ClinicalTrials.gg
Not yet recruitingNCT07775040Updated Aug 20, 2026

Spatially Fractionated Radiotherapy With Tislelizumab and Chemotherapy for Bulky Stage III NSCLC: A Phase II Trial

A Phase 2 interventional study of Spatially Fractionated Radiotherapy (SFRT) and Tislelizumab in Non-Small Cell Lung Cancer, sponsored by Sichuan Cancer Hospital and Research Institute. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-08-20.

Sponsored by Sichuan Cancer Hospital and Research Institute · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
43
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

This is a prospective, single-arm, multicenter phase II clinical study evaluating the efficacy and safety of spatially fractionated radiotherapy (SFRT) combined with tislelizumab and platinum-based doublet chemotherapy as induction/conversion therapy for patients with potentially resectable stage III non-small cell lung cancer (NSCLC) with bulky disease (primary tumor >5 cm).

SFRT, also known as lattice radiation therapy, is a novel radiotherapy technique that creates alternating high-dose and low-dose regions within the tumor. This approach not only reduces tumor burden but also may enhance anti-tumor immune responses, potentially working synergistically with immunotherapy.

Study participants will receive SFRT to the primary lung tumor (GTV 20 Gy/5 fractions, GTV-Lattice 60 Gy/5 fractions), followed by 2-4 cycles of tislelizumab (200 mg, Q3W) combined with platinum-based doublet chemotherapy. Surgery will be performed 4-6 weeks after the last cycle of neoadjuvant therapy. The first 6 enrolled patients will undergo dose-limiting toxicity (DLT) assessment within 21 days after the first dose of study drug.

The primary endpoint is major pathological response (MPR) rate, defined as the proportion of patients with ≤10% viable tumor cells in the resected specimen. Secondary endpoints include 1-year event-free survival (EFS), pathological complete response (pCR) rate, objective response rate (ORR), disease control rate (DCR), R0 resection rate, 1-year overall survival (OS), time to distant metastasis (TTDM), and safety.

A total of 44 patients will be enrolled across multiple centers in China. An interim analysis will be conducted after 50% of patients are enrolled.

02

Conditions studied

  • Non-Small Cell Lung Cancer

Keywords

  • Non-Small Cell Lung Cancer (Stage III, Bulky Disease, Potentially Resectable)
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 43 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

Sichuan Cancer Hospital and Research Institute is the lead sponsor of 64 studies on the registry; 33 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 75 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

  • Voluntary agreement to participate and signed written .
  • or histologically confirmed (via percutaneous lung , bronchoscopy, mediastinoscopy, etc.) bulky stage III non-small cell lung cancer (NSCLC) per AJCC 9th edition staging, with primary tumor >5 cm (T3-T4), N0-N2, and no prior chemotherapy, radiotherapy, surgery, or immunotherapy.
  • Pulmonary lesion considered potentially resectable by a multidisciplinary team (MDT) including a thoracic surgeon.
  • (ECOG) performance status score of 0-1.
  • Adequate hematologic and organ function as demonstrated by:

≥ 1,500 × 10⁹/L.

count ≥ 100 × 10⁹/L.

> 9.0 g/dL.

Serum creatinine ≤ 1.5 × (ULN) or (CrCl) ≥ 40 mL/min.

/ALT ≤ 3 × ULN.

Total ≤ 1.5 × ULN.

≥ 1.2 L or > 40% of predicted value.

/APTT within normal limits.

-Age 18 to 75 years (inclusive).

Exclusion criteria

Exclusion Criteria:

  • Has or is suspected of having an disease. Note: patients with vitiligo, type I diabetes mellitus, or hypothyroidism (Hashimoto's thyroiditis) requiring only hormone replacement therapy may be enrolled if no significant signs of recurrence are present.
  • Requires systemic therapy (>10 mg prednisone or equivalent per day) or other agents within 14 days after enrollment. Note: inhaled or topical corticosteroids, or adrenal hormone replacement therapy (>10 mg prednisone or equivalent per day) for patients without active autoimmune disease, are permitted.
  • Prior history of thoracic radiotherapy.
  • Active bleeding prior to treatment.
  • Severe cardiac, pulmonary, hepatic, renal, or hematopoietic dysfunction, cachexia, or any condition that would preclude tolerance to radiochemotherapy.
  • History of diabetes mellitus for >10 years with poorly controlled blood glucose.
  • History of interstitial lung disease or non-infectious pneumonitis.
  • NSCLC with known EGFR-sensitizing mutations, ALK fusion gene, or ROS1 rearrangement.
  • History of another (excluding non-melanoma skin cancer and carcinoma in situ of the bladder, stomach, colon, endometrium, cervix, melanoma, or breast) unless the malignancy has been in complete remission for ≥2 years and no additional anti-tumor therapy is required during the study period.
  • In the investigator's opinion, medically, psychologically, or physically unable to complete the study or to understand the patient information.
  • Prior treatment with , anti-PD-L1, anti-PD-L2, anti-CTLA-4, or other agents targeting T-cell co-stimulation or immune checkpoint pathways.
  • Active (HBV DNA ≥ 2000 IU/mL or ≥ 10⁴ copies/mL) or (anti-HCV antibody positive and HCV-RNA above the lower limit of detection).
  • -positive or diagnosed with acquired immunodeficiency syndrome (AIDS).
  • Known or suspected allergy to the study drugs or to any agent used in this trial.
  • Pregnant or breastfeeding women.
Terms in these criteria, in plain language(21)

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.

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.

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.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

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.

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.

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.

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.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

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.

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.

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.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

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.

05

Study design

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

Study arms

  • Experimental
    SFRT + Tislelizumab + Chemotherapy

    Participants receive spatially fractionated radiotherapy (lattice radiation therapy) to the primary lung tumor, with a prescription dose of GTV 20 Gy in 5 fractions and GTV-Lattice 60 Gy in 5 fractions, delivered on Monday, Wednesday, and Friday over one week. Following SFRT, participants receive 2 to 4 cycles (depending on clinical evaluation and per protocol specifications) of tislelizumab 200 mg intravenously on Day 1 of each 21-day cycle (Q3W), combined with platinum-based doublet chemotherapy (carboplatin AUC 5 or cisplatin 75 mg/m², plus pemetrexed 500 mg/m² for non-squamous histology or paclitaxel 175 mg/m² for squamous histology). Definitive radical surgery (lobectomy, bilobectomy, pneumonectomy, or sleeve resection with systematic mediastinal lymph node dissection) is performed 4 to 6 weeks (±7 days) after the last dose of neoadjuvant therapy. The first 6 enrolled patients undergo dose-limiting toxicity (DLT) assessment within 21 days after the first dose of study drugs.

    Radiation: Spatially Fractionated Radiotherapy (SFRT) · Drug: Tislelizumab · Drug: Carboplatin · Drug: Cisplatin · Drug: Pemetrexed · Drug: Paclitaxel · Procedure: Radical Lung Resection Surgery

Interventions

  • RadiationSpatially Fractionated Radiotherapy (SFRT)

    Participants receive lattice radiation therapy to the primary lung tumor. The gross tumor volume (GTV) is delineated, and lattice target volumes (GTV-Lattice) are generated using a hexagonal close-packed model within the tumor. Volumetric modulated arc therapy (VMAT) plans are designed. Prescription dose: GTV receives 20 Gy in 5 fractions, and GTV-Lattice receives 60 Gy in 5 fractions. After plan verification, treatment is delivered on 3 non-consecutive working days (e.g., Monday, Wednesday, Friday).

  • 200 mg administered via intravenous infusion on Day 1 of each 21-day cycle (Q3W) for 2 to 4 cycles, starting on Day 8-15 following SFRT.

  • AUC 5 administered via intravenous infusion on Day 1 of each 21-day cycle (Q3W) for 2 to 4 cycles. Used in combination with either pemetrexed (for non-squamous histology) or paclitaxel (for squamous histology), at the investigator's discretion.

  • 75 mg/m² administered via intravenous infusion on Day 1 of each 21-day cycle (Q3W) for 2 to 4 cycles. Used in combination with either pemetrexed (for non-squamous histology) or paclitaxel (for squamous histology), at the investigator's discretion. Adequate hydration and antiemetic prophylaxis are required.

  • 500 mg/m² administered via intravenous infusion on Day 1 of each 21-day cycle (Q3W) for 2 to 4 cycles. Indicated only for patients with non-squamous NSCLC. Vitamin B12 and folic acid supplementation are required per standard practice.

  • 175 mg/m² administered via intravenous infusion on Day 1 of each 21-day cycle (Q3W) for 2 to 4 cycles. Indicated only for patients with squamous NSCLC. Premedication to prevent hypersensitivity is required per standard practice.

  • ProcedureRadical Lung Resection Surgery

    Definitive radical surgery is performed 4 to 6 weeks (±7 days) after the last dose of neoadjuvant therapy. Surgical approaches include minimally invasive techniques (video-assisted thoracoscopic surgery \[VATS\] or robotic-assisted surgery) or open thoracotomy. Procedures include lobectomy, bilobectomy, pneumonectomy, or sleeve resection, combined with ipsilateral systematic mediastinal lymph node dissection.

06

What researchers measure

Primary outcomes

  1. Major Pathological Response (MPR) Rate

    MPR is defined as the proportion of participants with ≤10% viable tumor cells remaining in the resected primary tumor specimen. Assessment method: based on the longest diameter (a cm) of the gross tumor, at least one pathological section per cm is stained with H\&E; the percentages of viable tumor cells, necrosis, stroma, and inflammatory cells are calculated for each section, and the average percentage of viable tumor cells is derived. MPR is achieved when this average is ≤10%.

    Time frame: Assessed at the time of surgical resection, performed 4-6 weeks (±7 days) after the last dose of neoadjuvant therapy.

Secondary outcomes

  1. 1-Year Event-Free Survival (EFS) Rate

    EFS is defined as the time from enrollment to the first occurrence of any of the following events: (a) disease progression per RECIST v1.1 before surgery precluding resection; (b) local disease progression preventing surgery; (c) postoperative local, regional, or distant recurrence; or (d) death from any cause. The 1-year EFS rate will be estimated using the Kaplan-Meier method.

    Time frame: At 1 year after enrollment

  2. Pathological Complete Response (pCR) Rate

    pCR is defined as the absence of residual invasive viable tumor cells in both the resected primary tumor and all sampled regional lymph nodes (i.e., ypT0/Tis ypN0) upon pathological evaluation.

    Time frame: At the time of surgical resection

  3. Objective Response Rate (ORR)

    ORR is defined as the proportion of participants whose best overall response is either Complete Response (CR) or Partial Response (PR) per RECIST v1.1.

    Time frame: At the pre-operative imaging assessment (within 14 days before surgery)

  4. Disease Control Rate (DCR)

    DCR is defined as the proportion of participants whose best overall response is CR, PR, or Stable Disease (SD) per RECIST v1.1.

    Time frame: At the pre-operative imaging assessment (within 14 days before surgery)

  5. R0 Resection Rate

    R0 resection rate is defined as the proportion of participants who undergo radical surgery and have microscopically negative margins (R0) on final pathology.

    Time frame: At the time of surgery

  6. 1-Year Overall Survival (OS) Rate

    OS is defined as the time from enrollment to death from any cause. The 1-year OS rate will be estimated using the Kaplan-Meier method.

    Time frame: At 1 year after enrollment

  7. Time to Distant Metastasis (TTDM)

    TTDM is defined as the time from enrollment to the first documented distant metastasis.

    Time frame: During post-operative follow-up (assessed at 1 month after surgery, then every 3 months for the first 2 years, and every 6 months for years 3-5, with chest/abdominal CT and, if indicated, brain MRI/CT)

  8. Safety and Tolerability

    Safety endpoints include: (a) incidence, severity, and relationship to study drugs of all adverse events (AEs), treatment-emergent AEs (TEAEs), serious AEs (SAEs), and immune-related AEs (irAEs); (b) proportion of participants discontinuing treatment due to AEs; (c) changes from baseline in vital signs, physical examination findings, and laboratory parameters (hematology, serum chemistry, urinalysis, ECG, etc.). AEs will be graded according to NCI CTCAE v5.0.

    Time frame: From signing of informed consent through 90 days after the last dose (SAEs reported up to 90 days; SAEs considered related to study drugs reported beyond 90 days)

Other outcomes

  1. Non-delayed Surgery Rate

    Defined as the proportion of participants who undergo surgery within ≤42 days from the completion of neoadjuvant therapy (i.e., last dose of study drug).

    Time frame: At the time of surgery

  2. Surgical Complication Rate

    Defined as the proportion of participants who experience intraoperative or perioperative complications of Grade ≥3 or serious complications.

    Time frame: Intraoperatively and within 30 days post-surgery

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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 Aug 2026; primary completion for Jun 2030, 46 months later.

Of 730 non-industry phase 2 interventional studies under Carcinoma, Non-Small-Cell Lung, half reached primary completion within 56 months of starting (the median), counting those still running; a quarter within 36 and three quarters within 84. This study's planned 46 months is below that.

Counting every sponsor, half of 1,047 studies reached it within 48 months; a quarter within 30 and three quarters within 76.

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

Registered
Aug 15, 2026
First posted
Aug 20, 2026
StartEst.
Aug 20, 2026
Primary completionEst.
Jun 30, 2030
CompletionEst.
Jun 30, 2030
Last update
Aug 20, 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.
No changes since tracking began. The registry record was last updated on Aug 20, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07775040
Lead sponsor
Sichuan Cancer Hospital and Research Institute
Responsible party
Hu Bin (Deputy Director of Thoracic Surgery and Chief of the Second Ward, Sichuan Cancer Hospital and Research Institute) — Principal investigator
First posted
Aug 20, 2026
Start date
Aug 20, 2026 (estimated)
Primary completion
Jun 30, 2030 (estimated)
Completion
Jun 30, 2030 (estimated)
Last update
Aug 20, 2026

Study contacts

bin hu, PhD
Contact
hubin@sczlyy.org.cn
028-85420367
peng xu, PhD
Contact
xupeng4618@163.com

Oversight

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

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Studies of the drug tested here: Tislelizumab

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