REFINE-Lung implements a novel multi-arm randomised trial design to address possible immunotherapy overtreatment.
Ehsan Ghorani, Matteo Quartagno, Fiona Blackhall...
https://pubmed.ncbi.nlm.nih.gov/37142383/Actively Recruiting
Led by Imperial College London · Updated on 2024-03-07
1750
Participants Needed
37
Research Sites
N/A
Total Duration
Researchers are evaluating whether less frequent dosing of pembrolizumab after six months of standard treatment is safe and effective for patients with advanced non-small cell lung cancer NSCLC. Pembrolizumab, an immunotherapy targeting the PD-1 receptor, has improved outcomes in NSCLC, but current dosing every six weeks for up to two years may result in overtreatment. This UK phase III trial aims to find if reducing dose frequency can maintain effectiveness while improving quality of life and lowering costs. Participants who have received six months of pembrolizumab, with or without chemotherapy, and plan to continue treatment will be randomized to receive pembrolizumab intravenously every six weeks control or every twelve weeks initially. If the 12-week dosing is found to be not less effective, additional groups receiving doses every nine, fifteen, and eighteen weeks will be included. Patients who experience disease progression while on reduced frequency dosing can return to the standard six-week schedule. Throughout the study, participants will be monitored for overall survival at 18 months from randomization, along with other outcomes such as progression-free survival, response rate, duration of response, and adverse events over two years. The study involves regular hospital visits for treatment and assessments, and the results may lead to safer, more convenient treatment options for NSCLC patients. The total participation time varies depending on individual treatment and follow-up schedules.
CONDITIONS
A Randomised Open-label Phase III Trial of REduced Frequency Pembrolizumab immuNothErapy for First-line Treatment of Patients With Advanced Non-small Cell Lung Cancer (NSCLC)
A
Alex Baker
P
Philip Badman
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Imperial College London
Lead Sponsor
National Institute for Health Research, United Kingdom
Collaborating Sponsor
You may qualify if you...
You will not qualify if you...
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 screening and enrollment visit (in-person)
Duration - Up to 18 months from randomization
Participants receive pembrolizumab immunotherapy at reduced frequencies after completing 6 months of standard treatment. The dosing interval varies between 6 to 18 weeks depending on the assigned arm.
Visits every 6 to 18 weeks depending on dosing frequency
Duration - Up to 6 months after treatment ends, total follow-up 2 years from study entry
Participants are monitored for overall survival, progression, response, and adverse events after completing treatment.
Periodic visits during follow-up period
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
5
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Ehsan Ghorani, Matteo Quartagno, Fiona Blackhall...
https://pubmed.ncbi.nlm.nih.gov/37142383/Imperial College London
Lead Sponsor
National Institute for Health Research, United Kingdom
Collaborating Sponsor