ClinicalTrials.gg
Not yet recruitingNCT05998993CULTROUpdated Aug 21, 2023

Study to Evaluate SBRT for EGFR Mutant NSCLC Patients Receiving Osimertinib (CULTRO)

An interventional study of Stereotactic Body Radiation Therapy SBRT in EGF-R Positive Non-Small Cell Lung Cancer, Non Small Cell Lung Cancer and EGFR Exon 19 Deletion, sponsored by Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo. Not yet recruiting at 1 site in Colombia. Open to participants aged 18 Years to 99 Years. Per ClinicalTrials.gov, last updated 2023-08-21.

Sponsored by Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
35
Allocation
Not applicable
Ages
18 Years to 99 Years
Sex
All
01

Study summary

Phase II Study to Evaluate the Impact of SBRT (Stereotactic Body Radiation Therapy) and/or SRS (Stereotactic Radiosurgery) on Oligoresidual Disease in EGFR Mutation Patients Treated with Osimertinib as First-Line Systemic Intervention. All candidates must exhibit a partial response after 12 weeks of treatment with the third-generation tyrosine kinase inhibitor (alone or in combination with chemotherapy) and a maximum of five (5) residual lesions in a maximum of two (2) organs. The primary outcome will be progression-free survival (PFS), and secondary outcomes will include overall survival (OS), proportion of patients without progression at months 12 and 36, safety, and overall response rate (ORR). Additionally, an exploratory analysis will be conducted on the prognostic value of liquid biopsy (supplementary information), considering baseline presence of mutations (determined by Next Generation Sequencing tests) and reduction or negativization of allelic fraction (AF).

Read the detailed description

Phase II study with a single-stage Fleming design based on a normal approximation to the binomial distribution, with a one-sided type I error of 10% and a power of 90% to detect 30 events related to disease progression. Under the alternative hypothesis to detect a 35% improvement in PFS, 35 patients are required to be recruited over 22 months, with a minimum median follow-up of 14 months. An interim analysis will be conducted to determine early termination of the study using a Lan-DeMets monitoring boundary and an O'Brien-Fleming stopping rule. The interim analysis will be performed when 20 out of the expected 30 events have been observed. Employing the O'Brien-Fleming statistic, the critical value for the Z-score in the interim analysis (to stop and reject the null hypothesis) will be 1.054, and the critical value for the Z-score to stop and reject the alternative (futility) will be -0.204.

02

Conditions studied

  • EGF-R Positive Non-Small Cell Lung Cancer
  • Non Small Cell Lung Cancer
  • EGFR Exon 19 Deletion
  • EGFR Exon 21 Mutation
  • EGFR G719X
03

In context

Carcinoma, Non-Small-Cell Lung

7,620 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,838 are open to participants now.

This study's planned enrollment of 35 is below the median of 62 across 6,019 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo is the lead sponsor of 5 studies on the registry; 5 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 99 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Be older than 18 years of age.
  • Be capable of giving to participate in the study.
  • Have histological confirmation compatible with EGFR mutant non-small cell lung cancer (NSCLC) and disease (with or without histological confirmation of metastatic lesions).
  • Have confirmation of the presence of common EGFR mutations (exon 19 deletion, L858R/exon 21, or G719X) through any locally and internationally accepted standard tests.
  • Have received at least 12 weeks of Osimertinib treatment (with or without the addition of chemotherapy based on FLAURA2 study results after discussion with the investigative team).
  • Have a partial response defined by 1.1 criteria.
  • Have a maximum of 5 residual tumor lesions in up to 2 organs suitable for treatment with Stereotactic Ablative Radiotherapy (SABR).
  • Have the following imaging and clinical tests within 4 weeks before study entry:
  • Contrast-enhanced brain MRI.
  • Chest/abdomen/pelvis CT scan, with or without bone scan (at the investigator's discretion) if PET-CT was not performed.
  • 18-FDG PET-CT.
  • Spinal MRI for patients with vertebral or paravertebral metastases.
  • (EKG) and transthoracic echocardiogram.
  • Complete blood count and standard blood chemistry.
  • Negative pregnancy test for fertile women within 4 weeks prior to starting radiotherapy.
  • Liquid for assessment of tumor allelic fraction (baseline).
  • performance status 0-2.
  • All sites of oligoresidual disease must be safely treatable according to the following criteria:
  • All brain lesions must be treatable with SRS.
  • The maximum size for extracranial lesions will be up to 6 cm, with exceptions for bone metastases which may include lesions larger than 6 cm at the discretion of the investigative medical team (e.g., ribs, scapula, or pelvis).
  • >6 months.
  • Not eligible for surgical treatment.
  • Osimertinib treatment must be suspended 48 hours before the start of ablative therapy and cannot be initiated within 48 hours of receiving the last fraction. In patients receiving SBRT for central lung lesions, the suspension time for Osimertinib may be extended up to 5 days before and after ablative therapy.
  • Patients may have previously received treatments such as radiofrequency or microwave ablation for oligoresidual lesions, but imaging must demonstrate that the lesion persists and is treatable with SABR.
  • Metastatic tumor lesions that received initial treatment with radiosurgery cannot be included for SABR treatment.
  • If initial treatment was conventional radiotherapy, SABR could be considered if safe to administer. In this case, the ablative therapy must be discussed by the investigative team.
  • The eligibility and prognosis criteria will be reviewed by the multidisciplinary thoracic tumor board at CTIC Centro de Tratamiento e Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo.

Exclusion criteria

Exclusion Criteria:

  • Severe comorbidities contraindicating radiation therapy.
  • Bone in the femur with a high risk of fracture.
  • Complete response to Osimertinib treatment (no oligoresidual disease for ablative treatment).
  • Inability to treat all oligoresidual lesions with ablative intent.
  • History of pneumonitis or functionally limiting interstitial lung disease. It may be considered limiting if the patient is unable to perform DLCO maneuvers or if adjusted DLCO is less than 35% of predicted, PaO2 at Bogotá altitude with FiO2 21% is less than or equal to 50 mmHg.
  • Clinical or radiological evidence of symptomatic spinal cord compression.
  • Dominant brain metastatic disease requiring surgical management (e.g., imminent herniation or hydrocephalus).
  • Candidate for a clinical trial with an experimental drug.
  • Inability to receive Osimertinib with minimal adherence.
  • Oligoresidual involvement in peritoneum, pleura, or bone marrow (non-).
  • (presumed based on imaging findings or confirmed by cerebrospinal fluid cytology).
  • Pregnant or breastfeeding women.
Terms in these criteria, in plain language(9)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
35 participants (estimated)

Study arms

  • Experimental
    Radiation

    A total of 35 patients diagnosed and treated at CTIC Centro de Tratamiento e Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo.

    Radiation: Stereotactic Body Radiation Therapy SBRT

Interventions

  • RadiationStereotactic Body Radiation Therapy SBRT

    This is a non-randomized Phase II study in which all patients receive the experimental treatment with Stereotactic Ablative Radiotherapy (SABR) to residual tumor lesions (up to 5 residual metastatic lesions in a maximum of 2 organs) following 12 weeks of systemic treatment with Osimertinib. The study aims to enroll 35 patients diagnosed and treated at CTIC Centro de Tratamiento e Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo.

    Also known as: Stereotactic radiosurgery SRS

This study also gives Osimertinib. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. Progression-Free Survival

    Time from the initiation of systemic treatment (Osimertinib) to disease progression or death. This outcome is not influenced by second-line interventions and allows for the estimation of the relative efficacy of the treatment and its Hazard Ratio (HR)

    Time frame: Month 12

Secondary outcomes

  1. Overall Response Rate (ORR)

    Proportion of patients with partial or complete response following the implementation of SBRT. This measurement does not include stable disease

    Time frame: Month 12

  2. Overall Survival (OS)

    Time from diagnosis, the first day of systemic treatment, and implementation of SBRT to death from any cause or last follow-up

    Time frame: Month 12

  3. Progression-Free Time (PFT)

    Time from the execution of SBRT to objective tumor progression, excluding death

    Time frame: Month 12

  4. Adverse Events and Safety

    Adverse events will be graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5 from the National Cancer Institute (NCI) US

    Time frame: Month 12

07

Study locations

1 site
  • CTIC - Centro de Tratamiento e Investigación Sobre Cáncer Luis Carlos Sarmiento Angulo
    Bogotá, Colombia
    • Liliana Gutiérrez, RN · Contactlgutierrez@fctic.org · 573003768158
    • Briegel De Las Salas, Microb · Contactbcalderon@fctic.org · 573044921963
    • Luis Rojas, MD · Principal investigator
    • Andrés Cardona, MD · Principal investigator
    • Iván Bobadilla, MD · Principal investigator
    • Jairo Zuluaga, MD · Sub investigator
    • Alejandro González, MD · Sub investigator
    • Lucía Viola, MD · Sub investigator
    • Stella Martínez, MD · Sub investigator
08

References and documents

Publications

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  • Goss G, Tsai CM, Shepherd FA, Bazhenova L, Lee JS, Chang GC, Crino L, Satouchi M, Chu Q, Hida T, Han JY, Juan O, Dunphy F, Nishio M, Kang JH, Majem M, Mann H, Cantarini M, Ghiorghiu S, Mitsudomi T. Osimertinib for pretreated EGFR Thr790Met-positive advanced non-small-cell lung cancer (AURA2): a multicentre, open-label, single-arm, phase 2 study. Lancet Oncol. 2016 Dec;17(12):1643-1652. doi: 10.1016/S1470-2045(16)30508-3. Epub 2016 Oct 14. PubMed 27751847 ↗
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  • Carrot-Zhang J, Soca-Chafre G, Patterson N, Thorner AR, Nag A, Watson J, Genovese G, Rodriguez J, Gelbard MK, Corrales-Rodriguez L, Mitsuishi Y, Ha G, Campbell JD, Oxnard GR, Arrieta O, Cardona AF, Gusev A, Meyerson M. Genetic Ancestry Contributes to Somatic Mutations in Lung Cancers from Admixed Latin American Populations. Cancer Discov. 2021 Mar;11(3):591-598. doi: 10.1158/2159-8290.CD-20-1165. Epub 2020 Dec 2. PubMed 33268447 ↗

Individual participant data

Plan to share: Yes — The current study is intended to be published, even if prematurely terminated. The publication may encompass all or part of the following variations: online publication of a synopsis, abstract and/or presentation at a scientific conference, or publication of a complete scientific article.

Supporting information: Study protocol, Statistical analysis plan, Clinical study report

Time frame: 5 years

Access criteria: Email to PI

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Nov 2023; primary completion for Nov 2026, 36 months later.

Of 343 non-industry interventional studies with no phase under Carcinoma, Non-Small-Cell Lung, half reached primary completion within 52 months of starting (the median), counting those still running; a quarter within 28 and three quarters within 98. This study's planned 36 months is below that.

Counting every sponsor, half of 359 studies reached it within 51 months; a quarter within 26 and three quarters within 97.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 28, 2023
First posted
Aug 21, 2023
StartEst.
Nov 2023
Primary completionEst.
Nov 2026
CompletionEst.
Nov 2028
Last update
Aug 21, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 21, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05998993
Lead sponsor
Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo
Responsible party
Sponsor
First posted
Aug 21, 2023
Start date
Nov 2023 (estimated)
Primary completion
Nov 2026 (estimated)
Completion
Nov 2028 (estimated)
Last update
Aug 21, 2023

Study contacts

Liliana Gutiérrez, RN
Contact
lgutierrez@fctic.org
3003768158
Briegel De Las Salas, Microb
Contact
bcalderon@fctic.org
3044921963
Luis Rojas, MD
principal investigator · Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2023. You cannot join it, but the record below documents what was studied.

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Discussion

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