FMT+Immunotherapy+Chemotherapy As First-line Treatment for Driver-gene Negative Advanced NSCLC

Last updated: December 18, 2024
Sponsor: Changzhou No.2 People's Hospital
Overall Status: Active - Recruiting

Phase

2

Condition

Non-small Cell Lung Cancer

Treatment

Fecal Microbiota Transplantation (FMT)+chemotherapy+immunotherapy

Clinical Study ID

NCT06403111
[2024]YLJSA005
  • Ages 18-80
  • All Genders
  • Accepts Healthy Volunteers

Study Summary

This study plans to reconstruct intestinal microecology through fecal microbiota transplantation (FMT), and combine with standard first-line therapy to enhance the anti-tumor immune effect at the same time, thereby extending the progression-free survival of patients and improving the prognosis of patients.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. The subjects voluntarily joined the study and were able to sign the informed consentwith good compliance;

  2. Age 18-80 years old (when signing the informed consent form);

  3. Patients with histologically or cytologically proven locally advanced (stageIIIB/IIIC), metastatic, or recurrent (stage IV) NSCLC who are inoperable and unableto receive radical concurrent chemoradiotherapy, according to the InternationalAssociation for the Study of Lung Cancer and the American Joint Committee on CancerClassification, 8th Edition TNM Classification of Lung cancer;

  4. Have not received systemic intravenous anti-tumor therapy before, and the drivergene is negative;

  5. PD-L1 expression < 50%;

  6. According to the solid tumor efficacy evaluation criteria (RECIST version 1.1),there is at least one radiographically measurable lesion; That is, in CT or MRIdetection, the longest diameter of a single lesion was ≥10mm, or the pathologicalenlargement of a single lymph node was ≥15mm.

  7. The physical status score of Eastern Tumor Collaboration Group (ECOG) was 0-1;

  8. Expected survival > 3 months;

  9. Have adequate organ and bone marrow function, laboratory examination within 7 daysprior to enrollment meets the following requirements (no blood components, cellgrowth factors, albumin or other corrective drugs are allowed within 14 days priorto obtaining laboratory examination), as follows: 1) Blood routine: absoluteneutrophil count (ANC) ≥1.5×10 9/L, platelet (PLT) ≥75×10 9/L, hemoglobin (HGB) ≥90g/L (no blood transfusion or erythropoietin dependence within 14 days); 2) Liverfunction: serum total bilirubin (TBIL) ≤2 times the upper limit of normal (ULN);Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) ≤ 5x ULN,serum albumin ≥28 g/L; alkaline phosphatase (ALP) ≤5×ULN; 3) Renal function: serumcreatinine (Cr) ≤1.5×ULN, or creatinine clearance ≥50 mL/min (using the standardCockcroft-Gault formula) : Urine routine results showed urinary protein < 2+; Forpatients with urine protein ≥2+ at baseline, 24-hour urine collection and 24-hoururine protein quantification < 1g should be performed. 4) Coagulation function:International standardized ratio (INR) or prothrombin time (PT) ≤1.5 times ULN; Ifthe subject is receiving anticoagulant therapy, as long as the INR is within theintended range of anticoagulant drug use.

  10. For female subjects of reproductive age, a urine or serum pregnancy test should beperformed and the result is negative 3 days prior to receiving the initial studydrug administration;

  11. Subjects and their sexual partners are required to use a medically approvedcontraceptive method (such as an intrauterine device (IUD), contraceptive pill, orcondom) during the study treatment period and for 6 months after the end of thestudy treatment period.

Exclusion

Exclusion Criteria:

  1. Currently participating in an interventional clinical study or receiving anotherinvestigational drug or investigational device within 4 weeks prior to initialdosing;

  2. Received proprietary Chinese medicines with anti-tumor indications orimmunomodulatory drugs (thymosin, interferon, interleukin, etc.) within 2 weeksbefore the first administration, or received major surgical treatment within 3 weeksbefore the first administration;

  3. Class III - IV congestive heart failure (New York Heart Association classification),poorly controlled and clinically significant arrhythmias;

  4. Any arterial thrombosis, embolism or ischemia, such as myocardial infarction,unstable angina pectoris, cerebrovascular accident or transient ischemic attack,occurred within 6 months before treatment;

  5. Known allergic reaction to the drug in this study;

  6. Patients who require long-term oral, intravenous, or intramuscular administration ofsystemic corticosteroids;

  7. Symptomatic central nervous metastases. Patients with asymptomatic brain metastases (BMS) or BMS whose symptoms are stable after treatment are eligible to participatein this study if they meet all of the following criteria: measurable lesions outsidethe central nervous system; No midbrain, pontine, cerebellum, meninges, medullaoblongata or spinal cord metastasis; Maintain clinical stability for at least 2weeks; Stop hormone therapy 3 days before the first dose of the study drug;

  8. There is an active infection requiring treatment or systemic anti-infective drugshave been used in the week prior to the first dosing;

  9. Has not fully recovered from toxicity and/or complications caused by anyintervention before starting treatment (i.e., ≤ grade 1 or baseline, excludingweakness or hair loss);

  10. Known history of human immunodeficiency virus (HIV) infection (i.e. HIV 1/2 antibodypositive);

  11. Untreated active hepatitis B (defined as HBsAg positive and HBV-DNA copy numberdetected greater than the upper limit of normal value in the laboratory of the studycenter);

  12. Active HCV-infected subjects (HCV antibody positive and HCV-RNA levels above thelower limit of detection);

  13. Received live vaccine within 30 days prior to the first dose (cycle 1, day 1); Note:Injectable inactivated virus vaccine against seasonal influenza is permitted for 30days prior to initial administration; However, live attenuated influenza vaccinesadministered intranasally are not permitted.

  14. Pregnant or lactating women;

  15. Medical history or evidence of disease that may interfere with test results, preventparticipants from fully participating in the study, abnormal treatment or laboratorytest values, or other conditions that the investigator considers unsuitable forenrollment The Investigator considers other potential risks unsuitable forparticipation in the study.

Study Design

Total Participants: 62
Treatment Group(s): 1
Primary Treatment: Fecal Microbiota Transplantation (FMT)+chemotherapy+immunotherapy
Phase: 2
Study Start date:
June 01, 2024
Estimated Completion Date:
June 01, 2026

Study Description

This is a prospective, single-arm, multi-center, exploratory clinical study. That is, eligible patients with driver-gene negative, ECOG PS 0-1, PD-L1<50% advanced non-small cell lung cancer who have not received prior treatment will be screened after signing informed consent and receive FMT combined with tislelizumab + pemetrexed + platinum-based treatment (lung adenocarcinoma) / albumin-bound paclitaxel + platinum-based treatment (lung squamous cell carcinoma) for 4-6 cycles. If there is no progression of the disease after 4-6 cycles of the first-line treatment, then patients will enter the maintenance treatment stage. Patients will receive tislelizumab maintenance treatment (lung squamous cell carcinoma), or tislelizumab + pemetrexed maintenance treatment (lung adenocarcinoma). RECIST v1.1 was used for tumor evaluation every 6 weeks during treatment. NCI-CTCAE 5.0 was used for safety assessment every 3 weeks. Adverse events were recorded throughout the study to 30 days after the end of treatment. Treatment continues until disease progression, subject withdraws informed consent, loss of follow-up, or death. Patients should provide 10ml whole blood samples and fecal samples at baseline, after two cycles of treatment, before maintenance treatment, and after two cycles of maintenance treatment for the detection of efficacy prediction markers (each cycle is 21 days).

Connect with a study center

  • Changzhou No.2 Poeple's Hospital

    Changzhou,
    China

    Active - Recruiting

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