NCT03313804

Priming Immunotherapy in Advanced Disease With Radiation

• Status: Completed
• Phase: Phase 2
• Study type: Interventional
• Enrollment: 76 (actual)
• Sponsor: John L. Villano, MD, PhD · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

This study proposes to treat metastatic non-small cell lung cancer (NSCLC) and head/neck squamous cell cancer (HNSCC) patients who are already initiating an immune checkpoint inhibitor (such as Nivolumab, Atezolizumab or Pembrolizumab) for disease treatment as per FDA approved guidelines. In these patients we will deliver a short-course radiation to a single systemic (non-CNS) site within 14 days of receiving the first dose of immune checkpoint inhibitors. This sequence allows radiation to release tumor antigens from immune inaccessible areas such as necrotic tumor or low perfusion to provide a robust anti-tumor immune response with immune checkpoint inhibitors. The primary objective is to assess six-month progression free survival (PFS) compared to historical control.

Detailed description

Subjects with front-line or relapsed NSCLC or relapsed HNSCC who are intended to receive standard of care immune checkpoint inhibitors without a contraindication to Stereotactic Body Radiation Therapy (SBRT) to a single cancer deposit greater than 1 cm (metastasis or primary cancer) will be enrolled. Subjects will receive standard of care (SOC) immune checkpoint inhibitors and within 2 weeks of initiation, and will receive either: * SBRT to target to achieve Biological Equivalent Dose (BED) \> 100 Gy OR * 30 Gy fractionated radiation therapy (RT) delivered as a 3 dimensional (3-D) dose. The lesion choice will be made by the treating radiation oncologist and will be directed to a single malignant focus (non-CNS) that measures ≥ 1 cm. Essentially, the goals of both techniques are the same but SBRT is reserved for lesions that are readily encompassed by a single field with large RT fractions in which dose-limiting organs are within safe limits.

Conditions

• Non-small Cell Lung Cancer
• Squamous Cell Carcinoma of the Head and Neck

Interventions

Type	Name	Description
DRUG	Immune checkpoint inhibitor	Standard of care immune checkpoint inhibitor
RADIATION	Radiation Therapy	Stereotactic Body Radiation Therapy OR Fractionated radiation therapy

Timeline

• Start date: 2017-10-26
• Primary completion: 2024-02-16
• Completion: 2026-02-16
• First posted: 2017-10-18
• Last updated: 2026-03-11
• Results posted: 2025-04-06

Locations

1 site across 1 country: United States

Regulatory

• FDA-regulated drug study
• FDA-regulated device study