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Phase 1 Study of ATRA Plus a PD-1 Inhibitor in EGFR-Mutant NSCLC After Third-Generation EGFR-TKI Resistance
Sponsor: Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Summary
The goal of this Phase 1 clinical trial is to learn whether all-trans retinoic acid (ATRA) combined with tislelizumab is safe and tolerable in adults with EGFR-mutant non-small cell lung cancer (NSCLC). The study is for people whose cancer has worsened after treatment with a third-generation EGFR tyrosine kinase inhibitor and at least one standard systemic treatment, or who cannot tolerate or are not suitable for currently available standard treatments. The main questions this study aims to answer are: * What side effects and dose-limiting toxicities occur with the combination of ATRA and tislelizumab? * What is the highest dose of ATRA that can be given safely with tislelizumab, and what dose should be recommended for future studies? Researchers will also look for early signs that the combination can shrink or control the cancer and will assess how long participants live without their cancer getting worse and how long they live overall. Tumor tissue and blood samples will be studied to explore changes in the cancer and the immune system and to identify possible markers associated with treatment response or side effects. All participants will receive ATRA and tislelizumab; there is no comparison or placebo group. Participants will: * Take ATRA by mouth twice daily, beginning 7 days before the first dose of tislelizumab. The ATRA dose will be assigned according to the dose level being studied. * Receive tislelizumab by intravenous infusion once every 3 weeks. * Undergo regular safety assessments, including physical examinations, blood tests, vital-sign measurements, and monitoring for side effects. * Undergo imaging examinations approximately every 6 weeks during the first year to assess the cancer. * Provide tumor tissue and blood samples for biomarker research. * Attend an end-of-treatment visit, safety follow-up visits, and survival follow-up approximately every 3 months after treatment ends.
Official title: A Phase 1 Clinical Study of All-Trans Retinoic Acid in Combination With a PD-1 Inhibitor in Patients With EGFR-Mutant Non-Small Cell Lung Cancer After Acquired Resistance to a Third-Generation EGFR Tyrosine Kinase Inhibitor
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
24
Start Date
2026-10-01
Completion Date
2028-10-10
Last Updated
2026-09-25
Healthy Volunteers
No
Interventions
All-trans retinoic acid
All-trans retinoic acid will be administered orally twice daily at an assigned dose level of 30 mg, 40 mg, or 50 mg. ATRA will begin 7 days before the first tislelizumab infusion and will continue during the subsequent 21-day combination-treatment cycles. Dose escalation will follow a conventional 3+3 design. After the recommended dose for further study has been determined, additional participants will receive ATRA at that dose in the dose-expansion cohort. ATRA may be interrupted, reduced, or permanently discontinued according to the type, severity, duration, and recovery of treatment-related toxicity.
Tislelizumab
Tislelizumab, a programmed cell death protein 1 (PD-1) inhibitor, will be administered at a dose of 200 mg by intravenous infusion once every 3 weeks. The first dose will be administered after the 7-day ATRA lead-in period, and tislelizumab will then be given in combination with oral ATRA during each 21-day treatment cycle. Dose reduction of tislelizumab is not permitted. Treatment may be interrupted, resumed, or permanently discontinued for immune-related or other clinically significant adverse events according to applicable prescribing information, established toxicity-management guidance, and the investigator's clinical judgment.
Locations (1)
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital
Beijing, Beijing Municipality, China