2-4 cycles. Maintenance therapy: TQB2450 1200mg, d1, q3w, thereafter until progression disease, or other discontinuation criteria (intolerant toxicity, no more clinical benefit, receiving another anti-tumor regimen [except radiotherapy], withdrawal of informed consent or death).	Drug: TQB2450; Inductive therapy: TQB2450 + EP Maintenance therapy: TQB2450; Other Names: Cisplatin; Etoposide
Experimental: LS-SCLC; Neoadjuvant therapy: TQB2450 1200mg, d1, q3w, 2-4 cycles; cisplatin 75mg/m2, d1+ etoposide 100mg/m2, d1,d2,d3, q3w, 2-4 cycles. Surgery or/and radiotherapy: the patients will receive surgery or/and radiotherapy, or multi-disciplinary treatment. Adjuvant therapy: TQB2450 1200mg, d1, q3w, thereafter until progression disease, or other discontinuation criteria (intolerant toxicity, no more clinical benefit, receiving another anti-tumor regimen [except radiotherapy], withdrawal of informed consent or death).	Drug: TQB2450; Neoadjuvant therapy: TQB2450 + EP Adjuvant therapy: TQB245; Other Names: Cisplatin; Etoposide

Outcome Measures

Primary Outcome Measures :

1. Objective response rate (ORR) [ Time Frame: up to 4 months ]
   It refers to the proportion of patients who have had a complete response or partial response (according to RECIST1.1) as confirmed by CT evaluation after 3 weeks in all patients who have completed the inductive/neoadjuvant therapy. Only patients with measurable lesions at baseline will be analyzed.

Secondary Outcome Measures :

1. Progression-free survival (PFS) [ Time Frame: up to 60 months ]
   It refers to the time from the first administration of TQB2450 in this study to the disease progression or death (including any cause of death in the case of no progression) as recorded in CRF, regardless of whether the patient exits from the treatment or receives other anti-cancer treatment before progression.
2. Disease-free survival (DFS) [ Time Frame: up to 60 months ]
   It refers to the time from radical surgery to relapse or death of a participant due to disease progression. In the case of a patient who still survives at the time of analysis, the latest evaluation date will be used for interpolation (censoring).
3. Overall survival (OS) [ Time Frame: up to 63 months ]
   It is defined as the time from enrollment to death of participant due to any cause. In the case of a patient who still survives at the time of analysis, the date of last contact will be taken as the censoring date.
4. Major pathologic response (MPR) [ Time Frame: up to 5 months ]
   MPR is defined as the proportion of participants who have achieved major pathologic response (on routine hematoxylin and eosin staining, tumors with no more than 10% viable tumor cells) in all participants who have completed the neoadjuvant therapy before surgery.
5. Safety: frequency of severe adverse events [ Time Frame: up to 18 months ]
   The frequency of severe adverse events from the participants enrolling to 90 days after the last drug administration or 30 days after surgery or new anti-cancer therapy, which comes first.
6. Health related quality of life (HRQol) [ Time Frame: up to 12 months ]
   The assessment is made according to the Quality of Life Scale for Lung Cancer Patients (EORTC-QLQ-C30 & LC13, Version 3). EORTC's QLQ-C30 & LC13 (V3.0) is a core scale for lung cancer patients, with a total of 43 items. Among them, Item 29 and 30 are divided into seven grades, which are assigned with 1 to 7 scores according to the answer options. The other items are divided into 4 grades: Not at All, A Little, Quite a Bit, and Very Much, assigned with 1 to 4 scores respectively. The higher score, the worse quality.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 75 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. The patient shall sign the Informed Consent Form.
2. Aged 18 ≥ years.
3. Histological or cytological diagnosis of SCLC by needle biopsy, and extensive stage or limited stage (local advanced) confirmed by imageological examinations.
4. Eastern Cooperative Oncology Group (ECOG) performance-status score of 0 or 1.
5. Life expectancy is at least 12 weeks.
6. At least 1 measurable lesion according to RECIST 1.1.

7. Patients with good function of other main organs (liver, kidney, blood system, etc.):

   • ANC count ≥1.5×10^9/L, platelet count ≥100×10^9/L，hemoglobin ≥90 g/L;
   • the international standard ratio of prothrombin time (INR) and prothrombin time (PT) < 1.5 times of upper limit of normal (ULN);
   • partial thromboplastin time (APTT) ≤1.5×ULN;
   • total bilirubin ≤1.5×ULN;
   • alanine aminotransferase (ALT) aspartate aminotransferase (AST) ≤2.5×ULN, or ALT and AST ≤5×ULN in the patients with liver metastatic tumor.
8. Fertile female patients must voluntarily use effective contraceptives not less than 120 days after chemotherapy or the last dose of TQB2450 (whichever is later) during the study period, and urine or serum pregnancy test results within 7 days prior to enrollment are negative.
9. Unsterilized male patients must voluntarily use effective contraception during the study period not less than 120 days after chemotherapy or the last dose of TQB2450 (whichever is later).

Exclusion Criteria:

1. Participants who have received any systemic anti-cancer treatment for SCLC, including surgical treatment, local radiotherapy, cytotoxic drug treatment, targeted drug treatment and experimental treatment;
2. Administration of any Chinese medicine against cancer before administration of the drug;
3. Participants with cancer other than SCLC (excluding cervical carcinoma in situ, cured basal cell carcinoma, bladder epithelial tumor [including TA and tis]) within five years before the start of this study;
4. Participants with any unstable systemic disease (including active infection, uncontrolled hypertension), unstable angina pectoris, angina pectoris starting in the last three months, congestive heart failure (>= NYHA) Grade II), myocardial infarction (6 months before admission), severe arrhythmia requiring drug treatment, liver, kidney or metabolic diseases;
5. With activate or suspectable autoimmune disease, or autoimmune paracancer syndrome requiring systemic treatment;
6. Antibiotics were used to treat the infection for 4 weeks prior to the start of the trial;
7. Participants who were systemically treated with corticosteroids (prednisone or other corticosteroids >10 mg/ day) or other immunosuppressive agents within 2 weeks prior to first administration. In the absence of active autoimmune disease, inhaled or topical corticosteroids and adrenal hormone replacement therapy with a dose of less than 10 mg/ day of prednisone are permitted;
8. Participants who are allergic to the test drug or any auxiliary materials
9. Participants with active hepatitis B, hepatitis C or HIV;
10. The vaccine was administered within 4 weeks of the start of the trial;
11. Participants who have undergone major surgery or severe trauma in other systems within 2 months before the start of this trial;
12. Pleural effusion, pericardial effusion or ascites that are not clinically controlled and require pleural puncture or abdominal puncture drainage within 2 weeks before inclusion;
13. The patients have active pia meningioma, uncontrolled or untreated brain metastases.
14. Pregnant or lactating women;
15. Participants suffering from nervous system diseases or mental diseases that cannot cooperate;
16. Participated in another therapeutic clinical study
17. Other factors that researchers think it is not suitable for enrollment.

Contacts and Locations

Contacts

Contact: Peng Zhang, MD; +8613512185932; zhangpeng1121@outlook.com

Locations

China, Shanghai

Shanghai Pulmonary Hospital; Recruiting

Shanghai, Shanghai, China, 200433

Contact: Peng Zhang, MD zhangpeng1121@outlook.com

Sponsors and Collaborators

Shanghai Pulmonary Hospital, Shanghai, China

More Information

• Responsible Party: Peng Zhang, Director of science and education department, Shanghai Pulmonary Hospital, Shanghai, China
• ClinicalTrials.gov Identifier: NCT04539977
• Other Study ID Numbers: LungMate-005(SCLC-TQB2450-001)
• First Posted: September 7, 2020
• Last Update Posted: January 28, 2021
• Last Verified: January 2021

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Undecided
• Plan Description: The researchers will consider whether IPD is available to other researchers only after the paper is published

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Lung Neoplasms; Small Cell Lung Carcinoma; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases; Carcinoma, Bronchogenic; Bronchial Neoplasms; Cisplatin; Etoposide; Etoposide phosphate; Antineoplastic Agents; Antineoplastic Agents, Phytogenic; Topoisomerase II Inhibitors; Topoisomerase Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action