To Explore the Effect of Immune-induced Stereotactic Body Radiotherapy (SBRT) on Reversing Immunoresistance in Stage IIIc/IV Non-small Cell Lung Cancer (NSCLC)

Study Overview
=================
Brief Summary
-----------------
The goal of this clinical trial is to learn about in describe participant population. The main questions it aims to answer are: the outcomes of the efficacy (ORR) and safety (adverse events, including irAEs, AE, SAEs, and laboratory indicators) of continued immunotherapy in patients with immune-resistant IIIc/IV metastatic NSCLC treated with immune-induced radiotherapy (SBRT). Participants will be asked to accept the treatment of ICIs regimen and SBRT plan as follows: ICIs regimen: tislelizumab 200mg every 3 weeks, the first dose was given 7 days after the last SBRT treatment, then the first day of each cycle, 21 days as a cycle until disease progression. SBRT plan: The radiation dose and fractionation of SBRT should be evaluated according to the size and location of the tumor.

Official Title
-----------------
To Explore the Effect of Immune-induced Stereotactic Body Radiotherapy (SBRT) on Reversing Immunoresistance in Stage IIIc/IV Non-small Cell Lung Cancer (NSCLC)

Conditions
-----------------
Non-Small Cell Lung Cancer Without Mutation in Epidermal Growth Factor Receptor (Disorder)

Intervention / Treatment
-----------------
* Radiation: tereotactic body radiotherapy


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients with IIIc/IV NSCLC confirmed by histology and imaging Previous treatment with anti-PD1 or anti-PDL1, and resistantance to ICIs Without standard treatment regimen At least one measurable target (primary tumour or metastasis) according to RECIST v1.1 Age ≥ 18 and ≤ 75 ECOG PS ≤ 2 Life expectancy ≥ 3 months Exclusion Criteria: Autoimmune disease that might be aggravated during treatment with an immuno-stimulating agent (patients with type I diabetes, vitiligo, psoriasis, hypo- or hyperthyroid disease not requiring immunosuppressive treatment are eligible) Immunosuppressive long-term treatment (patients necessitating a corticotherapy are eligible if they are administered in doses < or = to the equivalent of 10 mg of prednisone daily, administration of steroids by a route resulting in minimal systemic exposure (local, intra-anal, intraocular or inhalation) are eligible). Transplant patients (including stem cell transplants), HIV positive or other immune deficiency syndromes Active infection by HBV or HCV Known severe hypersensitivity to monoclonal antibodies or history of anaphylactic shock, or uncontrolled asthma Patient with interstitial pneumonitis or pulmonary fibrosis or any other known severe respiratory insufficiency Patient already included in another clinical trial during treatment with an experimental

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ICIs regimen: tislelizumab 200mg every 3 weeks, the first dose was given 7 days after the last SBRT<br> | Radiation: tereotactic body radiotherapy<br>* In second-line and later treatment, the treatment regimen of SBRT combined with tislelizumab is used<br>* Other names: tislelizumab;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Overall Response Rate out of the radiation field | To evaluate the efficacy of this protocol，Measurements were based on recist1.1 | Individual patients should be evaluated within 3 days after the patient follow-up examination |