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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2400093459 |
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最近更新日期: Date of Last Refreshed on: |
2024-12-05 10:16:32 |
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注册时间: Date of Registration: |
2024-12-05 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
EGFR突变的初始III期N3非小细胞肺癌在一线治疗(阿美替尼+化疗)基础上联合局部治疗(手术+放疗或放疗)对预后和患者报告结局的影响:一项前瞻性、单中心、II期临床研究 |
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Public title: |
Prognosis and Patient-Reported Outcomes of Combined Local Treatments (Radiotherapy and Surgery or Radiotherapy Alone) with Almonertinib and Chemotherapy in EGFR-Mutant Stage III-N3 Non-Small Cell Lung Cancer: A Prospective, Single-Center, Phase II Trial |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
EGFR突变的初始III期N3非小细胞肺癌在一线治疗(阿美替尼+化疗)基础上联合局部治疗(手术+放疗或放疗)对预后和患者报告结局的影响:一项前瞻性、单中心、II期临床研究 |
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Scientific title: |
Prognosis and Patient-Reported Outcomes of Combined Local Treatments (Radiotherapy and Surgery or Radiotherapy Alone) with Almonertinib and Chemotherapy in EGFR-Mutant Stage III-N3 Non-Small Cell Lung Cancer: A Prospective, Single-Center, Phase II Trial |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
李爱琳 |
研究负责人: |
刘宏旭 |
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Applicant: |
Ailin Li |
Study leader: |
Hongxu Liu |
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申请注册联系人电话: Applicant telephone: |
+86 185 0986 0482 |
研究负责人电话:
Study leader's |
+86 24 8191 6273 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
liailin0312@163.com |
研究负责人电子邮件: Study leader's E-mail: |
hongxuliu@qq.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
辽宁省沈阳市大东区小河沿路44号 |
研究负责人通讯地址: |
辽宁省沈阳市大东区小河沿路44号 |
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Applicant address: |
No.44 Xiao Heyan Road, Dadong District, Shenyang, Liaoning, China |
Study leader's address: |
No.44 Xiao Heyan Road, Dadong District, Shenyang, Liaoning, China |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
辽宁省肿瘤医院 |
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Applicant's institution: |
Liaoning Cancer Hospital & Institute |
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研究负责人所在单位: |
辽宁省肿瘤医院 |
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Affiliation of the Leader: |
Liaoning Cancer Hospital & Institute |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
20241030 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
辽宁省肿瘤医院医学伦理委员会 |
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Name of the ethic committee: |
Ethics Committee of Liaoning Cancer Hospital & Institute |
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伦理委员会批准日期: Date of approved by ethic committee: |
2024-10-12 00:00:00 | ||
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伦理委员会联系人: |
李爽 |
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Contact Name of the ethic committee: |
Shuang Li |
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伦理委员会联系地址: |
辽宁省沈阳市大东区小河沿路44号 |
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Contact Address of the ethic committee: |
No.44 Xiao Heyan Road, Dadong District, Shenyang, Liaoning, China |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 24 8191 6632 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
szlyy315@163.com |
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研究实施负责(组长)单位: |
辽宁省肿瘤医院 |
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Primary sponsor: |
Liaoning Cancer Hospital & Institute |
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研究实施负责(组长)单位地址: |
辽宁省沈阳市大东区小河沿路44号 |
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Primary sponsor's address: |
No.44 Xiao Heyan Road, Dadong District, Shenyang, Liaoning, China |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
无 |
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Source(s) of funding: |
None |
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研究疾病: |
非小细胞肺癌 |
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Target disease: |
Non-Small Cell Lung Cancer |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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研究设计: |
单臂 |
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Study design: |
Single arm |
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研究目的: |
评价局部治疗(放疗+手术或单纯放疗)联合阿美替尼与化疗对表皮生长因子受体突变的III期-N3非小细胞肺癌患者的预后及患者报告结局 |
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Objectives of Study: |
To evaluate the prognosis and patient-reported outcomes of combined local treatment (radiotherapy and surgery or radiotherapy alone) with almonertinib and chemotherapy in EGFR-mutant stage III-N3 non-small cell lung cancer |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1. 年龄在 18 岁以上(含 18 岁); 2. 东部肿瘤组织协作组(ECOG)体力状态评分为 0 或 1,并且在治疗前2周内没有恶化,预期生存期不少于12周; 3. 组织学或细胞学证实为NSCLC,T1-4N3M0(AJCC 9th);全身18F-氟代-脱氧葡萄糖正电子发射断层扫描(PET)或造影剂增强计算机断层扫描(CT)或PET-CT可疑的淋巴结,应接受侵袭性淋巴结分期,可经支气管内超声、纵隔镜检查、胸腔镜检查或穿刺活检来证实;但纵隔5区和6区淋巴结高度可疑的时候不强制; 4. 确诊为NSCLC之后未接受过任何系统性治疗或局部治疗; 5. 已知EGFR敏感突变(包括外显子19缺失或21 L858R,两者单独存在或共存或伴有其他EGFR位点突变均可,伴有原发 T790M 突变可以入组,伴有 20 外显子插入突变不能入组,血检/细胞学/组织学均认可); 6. 患者至少有1个肿瘤病灶在基线时为符合 RECIST 1.1 标准的可测量病灶。基线期最长径≥10 mm(如果是淋巴结,要求短径≥15 mm)。选择的测量方法适合准确重复测量,可以是CT或磁共振扫描(MRI)。如仅存在1个可测量的病灶则可接受其作为靶病灶,需在诊断性活检至少14天之后进行肿瘤病灶基线评价。肿瘤基线影像学评估在首次用药前的 28 天内进行; 7. 育龄女性从筛选到停止研究治疗后3个月需采取合适的避孕措施且不应该哺乳。开始给药前,妊娠试验为阴性,或者满足下列标准之一证明没有妊娠风险:①绝经后定义为年龄大于50岁和停止所有外源性激素替代治疗后闭经至少12个月;②年龄小于50岁的女性,如果停止所有外源性激素治疗后闭经12个月或以上,且促黄体激素(LH)和卵泡刺激激素(FSH)水平在实验室绝经后参考值范围内,也可认为是绝经后;③曾经接受不可逆的绝育手术,包括子宫切除,双侧卵巢切除或双侧输卵管切除,但双侧输卵管结扎除外; 8. 从筛选到停止研究治疗后3个月男性患者应使用屏障避孕(即避孕套); 9. 受试者本人自愿参加并书面签署知情同意书。 |
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Inclusion criteria |
1. Age above 18 years old (including 18 years old); 2. The Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1, and no deterioration in the first 2 weeks of treatment, and the expected survival time is not less than 12 weeks; 3. Histological or cytological confirmation of NSCLC, T1-4N3M0 (AJCC 9th); Systemic 18F-fluorodeoxyglucose positron emission tomography (PET) or contrast-enhanced computed tomography (CT) or PET-CT suspicious lymph nodes should undergo invasive lymph node staging, which can be confirmed by endobronchial ultrasound, mediastinoscopy, thoracoscopy, or needle biopsy; However, when the lymph nodes of mediastinal region 5 and 6 were highly suspicious, they were not forced; 4. Did not receive any systemic or local treatment after diagnosis of NSCLC; 5. Known EGFR-sensitive mutations (including exon 19 deletion or 21 L858R, both alone or co-existing or accompanied by other EGFR site mutations, with primary T790M mutation can be included, with exon 20 insertion mutation can not be included, blood/cytology/histology approved); 6. The patient had at least one tumor lesion that was measurable at baseline according to RECIST 1.1 criteria. Maximum diameter ≥10 mm at baseline (minimum diameter ≥15 mm in case of lymph nodes). The measurement method chosen is suitable for accurate repeat measurements and can be a CT or magnetic resonance scan (MRI). If only one measurable lesion is present, it can be accepted as a target lesion, and baseline evaluation of the tumor lesion should be performed at least 14 days after the diagnostic biopsy. Baseline imaging assessment of the tumor was performed within 28 days prior to the first dose. 7. Women of childbearing age should use appropriate contraception and should not breastfeed for 3 months from screening to discontinuation of study treatment. Prior to initiation of the drug, the pregnancy test was negative, or one of the following criteria was met to demonstrate that there was no pregnancy risk: ① Postmenopause was defined as age greater than 50 years and amenorrhea for at least 12 months after discontinuation of all exogenous hormone replacement therapy; (2) Women younger than 50 years of age may also be considered postmenopausal if they have stopped all exogenous hormone therapy for 12 months or more and their luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels are within the laboratory postmenopausal reference range; Have undergone irreversible sterilization, including hysterectomy, bilateral ovariectomy, or bilateral tubal resection, except bilateral tubal ligation; 8. Male patients should use barrier contraception (i.e., condoms) for 3 months from screening to discontinuation of study treatment; 9. The participant must voluntarily agree to participate and provide written informed consent. |
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排除标准: |
1. 确诊肺上沟瘤; 2. 原发肿瘤或转移淋巴结包绕或浸润主动脉/气管/食管/心脏等; 3. 接受过下列任一治疗:①既往接受过肺部手术;②既往使用过任何EGFR酪氨酸激酶抑制剂;③既往接受任何针对肺癌的系统性化疗或免疫治疗等抗肿瘤治疗;④既往接受任何肺癌放疗;⑤在患者使用研究药物之前14天内接受过重大手术;或者28天内接受过重大手术,尚未从干预治疗的毒性和/或并发症中充分恢复;⑥如曾使用过抗肿瘤作用的中成药但使用时间不超过7天,且在本研究药物治疗前已停药2周及以上可以入组; 4. 除了NSCLC之外,近5年内还被诊断有另外一种恶性疾病(不包括完全切除的基底细胞或鳞状细胞皮肤癌,浅表性膀胱癌,宫颈原位癌或乳腺原位癌); 5. 既往做过胃大部分切除术者,以及患有吞咽功能障碍、活动性胃肠道疾病或其他显著影响口服药物的吸收、分布、代谢以及排泄的疾病; 6. 近1周内有发热且体温在38℃以上,或有临床意义的活动性感染,活动性肺结核,以及需要全身治疗的活动性真菌、细菌和/或病毒感染【允许慢性乙型肝炎病毒(HBV)或丙型肝炎病毒(HCV)感染患者接受抗病毒治疗】; 7. 有活动性出血或新发血栓性疾病正在服用治疗量抗凝药物或有出血倾向者; 8. 符合以下任一项心脏检查结果:①静息状态下的心电图(ECG)检查得出的校正QT间期(QTc)> 470 msec;②静息ECG提示存在各种有临床意义的节律,传导或ECG形态学重大异常(例如具有临床意义的室性心律失常或心房颤动、完全性左束支传导阻滞、3度房室传导阻滞、2度房室传导阻滞和PR间期> 250 msec);③3个月内发生过不稳定心绞痛、心肌梗塞、冠状动脉/外周动脉搭桥或脑血管意外;④存在导致QT间期延长的危险因素或增加心律不齐的危险因素,如心衰,≥CTCAE(4.03版)、2度低钾血症(血钾<3.0mmol/L,并且有症状、需要治疗),先天性长QT综合症,长QT综合症家族史;或40岁以下直系亲属的不明原因猝死;或首次给药前2周内正在使用任何已知延长QT间期的药物;⑤充血性心力衰竭,纽约心脏病协会(NYHA)分级≥ 2 级的慢性心衰;⑥左心室射血分数(LVEF)≤40%; 9. 未得到控制的高血压(即指经过药物治疗后仍为大于或等于 CTCAE 3 级高血压)的证据; 10. 存在严重或不能控制的全身性疾病、不稳定或不能代偿的呼吸、肝或肾脏疾病; 11. 有间质性肺病病史或有临床活动性间质性肺病、肺部炎症(非感染性)或控制不佳的肺部疾病(包括肺纤维化、急性肺疾病等); 12. 骨髓储备或器官功能不足,达到下列任何一项实验室限值(实验室检查抽血前1周内无纠正治疗):①绝对嗜中性粒细胞计数<1.5×109 / L;②血小板计数<90×109 / L;③血红蛋白<90 g/L(<9 g/dL);④丙氨酸氨基转移酶>2.5倍的正常上限(ULN);⑤天冬氨酸氨基转氨酶>2.5×ULN;⑤总胆红素> 1.5×ULN,或存在Gilbert综合征(未结合的高胆红素血症);⑥肌酐>1.5×ULN或肌酐清除率<45 mL/min(通过Cockcroft - Gault公式计算);仅当肌酐>1.5×ULN时才需要确认肌酐清除率;⑦血清白蛋白(ALB)<28 g/L; 13. 需要频繁引流的、控制不良的胸腔积液、心包积液或腹水(干预后2周内复发); 14. 在研究治疗首次给药前14天内,存在控制不良的糖尿病,或者尽管进行了规范的药物治疗但仍存在> 1级的钾、钠或校正钙实验室检查结果异常; 15. 妊娠期、哺乳期或计划在研究期间妊娠的女性受试者; 16. 对阿美替尼的任何活性或非活性成分或对与阿美替尼化学结构类似或阿美替尼同类别的 药物有超敏反应史; 17. 对培美曲塞或该制剂中其他任何成分、顺铂或其他含铂化合物过敏的患者;存在顺铂、培美曲塞禁忌症的患者; 18. 任何严重或者未控制的眼部病变(特别是严重干眼综合征、干性角膜结膜炎、严重的暴露 性角膜炎或其他可能增加上皮损害的疾病),经医生判断可能增加受试者的安全性风险;或需要手术或预期研究期间需要手术治疗的眼部异常者; 19. 2周内使用/食用已知具有强效CYP3A4抑制作用的药物或食物,包括但不限于阿扎那韦、 克拉霉素、茚地那韦、伊曲康唑、酮康唑、奈法唑酮、奈非那韦、利托那韦、沙奎那韦、泰利霉素、醋竹桃霉素、伏立康唑和葡萄柚或葡萄柚汁; 20. 2周内使用已知具有强效CYP3A4诱导作用的药物,包括但不限于卡马西平、苯巴比妥、 苯妥英、利福布丁、利福平和贯叶连翘; 21. 2周内使用作为CYP3A4底物(具有狭窄治疗指数)的药物,包括但不限于双氢麦角胺、 麦角胺、匹莫齐特、阿司咪唑、西沙必利和特非那定; 22. 经研究者判断可能对研究的程序和要求依从性不佳的受试者,如受试者既往有明确的神 经或精神障碍病史(包括癫痫或痴呆)、目前患有精神障碍类疾病等; 23. 同时参与另一项治疗性临床试验【允许同时参与观察性或非干预性研究】; 24. 研究者判断存在任何危及受试者安全或干扰研究评估的状况的受试者。 |
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Exclusion criteria: |
1. Diagnosis of superior lung sulcus tumor; 2. Primary tumor or metastatic lymph nodes surround or infiltrate aorta/trachea/esophagus/heart, etc. 3. Have received any of the following treatment: ① Have previously undergone lung surgery; ② Previous use of any EGFR tyrosine kinase inhibitors; (3) Prior acceptance of any antitumor therapy such as systemic chemotherapy or immunotherapy for lung cancer; (4) Receiving any previous radiotherapy for lung cancer; Had undergone major surgery within 14 days prior to use of the study drug; Or have undergone major surgery within 28 days and have not fully recovered from the toxicity and/or complications of the intervention; (6) Patients who had used proprietary Chinese medicines with anti-tumor effects for no more than 7 days, and had stopped taking the drugs for 2 weeks or more before the drug treatment in this study could be enrolled; 4. In addition to NSCLC, have been diagnosed with another malignant disease within the last 5 years (excluding completely resected basal cell or squamous cell skin cancer, superficial bladder cancer, cervical carcinoma in situ, or breast carcinoma in situ); 5. People who have had a major gastrectomy in the past, and who have swallowing dysfunction, active gastrointestinal disease, or other diseases that significantly affect the absorption, distribution, metabolism, and excretion of oral drugs; 6. Fever with a body temperature above 38 ° C within the last 1 week, or clinically significant active infections, active tuberculosis, and active fungal, bacterial, and/or viral infections requiring systemic treatment [Allow patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection to receive antiviral therapy]; 7. Patients with active bleeding or new thrombotic diseases who are taking therapeutic amounts of anticoagulant drugs or have bleeding tendencies; 8. Meet any of the following cardiac test results: (1) Corrected QT interval (QTc) from resting electrocardiogram (ECG) examination > 470 msec; The resting ECG indicates a variety of clinically significant rhythms, conduction or ECG morphological abnormalities (e.g., clinically significant ventricular arrhythmia or atrial fibrillation, complete left bundle branch block, 3rd degree atrioventricular block, 2nd degree atrioventricular block, and PR interval > 250 msec); ③ Unstable angina pectoris, myocardial infarction, coronary/peripheral artery bypass, or cerebrovascular accident occurred within 3 months; (4) There are risk factors leading to prolonged QT interval or increased risk factors for arrhythmia, such as heart failure, ≥CTCAE (4.03 version), 2 degrees hypokalemia (blood potassium <3.0mmol/L, and symptoms, need treatment), congenital long QT syndrome, long QT syndrome family history; Or sudden unexplained death of an immediate family member under the age of 40; Or being on any drug known to prolong the QT interval within 2 weeks prior to initial dosing; Congestive heart failure, New York Heart Association (NYHA) grade ≥ 2 chronic heart failure; Left ventricular ejection fraction (LVEF) ≤40%; 9. Evidence of uncontrolled hypertension (i.e., hypertension greater than or equal to CTCAE level 3 after medication); 10. The presence of severe or uncontrolled systemic disease, unstable or uncompensable respiratory, liver or kidney disease; 11. A history of interstitial lung disease or clinically active interstitial lung disease, lung inflammation (non-infectious) or poorly controlled lung disease (including pulmonary fibrosis, acute lung disease, etc.); 12. Insufficient bone marrow reserve or organ function, reaching any of the following laboratory limits (no corrective treatment within 1 week before blood drawing by laboratory test) : ① Absolute neutrophil count <1.5×109 / L; ② Platelet count <90×109 / L; Hemoglobin <90 g/L (<9 g/dL); ④ Alanine aminotransferase >2.5 times the upper limit of normal (ULN); ⑤ Aspartate aminotransferase >2.5×ULN; (5) Total bilirubin > 1.5×ULN, or Gilbert syndrome (unbound hyperbilirubinemia); Creatinine >1.5×ULN or creatinine clearance <45 mL/min (calculated by Cockcroft-Gault formula); Creatinine clearance needs to be confirmed only when creatinine >1.5×ULN; Serum albumin (ALB) <28 g/L; 13. Poorly controlled pleural effusion, pericardial effusion, or ascites requiring frequent drainage (recurrence within 2 weeks after intervention); 14. The presence of poorly controlled diabetes or abnormal grade 1 potassium, sodium, or corrected calcium laboratory findings in the 14 days prior to the first dosing of the study therapy; 15. Female subjects who are pregnant, breastfeeding, or planning to become pregnant during the study period; 16. A history of hypersensitivity to any active or inactive component of ametinib or to drugs chemically similar to or in the same class of ametinib; 17. Patients who are allergic to pemetrexed or any other component of the preparation, cisplatin or other platinum-containing compounds; Patients with contraindications to cisplatin and pemetrexed; 18. Any severe or uncontrolled ocular disease (especially severe dry eye syndrome, dry keratoconjunctivitis, severe exposure keratitis, or other disease that may increase epithelial damage) that, in the physician's judgment, may increase the subject's safety risk; Or eye abnormalities that require surgery or are expected to require surgery during the study period; 19. Use/consumption of drugs or foods known to have potent CYP3A4 inhibition within 2 weeks, including but not limited to azanavir, clarithromycin, indinavir, itraconazole, ketoconazole, nefazodone, nefinavir, Ritonavir, saquinavir, tellycin, acetotomycin, voriconazole, and grapefruit or grapefruit juice; 20. Use drugs known to have potent CYP3A4 induction, including but not limited to carbamazepine, phenobarbital, phenytoin, rifampudding, and rifampicin for 2 weeks; 21. Drugs used within 2 weeks as substrates for CYP3A4 (with a narrow therapeutic index), including but not limited to dihydroergotamine, ergotamine, pimoxide, astimizole, Cisapride, and terphenadine; 22. Subjects who, according to the investigator's judgment, may have poor compliance with the procedures and requirements of the study, such as subjects with a clear past history of scripture or mental disorders (including epilepsy or dementia), and currently suffering from mental disorders; 23. Concurrent participation in another therapeutic clinical trial [concurrent participation in observational or non-interventional studies is permitted]; 24. Subjects who the investigator determines have any condition that endangers subjects' safety or interferes with study evaluation. |
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研究实施时间: Study execute time: |
从 From 2025-01-01 00:00:00至 To 2029-01-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2025-01-01 00:00:00 至 To 2027-01-01 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
无 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
None |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
无 |
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Blinding: |
None |
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是否共享原始数据: IPD sharing |
否No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
无 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
电子采集和管理系统 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
EDC |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
暂未确定/Not yet |