Checkpoint inhibition in combination with an immunoboost of external beam radiotherapy in solid tumors (CHEERS) : study protocol for a phase 2, open-label, randomized controlled trial
- Author
- Mathieu Spaas (UGent) , Nora Sundahl, Eva Hulstaert, Vibeke Kruse (UGent) , Sylvie Rottey (UGent) , Daan De Maeseneer (UGent) , Veerle Surmont (UGent) , Annabel Meireson, Lieve Brochez (UGent) , Dries Reynders (UGent) , Els Goetghebeur (UGent) , Robbe Van den Begin, Dirk Van Gestel, Vincent Renard, Piet Dirix, Pieter Mestdagh (UGent) and Piet Ost (UGent)
- Organization
- Abstract
- Background: While the introduction of checkpoint inhibitors (CPIs) as standard of care treatment for various tumor types has led to considerable improvements in clinical outcome, the majority of patients still fail to respond. Preclinical data suggest that stereotactic body radiotherapy (SBRT) could work synergistically with CPIs by acting as an in situ cancer vaccine, thus potentially increasing response rates and prolonging disease control. Though SBRT administered concurrently with CPIs has been shown to be safe, evidence of its efficacy from large randomized trials is still lacking. The aim of this multicenter randomized phase II trial is to assess whether SBRT administered concurrently with CPIs could prolong progression-free survival as compared to standard of care in patients with advanced solid tumors. Methods/design: Ninety-eight patients with locally advanced or metastatic disease will be randomized in a 1:1 fashion to receive CPI treatment combined with SBRT (Arm A) or CPI monotherapy (Arm B). Randomization will be stratified according to tumor histology (melanoma, renal, urothelial, head and neck squamous cell or non-small cell lung carcinoma) and disease burden (<= or > 3 cancer lesions). The recommended SBRT dose is 24Gy in 3 fractions, which will be administered to a maximum of 3 lesions and is to be completed prior to the second or third CPI cycle (depending on CPI treatment schedule). The study's primary endpoint is progression-free survival as per iRECIST. Secondary endpoints include overall survival, objective response, local control, quality of life and toxicity. Translational analyses will be performed using blood, fecal and tissue samples. Discussion: The CHEERS trial will provide further insights into the clinical and immunological impact of SBRT when combined with CPIs in patients with advanced solid tumors. Furthermore, study results will inform the design of future immuno-radiotherapy trials.
- Keywords
- Cancer Research, Genetics, Oncology, Head and neck squamous cell carcinoma, Melanoma, Non-small-cell lung carcinoma, Renal cell carcinoma, Transitional cell carcinoma, Immunotherapy, Checkpoint inhibitor, Stereotactic body radiotherapy, Survival, Clinical trial, SQUAMOUS-CELL CARCINOMA, BODY RADIATION-THERAPY, ADVANCED MELANOMA, NIVOLUMAB, PEMBROLIZUMAB, IPILIMUMAB, IMMUNE, CHEMOTHERAPY, MULTICENTER, DOCETAXEL
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-8730502
- MLA
- Spaas, Mathieu, et al. “Checkpoint Inhibition in Combination with an Immunoboost of External Beam Radiotherapy in Solid Tumors (CHEERS) : Study Protocol for a Phase 2, Open-Label, Randomized Controlled Trial.” BMC CANCER, vol. 21, no. 1, 2021, doi:10.1186/s12885-021-08088-w.
- APA
- Spaas, M., Sundahl, N., Hulstaert, E., Kruse, V., Rottey, S., De Maeseneer, D., … Ost, P. (2021). Checkpoint inhibition in combination with an immunoboost of external beam radiotherapy in solid tumors (CHEERS) : study protocol for a phase 2, open-label, randomized controlled trial. BMC CANCER, 21(1). https://doi.org/10.1186/s12885-021-08088-w
- Chicago author-date
- Spaas, Mathieu, Nora Sundahl, Eva Hulstaert, Vibeke Kruse, Sylvie Rottey, Daan De Maeseneer, Veerle Surmont, et al. 2021. “Checkpoint Inhibition in Combination with an Immunoboost of External Beam Radiotherapy in Solid Tumors (CHEERS) : Study Protocol for a Phase 2, Open-Label, Randomized Controlled Trial.” BMC CANCER 21 (1). https://doi.org/10.1186/s12885-021-08088-w.
- Chicago author-date (all authors)
- Spaas, Mathieu, Nora Sundahl, Eva Hulstaert, Vibeke Kruse, Sylvie Rottey, Daan De Maeseneer, Veerle Surmont, Annabel Meireson, Lieve Brochez, Dries Reynders, Els Goetghebeur, Robbe Van den Begin, Dirk Van Gestel, Vincent Renard, Piet Dirix, Pieter Mestdagh, and Piet Ost. 2021. “Checkpoint Inhibition in Combination with an Immunoboost of External Beam Radiotherapy in Solid Tumors (CHEERS) : Study Protocol for a Phase 2, Open-Label, Randomized Controlled Trial.” BMC CANCER 21 (1). doi:10.1186/s12885-021-08088-w.
- Vancouver
- 1.Spaas M, Sundahl N, Hulstaert E, Kruse V, Rottey S, De Maeseneer D, et al. Checkpoint inhibition in combination with an immunoboost of external beam radiotherapy in solid tumors (CHEERS) : study protocol for a phase 2, open-label, randomized controlled trial. BMC CANCER. 2021;21(1).
- IEEE
- [1]M. Spaas et al., “Checkpoint inhibition in combination with an immunoboost of external beam radiotherapy in solid tumors (CHEERS) : study protocol for a phase 2, open-label, randomized controlled trial,” BMC CANCER, vol. 21, no. 1, 2021.
@article{8730502, abstract = {{Background: While the introduction of checkpoint inhibitors (CPIs) as standard of care treatment for various tumor types has led to considerable improvements in clinical outcome, the majority of patients still fail to respond. Preclinical data suggest that stereotactic body radiotherapy (SBRT) could work synergistically with CPIs by acting as an in situ cancer vaccine, thus potentially increasing response rates and prolonging disease control. Though SBRT administered concurrently with CPIs has been shown to be safe, evidence of its efficacy from large randomized trials is still lacking. The aim of this multicenter randomized phase II trial is to assess whether SBRT administered concurrently with CPIs could prolong progression-free survival as compared to standard of care in patients with advanced solid tumors. Methods/design: Ninety-eight patients with locally advanced or metastatic disease will be randomized in a 1:1 fashion to receive CPI treatment combined with SBRT (Arm A) or CPI monotherapy (Arm B). Randomization will be stratified according to tumor histology (melanoma, renal, urothelial, head and neck squamous cell or non-small cell lung carcinoma) and disease burden (<= or > 3 cancer lesions). The recommended SBRT dose is 24Gy in 3 fractions, which will be administered to a maximum of 3 lesions and is to be completed prior to the second or third CPI cycle (depending on CPI treatment schedule). The study's primary endpoint is progression-free survival as per iRECIST. Secondary endpoints include overall survival, objective response, local control, quality of life and toxicity. Translational analyses will be performed using blood, fecal and tissue samples. Discussion: The CHEERS trial will provide further insights into the clinical and immunological impact of SBRT when combined with CPIs in patients with advanced solid tumors. Furthermore, study results will inform the design of future immuno-radiotherapy trials.}}, articleno = {{514}}, author = {{Spaas, Mathieu and Sundahl, Nora and Hulstaert, Eva and Kruse, Vibeke and Rottey, Sylvie and De Maeseneer, Daan and Surmont, Veerle and Meireson, Annabel and Brochez, Lieve and Reynders, Dries and Goetghebeur, Els and Van den Begin, Robbe and Van Gestel, Dirk and Renard, Vincent and Dirix, Piet and Mestdagh, Pieter and Ost, Piet}}, issn = {{1471-2407}}, journal = {{BMC CANCER}}, keywords = {{Cancer Research,Genetics,Oncology,Head and neck squamous cell carcinoma,Melanoma,Non-small-cell lung carcinoma,Renal cell carcinoma,Transitional cell carcinoma,Immunotherapy,Checkpoint inhibitor,Stereotactic body radiotherapy,Survival,Clinical trial,SQUAMOUS-CELL CARCINOMA,BODY RADIATION-THERAPY,ADVANCED MELANOMA,NIVOLUMAB,PEMBROLIZUMAB,IPILIMUMAB,IMMUNE,CHEMOTHERAPY,MULTICENTER,DOCETAXEL}}, language = {{eng}}, number = {{1}}, pages = {{10}}, title = {{Checkpoint inhibition in combination with an immunoboost of external beam radiotherapy in solid tumors (CHEERS) : study protocol for a phase 2, open-label, randomized controlled trial}}, url = {{http://doi.org/10.1186/s12885-021-08088-w}}, volume = {{21}}, year = {{2021}}, }
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