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Intensified Chemo-immuno-radiotherapy With Durvalumab for Stage III Non-Small Cell Lung Cancers

Phase 2
Completed
Conditions
Lung Neoplasms
Interventions
Registration Number
NCT04230408
Lead Sponsor
Latin American Cooperative Oncology Group
Brief Summary

This is a phase II study that will assess if Durvalumab (MEDI4736) used as induction chemo-immunotherapy followed by concurrent chemo-immuno-radiotherapy and consolidation immunotherapy may improve oncologic outcomes compared with standard of care chemoradiation followed by durvalumab (as in the PACIFIC trial) with a reasonable safety profile.

Detailed Description

Prospective, non-randomized, open label, single arm, multi-institutional, phase 2 study, including patients with stage III non-small cell lung cancer able to receive concurrent chemoradiation. Eligible patients will then receive treatment as follows:

Induction chemo-immunotherapy Two 21-day cycles of carboplatin, paclitaxel and durvalumab will be given BEFORE concurrent chemo-immuno-radiotherapy.

Thereafter, patients without progressive disease (or patients with disease progression that is still locally advanced and can be safely encompassed within tolerable radiation fields) will receive concurrent chemo-immuno-radiotherapy, as follows:

Concurrent chemo-immuno-radiotherapy Concurrent carboplatin, paclitaxel, and durvalumab with radiation therapy, initiated preferably 3-5 weeks after the last dose of induction chemo-immunotherapy.

Thereafter, patients without progressive disease will receive consolidation immunotherapy, as follows:

Consolidation immunotherapy Twelve 28-day cycles of durvalumab will be given, initiated preferably within one week following concurrent chemo-immuno-radiotherapy.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
DURVALUMAB (MEDI4736) + carboplatin-paclitaxelDurvalumabInduction chemo-immunotherapy phase: Two cycles of Paclitaxel 200 mg/m2, Carboplatin AUC 6 and Durvalumab 1500 mg intravenously every 21 days. Concurrent chemo-immuno-radiotherapy phase: Radiation therapy concomitantly with: paclitaxel 50 mg/m2 intravenously every 7 days (+/- 3 days) until completion of radiation therapy, carboplatin AUC 2 intravenously every 7 days (+/- 3 days) until completion of radiation therapy and durvalumab 1500 mg intravenously every 21 days (+/- 6 days) for a maximum of 2 doses. Concurrent chemo-immuno-radiotherapy: Durvalumab 1500 mg intravenously every 28 days (+/- 7 days) for a maximum of 12 doses
Primary Outcome Measures
NameTimeMethod
12 months Progression-Free SurvivalTumor scans will be performed at baseline, after the induction and concomitant phases and 3, 6, 9, and 12 months after the last dose of radiation therapy.

Proportion of patients who are alive and progression-free 12 months after cycle 1, day 1 of induction treatment, estimated by the Kaplan-Maier method and using Response Evaluation Criteria in Solid Tumors (RECIST) v1.1.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS)OS will be evaluated until month 24 after C1D1.

Time from cycle 1, day 1 of induction treatment until death due to any cause.

Overall response rate to induction treatmentTumor scans will be performed at baseline, after the induction and concomitant phases and 3, 6, 9, and 12 months after the last dose of radiation therapy.

The proportion of patients with at least one tumor scan of complete response (CR) or partial response (PR) using RECIST v1.1.

Patterns of FailureTumor scans will be performed at baseline, after the induction and concomitant phases and 3, 6, 9, and 12 months after the last dose of radiation therapy.

Rate of disease failure in local, regional and distant sites

Trial Locations

Locations (6)

Beneficiencia Portuguesa de São Paulo/Hospital São José

🇧🇷

São Paulo, Brazil

ICESP

🇧🇷

São Paulo, Brazil

Liga Norte Riograndense Contra o Câncer

🇧🇷

Natal, Rio Grande Do Norte, Brazil

CPO

🇧🇷

Porto Alegre, Rio Grande Do Sul, Brazil

INCA

🇧🇷

Rio De Janeiro, RJ, Brazil

COI Américas

🇧🇷

Rio De Janeiro, Brazil

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