ClinicalTrials.gg
Not yet recruitingNCT07818304Endouble 2Updated Sep 14, 2026

SRT Combined With Envafolimab and Endostar in the First-line Treatment of Advanced NSCLC

A Phase 2 interventional study of Stereotactic Radiation Therapy and Envafolimab in Non Small Cell Lung Cancer and Lung Neoplasms, sponsored by The First People's Hospital of Lianyungang. Not yet recruiting at 1 site in China. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-09-14.

Sponsored by The First People's Hospital of Lianyungang · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
61
Allocation
Not applicable
Ages
18 Years to 80 Years
Sex
All
01

Study summary

This is a prospective, single-arm phase II clinical study. It intends to evaluate the efficacy and safety of stereotactic radiation therapy (SRT) combined with envafolimab and endostar as first-line treatment in stage IV non-small cell lung cancer (NSCLC) patients without actionable EGFR/ALK/ROS1 driver gene alterations and with PD-L1 TPS ≥ 1%. A total of 61 eligible participants will receive combination treatment of stereotactic radiotherapy, envafolimab and endostar. Tumor response will be evaluated every 6 weeks according to RECIST v1.1, and treatment-related adverse events will be monitored based on NCI-CTCAE v5.0. The treatment will continue until disease progression, patient withdrawal, loss of follow-up or death.

Read the detailed description

This prospective multi-center single-arm phase II trial focuses on unresectable stage IV NSCLC patients with negative driver genes and positive PD-L1 expression (TPS ≥1%). Eligible subjects are treatment-naive patients or recurrent cases after adjuvant chemotherapy. Patients will receive stereotactic body radiation therapy targeting 1 to 5 metastatic lesions with a dose of 30-50 Gy in 5-10 fractions. Within 1 to 7 days after radiotherapy, patients will receive 300 mg envafolimab subcutaneously on day 1 and 210 mg endostar continuous intravenous pumping on days 1-3 of each 3-week cycle. The overall clinical efficacy and safety profiles of this combined regimen will be systematically observed.

02

Conditions studied

  • Non Small Cell Lung Cancer
  • Lung Neoplasms

Keywords

  • Non-small-cell lung cancer
  • Stereotactic radiation therapy
  • Envafolimab
  • Endostar
  • Immunotherapy
  • Anti-angiogenic therapy
  • Phase II clinical trial
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 61 is close to 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

The First People's Hospital of Lianyungang is the lead sponsor of 21 studies on the registry; 10 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 80 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

  1. Subjects voluntarily participate in this study, sign the written form, and demonstrate good compliance.
  2. Aged 18-80 years old at the time of signing informed consent, male or female.
  3. confirmed stage IV non-small-cell lung cancer (NSCLC) according to the 8th IASLC/AJCC TNM staging system, with negative actionable driver gene alterations (EGFR/ALK/ROS1), and no prior systemic anti-cancer treatment.
  4. Provide archived tumor tissue samples or newly obtained core/excisional specimens from tumor lesions which have not received prior anti-tumor therapy or radiotherapy. Formalin-fixed paraffin-embedded (FFPE) tissue blocks are preferred over slides; newly-obtained biopsy samples are preferred over archived tissues. expression ≥1% is confirmed by immunohistochemistry. For subjects without newly-obtained tissue, 5-8 slices of 3-5 μm paraffin sections of archived tissue collected within 2 years before enrollment are acceptable.
  5. Have at least one radiologically per version 1.1: target lesion with longest diameter ≥10 mm on CT/MRI, or pathologically enlarged lymph node with short-axis diameter ≥15 mm on CT scan.
  6. (ECOG) performance status of 0-1.
  7. Expected survival time ≥ 3 months.
  8. Treatment-naive patients without previous systemic anti-tumor therapy (including radiotherapy, chemotherapy, targeted or immunotherapy), or patients with disease recurrence more than 6 months after completion of postoperative chemotherapy.
  9. Adequate organ and bone marrow function confirmed by laboratory tests obtained within 7 days before enrollment. No blood product transfusion, growth factors, albumin or other corrective medications are permitted within 14 days prior to laboratory assessment:

1) Hematology: (ANC) ≥1.5×10⁹/L, count (PLT) ≥75×10⁹/L, (HGB) ≥90 g/L (no transfusion or erythropoietin-dependency within 14 days); 2) Liver function: total (TBIL) ≤2×; (ALT) and/or aspartate aminotransferase (AST) ≤5×ULN; serum albumin ≥28 g/L; alkaline phosphatase (ALP) ≤5×ULN; 3) Renal function: serum creatinine (Cr) ≤1.5×ULN, or ≥50 mL/min using Cockcroft-Gault formula; urine protein \<2+ on urinalysis. For baseline urine protein ≥2+, 24-hour urine protein quantification must be \<1 g.

4) Coagulation function: (INR) or prothrombin time (PT) ≤1.5×ULN. For subjects receiving anticoagulants, INR within the therapeutic target range of anticoagulation is acceptable.

10. For women of , negative urine or serum pregnancy test within 3 days prior to first study drug administration.

11. Tissue samples must be available for biomarker (e.g. PD-L1) analysis. Newly-obtained specimens are preferred; archived paraffin sections obtained within 2 years before enrollment are allowed if fresh tissue cannot be acquired.

Exclusion criteria

Exclusion Criteria:

  1. Tumor invades major blood vessels on CT/MRI, or judged to carry high risk of invading critical vessels and causing fatal hemorrhage during study treatment.
  2. Currently participating in another interventional clinical trial, or received drug/device within 4 weeks before first study drug administration.
  3. Received anti-tumor Chinese patent medicine or immunomodulatory agents (such as thymosin, interferon, interleukin) within 2 weeks prior to first dose; or underwent major surgical operation within 3 weeks before first dose.
  4. Active hemoptysis requiring clinical intervention, active diverticulitis, intra-abdominal abscess, gastrointestinal obstruction, or peritoneal .
  5. Any bleeding diathesis regardless of severity; any bleeding/hemorrhagic event ≥ grade 3 within 4 weeks before enrollment; unhealed wound, ulcer or fracture.
  6. (NYHA) class III-IV congestive heart failure, or uncontrolled arrhythmia.
  7. History of arterial thrombosis, embolism or ischemic events within 6 months before study entry, such as myocardial infarction, unstable angina, cerebrovascular accident or .
  8. Known to any study drug.
  9. Require chronic systemic therapy. Intermittent bronchodilators, inhaled corticosteroids for /asthma, or local corticosteroid injection are permitted.
  10. Symptomatic central nervous system (CNS) metastases. Patients with asymptomatic or treated-stable may be enrolled only if all of the following criteria are met: measurable extracranial lesion; no midbrain, pons, cerebellum, meningeal, medulla oblongata or spinal cord metastasis; clinically stable for at least 2 weeks; systemic steroid discontinued at least 3 days before first study drug dose.
  11. Active infection requiring treatment, or systemic anti-infective medication administered within 1 week before first dose. Subjects have not sufficiently recovered from toxicity/complications induced by prior interventions (≤ grade 1 or return to baseline, excluding fatigue and alopecia).
  12. Known (HIV-1/2 antibody positive).
  13. Untreated active (HBsAg positive with HBV-DNA above local laboratory ). Subjects with HBV viral load \<1000 copies/mL (200 IU/mL) are eligible and should receive anti-HBV prophylaxis during study therapy to prevent viral reactivation. Anti-HBc positive, HBsAg negative, anti-HBs negative and HBV-DNA negative subjects do not require prophylactic anti-HBV therapy but need close monitoring for viral reactivation.
  14. Active infection (HCV-Ab positive with HCV-RNA above assay lower limit).
  15. Received within 30 days before Cycle 1 Day 1. Seasonal inactivated injectable influenza vaccine within 30 days before first dose is allowed; intranasal live-attenuated influenza vaccine is prohibited.
  16. Pregnant or breastfeeding women.
  17. Medical history, disease condition, treatment or laboratory abnormality that may interfere with study results or prevent full participation in the trial; or other conditions judged by the investigator to render the subject unsuitable for enrollment or associated with potential safety risks.
Terms in these criteria, in plain language(31)

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.

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.

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.

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.

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.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

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).

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.

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.

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.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Metastases

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

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

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.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

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.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

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.

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.

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
61 participants (estimated)

Study arms

  • Experimental
    SRT + Envafolimab + Endostar

    All eligible subjects receive stereotactic body radiotherapy combined with envafolimab and endostar as first-line treatment.

    Radiation: Stereotactic Radiation Therapy · Drug: Envafolimab · Drug: Endostar

Interventions

  • RadiationStereotactic Radiation Therapy

    Stereotactic radiotherapy delivered to 1-5 metastatic lesions, with a total dose of 30-50 Gy in 5-10 fractions. Lesions are selected based on larger volume, symptomatic status, or visceral location; treatment of all metastatic lesions is not required.

  • 300 mg administered by subcutaneous injection on Day 1 of each 3-week treatment cycle, initiated within 1-7 days after completion of radiotherapy.

  • 210 mg administered by continuous intravenous pumping on Days 1-3 of each 3-week treatment cycle, initiated within 1-7 days after completion of radiotherapy.

06

What researchers measure

Primary outcomes

  1. Objective Response Rate (ORR)

    Percentage of participants achieving complete response (CR) or partial response (PR) as assessed by the investigator according to RECIST version 1.1. CR and PR must be confirmed by subsequent tumor assessment during the study.

    Time frame: From treatment initiation up to 24 weeks

  2. Incidence of Treatment-Related Adverse Events

    Number and severity of treatment-related adverse events, laboratory abnormalities, vital sign and electrocardiogram changes, evaluated according to NCI-CTCAE version 5.0. Safety analyses will be performed in the safety set.

    Time frame: From first study treatment to 90 days after last study treatment

Secondary outcomes

  1. Progression-Free Survival (PFS)

    Time from treatment initiation to first documented radiological disease progression (per RECIST v1.1, investigator-assessed) or death from any cause, whichever occurs first. Participants without progression or death will be censored at the date of last valid tumor assessment.

    Time frame: From treatment start until progression or death, up to 36 months

  2. Overall Survival (OS)

    Time from treatment initiation to death due to any cause.

    Time frame: From treatment start until death from any cause, up to 48 months

  3. Disease Control Rate (DCR)

    Percentage of participants achieving complete response (CR), partial response (PR), or stable disease (SD), as assessed by the investigator according to RECIST version 1.1.

    Time frame: From treatment initiation up to 24 weeks

  4. Duration Of Response (DOR)

    Time interval from the first documented objective tumor response until disease progression or death from any cause, whichever occurs first.

    Time frame: From first confirmed response until progression or death, up to 36 months

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

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 14, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07818304
Lead sponsor
The First People's Hospital of Lianyungang
Responsible party
Sponsor
First posted
Sep 14, 2026
Start date
Oct 2026 (estimated)
Primary completion
Apr 2028 (estimated)
Completion
Oct 2028 (estimated)
Last update
Sep 14, 2026

Study contacts

Xiaodong Jiang, MD
Contact
jxdysy1970@126.com
86-18961325359

Oversight

Data monitoring committee
No
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 Sep 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Envafolimab · Endostar protein

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