Clinical trial NCT05636605: Analysis of the Microenvironment of Lung Cancer and Exploration of the Mechanism of Resistance to Immunotherapy
Official title: Analysis of the Microenvironment of Lung Cancer and Exploration of the Mechanism of Resistance to Immunotherapy
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Lung Cancer
Lead sponsor: The Fourth Affiliated Hospital of Zhejiang University School of Medicine
Sponsor class: OTHER
Collaborators: name: Second Affiliated Hospital, School of Medicine, Zhejiang University
First posted: 2022-12-05
Enrollment: 200
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: OTHER
Sampling method: PROBABILITY_SAMPLE
Study population: Newly diagnosed lung cancer patients

Brief summary: The investigators plan to conduct a multiomics analysis（such as, Genomics, proteomics, single cell RNA sequencing, space transcriptomics）of tumor tissue and blood, aiming at analyzing tumor heterogeneity, mapping the microenvironment map of lung cancer and exploring the mechanism of sensitivity and resistance to anti-PD1/PD-L1 antibodies.

Detailed description: Lung cancer is a highly heterogeneous disease. Cancer cells and cells within the tumor microenvironment together determine disease progression, as well as response to or escape from treatment. Tumor ecosystems are comprised of cancer cells, infiltrating immune cells, stromal cells, and other cell types together with noncellular tissue components, which interact and collectively determine disease progression as well as response to therapy. It is well known that cancer patients elicit very individualized responses to different treatments, demanding better characterization of the whole tumor ecosystem beyond currently applied clinical typing of somatic mutations in cancer cells.

Immune checkpoint blockers (ICBs) have revolutionized the management of patients with lung cancer. Blocking the interaction between the programmed cell death protein 1 (PD-1) receptor and its primary ligand (PD-L1) has demonstrated remarkable anticancer activity, and anti-PD-1/PD-L1 drugs have been approved both as single agents or in combination with cytotoxic chemotherapy. However, most patients receiving anti-PD-1/PD-L1 monoclonal antibodies do not derive benefit. Hence, there is a crucial need to identify reliable predictive biomarkers of the response to anti-PD-1/PD-L1 agents to develop precision medicine for NSCLC immunotherapy as well as to identify novel mechanisms underlying resistance to ICBs.

To map the cell type-specific landscape of cancer cells and their tumor microenvironment in lung cancer, the investigators plan to conduct a multiomics analysis（such as, Genomics, proteomics, single cell RNA sequencing, space transcriptomics）of tumor tissue and blood, aiming at analyzing tumor heterogeneity, mapping the microenvironment map of lung cancer and exploring the mechanism of sensitivity and resistance to anti-PD1/PD-L1 antibodies.

Eligibility criteria: Inclusion Criteria:

* Histopathology or hemology diagnostics of lung cancer
* Patients have never received any antineoplastic therapy

Exclusion Criteria:

* Within 5 years or at the same time, there are other active malignancies
* Currently participating in interventional clinical research treatment, or received other research drugs or used research devices within 4 weeks before the first administration
* Active autoimmune diseases requiring systemic treatment (such as the use of disease relieving drugs, glucocorticoids or immunosuppressants) occurred within 2 years before the first administration
* The study was receiving systemic glucocorticoid treatment (excluding local glucocorticoids by nasal spray, inhalation or other means) or any other form of immunosuppressive therapy within 7 days before the first administration; Note: It is allowed to use glucocorticoid with physiological dose (prednisone ≤ 10mg/day or equivalent)
* Known history of allogeneic organ transplantation and allogeneic hematopoietic stem cell transplantation

Primary outcomes:
measure: objective response rate
timeFrame: three years
measure: Major Pathologic Response
timeFrame: three-four months
measure: progression-free survival
timeFrame: three years
Secondary outcomes:
Other outcomes:
Locations:
city: Yiwu
country: China
facility: The Fourth Affiliated Hospital of Zhejiang University
state: Zhejiang
Study officials:
affiliation: The Fourth Affiliated Hospital of Zhejiang University
name: Kai Wang, PhD
role: PRINCIPAL_INVESTIGATOR
References: