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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04402788
Other study ID # NCI-2020-03472
Secondary ID NCI-2020-03472NR
Status Recruiting
Phase Phase 2/Phase 3
First received
Last updated
Start date January 7, 2021
Est. completion date April 30, 2027

Study information

Verified date March 2024
Source National Cancer Institute (NCI)
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This phase II/III trial compares the effect of adding radiation therapy to the usual maintenance therapy with atezolizumab versus atezolizumab alone in patients who have already received atezolizumab plus chemotherapy for the treatment of small cell lung cancer that has spread outside of the lung or to other parts of the body (extensive stage). Immunotherapy with monoclonal antibodies, such as atezolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Giving radiation therapy in addition to atezolizumab may extend the time without extensive small cell lung cancer growing or spreading compared to atezolizumab alone.


Description:

PRIMARY OBJECTIVES: I. To compare investigator-assessed progression free survival (PFS) between atezolizumab plus radiotherapy and atezolizumab alone. (Phase II) II. To compare overall survival (OS) between atezolizumab plus radiotherapy and atezolizumab alone. (Phase III) SECONDARY OBJECTIVES: I. To assess the toxicity between the atezolizumab plus radiotherapy arm and the atezolizumab arm. II. To assess the impact of adding radiotherapy on PFS and OS in patients with 1-3 visible tumors and > 3 visible tumors. III. To assess the impact of adding radiotherapy on PFS and OS in patients receiving consolidation radiotherapy to all visible disease ("complete consolidation") and patients who do not receive consolidation radiation to all visible disease ("incomplete consolidation"). EXPLORATORY OBJECTIVE: I. To assess the association between pre-treatment tumor burden (determined by central radiographic assessment, using both tumor number and tumor volume), and PFS and OS benefit. OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients receive atezolizumab intravenously (IV) over 30 minutes +/- 10 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive atezolizumab IV over 30 minutes +/- 10 minutes. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo radiation therapy once daily (QD) on days 1-5 during weeks 1-5 only. Patients undergo positron emission tomography and computed tomography (PET/CT) scan, computed tomography (CT), and magnetic resonance imaging (MRI) throughout the trial. Patients also undergo blood and tissue collection throughout the trial. After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter.


Recruitment information / eligibility

Status Recruiting
Enrollment 138
Est. completion date April 30, 2027
Est. primary completion date April 30, 2027
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Any confirmation (cytologic, histologic, or pathologic) of extensive stage small cell lung cancer at any site, either primary or metastases - Partial response (PR) or stable disease (SD) after 4-6 cycles of etoposide/platinum (E/P) doublet plus atezolizumab by re-staging scans (positron emission tomography [PET]/computed tomography [CT] scan, diagnostic CT scan, magnetic resonance imaging [MRI] optional per treating physician); atezolizumab should continue through randomization. Patients must be randomized within 9 weeks of last dose of etoposide/platinum (if not receiving PCI) or 6 weeks from completion of prophylactic cranial irradiation (PCI) - NOTE: Patients must have at least 3 cycles of E/P plus atezolizumab. They can have one cycle of induction E/P without concurrent atezolizumab if unable to receive concurrent E/P combined with atezolizumab for all cycles of induction therapy - Patients must have measurable disease (per Response Evaluation Criteria in Solid Tumors [RECIST]) and 3 or fewer observable liver metastases and no evidence of progressive disease (per RECIST) at time of enrollment - At time of enrollment after induction E/P chemotherapy and atezolizumab, if there is a pleural effusion, patients will be eligible if thoracentesis is cytologically negative or if pleural fluid is too small a volume to effectively sample by thoracentesis and does not show increased metabolic activity on CT/PET imaging - Appropriate stage for study entry based on the following diagnostic workup: - History/physical examination within 14 days prior to registration; - Imaging within 42 days prior to registration to include: - MRI brain with contrast or CT brain with contrast - CT chest, abdomen and pelvis or whole body PET/CT scan any time after the fourth cycle of chemotherapy and prior to registration - Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 within 14 days prior to registration - Absolute neutrophil count (ANC) >= 1,000/cells/mm^3 (within 14 days prior to registration) - Platelets >= 75,000 cells/mm^3 (within 14 days prior to registration) - Hemoglobin >= 8 g/dL (within 14 days prior to registration) - Total bilirubin =< 1.5 x upper limit of normal (ULN) (within 14 days prior to registration) - Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 3.0 x ULN (AST and/or ALT =< 5 ULN for patients with liver involvement) (within 14 days prior to registration) - Alkaline phosphatase =< 2.5 x ULN (=< 5 ULN for patients with documented liver involvement or bone metastases) (within 14 days prior to registration) - Adequate renal function = Creatinine clearance >=40 mL/min by the Cockcroft-Gault (C-G) equation: (within 14 days prior to registration) - Upfront radiation therapy of symptomatic metastatic site is permissible if causing symptoms such as pain or impending fracture - Patients with brain metastases are eligible after receiving whole brain radiation before enrollment (anytime during induction systemic therapy). Whole brain radiation can be delivered with hippocampal sparing or 3-D conformal technique. Patients with irradiated brain metastases are eligible if they are clinically stable from a neurological standpoint after completing radiotherapy (e.g. not having uncontrolled seizures) and do not require use of steroids above a dose of 10 mg of prednisone daily - For women of childbearing potential, a negative serum or urine pregnancy test within 14 days prior to registration. - Note: Women will be considered post-menopausal if they have been amenorrheic for 12 months without an alternative medical cause. The following age-specific requirements apply: - Women < 50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and if they have luteinizing hormone and follicle-stimulating hormone levels in the post-menopausal range for the institution or underwent surgical sterilization (bilateral oophorectomy or hysterectomy) - Women >= 50 years of age would be considered post-menopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments, had radiation-induced menopause with last menses > 1 year ago, had chemotherapy-induced menopause with last menses > 1 year ago, or underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy or hysterectomy) - Patients positive for human immunodeficiency virus (HIV) on effective anti-retroviral therapy with undetectable viral load within 6 months and a stable regimen of highly active anti-retroviral (HAART) HIV-positive patients must have no requirement for concurrent antibiotics or antifungal agents for the prevention of opportunistic infections - The patient or a legally authorized representative must provide study-specific informed consent prior to study entry Exclusion Criteria: - Metastatic disease invading the liver (> 3 metastases), heart or > 10 metastatic sites detectable after induction systemic therapy. Each visible bone metastasis on radiographic scan counts as one site - Patients with a concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen with atezolizumab or radiation - Prior radiotherapy in the thorax that would result in overlapping RT fields, unless the overlapping fields meet acceptable dose constraints for normal tissue - Active autoimmune disease, including, but not limited to: systemic lupus erythematosus; rheumatoid arthritis; inflammatory bowel disease (e.g. Crohn's, ulcerative colitis); vascular thrombosis associated with antiphospholipid syndrome; Wegener's granulomatosis; Sjogren's syndrome; Guillain-Barre syndrome; multiple sclerosis; vasculitis; or glomerulonephritis. - If the autoimmune disease is not active for over 3 years and the patient is not receiving immunosuppressive treatment such as methotrexate or steroids above a dose equivalent to 10 mg prednisone daily, the patient is eligible. - Patients with a history of autoimmune hypothyroidism on a stable dose of thyroid replacement hormone are eligible - Patients with controlled type 1 diabetes mellitus on a stable insulin regimen are eligible - Patients with eczema, psoriasis, lichen simplex chronicus or vitiligo with dermatologic manifestations are excluded only if they have active disease with acute exacerbation and on immunosuppressive medications within the 12 months prior to enrollment. They are eligible otherwise. - Severe, active co-morbidity defined as follows: - Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the patient at high risk from treatment complications; - Active tuberculosis; - Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis; cirrhosis; fatty liver; and inherited liver disease - Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface antigen [HBsAg] test and a positive anti-HBc [antibody to hepatitis B core antigen] antibody test) are eligible - Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV ribonucleic acid (RNA). (The HCV RNA test must be performed for patients who have a positive HCV antibody test) - Known immunosuppressive disease, for example history of bone marrow transplant or chronic lymphocytic leukemia (CLL); - Chronic obstructive pulmonary disease (COPD) requiring chronic oral steroid therapy of > 10 mg prednisone daily or equivalent at the time of registration. Inhaled corticosteroids are not exclusionary; - Unstable angina and/or congestive heart failure requiring hospitalization within the last 3 months; - History of recent myocardial infarction within 6 months prior to registration. - Clinically significant interstitial lung disease - Pregnancy: Administration of atezolizumab may have an adverse effect on pregnancy and poses a risk to the human fetus, including embryo-lethality. Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study treatment, and for 5 months (150 days) after the last dose of study agent. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately - Women who are breastfeeding and unwilling to discontinue - History of allogeneic organ transplant - Patients who have had immunotherapy-induced pneumonitis

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Atezolizumab
Given IV
Procedure:
Biospecimen Collection
Undergo blood and tissue collection
Computed Tomography
Undergo CT
Magnetic Resonance Imaging
Undergo MRI
Positron Emission Tomography
Undergo PET
Radiation:
Radiation Therapy
Undergo radiation therapy

Locations

Country Name City State
United States Hawaii Cancer Care - Westridge 'Aiea Hawaii
United States Pali Momi Medical Center 'Aiea Hawaii
United States Cleveland Clinic Akron General Akron Ohio
United States Atrium Health Stanly/LCI-Albemarle Albemarle North Carolina
United States Mayo Clinic Health System in Albert Lea Albert Lea Minnesota
United States Lovelace Medical Center-Saint Joseph Square Albuquerque New Mexico
United States Lovelace Radiation Oncology Albuquerque New Mexico
United States University of New Mexico Cancer Center Albuquerque New Mexico
United States Mission Cancer and Blood - Ankeny Ankeny Iowa
United States Langlade Hospital and Cancer Center Antigo Wisconsin
United States Emory Saint Joseph's Hospital Atlanta Georgia
United States Emory University Hospital Midtown Atlanta Georgia
United States Emory University Hospital/Winship Cancer Institute Atlanta Georgia
United States Grady Health System Atlanta Georgia
United States Mount Sinai Comprehensive Cancer Center at Aventura Aventura Florida
United States University of Maryland/Greenebaum Cancer Center Baltimore Maryland
United States MaineHealth Coastal Cancer Treatment Center Bath Maine
United States UPMC-Heritage Valley Health System Beaver Beaver Pennsylvania
United States UM Upper Chesapeake Medical Center Bel Air Maryland
United States PeaceHealth Saint Joseph Medical Center Bellingham Washington
United States Sanford Joe Lueken Cancer Center Bemidji Minnesota
United States Central Vermont Medical Center/National Life Cancer Treatment Berlin Vermont
United States University of Alabama at Birmingham Cancer Center Birmingham Alabama
United States Sanford Bismarck Medical Center Bismarck North Dakota
United States Illinois CancerCare-Bloomington Bloomington Illinois
United States Saint Joseph's/Candler - Bluffton Campus Bluffton South Carolina
United States Saint Alphonsus Cancer Care Center-Boise Boise Idaho
United States Saint Luke's Cancer Institute - Boise Boise Idaho
United States Boston Medical Center Boston Massachusetts
United States Bozeman Health Deaconess Hospital Bozeman Montana
United States Trinity Health IHA Medical Group Hematology Oncology - Brighton Brighton Michigan
United States Trinity Health Medical Center - Brighton Brighton Michigan
United States Montefiore Medical Center - Moses Campus Bronx New York
United States Montefiore Medical Center-Einstein Campus Bronx New York
United States Montefiore Medical Center-Weiler Hospital Bronx New York
United States Crozer-Keystone Regional Cancer Center at Broomall Broomall Pennsylvania
United States Bryn Mawr Hospital Bryn Mawr Pennsylvania
United States University of Vermont and State Agricultural College Burlington Vermont
United States University of Vermont Medical Center Burlington Vermont
United States Saint Alphonsus Cancer Care Center-Caldwell Caldwell Idaho
United States Cooper Hospital University Medical Center Camden New Jersey
United States Sands Cancer Center Canandaigua New York
United States Aultman Health Foundation Canton Ohio
United States Illinois CancerCare-Canton Canton Illinois
United States Trinity Health IHA Medical Group Hematology Oncology - Canton Canton Michigan
United States Trinity Health Medical Center - Canton Canton Michigan
United States Saint Francis Medical Center Cape Girardeau Missouri
United States Carlisle Regional Cancer Center Carlisle Pennsylvania
United States Illinois CancerCare-Carthage Carthage Illinois
United States Miami Valley Hospital South Centerville Ohio
United States Centralia Oncology Clinic Centralia Illinois
United States Christiana Care Health System-Concord Health Center Chadds Ford Pennsylvania
United States Chambersburg Hospital Chambersburg Pennsylvania
United States Medical University of South Carolina Charleston South Carolina
United States West Virginia University Charleston Division Charleston West Virginia
United States Atrium Health Pineville/LCI-Pineville Charlotte North Carolina
United States Atrium Health University City/LCI-University Charlotte North Carolina
United States Carolinas Medical Center/Levine Cancer Institute Charlotte North Carolina
United States Levine Cancer Institute-Ballantyne Charlotte North Carolina
United States Levine Cancer Institute-SouthPark Charlotte North Carolina
United States Chelsea Hospital Chelsea Michigan
United States Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital Chelsea Michigan
United States University of Illinois Chicago Illinois
United States University of Cincinnati Cancer Center-UC Medical Center Cincinnati Ohio
United States Clackamas Radiation Oncology Center Clackamas Oregon
United States Providence Cancer Institute Clackamas Clinic Clackamas Oregon
United States McLaren Cancer Institute-Clarkston Clarkston Michigan
United States Cleveland Clinic Cancer Center/Fairview Hospital Cleveland Ohio
United States Cleveland Clinic Foundation Cleveland Ohio
United States MetroHealth Medical Center Cleveland Ohio
United States Mercy Cancer Center-West Lakes Clive Iowa
United States Mission Cancer and Blood - West Des Moines Clive Iowa
United States Memorial Hospital North Colorado Springs Colorado
United States Penrose-Saint Francis Healthcare Colorado Springs Colorado
United States Rocky Mountain Cancer Centers-Penrose Colorado Springs Colorado
United States UCHealth Memorial Hospital Central Colorado Springs Colorado
United States Central Maryland Radiation Oncology in Howard County Columbia Maryland
United States MU Health - University Hospital/Ellis Fischel Cancer Center Columbia Missouri
United States Mount Carmel East Hospital Columbus Ohio
United States Mount Carmel Health Center West Columbus Ohio
United States Ohio State University Comprehensive Cancer Center Columbus Ohio
United States The Mark H Zangmeister Center Columbus Ohio
United States Atrium Health Cabarrus/LCI-Concord Concord North Carolina
United States MD Anderson in The Woodlands Conroe Texas
United States Mercy Hospital Coon Rapids Minnesota
United States UM Sylvester Comprehensive Cancer Center at Coral Gables Coral Gables Florida
United States Greater Regional Medical Center Creston Iowa
United States Carle at The Riverfront Danville Illinois
United States Geisinger Medical Center Danville Pennsylvania
United States Dayton Physician LLC - Englewood Dayton Ohio
United States Miami Valley Hospital Dayton Ohio
United States Miami Valley Hospital North Dayton Ohio
United States Premier Blood and Cancer Center Dayton Ohio
United States Cancer Care Specialists of Illinois - Decatur Decatur Illinois
United States Decatur Memorial Hospital Decatur Illinois
United States UM Sylvester Comprehensive Cancer Center at Deerfield Beach Deerfield Beach Florida
United States Broadlawns Medical Center Des Moines Iowa
United States Iowa Lutheran Hospital Des Moines Iowa
United States Iowa Methodist Medical Center Des Moines Iowa
United States Mercy Medical Center - Des Moines Des Moines Iowa
United States Mission Cancer and Blood - Des Moines Des Moines Iowa
United States Mission Cancer and Blood - Laurel Des Moines Iowa
United States Wayne State University/Karmanos Cancer Institute Detroit Michigan
United States Saint Luke's Hospital of Duluth Duluth Minnesota
United States Hematology Oncology Associates of Central New York-East Syracuse East Syracuse New York
United States Marshfield Medical Center-EC Cancer Center Eau Claire Wisconsin
United States Carle Physician Group-Effingham Effingham Illinois
United States Crossroads Cancer Center Effingham Illinois
United States Elmhurst Memorial Hospital Elmhurst Illinois
United States Ephrata Cancer Center Ephrata Pennsylvania
United States Saint Vincent Hospital Erie Pennsylvania
United States UPMC Hillman Cancer Center Erie Erie Pennsylvania
United States Illinois CancerCare-Eureka Eureka Illinois
United States Inova Schar Cancer Institute Fairfax Virginia
United States Smilow Cancer Hospital Care Center-Fairfield Fairfield Connecticut
United States Sanford Broadway Medical Center Fargo North Dakota
United States Sanford Roger Maris Cancer Center Fargo North Dakota
United States Farmington Health Center Farmington Utah
United States Parkland Health Center - Farmington Farmington Missouri
United States Weisberg Cancer Treatment Center Farmington Hills Michigan
United States UPMC Cancer Center at UPMC Horizon Farrell Pennsylvania
United States Genesys Hurley Cancer Institute Flint Michigan
United States Hurley Medical Center Flint Michigan
United States McLaren Cancer Institute-Flint Flint Michigan
United States Texas Oncology-Flower Mound Flower Mound Texas
United States Levine Cancer Institute - Rutherford Forest City North Carolina
United States Cancer Care and Hematology-Fort Collins Fort Collins Colorado
United States Poudre Valley Hospital Fort Collins Colorado
United States Texas Oncology - Fort Worth Cancer Center Fort Worth Texas
United States Beebe South Coastal Health Campus Frankford Delaware
United States Atrium Medical Center-Middletown Regional Hospital Franklin Ohio
United States Unity Hospital Fridley Minnesota
United States Saint Luke's Cancer Institute - Fruitland Fruitland Idaho
United States Gibbs Cancer Center-Gaffney Gaffney South Carolina
United States Illinois CancerCare-Galesburg Galesburg Illinois
United States Western Illinois Cancer Treatment Center Galesburg Illinois
United States Levine Cancer Institute-Gaston Gastonia North Carolina
United States Adams Cancer Center Gettysburg Pennsylvania
United States UM Baltimore Washington Medical Center/Tate Cancer Center Glen Burnie Maryland
United States Crozer Regional Cancer Center at Brinton Lake Glen Mills Pennsylvania
United States Benefis Sletten Cancer Institute Great Falls Montana
United States UCHealth Greeley Hospital Greeley Colorado
United States Saint Vincent Hospital Cancer Center Green Bay Green Bay Wisconsin
United States UPMC Cancer Centers - Arnold Palmer Pavilion Greensburg Pennsylvania
United States Miami Valley Cancer Care and Infusion Greenville Ohio
United States Prisma Health Cancer Institute - Eastside Greenville South Carolina
United States Prisma Health Cancer Institute - Faris Greenville South Carolina
United States Saint Francis Cancer Center Greenville South Carolina
United States Saint Francis Hospital Greenville South Carolina
United States Smilow Cancer Hospital Care Center at Greenwich Greenwich Connecticut
United States Self Regional Healthcare Greenwood South Carolina
United States Gibbs Cancer Center-Pelham Greer South Carolina
United States Prisma Health Cancer Institute - Greer Greer South Carolina
United States Legacy Mount Hood Medical Center Gresham Oregon
United States Smilow Cancer Hospital Care Center - Guilford Guilford Connecticut
United States Smilow Cancer Hospital-Hamden Care Center Hamden Connecticut
United States UPMC Pinnacle Cancer Center/Community Osteopathic Campus Harrisburg Pennsylvania
United States Margaret R Pardee Memorial Hospital Hendersonville North Carolina
United States Penn State Milton S Hershey Medical Center Hershey Pennsylvania
United States Hawaii Cancer Care Inc - Waterfront Plaza Honolulu Hawaii
United States Hawaii Cancer Care Inc-Liliha Honolulu Hawaii
United States Kapiolani Medical Center for Women and Children Honolulu Hawaii
United States Queen's Cancer Cenrer - POB I Honolulu Hawaii
United States Queen's Cancer Center - Kuakini Honolulu Hawaii
United States Queen's Medical Center Honolulu Hawaii
United States Straub Clinic and Hospital Honolulu Hawaii
United States The Cancer Center of Hawaii-Liliha Honolulu Hawaii
United States University of Hawaii Cancer Center Honolulu Hawaii
United States M D Anderson Cancer Center Houston Texas
United States MD Anderson West Houston Houston Texas
United States Cleveland Clinic Cancer Center Independence Independence Ohio
United States IRMC Cancer Center Indiana Pennsylvania
United States Mayo Clinic in Florida Jacksonville Florida
United States Jefferson Hospital Jefferson Hills Pennsylvania
United States NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro Jonesboro Arkansas
United States Borgess Medical Center Kalamazoo Michigan
United States Bronson Methodist Hospital Kalamazoo Michigan
United States West Michigan Cancer Center Kalamazoo Michigan
United States Illinois CancerCare-Kewanee Clinic Kewanee Illinois
United States Gundersen Lutheran Medical Center La Crosse Wisconsin
United States Mayo Clinic Health System-Franciscan Healthcare La Crosse Wisconsin
United States Karmanos Cancer Institute at McLaren Greater Lansing Lansing Michigan
United States University of Michigan Health - Sparrow Lansing Lansing Michigan
United States McLaren Cancer Institute-Lapeer Region Lapeer Michigan
United States Cancer Centers of Southwest Oklahoma Research Lawton Oklahoma
United States MD Anderson League City League City Texas
United States Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center Lebanon New Hampshire
United States Sechler Family Cancer Center Lebanon Pennsylvania
United States Geisinger Medical Oncology-Lewisburg Lewisburg Pennsylvania
United States Wilcox Memorial Hospital and Kauai Medical Clinic Lihue Hawaii
United States Atrium Health Lincoln/LCI-Lincolnton Lincolnton North Carolina
United States Trinity Health Saint Mary Mercy Livonia Hospital Livonia Michigan
United States Baptist Health Louisville Louisville Kentucky
United States Norton Audubon Hospital and Medical Campus Louisville Kentucky
United States Norton Brownsboro Hospital and Medical Campus Louisville Kentucky
United States Norton Hospital Pavilion and Medical Campus Louisville Kentucky
United States The James Graham Brown Cancer Center at University of Louisville Louisville Kentucky
United States Medical Center of the Rockies Loveland Colorado
United States Illinois CancerCare-Macomb Macomb Illinois
United States Cleveland Clinic Cancer Center Mansfield Mansfield Ohio
United States Saint John's Hospital - Healtheast Maplewood Minnesota
United States Marshfield Medical Center-Marshfield Marshfield Wisconsin
United States Levine Cancer Institute - Union West Matthews North Carolina
United States Carle Physician Group-Mattoon/Charleston Mattoon Illinois
United States Hillcrest Hospital Cancer Center Mayfield Heights Ohio
United States Texas Oncology-McKinney McKinney Texas
United States UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion Mechanicsburg Pennsylvania
United States Riddle Memorial Hospital Media Pennsylvania
United States Baptist Memorial Hospital and Cancer Center-Memphis Memphis Tennessee
United States Froedtert Menomonee Falls Hospital Menomonee Falls Wisconsin
United States Saint Luke's Cancer Institute - Meridian Meridian Idaho
United States University of Miami Miller School of Medicine-Sylvester Cancer Center Miami Florida
United States Mount Sinai Medical Center Miami Beach Florida
United States MyMichigan Medical Center Midland Midland Michigan
United States Medical College of Wisconsin Milwaukee Wisconsin
United States Abbott-Northwestern Hospital Minneapolis Minnesota
United States Marshfield Clinic-Minocqua Center Minocqua Wisconsin
United States Atrium Health Union/LCI-Union Monroe North Carolina
United States Forbes Hospital Monroeville Pennsylvania
United States UPMC Cancer Center - Monroeville Monroeville Pennsylvania
United States UPMC Hillman Cancer Center - Monroeville Monroeville Pennsylvania
United States McLaren Cancer Institute-Macomb Mount Clemens Michigan
United States Saint Alphonsus Cancer Care Center-Nampa Nampa Idaho
United States Saint Luke's Cancer Institute - Nampa Nampa Idaho
United States Edward Hospital/Cancer Center Naperville Illinois
United States Allegheny Valley Hospital Natrona Heights Pennsylvania
United States Yale University New Haven Connecticut
United States Mount Sinai Chelsea New York New York
United States Mount Sinai Hospital New York New York
United States Mount Sinai West New York New York
United States Helen F Graham Cancer Center Newark Delaware
United States Medical Oncology Hematology Consultants PA Newark Delaware
United States Providence Newberg Medical Center Newberg Oregon
United States CTCA at Southeastern Regional Medical Center Newnan Georgia
United States Yale-New Haven Hospital North Haven Medical Center North Haven Connecticut
United States Ascension Providence Hospitals - Novi Novi Michigan
United States Cancer Care Center of O'Fallon O'Fallon Illinois
United States HSHS Saint Elizabeth's Hospital O'Fallon Illinois
United States Drexel Town Square Health Center Oak Creek Wisconsin
United States Mercy Hospital Oklahoma City Oklahoma City Oklahoma
United States University of Oklahoma Health Sciences Center Oklahoma City Oklahoma
United States Nebraska Methodist Hospital Omaha Nebraska
United States University of Nebraska Medical Center Omaha Nebraska
United States UC Irvine Health/Chao Family Comprehensive Cancer Center Orange California
United States Illinois CancerCare-Ottawa Clinic Ottawa Illinois
United States Paoli Memorial Hospital Paoli Pennsylvania
United States Illinois CancerCare-Pekin Pekin Illinois
United States Capital Health Medical Center-Hopewell Pennington New Jersey
United States Illinois CancerCare-Peoria Peoria Illinois
United States Methodist Medical Center of Illinois Peoria Illinois
United States OSF Saint Francis Medical Center Peoria Illinois
United States Illinois CancerCare-Peru Peru Illinois
United States Jefferson Torresdale Hospital Philadelphia Pennsylvania
United States Thomas Jefferson University Hospital Philadelphia Pennsylvania
United States Cancer Center at Saint Joseph's Phoenix Arizona
United States Mayo Clinic Hospital in Arizona Phoenix Arizona
United States Avera Cancer Institute at Pierre Pierre South Dakota
United States Allegheny General Hospital Pittsburgh Pennsylvania
United States University of Pittsburgh Cancer Institute (UPCI) Pittsburgh Pennsylvania
United States UPMC-Passavant Hospital Pittsburgh Pennsylvania
United States UPMC-Saint Clair Hospital Cancer Center Pittsburgh Pennsylvania
United States UPMC-Saint Margaret Pittsburgh Pennsylvania
United States UPMC-Shadyside Hospital Pittsburgh Pennsylvania
United States West Penn Hospital Pittsburgh Pennsylvania
United States Edward Hospital/Cancer Center?Plainfield Plainfield Illinois
United States Texas Oncology-Plano West Plano Texas
United States McLaren-Port Huron Port Huron Michigan
United States Legacy Good Samaritan Hospital and Medical Center Portland Oregon
United States Maine Medical Center-Bramhall Campus Portland Maine
United States Providence Portland Medical Center Portland Oregon
United States Providence Saint Vincent Medical Center Portland Oregon
United States Illinois CancerCare-Princeton Princeton Illinois
United States Beebe Health Campus Rehoboth Beach Delaware
United States Renown Regional Medical Center Reno Nevada
United States Ascension Saint Mary's Hospital Rhinelander Wisconsin
United States Marshfield Medical Center-Rice Lake Rice Lake Wisconsin
United States VCU Massey Cancer Center at Stony Point Richmond Virginia
United States Virginia Commonwealth University/Massey Cancer Center Richmond Virginia
United States Oncology and Hematology Associates of Southwest Virginia Roanoke Virginia
United States Mayo Clinic in Rochester Rochester Minnesota
United States University of Rochester Rochester New York
United States Wilmot Cancer Institute Radiation Oncology at Greece Rochester New York
United States Levine Cancer Institute-Rock Hill Rock Hill South Carolina
United States Rock Hill Radiation Therapy Center Rock Hill South Carolina
United States UW Health Carbone Cancer Center Rockford Rockford Illinois
United States William Beaumont Hospital-Royal Oak Royal Oak Michigan
United States Ascension Saint Mary's Hospital Saginaw Michigan
United States Oncology Hematology Associates of Saginaw Valley PC Saginaw Michigan
United States Coborn Cancer Center at Saint Cloud Hospital Saint Cloud Minnesota
United States Dartmouth Cancer Center - North Saint Johnsbury Vermont
United States Mercy Hospital Saint Louis Saint Louis Missouri
United States Missouri Baptist Medical Center Saint Louis Missouri
United States Sainte Genevieve County Memorial Hospital Sainte Genevieve Missouri
United States Huntsman Cancer Institute/University of Utah Salt Lake City Utah
United States University of Utah Sugarhouse Health Center Salt Lake City Utah
United States North Coast Cancer Care Sandusky Ohio
United States MaineHealth Cancer Care Center of York County Sanford Maine
United States Lewis Cancer and Research Pavilion at Saint Joseph's/Candler Savannah Georgia
United States Memorial Health University Medical Center Savannah Georgia
United States Guthrie Medical Group PC-Robert Packer Hospital Sayre Pennsylvania
United States Maine Medical Center- Scarborough Campus Scarborough Maine
United States Mayo Clinic in Arizona Scottsdale Arizona
United States Prisma Health Cancer Institute - Seneca Seneca South Carolina
United States Saint Vincent Hospital Cancer Center at Sheboygan Sheboygan Wisconsin
United States Atrium Health Cleveland/LCI-Cleveland Shelby North Carolina
United States Saint Michael Cancer Center Silverdale Washington
United States Avera Cancer Institute Sioux Falls South Dakota
United States Sanford Cancer Center Oncology Clinic Sioux Falls South Dakota
United States Sanford USD Medical Center - Sioux Falls Sioux Falls South Dakota
United States Maine Medical Partners - South Portland South Portland Maine
United States Ascension Providence Hospitals - Southfield Southfield Michigan
United States Baptist Memorial Hospital and Cancer Center-Desoto Southhaven Mississippi
United States Spartanburg Medical Center Spartanburg South Carolina
United States Memorial Medical Center Springfield Illinois
United States Southern Illinois University School of Medicine Springfield Illinois
United States Springfield Clinic Springfield Illinois
United States Smilow Cancer Hospital Care Center at Long Ridge Stamford Connecticut
United States Ascension Saint Michael's Hospital Stevens Point Wisconsin
United States Marshfield Medical Center-River Region at Stevens Point Stevens Point Wisconsin
United States Stony Brook University Medical Center Stony Brook New York
United States Cleveland Clinic Cancer Center Strongsville Strongsville Ohio
United States Saint Vincent Hospital Cancer Center at Sturgeon Bay Sturgeon Bay Wisconsin
United States MD Anderson in Sugar Land Sugar Land Texas
United States Texas Oncology Cancer Center Sugar Land Sugar Land Texas
United States Missouri Baptist Sullivan Hospital Sullivan Missouri
United States BJC Outpatient Center at Sunset Hills Sunset Hills Missouri
United States Hematology Oncology Associates of Central New York-Onondaga Hill Syracuse New York
United States State University of New York Upstate Medical University Syracuse New York
United States Ascension Saint Joseph Hospital Tawas City Michigan
United States Texas Oncology-The Woodlands The Woodlands Texas
United States Upper Valley Medical Center Troy Ohio
United States William Beaumont Hospital - Troy Troy Michigan
United States Smilow Cancer Hospital Care Center-Trumbull Trumbull Connecticut
United States Legacy Meridian Park Hospital Tualatin Oregon
United States Banner University Medical Center - Tucson Tucson Arizona
United States University of Arizona Cancer Center-North Campus Tucson Arizona
United States Saint Luke's Cancer Institute - Twin Falls Twin Falls Idaho
United States MGC Hematology Oncology-Union Union South Carolina
United States Carle Cancer Center Urbana Illinois
United States The Carle Foundation Hospital Urbana Illinois
United States Westchester Medical Center Valhalla New York
United States Legacy Cancer Institute Medical Oncology and Day Treatment Vancouver Washington
United States Legacy Salmon Creek Hospital Vancouver Washington
United States MD Anderson Cancer Center at Cooper-Voorhees Voorhees New Jersey
United States Illinois CancerCare - Washington Washington Illinois
United States UPMC Cancer Center-Washington Washington Pennsylvania
United States UPMC Washington Hospital Radiation Oncology Washington Pennsylvania
United States Smilow Cancer Hospital-Waterbury Care Center Waterbury Connecticut
United States Smilow Cancer Hospital Care Center - Waterford Waterford Connecticut
United States Aspirus Regional Cancer Center Wausau Wisconsin
United States Froedtert West Bend Hospital/Kraemer Cancer Center West Bend Wisconsin
United States Saint Mary's Oncology/Hematology Associates of West Branch West Branch Michigan
United States University of Cincinnati Cancer Center-West Chester West Chester Ohio
United States Mercy Medical Center-West Lakes West Des Moines Iowa
United States Methodist West Hospital West Des Moines Iowa
United States Smilow Cancer Hospital Care Center - Westerly Westerly Rhode Island
United States Saint Ann's Hospital Westerville Ohio
United States Cleveland Clinic-Weston Weston Florida
United States Marshfield Medical Center - Weston Weston Wisconsin
United States Wexford Health and Wellness Pavilion Wexford Pennsylvania
United States Wheeling Hospital/Schiffler Cancer Center Wheeling West Virginia
United States Ascension Via Christi Hospitals Wichita Wichita Kansas
United States Geisinger Wyoming Valley/Henry Cancer Center Wilkes-Barre Pennsylvania
United States Divine Providence Hospital Williamsport Pennsylvania
United States Wake Forest University Health Sciences Winston-Salem North Carolina
United States Aspirus Cancer Care - Wisconsin Rapids Wisconsin Rapids Wisconsin
United States Cleveland Clinic Wooster Family Health and Surgery Center Wooster Ohio
United States Lankenau Medical Center Wynnewood Pennsylvania
United States Avera Cancer Institute at Yankton Yankton South Dakota
United States UPMC Memorial York Pennsylvania
United States WellSpan Health-York Cancer Center York Pennsylvania
United States WellSpan Health-York Hospital York Pennsylvania
United States Genesis Healthcare System Cancer Care Center Zanesville Ohio

Sponsors (2)

Lead Sponsor Collaborator
National Cancer Institute (NCI) NRG Oncology

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Tumor burden Tumor burden determined by central radiographic assessment, using both tumor number and tumor volume will be associated with PFS and OS benefit. The PFS and OS will be similarly summarized and compared between experimental and control in the following subgroups: 1) high or low tumor burden, using >= 4, 5, or 6 metastases as a cutoff; 2) high or low tumor burden, using the median of centrally reviewed radiographic tumor volume as a cutoff. Up to 6 years
Primary Progression-free survival (PFS) (Phase II) Will compare the distributions of PFS between treatment arms using a one-sided stratified log-rank test in all randomized eligible patients. The rates at various timepoints (e.g., every 6 months after randomization) and medians of PFS for each arm will be estimated using the Kaplan-Meier method. The associated 95% confidence interval (CI) will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function. Results from an unstratified analysis will also be provided. From randomization to any documented progression or death due to any cause, whichever occurs first, assessed up to 6 years
Primary Overall survival (OS) (Phase III) Will compare arm I to arm 2 based on OS using a stratified log-rank test. Hazard ratios will be estimated using a stratified Cox regression model. Event rates over time will be estimated within each treatment group using the Kaplan-Meier method. From randomization to the date of death due to any cause, assessed up to 6 years
Secondary Incidence of adverse events For each patient, the maximum severity reported for both immune mediated and non-immune mediated adverse events will be used in the summaries. Adverse events will be summarized regardless of relationship to protocol treatment as assessed by the investigator. All adverse events, adverse events leading to withdrawal, interruption or modification of protocol treatment, grade >= 3 adverse events, and serious adverse events will be summarized. Deaths and cause of death will be summarized. The rate of treatment-related adverse events using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE, version [v.]5.0) will be reported with the frequency and severity (e.g., type, grade, and attribution) by arm, the analysis will be performed at the time of both phase II and phase III (if applicable) primary endpoint analyses. All adverse events will be classified as either immune or non-immune mediated. Up to 6 years
Secondary PFS (Phase III) Assessed per Response Evaluation Criteria in Solid Tumors (RECIST). Will compare the distributions of PFS between treatment arms using a one-sided stratified log-rank test in all randomized eligible patients at 0.025 level. The rates at various timepoints (e.g., every 6 months after randomization) and medians of PFS for each arm will be estimated using the Kaplan-Meier method. The associated 95% CI will be calculated using Greenwood's formula and based on a log-log transformation applied on the survival function. If one stratum has less than 10 events, the stratification factor which contains the level with the smallest number of patients will be removed from the stratified analyses. Up to 6 years
Secondary PFS in patients with 1-3 distinct visible tumors and > 3 distinct visible tumors Will be similarly summarized and compared between experimental and control. The interaction between the treatment groups and tumor number groups will also be explored in Cox regression model. Up to 6 years
Secondary OS in patients with 1-3 distinct visible tumors and > 3 distinct visible tumors Will be similarly summarized and compared between experimental and control. The interaction between the treatment groups and tumor number groups will also be explored in Cox regression model. Up to 6 years
Secondary PFS in patients receiving consolidation radiotherapy to all visible disease and patients who do not receive consolidation radiotherapy to all visible disease Up to 6 years
Secondary OS in patients receiving consolidation radiotherapy to all visible disease and patients who do not receive consolidation radiotherapy to all visible disease Up to 6 years
See also
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