ClinicalTrials.gg
Not yet recruitingNCT07842471Updated Sep 25, 2026

Local Consolidative Therapy Versus Maintenance Immunotherapy After First-Line Chemoimmunotherapy in Metastatic NSCLC

A Phase 2 interventional study of Immediate Local Consolidative Therapy (LCT) in NSCLC (Non-small Cell Lung Carcinoma), sponsored by Guangdong Provincial People's Hospital. Not yet recruiting at 1 site in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-25.

Sponsored by Guangdong Provincial People's Hospital · Phase 2, Interventional, and Treatment

Updated Sep 25, 2026Newly registeredGo to Updates ↓
Phase
Phase 2
Study type
Interventional
Enrollment
117
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study explores the difference in progression-free survival (PFS) between local consolidative therapy (LCT arm) targeting residual lesions and continued systemic therapy (non-LCT arm) in patients with metastatic NSCLC who have achieved at least partial response (PR) following first-line chemoimmunotherapy. In this process, a multidisciplinary team (MDT) comprising surgical oncology, radiation oncology, and medical oncology will be integrated to administer local treatment modalities-including surgery, radiotherapy, and ablation-for oligometastatic lesions, aiming to address critical clinical questions regarding the optimal beneficiary population for local therapy, the best local treatment modality, and the optimal timing of local intervention.

Read the detailed description
  1. This study incorporates both a randomized controlled trial (RCT) cohort and a real-world study (RWS) cohort.

    RCT Cohort: A prospective, randomized, multicenter clinical study. The primary study population comprises patients with stage IV disease (9th edition TNM staging) who have received 4-6 cycles of first-line immunotherapy combined with platinum-based doublet chemotherapy, achieved at least partial response (PR) upon efficacy assessment, demonstrated metabolically active residual lesions on PET evaluation, and been clinically assessed by the multidisciplinary team (MDT) as amenable to individualized local therapy (e.g., ≤3 organs and ≤5 lesions, with feasibility for surgery/radiotherapy/ablation). Patients will be randomly assigned to:

    Local Therapy Arm: Receiving local treatment targeting residual lesions, followed by physician-assessed continuation of maintenance systemic therapy or surveillance monitoring; optional local treatment modalities include surgery, radiotherapy, and ablation. Assessment of residual lesions will be primarily based on imaging examinations including PET-CT and brain MRI. PET evaluation of residual lesions will primarily reference the PERCIST (PET Response Criteria in Solid Tumors) criteria. Compared with baseline imaging, lesions with metabolic activity exceeding that of the mediastinal blood pool or liver on PET evaluation will be considered potentially active residual lesions. The final determination shall be made through multidisciplinary assessment jointly by a radiologist or nuclear medicine physician with more than 10 years of clinical experience, together with thoracic surgeons, pulmonologists, and radiation oncologists.

    Systemic Therapy Arm: Continuation of systemic maintenance therapy until disease progression (PD) or intolerable toxicity; upon PD, patients may undergo MDT reassessment for potential local therapy opportunities.

  2. Primary Endpoint:

    Progression-Free Survival (PFS): Time from randomization to first documented disease progression or death from any cause.

  3. Secondary Endpoints:

    Overall Survival (OS): Time from randomization to death from any cause. Safety of local consolidative therapy. Impact of different local consolidative treatment modalities on prognosis. Time from local consolidative therapy to recurrence/progression of previously existing metastatic lesions.

    Time from local consolidative therapy to development of new metastatic lesions.

  4. Exploratory Endpoints:

    Tumor Immune Microenvironment (TiME) and prognosis. Tumor dormancy characteristics. Clinical outcomes of different treatment choices after disease progression (PD) in the control arm.

    Correlation between ctDNA-based minimal residual disease (MRD) status before and after randomization and prognosis.

  5. RCT Cohort: The time from randomization to disease progression (PD) or death in the control arm following induction therapy was 6 months. Assuming that the experimental arm combined with local therapy could be extended to 11 months (based on clinical experience and literature inference), with a one-sided α of 0.05, power of 80%, accrual period of 12 months, and a randomization ratio of 2:1, the total required sample size was calculated to be 105 patients (with a total of 76 required events), comprising 70 patients in the experimental arm and 35 patients in the control arm. Considering an 8%-10% dropout rate, a total of 117 patients are planned for enrollment.
  6. RWS Cohort: This cohort does not prespecify statistical hypotheses. It is designed to observe patients who met the eligibility criteria during the RCT study period but were unable to be enrolled in the RCT for various reasons. This cohort will serve to supplement the safety and clinical benefit data of the experimental arm in the RCT cohort. Based on epidemiological projections from our center, approximately 50 patients are expected to be enrolled during this period.
02

Conditions studied

  • NSCLC (Non-small Cell Lung Carcinoma)

Keywords

  • local consolidative therapy
  • surgery
  • radiotherapy
  • ablation
  • immunotherapy
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 117 is above 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

Guangdong Provincial People's Hospital is the lead sponsor of 237 studies on the registry; 102 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years and older
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. Voluntary participation in the study with signed ;
  2. Age ≥18 years, both male and female;
  3. (ECOG) performance status score of 0-1;
  4. Estimated ≥12 months;
  5. Histologically/ confirmed non-small cell lung cancer (NSCLC) at initial diagnosis, with TNM stage IV (IASLC 9th edition);
  6. Absence of actionable genetic mutations related to EGFR/ALK/ROS1 and other druggable targets;
  7. Completion of 4-6 cycles of immunotherapy (/PD-L1 monoclonal antibody) combined with platinum-based doublet chemotherapy prior to enrollment;
  8. Achievement of partial response (PR) or complete response (CR) as assessed by 1.1 criteria;
  9. Presence of metabolically active residual lesions on PET evaluation, and clinical assessment by the multidisciplinary team (MDT)* indicating feasibility of individualized local therapy (e.g., ≤3 organs and ≤5 lesions, amenable to surgery/radiotherapy/ablation);
  10. Adequate organ function.

Exclusion criteria

Exclusion Criteria:

  1. Expected to be unable to tolerate surgery, radiation therapy, or ablation;
  2. Unable to receive local treatment for all active residual lesions;
  3. Patients with a confirmed history of malignant pleural effusion or pleural dissemination;
  4. diagnosed with neuroendocrine cancer at initial diagnosis (including small cell lung cancer, combined small cell lung cancer, large cell neuroendocrine carcinoma, mixed large cell neuroendocrine carcinoma, and carcinoid). Patients who do not show neuroendocrine components at initial diagnosis but develop such components in post-surgical pathology may be included;
  5. Previously received allogeneic tissue or solid organ transplantation;
  6. History of interstitial lung disease requiring treatment (non-infectious) or currently suffering from interstitial lung disease requiring steroid treatment;
  7. Presence of viral infectious diseases during screening:

    1. Positive serum test for (HIV);
    2. Active : positive hepatitis B surface antigen (HBsAg) and HBV-DNA quantitative test >500 IU/mL or >2000 copies/mL;
    3. Active : positive hepatitis C virus (HCV) antibody and HCV-RNA quantitative test above the ;
  8. Participants with uncontrolled hypertension defined as systolic blood pressure >150 mmHg or diastolic blood pressure >90 mmHg (adjustment of antihypertensive medications is allowed prior to study initiation, but the average of the most recent three consecutive blood pressure readings before enrollment must be ≤150/90 mmHg) (each measurement separated by at least 2 minutes);
  9. Active infection requiring intravenous antimicrobial therapy at screening;
  10. Diagnosis of another within 3 years prior to signing , excluding cured cases of cutaneous basal cell carcinoma, cervical or breast in situ carcinoma, superficial bladder cancer, localized prostate cancer; participants with low-risk early-stage prostate cancer (T1-T2a stage, Gleason score ≤6, PSA \<10 ng/mL) are eligible if they have undergone curative treatment or are under active surveillance with stable disease, regardless of whether they have received treatment;
  11. Conditions that may interfere with interpretation of study results or affect the participant's ability to complete the entire study, or where, in the investigator's judgment, participation does not serve the participant's best interest;
  12. Pregnant, breastfeeding, or planning pregnancy; positive pregnancy test within 7 days prior to first study treatment;
  13. Poor compliance, unwillingness or inability to follow the study procedures as required.
Terms in these criteria, in plain language(12)

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.

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.

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.

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.

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.

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.

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.

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.

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.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
117 participants (estimated)

Study arms

  • Experimental
    LCT

    Receiving local treatment targeting residual lesions, followed by physician-assessed continuation of maintenance systemic therapy or surveillance monitoring; optional local treatment modalities include surgery, radiotherapy, and ablation. Assessment of residual lesions will be primarily based on imaging examinations including PET-CT and brain MRI. PET evaluation of residual lesions will primarily reference the PERCIST (PET Response Criteria in Solid Tumors) criteria. Compared with baseline imaging, lesions with metabolic activity exceeding that of the mediastinal blood pool or liver on PET evaluation will be considered potentially active residual lesions. The final determination shall be made through multidisciplinary assessment jointly by a radiologist or nuclear medicine physician with more than 10 years of clinical experience, together with thoracic surgeons, pulmonologists, and radiation oncologists.

    Procedure: Immediate Local Consolidative Therapy (LCT)

  • No intervention
    non-LCT

    Continuation of systemic maintenance therapy until disease progression (PD) or intolerable toxicity; upon PD, patients may undergo MDT reassessment for potential local therapy opportunities.

Interventions

  • ProcedureImmediate Local Consolidative Therapy (LCT)

    Patients with stage IV disease (9th edition TNM staging) who have received 4-6 cycles of first-line immunotherapy combined with platinum-based doublet chemotherapy, achieved at least partial response (PR) upon efficacy assessment, demonstrated metabolically active residual lesions on PET evaluation, and been clinically assessed by the multidisciplinary team (MDT) as amenable to individualized local therapy. And then receiving local treatment targeting residual lesions, followed by physician-assessed continuation of maintenance systemic therapy or surveillance monitoring; optional local treatment modalities include surgery, radiotherapy, and ablation.

    Also known as: radiotherapy, ablation

06

What researchers measure

Primary outcomes

  1. Progression-Free Survival (PFS)

    Time frame: Time from randomization to the date of the first documentation of disease progression according to Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.1) or death from any cause, whichever is earlier, assessed up to 60 months.

Secondary outcomes

  1. Overall Survival (OS)

    Time frame: time from randomization to the date of death from any cause, assessed up to 60 months.

  2. Safety of local consolidative therapy.

    Safety follow-up will be conducted at 30 days (±5 days) after local therapy or prior to the first maintenance therapy following local therapy. Occurrence and severity of adverse events, with severity determined by NCI CTCAE v6.0 criteria.

    Time frame: 30 days (±5 days) after local therapy or prior to the first maintenance therapy following local therapy.

  3. Impact of different local consolidative treatment modalities on prognosis.

    Impact of different local consolidative treatment modalities on PFS and OS.

    Time frame: When a PFS or OS event occurs

  4. Time from local consolidative therapy to recurrence/progression of previously existing metastatic lesions.

    Time frame: From date of local consolidative therapy until the date of first documented recurrence/progression of previously existing metastatic lesions, assessed up to 60 months..

  5. Time from local consolidative therapy to development of new metastatic lesions.

    Time frame: From date of local consolidative therapy until the date of first documented new distant metastasis, assessed up to 60 months.

07

Study locations

1 site
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Registered
First appeared on the registry. No changes since
Sep 25, 2026
Show all 1 update
  1. Sep 25, 2026
    First appeared on the registry

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 ↗

10

Registry details

Key details

Study ID
NCT07842471
Responsible party
Wen-zhao ZHONG (Chief Physician, Guangdong Provincial People's Hospital) — Principal investigator
First posted
Sep 25, 2026
Start date
Oct 8, 2026 (estimated)
Primary completion
Dec 31, 2029 (estimated)
Completion
Dec 31, 2032 (estimated)
Last update
Sep 25, 2026

Study contacts

Wen-Zhao Zhong, MD, PhD
Contact
syzhongwenzhao@scut.edu.cn
+86-020-83827812
Rui Fu, MD, PhD
Contact
ruifu66@foxmail.com
+86-020-83827812

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 Jul 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion