ChiCTR2500110139 版本V1.0 版本创建时间2025/10/09 08:49:13 中国临床试验注册中心

审核状态:

Project audit state:

通过审核

Successful

注册号:

Registration number:

ChiCTR2500110139 

最近更新日期:

Date of Last Refreshed on:

2025-10-09 08:48:55 

注册时间:

Date of Registration:

2025-10-09 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

利厄替尼联合放射性125I粒子植入用于经EGFR-TKI治疗出现寡进展的EGFR突变晚期非鳞非小细胞肺癌患者疗效和安全性的前瞻、单臂、多中心、观察性研究

Public title:

?Efficacy and Safety of Limertinib Combined with Radioactive Iodine-125 Seed Implantation in Patients with EGFR-Mutant Advanced Non-Squamous Non-Small Cell Lung Cancer Exhibiting Oligoprogression After Prior EGFR-TKI Therapy: A Prospective, Single-Arm, Multicenter, Observational Study?

注册题目简写:

English Acronym:

研究课题的正式科学名称:

利厄替尼联合放射性125I粒子植入用于经EGFR-TKI治疗出现寡进展的EGFR突变晚期非鳞非小细胞肺癌患者疗效和安全性的前瞻、单臂、多中心、观察性研究

Scientific title:

?Efficacy and Safety of Limertinib Combined with Radioactive Iodine-125 Seed Implantation in Patients with EGFR-Mutant Advanced Non-Squamous Non-Small Cell Lung Cancer Exhibiting Oligoprogression After Prior EGFR-TKI Therapy: A Prospective, Single-Arm, Multicenter, Observational Study?

研究课题代号(代码):

Study subject ID:

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:

申请注册联系人:

高贞 

研究负责人:

张宏涛 

Applicant:

Zhen Gao 

Study leader:

Hongtao Zhang 

申请注册联系人电话:

Applicant telephone:

+86 177 6903 0721

研究负责人电话:

Study leader's telephone:

+86 311 8598 8741

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

gaozhen67@163.com

研究负责人电子邮件:

Study leader's E-mail:

hongtaozhangmd@163.com

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):

申请注册联系人通讯地址:

河北省石家庄市和平西路348号

研究负责人通讯地址:

河北省石家庄市和平西路348号

Applicant address:

NO.348 Heping West Road, Xinhua District, Shijiazhuang City, Hebei Province, China

Study leader's address:

NO.348 Heping West Road, Xinhua District, Shijiazhuang City, Hebei Province, China

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:

申请人所在单位:

河北省人民医院

Applicant's institution:

Hebei General Hospital?

研究负责人所在单位:

河北省人民医院

Affiliation of the Leader:

Hebei General Hospital?

是否获伦理委员会批准:

是/Yes

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

(2025)科研伦审第(462)号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

河北省人民医院临床科研项目伦理委员会

Name of the ethic committee:

?Ethics Committee for Clinical Research Projects of Hebei General Hospital?

伦理委员会批准日期:

Date of approved by ethic committee:

2025-08-20 00:00:00

伦理委员会联系人:

鲁杨

Contact Name of the ethic committee:

Yang Lu

伦理委员会联系地址:

河北省石家庄市和平西路348号

Contact Address of the ethic committee:

NO.348 Heping West Road, Xinhua District, Shijiazhuang City, Hebei Province, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 311 8598 8311

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

河北省人民医院

Primary sponsor:

Hebei General Hospital?

研究实施负责(组长)单位地址:

河北省石家庄市和平西路348号

Primary sponsor's address:

NO.348 Heping West Road, Xinhua District, Shijiazhuang City, Hebei Province, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

河北

市(区县):

Country:

China

Province:

Hebei

City:

单位(医院):

河北省人民医院

具体地址:

河北省石家庄市和平西路348号

Institution
hospital:

Hebei General Hospital

Address:

NO.348 Heping West Road, Xinhua District, Shijiazhuang City, Hebei Province, China

经费或物资来源:

自筹

Source(s) of funding:

?Self-finance?

Target disease:

Non-small cell lung cancer

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

单臂 

Study design:

Single arm 

研究目的:

(一) 主要目的: 评价利厄替尼联合放射性125I粒子植入用于经EGFR-TKI治疗出现寡进展的EGFR突变晚期非鳞非小细胞肺癌患者疗效; (二) 次要目的: 评价利厄替尼联合放射性125I粒子植入用于经EGFR-TKI治疗出现寡进展的EGFR突变晚期非鳞非小细胞肺癌患者的安全性和耐受性:包括不良事件(AE)和严重不良事件(SAE)的发生率,AE/SAE导致治疗终止的发生率。  

Objectives of Study:

(I) Primary Objective? To evaluate the ?efficacy of limertinib combined with radioactive iodine-125 (125I) seed implantation? in patients with ?EGFR-mutant advanced non-squamous non-small cell lung cancer (NSCLC)?? exhibiting ?oligoprogression? after prior EGFR-tyrosine kinase inhibitor (TKI) therapy. ??(II) Secondary Objectives? To assess the ?safety and tolerability profile? of the combined regimen, including incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)?? graded by CTCAE v5.0.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

合格入选本研究的受试者必须符合以下所有标准: 1. 在实施任何试验相关流程之前,签署书面知情同意; 2. 年龄≥18周岁; 3. 组织学或细胞学证实的非鳞状非小细胞肺癌; 4. 按照国际肺癌研究协会和美国癌症分类联合委员会第8版TNM肺癌分期的转移或复发性(IV期)患者; 5. 经肿瘤组织学或细胞学或血液学证实存在EGFR敏感突变(Ex19del、L858R); 6. 经EGFR-TKI治疗出现缓慢/寡进展; 7. 不能耐受或拒绝手术、外放疗; 8. ECOG评分0-2分; 9. 预期生存时间≥3个月; 10. 根据实体肿瘤疗效评价标准(RECIST v1.1版),至少有一处影像学可测量病灶。位于既往放疗照射野内的病灶如证实发生进展可视为可测量病灶; 11. 足够器官功能,受试者需满足如下实验室指标: 1) 近14天未使用粒细胞集落刺激因子的情况下,中性粒细胞绝对值(ANC)≥1.5x10^9/L; 2) 近14天未输血的情况下,血小板≥100×10^9/L; 3) 近14天内无输血或使用促红细胞生成素的情况下,血红蛋白>9g/dL; 4) 总胆红素≤1.5×正常值上限(ULN); 5) 天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)在≤2.5×ULN(有肝转移的受试者允许ALT 或AST ≤5×ULN); 6) 血肌酐≤1.5×ULN并且肌酐清除率(采用Cockcroft-Gault 公式计算)≥60 ml/min; 7) 凝血功能良好,定义为国际标准化比值(INR)或凝血酶原时间(PT)≤1.5倍ULN; 8) 甲状腺功能正常,定义为促甲状腺激素(TSH)在正常范围内。如基线TSH超出正常范围,如果总T3(或FT3)及FT4在正常范围内的受试者亦可入组; 9) 心肌酶谱在正常范围内(如研究者综合判断为不具有临床意义的单纯实验室异常也允许入组); 12. 对于育龄期女性受试者,应在接受首次研究药物给药(第1周期第1天)之前的3天内接受尿液或血清妊娠试验且结果为阴性。如果尿液妊娠试验结果无法确认为阴性,则要求进行血液妊娠试验。非育龄期女性定义为绝经后至少1年,或进行过手术绝育或子宫切除术; 13. 如存在受孕风险,所有受试者(不论男性或女性)均需在整个治疗期间直至治疗末次研究药物给药后120天(或末次研究药物给药后180天)内采用年失败率低于1%的避孕措施。

Inclusion criteria

Eligible subjects must meet all of the following criteria for enrollment: 1. Written informed consent obtained prior to any trial-related procedures. 2. Age >=18 years. 3. Histologically or cytologically confirmed non-squamous non-small cell lung cancer (NSCLC). 4. Metastatic or recurrent (Stage IV) disease per the 8th edition TNM classification by the International Association for the Study of Lung Cancer (IASLC) and American Joint Committee on Cancer (AJCC). 5. EGFR-sensitive mutations (Ex19del, L858R) confirmed by tumor histology/cytology or blood-based testing. 6. Oligoprogression or gradual after EGFR-TKI therapy. 7. Intolerance or refusal of surgery or external beam radiotherapy. 8. ECOG performance status of 0–2. 9. Life expectancy >=3 months. 10. At least one measurable lesion per RECIST v1.1 criteria. Lesions within prior radiotherapy fields may be considered measurable if progression is documented. 11. Adequate organ function, defined as: (a) Absolute neutrophil count (ANC) >=1.5×10?/L without granulocyte colony-stimulating factor support within 14 days; (b) Platelets >=100×10?/L without transfusion within 14 days; (c) Hemoglobin >9 g/dL without transfusion or erythropoietin use within 14 days; (d) Total bilirubin <=1.5×ULN; (e) AST/ALT <=2.5×ULN (<=5×ULN allowed with liver metastases); (f) Serum creatinine <=1.5×ULN and creatinine clearance >=60 mL/min (Cockcroft-Gault formula); (g) INR or PT <=1.5×ULN; (h) Normal thyroid function (TSH within reference range; if abnormal, FT3/FT4 must be normal); (i) Myocardial enzymes within normal limits (clinically insignificant lab abnormalities per investigator judgment allowed). 12. Negative pregnancy test (urine/serum) within 3 days prior to Cycle 1 Day 1 for premenopausal women. Non-childbearing potential defined as: postmenopausal (>=1 year amenorrhea), surgical sterilization, or hysterectomy. 13. Contraceptive measures with a failure rate of <1% per year for all subjects at risk of conception, during treatment and for 120 days (or 180 days per specific drug half-life) after the last dose.

排除标准:

符合以下标准的受试者不能入选本研究: 1. 病理为小细胞肺癌(SCLC),包括SCLC与NSCLC混合的肺癌; 2. EGFR-TKI一线治疗出现广泛进展和脑部转移; 3. 存在放射性粒子植入治疗禁忌证: a) 有严重出血倾向,血小板≤50×109/L和凝血功能严重紊乱者(凝血酶原时间>18 s,凝血酶原活动度<40%)。抗凝治疗和(或)抗血小板药物应在粒子植入治疗前停用1周; b) 肿瘤破溃; c) 严重糖尿病; d) 没有合适穿刺路径; e) 预计划靶区剂量达不到处方剂量设计要求; 4. 接受过以下治疗: ? 首次研究药物给药前4周内接受过大手术(包括原发肿瘤手术,血管通路置入除外); ? 当前使用或无法在首次给药前停用强效CYP3A4诱导剂(需至少停药3周); ? 已知化合物半衰期5倍时间内使用过试验性药物或其相关物质。 5. 接受研究治疗前1个月内使用抗血管生成类药物(比如:贝伐珠单抗、安罗替尼等); 6. 其他恶性肿瘤病史,例外情况:已治愈的非黑色素瘤皮肤癌、原位癌,或治疗后超过5年无复发证据的其他实体瘤(需研究者评估复发风险低) 7. 研究治疗开始时,既往治疗导致的毒性需≤CTCAE 1级(脱发及既往铂类相关2级神经病变除外) 8. 未控制的高血压、活动性出血性疾病、需要静脉治疗的感染(乙肝、丙肝、HIV感染等),研究者判断可能影响试验安全性或方案依从性 9. 难治性恶心呕吐、慢性胃肠道疾病、吞咽困难或可能影响利厄替尼正常吸收的重大肠切除史 10. 心脏功能标准: ? QT间期延长:平均静息校正QTc>470毫秒(基于3次心电图); ? 心电图异常:完全性左束支传导阻滞、III度房室传导阻滞等; ? 心律失常风险因素:低钾血症、先天性长QT综合征、家族史等。 11. 既往间质性肺病(ILD)病史、需激素治疗的放射性肺炎或活动性ILD 12. 实验室指标异常 ? 骨髓抑制:中性粒细胞<1.5×10?/L,血小板<100×10?/L,血红蛋白<90 g/L; ? 肝功能不全:ALT/AST>2.5×ULN,总胆红素>1.5×ULN(Gilbert综合征>3×ULN); ? 肾功能不全:肌酐>1.5×ULN且肌酐清除率<50 mL/min; 13. 妊娠或哺乳期妇女; 14. 对利厄替尼成分或类似结构药物过敏者; 15. 有可能干扰试验结果、妨碍受试者全程参与研究的病史或疾病证据、治疗或实验室检查值异常,或研究者认为其他不适合入组的情况研究者认为存在其他潜在风险不适合参加本研究。

Exclusion criteria:

Subjects meeting any of the following criteria will be excluded from the study: 1. Pathologically confirmed small cell lung cancer (SCLC), including mixed SCLC and NSCLC histology. 2. Extensive progression or brain metastasis after first-line EGFR-TKI therapy. 3. Contraindications to radioactive seed implantation: (a) Severe bleeding tendency: platelets ≤50×10?/L or severe coagulopathy (prothrombin time >18 s, prothrombin activity <40%). Anti-coagulant/anti-platelet agents must be discontinued >=1 week prior to implantation. (b) Tumor ulceration. (c) Uncontrolled diabetes mellitus. (d) Lack of suitable puncture pathway. (e) Failure to achieve prescribed dose requirements in pre-planning. 4. Prior treatments: a) Major surgery (excluding vascular access placement) within 4 weeks before the first study dose. b) Current use or inability to discontinue strong CYP3A4 inducers >=3 weeks before the first dose. c) Use of investigational agents within 5 half-lives prior to enrollment. 5. Anti-angiogenic therapy (e.g., bevacizumab, anlotinib) within 1 month before study treatment. 6. Other active malignancies, except: a) Cured non-melanoma skin cancer or carcinoma in situ. b) Solid tumors with no recurrence >5 years post-treatment (low recurrence risk per investigator assessment). 7. Residual toxicities from prior therapy >CTCAE Grade 1 (excluding alopecia or Grade 2 neuropathy from platinum-based regimens). 8. Uncontrolled comorbidities: a) Hypertension, active bleeding disorders, or infections requiring IV therapy (e.g., HBV, HCV, HIV). b) Conditions compromising safety or protocol compliance per investigator judgment. 9. Gastrointestinal disorders affecting drug absorption: Refractory nausea/vomiting, chronic GI diseases, dysphagia, or major bowel resection. 10. Cardiac dysfunction: a) QTc interval >470 ms (mean of 3 ECGs). b) ECG abnormalities: complete left bundle branch block, third-degree AV block. c) Arrhythmia risk factors: hypokalemia, congenital long QT syndrome, family history. 11. Interstitial lung disease (ILD) history, radiation pneumonitis requiring steroids, or active ILD. 12. Laboratory abnormalities: a) Bone marrow suppression: ANC <1.5×10?/L, platelets <100×10?/L, hemoglobin <90 g/L. b) Hepatic impairment: ALT/AST >2.5×ULN; total bilirubin >1.5×ULN (>3×ULN if Gilbert’s syndrome). c) Renal impairment: Creatinine >1.5×ULN with creatinine clearance <50 mL/min. 13. Pregnancy or lactation. 14. Hypersensitivity to limertinib or structurally similar compounds. 15. Any condition that may interfere with study results, participation, or pose risks, as determined by the investigator.

研究实施时间:

Study execute time:

From 2025-10-09 00:00:00 To 2028-09-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-10-09 00:00:00 To 2026-09-30 00:00:00  

干预措施:

Interventions:

组别:

治疗组

样本量:

33

Group:

Treatment group

Sample size:

干预措施:

利厄替尼+放射性125I粒子植入

干预措施代码:

Intervention:

Limertinib Combined with Radioactive Iodine-125 Seed Implantation

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

河北 

市(区县):

 

Country:

China 

Province:

Hebei 

City:

 

单位(医院):

河北省人民医院 

单位级别:

三甲 

Institution
hospital:

Hebei General Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

河北 

市(区县):

 

Country:

China 

Province:

Hebei 

City:

 

单位(医院):

唐山市人民医院 

单位级别:

三甲 

Institution
hospital:

Tangshan Peaple's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

河北 

市(区县):

 

Country:

China 

Province:

Hebei 

City:

 

单位(医院):

承德医学院附属医院  

单位级别:

三甲 

Institution
hospital:

Affiliated Hospital of Chengde Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

无进展生存

指标类型:

主要指标

Outcome:

Progression Free Survival

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

总生存期

指标类型:

次要指标

Outcome:

Overall Survival

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

客观缓解率

指标类型:

次要指标

Outcome:

Objective Response Rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

疾病控制率

指标类型:

次要指标

Outcome:

Disease Control Rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

缓解持续时间

指标类型:

次要指标

Outcome:

Duration of Response

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

安全性

指标类型:

次要指标

Outcome:

Safety

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

NONE

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

盲法:

Blinding:

是否共享原始数据:

IPD sharing

No

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):

邮件申请并获得研究者同意

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

upon request by the investigator through the e-mail

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:

病例记录表

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-10-09 08:48:55