This is an open-label, single-arm, prospective phase 2 study, evaluating the efficacy and safety of tislelizumab combined with sitravatinib as maintenance therapy following tislelizumab and chemotherapy for treatment naïve extensive stage small cell lung cancer.
The study included screening period, treatment period (including induction and maintenance), safety follow-up and survival follow-up periods. Induction treatment will be administered on a Q3W cycle for 4 cycles. Following induction treatment, patients who have received 4 cycles of tislelizumab and platinum-based chemotherapy and meet the following criteria will enter a maintenance treatment phase with tislelizumab and sitravatinib: Patients have an ongoing response per RECIST v1.1 criteria of SD or better assessed by the investigator according to RECIST v1.1(Patients will be eligible to enter maintenance phase if chemotherapy interruption due to toxicity, but at least 3 cycles of tislelizumab combined with chemotherapy are completed and assessed as CR, PR or SD according to RECISTv1.1 criteria). Excluded patients with central cavitary ES-SCLC, or tumor invading or adjacent to large vessels as shown by imaging, and likely to invade large vessels and cause fatal bleeding assessed by the investigator. During the maintenance treatment period prophylactic cranial irradiation (PCI) is permitted as per local standard of care. Treatment may continue until 1) disease progression as assessed by the investigator per RECIST v1.1, 2) loss of clinical benefit as assessed by the investigator, 3) unacceptable toxicity, or 4) withdrawal of informed consent, whichever occurs first, 5) study treatment duration reached 2 years (including induction and maintenance period). Per investigator's discretion, patients who may continue to benefit from study treatment after progressive disease must meet the following criteria in order to be treated and documented in the study records: Absence of symptoms and signs indicating clinically significant progression of disease and absence of worsening of laboratory values indicating disease progression. Stable ECOG performance status ≤ 1 Absence of rapid progression of disease or of progressive tumor at critical anatomical sites (eg,cord compression) that requires urgent alternative medical intervention Investigators must obtain written informed consent for treatment beyond radiologic disease. Study treatment will be administered for up to 2 years (including induction and mantenance period).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
21
Tislelizumab 200mg IV D1, Q3W
The starting dose of sitravatinib in this study is 70 mg, oral once daily. After receiving 1 cycle of starting dose at 70 mg once daily with sitravatinib, if patients were tolerated well with study treatment (without AEs definitely related to sitravatinib nor TRAEs leading to sitravatinib dose reduction and interruption), it is recommended to escalate sitravatinib dose to 100 mg once daily at the discretion of the investigators after discussion with patients.
Zhejiang Cancer Hospital
Hangzhou, Zhejiang, China
1-year Progression-Free-Survival (PFS) rate assessed by investigator in maintenance phase-patient analysis set per RECIST v1.1
1-year PFS rate assessed by investigator in maintenance phase-patient analysis set per RECIST v1.1. PFS is defined as the time from the first dose of study drug(s) in maintenance phase to the first occurrence of disease progression as determined by investigator using RECIST v1.1 or death from any cause, whichever occurs first.
Time frame: Start of maintenance therapy until 1-year follow-up
Progression-Free-Survival (PFS)
PFS assessed by investigators per RECIST v1.1 in maintenance phase-patient analysis set and induction phase-patient analysis set, respectively.
Time frame: up to 2 year
Overall Survival (OS)
OS, defined as the time from first dose of study drug(s) to death from any cause, in maintenance phase-patient analysis set and induction phase-patient analysis set, respectively.
Time frame: up to 2 year
Objective Response Rate (ORR)
ORR, defined as the proportion of patients with partial response or complete response as determined by the investigators based on RECIST v1.1 in maintenance phase-patient analysis set and induction phase-patient analysis set, respectively.
Time frame: up to 2 year
Disease Control Rate (DCR)
DCR, defined as the proportion of patients achieving complete response (CR), partial response (PR), or stable disease (SD) as determined by the investigators based on RECIST v1.1 in maintenance phase-patient analysis set and induction phase-patient analysis set, respectively.
Time frame: up to 2 year
Duration of Response (DOR)
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DOR is defined as the duration from the date of patients achieve CR or PR to the date of PD or death, which occurs first, for patients with an objective response in maintenance phase-patient analysis set and induction phase-patient analysis set, respectively.
Time frame: up to 2 year
Adverse events (per CTCAE v5.0 criteria)
Safety characterized by type, incidence, severity, timing, seriousness and relationship to study treatment of adverse events (AEs) and serious adverse events (SAEs) per the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 5.0.
Time frame: Up to 2 years