ClinicalTrials.gg
RecruitingNCT07770100Updated Oct 14, 2026

Concurrent Immunotherapy and Systemic Therapy With Stereotactic Body Radiation Therapy (SBRT) for Stage IV Cancers (COINSSS IV)

A Phase 2 interventional study of Stereotactic Body Radiation Therapy (SBRT) and Pembrolizumab in Head and Neck Cancer, Non-Small Cell Lung Cancer and Cervical Cancer, sponsored by Mark Bernard. Recruiting at 1 site in United States. Open to participants aged 18 Years to 99 Years. Per ClinicalTrials.gov, last updated 2026-10-14.

Primary conditionEsophageal NeoplasmsRegistry: Head and Neck NeoplasmsReclassifiedWhy we changed it
Registry
Head and Neck Neoplasms — the first condition term the registry derived for this study.
ClinicalTrials.gg
Esophageal Neoplasms
Why
  1. The study's listed conditions name Esophageal Neoplasms, a narrower term within Head and Neck Neoplasms.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Mark Bernard · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2026; still recruiting 2 months later.
Updated Oct 14, 2026Now RecruitingSite recruiting status changed+1 moreGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
35
Allocation
Not applicable
Ages
18 Years to 99 Years
Sex
All
01

Study summary

This is a Phase II clinical study for people with stage IV cancer. The study will evaluate the use of stereotactic body radiation therapy (SBRT), a type of focused radiation treatment, together with immunotherapy-based treatment. SRBT will be used to treat multiple areas of cancer that have spread to other parts of the body. The study will evaluate whether this treatment approach can be safely given while patients continue their planned cancer treatment and may help control their cancer.

02

Conditions studied

  • Head and Neck Cancer
  • Non-Small Cell Lung Cancer
  • Cervical Cancer
  • Esophageal Cancer
  • Gastric Cancer (GC)
03

In context

Esophageal Neoplasms Reclassified

1,873 studies on the registry are indexed under Esophageal Neoplasms; 501 are open to participants now.

This study's planned enrollment of 35 is below the median of 58 across 1,347 interventional studies indexed under Esophageal Neoplasms.

Browse Esophageal Neoplasms studies →

Lead sponsor

This is the only study on the registry with Mark Bernard as lead sponsor.

Compared within Esophageal Neoplasms, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Head and Neck Neoplasms. The counts are of registry records indexed under each term, refreshed daily. How we classify →

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

  • proven advanced or stage IV head \& neck, non-small cell lung cancer, cervical, esophageal, gastric, and gastroesophageal cancer at least 6 that are eligible for SBRT comprising: lung, liver, adrenal glands, bone, and lymph node sites with at least 1 other lesion meeting criteria of which this additional lesion not be treated with SBRT ( performed for diagnosis are standard of care).
  • At least 6 metastases eligible for SBRT comprising: lung, liver, adrenal glands, bone, and lymph node sites
  • The 1 irradiated lesion must have a max point dose of 5Gy or less.
  • Eligible for Immunotherapy for an FDA-approved indication as defined in section 6.1. NOTE: No limit is placed on prior systemic treatment unless it affects the eligibility for administration of therapy.
  • If prior treatment with chemotherapy or radiotherapy or surgery has occurred: Prior chemotherapy or radiation must have concluded > 21 days prior to the start of study treatment. Exception: study treatment can start within 2-3 days following GKS [gamma knife surgery] or whole brain radiation therapy [ WBRT], as long as patient is not experiencing ongoing/residual AE's related to GKS or WBRT at discretion of treating physician.
  • immunotherapy-based treatments only. The patient may have received prior cycles of immunotherapy, but has to be on the first line of immunotherapy-based treatments.
  • If non-small cell lung cancer patient with pembrolizumab, PD-L1 testing CPS score > or = to 50% will have to be shown
  • If cervical cancer patient on secondary line therapy with pembrolizumab, CPS score of > or = to 1 will have to be done. Please note, second line therapy with pembrolizumab is only allowed if the patient's first line of therapy did NOT include immunotherapy.
  • If non-small cell lung cancer on first line ipilimumab in combination with nivolumab, PD-L1 of 1% and negative epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) genomic tumor aberrations.
  • If pembrolizumab is given for a gastric cancer, a PD-L1 expression (CPS =1) will need to be shown
  • If pembrolizumab is given as a single agent treatment after progression of one prior systemic therapy agent for esophageal or gastroesophageal squamous cell carcinoma histology, a PD-L1 (CPS=1) expression will have to be shown.
  • Performance Status 0 - 1 (see Appendix A).
  • > or equal to 6 months.
  • Adequate organ and bone marrow function prior to study treatment as defined by: Thresholds for lab values prior to initiation of study treatment.
  • > or equal to 1,000/mm3
  • > or equal to 100,000/mm3
  • Total \< or equal to or equal to 1.5 x
  • and ALT - With hepatic metastasis, \< or equal to or equal to 5 x ULN. If no hepatic metastasis, \< or equal to 2.5 times x ULN
  • Creatinine Or \< or equal to 1.5 x ULNand/or CrCl > or equal to 30ml/min (per 24-hour urine collection) or calculated according to the Cockcroft-Gault formula (Appendix B)
  • No previous or concurrent is allowed except for adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, or other cancer for which the patient has been disease free for the past 3 years.
  • Non-pregnant and non-nursing women -Women of must have a negative serum pregnancy test performed within 7 days prior to the start of treatment.
  • Women of childbearing potential and men must agree to use adequate methods prescribed their the patients primary care physician, urologist, or obstetrician/gynecologist prior to study entry and for the duration of study participation.
  • Subjects should use adequate birth control for at least 3 months after the last administration of immune checkpoint inhibitors.
  • Ability to understand and the willingness to sign a written document

Exclusion criteria

Exclusion Criteria:

  • Presence of \< or equal to 5 sites amenable to SBRT
  • Ineligible for based on package insert of the chosen immune checkpoint inhibitor
  • No more than 7 sites to an organ, defined as liver, left lung, right lung, single anatomically bone site (e.g. femur, humerus, single vertebral body).

NOTE: Multiple different vertebral bodies are allowed.

  • Peritoneal involvement, at the discretion of the study PI. NOTE: Peritoneal metastasis does not exclude GI nor cervical cancer, except in cases where there is a separate focus of spread to the peritoneum.
  • Presence of liver cirrhosis of any grade prohibits SBRT to the liver. NOTE: Pt can enroll to trial if receiving SBRT to other non-liver metastatic sites.
  • A plan that cannot meet organ at risk tolerance (as defined in section 6.7.2.1) Auto-immune diagnosis Medications prohibited while receiving concurrent SBRT: gemcitabine, Adriamycin, VEGF or BRAF inhibitors.

NOTE: However, if the patient is on the prohibited agent(s), the patient is still eligible for the trial so long as the prohibited agent can safely be held for at least 1 month before starting SBRT, during SBRT, and 1 month after completion of SBRT.

-Major surgical procedure (including craniotomy and open brain ) or significant traumatic injury (injury requiring immediate surgical intervention or involving loss of consciousness) within 14 days prior to registration or those patients who receive a nonCNS minor surgical procedures (e.g. core biopsy or fine needle aspiration) within 3 days prior to registration.

NOTE: There is no waiting period for central line placement. There is a 7-day window for recovery prior to registration for patients who underwent stereotactic biopsy of the brain.

  • Active clinically serious infection > Grade 2.
  • Serious non-healing wound, ulcer or bone fracture.
  • Uncontrolled inter-current illness. This includes, but is not limited to: ongoing or active infection; symptomatic congestive heart failure ( class III or IV); unstable angina pectoris or new onset angina that began within the last 3 months; cardiac ventricular arrhythmias requiring anti-arrhythmic therapy; thrombotic/ embolic events such as cerebrovascular accident, including within the past 6 months;
  • Uncontrolled hypertension defined as systolic blood pressure >150 mmHg or diastolic pressure > 90 mmHg, despite optimal medical management; Known (HIV) infection or chronic or C; Known Grade 3 or 4 neurotoxicity.
  • Receipt of within 30 days prior to the first dose of ICI.

Note: Patients, if randomized, should not receive live vaccine while receiving ICI and up to 30 days after the last dose of ICI.

-Inclusion of Women and Minorities - Consistent with NIH policy, both men and women of all races and ethnic groups are eligible for this trial.

Terms in these criteria, in plain language(24)

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.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

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.

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.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

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.

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

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.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

TIA (transient ischaemic attack)

A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.

Stroke symptoms need emergency care at once, even if they go away.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
35 participants (estimated)

Study arms

  • Experimental
    Concurrent Immunotherapy and SBRT

    Participants receive standard-of-care immune checkpoint inhibitor therapy and concurrent stereotactic body radiation therapy (SBRT) to 6-10 metastatic lesions.

    Radiation: Stereotactic Body Radiation Therapy (SBRT) · Drug: Pembrolizumab · Drug: Nivolumab · Drug: Atezolizumab · Drug: Ipilimumab

Interventions

  • RadiationStereotactic Body Radiation Therapy (SBRT)

    SBRT administered to 6-10 metastatic lesions during the first cycle of immunotherapy.

  • FDA-approved immune checkpoint inhibitor administered according to standard clinical practice and disease-specific indications.

  • FDA-approved immune checkpoint inhibitor administered according to standard clinical practice and disease-specific indications.

  • FDA-approved immune checkpoint inhibitor administered according to clinical practice and disease-specific indications.

  • FDA-approved immune checkpoint inhibitor administered according to standard clinical practice and disease-specific indications.

06

What researchers measure

Primary outcomes

  1. 6-Month Progression-Free Survival (PFS)

    Progression-Free Survival (PFS) measured from study enrollment until disease progression or death from any cause.

    Time frame: 6 Months

Secondary outcomes

  1. Acute Grade 2 or Higher Toxicity

    Number of participants experiencing Grade 2 or higher adverse events according to CTCAE version 6.0.

    Time frame: Up to 1 Year

  2. Overall Survival

    Overall survival from study enrollment.

    Time frame: 1 Year

  3. Local Recurrence-Free Survival

    Time from study enrollment to local recurrence.

    Time frame: 1 Year

  4. Distant Metastasis Progression-Free Survival

    Time from study enrollment to distant metastatic progression.

    Time frame: 1 Year

  5. Objective Response Rate

    Tumor response rate assessed using iRECIST criteria.

    Time frame: 1 Year

  6. Continuation of Systemic Therapy

    Proportion of participants continuing planned systemic therapy without interruption attributable to SBRT. Interruption is defined as cessation of immunotherapy administration lasting 30 days or more.

    Time frame: 1 Year

07

Study locations

1 of 1 sites recruiting
08

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar 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

Started Sep 2026 (actual). Primary completion is estimated for Feb 2040, 161 months after the start.

Of 174 non-industry phase 2 interventional studies under Esophageal Neoplasms, half reached primary completion within 55 months of starting (the median), counting those still running; a quarter within 33 and three quarters within 85. This study's planned 161 months is above that.

Counting every sponsor, half of 198 studies reached it within 52 months; a quarter within 33 and three quarters within 78.

Start moved once since we started tracking on Sep 25, 2026: Oct 2026 → Sep 2026, on Oct 14, 2026.

Earlier changes are on the record history on ClinicalTrials.gov ↗

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

Registered
Aug 10, 2026
First posted
Aug 18, 2026
StartActual
Sep 9, 2026was Oct 2026
Primary completionEst.
Feb 28, 2040
CompletionEst.
Feb 28, 2040
Last update
Oct 14, 2026
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.
Status
Not yet recruiting→Recruiting
changed Oct 14, 2026
Sites
University of Kentucky Markey Cancer Center is now Recruiting
Oct 14, 2026
Start date
Oct 1, 2026→Sep 9, 2026 (actual)
Oct 14, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • University of Kentucky Markey Cancer Center · Lexington, United StatesContact added m•••@uky.edu · •••7618
Oct 14, 2026
Show all 1 update
  1. Oct 14, 2026
    Not yet recruiting→Recruiting
    University of Kentucky Markey Cancer Center is now Recruiting
    Start date Oct 1, 2026→Sep 9, 2026 (now actual)
    Site contacts Changed at 1 site. See the sites
    Show the site
    • University of Kentucky Markey Cancer Center · Lexington, United StatesContact added m•••@uky.edu · •••7618
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT07770100
Lead sponsor
Mark Bernard
Responsible party
Mark Bernard (Associate Professor, University of Kentucky) — Sponsor-investigator
First posted
Aug 18, 2026
Start date
Sep 9, 2026
Primary completion
Feb 28, 2040 (estimated)
Completion
Feb 28, 2040 (estimated)
Last update
Oct 14, 2026

Study contacts

Mark Bernard, MD
Contact
mark.bernard@uky.edu
8592577618

Oversight

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

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