Phase
Condition
Melanoma
Non-small Cell Lung Cancer
Treatment
Stereotactic radiosurgery
Immune checkpoint inhibitor
Clinical Study ID
Ages > 18 All Genders
Study Summary
Eligibility Criteria
Inclusion
Most important inclusion criteria:
Newly diagnosed, previously untreated (except for surgery, see below) asymptomaticor oligo-symptomatic brain metastases, e.g., controlled symptomatic seizuredisorder. Note: patients with neurological symptoms or signs that require more thana stable dose of 4 mg dexamethasone equivalent for more than one week are notconsidered oligo-symptomatic.
Requirements for brain metastases:
Brain metastases must be previously untreated, except for surgery.
Prior surgery (including biopsies, resection, and cyst aspiration) for brainmetastases is allowed. Residual and measurable disease after surgery is notrequired, but surgery must have confirmed the diagnosis. An MRI performed within 72hours post-surgery should be available.
Number and size of metastases at diagnosis of brain metastases:
Maximum 1-10 brain metastases at screening
At least one brain metastasis must be of ≥5 mm in diameter
In case of 1-4 brain metastases:
Longest diameter of largest brain metastasis must be ≤30 mm
In case of 5-10 brain metastases:
Largest metastasis must be ≤10 mL in volume and longest diameter must be ≤30 mm
Maximum cumulative brain metastases volume must be ≤30 mL
Primary disease of histologically confirmed (from primary tumour or from ametastatic lesion, including in the brain) melanoma or NSCLC
Requirements for patients with melanoma:
Prior treatment, including treatment with immune-checkpoint inhibitors is permitted,but brain metastases must be newly diagnosed and previously untreated (except forsurgery).
BRAF-mutation status, locally assessed, should be known (previous adjuvantBRAF-targeted therapy is allowed).
Requirements for patients with NSCLC:
Newly diagnosed, treatment-naïve (except for prior surgery) metastatic NSCLC, withor without a targetable oncogenic driver alteration.
Known PD-L1 expression status (from primary tumour or from a metastatic lesion,including brain)
Known driver mutation status (from primary tumour or from a metastatic lesion,including brain).
Age of 18 years or older
Karnofsky performance status of 60 or more
Life expectancy >12 weeks
Patients must be candidates for systemic treatment, within the defined cohorts (melanoma: cohorts 1a and 1b; NSCLC: cohorts 2a and 2b).
Women of childbearing potential, including women who had their last menstruation inthe last 2 years, must have a negative urinary or serum pregnancy test within 7 daysbefore randomisation.
Written IC for study participation must be signed and dated by the patient and theinvestigator prior to any study-related intervention.
Exclusion
Most important exclusion criteria:
Confirmed or probable leptomeningeal metastases according to EANO ESMO criteria
Symptomatic brain metastases at time of randomisation, e.g., neurological symptomsor signs that require more than a stable dose of 4 mg dexamethasone equivalent formore than one week.
Patients must be off steroids or on a stable dose of ≤4 mg dexamethasone equivalentat randomisation.
Patients experiencing seizures controlled by anti-epileptic drugs are eligible.
Prior whole brain irradiation or focal radiation therapy to the brain
Prior systemic treatment for brain metastases
Contra-indication for SRS
Judgment by the investigator that the patient should not participate in the study ifthe patient is unlikely to comply with study procedures, restrictions andrequirements.
Women who are pregnant or in the period of lactation.
Sexually active men and women of childbearing potential who are not willing to usean effective contraceptive method during the study.
Study Design
Connect with a study center
Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale"
Napoli,
ItalySite Not Available
Instituto Oncologico Veneto IRCCS
Padova,
ItalySite Not Available
Santa Maria della Misericordia Hospital
Perugia,
ItalyActive - Recruiting
Istituto Nazionale Tumori "Regina Elena"
Roma,
ItalyActive - Recruiting
Policlinico Umberto 1
Rome,
ItalyActive - Recruiting
Azienda ospedaliero-universitaria Senese Siena
Siena,
ItalyActive - Recruiting
NKI-AVL
Amsterdam,
NetherlandsActive - Recruiting
Vall Hebron Institute of Oncology (VHIO)
Barcelona,
SpainActive - Recruiting
Hospital Puerta de Hierro
Majadahonda,
SpainActive - Recruiting
Hospital La Fe
Valencia,
SpainActive - Recruiting
Inselspital
Bern,
SwitzerlandActive - Recruiting
Kantonsspital Winterthur
Winterthur,
SwitzerlandActive - Recruiting
Universitätsspital Zürich
Zürich,
SwitzerlandActive - Recruiting
Royal Marsden (Sutton)
London,
United KingdomActive - Recruiting
Christie NHS Manchester
Manchester,
United KingdomSite Not Available
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