Neoadjuvant Aliya™ PEF Soft Tissue Ablation With Systemic Therapy in Early-Stage Resectable NSCLC

Phase 4

Terminated

• Conditions: NSCLC
• Interventions: Device: Aliya Pulsed Electric Fields (PEF) ablation; Drug: Nivolumab plus Platinum Doublet Chemotherapy; Drug: Standard of care neoadjuvant therapy; Other: Surgical Resection

• Registration Number: NCT05583188
• Lead Sponsor: Galvanize Therapeutics, Inc.

Brief Summary

A prospective, single-arm, non-randomized, multi-center, open-label study following patients with resectable stage IIB to IIIA non-small cell lung cancer after Pulsed Electric Fields (PEF) ablation who may be candidates for standard of care neoadjuvant use of checkpoint inhibitor (nivolumab) treatment plus platinum doublet chemotherapy.

Detailed Description

This study is designed to evaluate the pathologic response of soft tissue ablated with Pulsed Electric Fields (PEF) in patients with resectable stage IIB to IIIA NSCLC who may be candidates for standard of care neoadjuvant use of checkpoint inhibitor (nivolumab) treatment plus platinum doublet chemotherapy. The study will enroll adult patients with suspected or confirmed 8th ed. Stage IIb-IIIA non-small cell lung cancer (NSCLC) who are surgical candidates and have not yet received treatment for NSCLC. PEF ablation may be performed in conjunction with the clinically appropriate approach to collect standard of care biopsy samples to confirm disease progression. PEF ablation will be delivered via percutaneous approach utilizing the Galvanize Aliya™ System and the percutaneous Aliya Ablation Device.

SOC neoadjuvant systemic treatment will be delivered following PEF ablation delivery according to EGFR and ALK mutation status, tumor histology, and surgical candidacy. Patients will undergo surgical resection per standard of care.

The study will consent up to 15 adult patients in order to accrue at least five (5) patients who have completed surgical resection after receiving neoadjuvant therapy with nivolumab plus chemotherapy following PEF ablation.

The remaining patients (up to 10) not eligible for neoadjuvant nivolumab plus chemotherapy will receive either SOC systemic therapy post-PEF ablation followed by resection or, if not eligible for systemic therapy, will receive definitive surgery without neoadjuvant therapy as per institutional SOC.

Study Timeline

• Study First Submitted: 2022-10-13
• Study First Submitted QC: 2022-10-13
• Study First Posted: 2022-10-17
• Study Start: 2023-02-01
• Primary Completion: 2024-02-08
• Study Completion: 2024-03-18
• Status Verified: 2024-07
• Last Update Submitted: 2024-07-17
• Last Update Posted: 2024-07-19

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 5

Inclusion Criteria

1. Patient is 18 years of age or older
2. Radiographic findings consistent with a lesion with high pre-procedure probability of malignancy as determined by the investigator to be NSCLC 8th Ed. stage IIB- IIIA cancer or biopsy-confirmed NSCLC 8th Ed. stage IIB-IIIA and lesion size ≤ 5 cm in greatest dimension
3. Lesion is targetable for biopsy and PEF delivery per investigator opinion
4. Patient deemed able to complete neoadjuvant therapy according to their EGFR/ALK mutation status and specific histology (if clinically appropriate) and per the manufacturer's systemic therapy labeling
5. Patient has been deemed a potential candidate for definitive lung tissue resection by a qualified study investigator
6. Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-1
7. Patient is able to adhere to protocol requirements
8. Patient is able to tolerate general anesthesia
9. Patient is cleared to undergo paralytic anesthesia
10. Patient has provided informed consent

Exclusion Criteria

1. Presence of advanced, inoperable, or metastatic disease
2. Radiographically suspicious findings for stage IIIA patients indicating a single mediastinal lymph node > 3 cm or multiple mediastinal lymph nodes and, therefore, potentially inoperable
3. Patient has recurrent NSCLC or has previously been treated for NSCLC
4. Patient has received chemotherapy or any other cancer therapy in 2 years prior to PEF ablation
5. Prior treatment with any drug that targets T cell co-regulatory pathways (such as checkpoint inhibitors) in 2 years prior to PEF ablation
6. Patient requires or is likely to require a pneumonectomy
7. Patient has received any vaccine against infectious diseases (e.g., influenza, COVID-19, varicella, etc.) within 30 days of PEF procedure Patient is unable or unwilling to complete all required screening and/or follow-up assessments
8. Patient is currently enrolled in another interventional clinical trial or is receiving treatment with an investigational medication or medical device that conflicts with the study protocol

Other protocol defined inclusion/exclusion criteria apply

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Aliya PEF ablation	Nivolumab plus Platinum Doublet Chemotherapy	Pulsed electric field treatment using the Aliya System
Aliya PEF ablation	Surgical Resection	Pulsed electric field treatment using the Aliya System
Aliya PEF ablation	Aliya Pulsed Electric Fields (PEF) ablation	Pulsed electric field treatment using the Aliya System
Aliya PEF ablation	Standard of care neoadjuvant therapy	Pulsed electric field treatment using the Aliya System

Primary Outcome Measures

Name	Time	Method
Pathologic response	Surgical resection	Pathologic response (percentage of residual viable tumor cells) of the resected lesion ablated with PEF and in resected lymph nodes in patients who received standard of care neoadjuvant nivolumab plus chemotherapy prior to resection.

Secondary Outcome Measures

Name	Time	Method
Rate of R0 resection	Surgical resection	R0 - no cancer cells seen microscopically at the primary tumor site

Trial Locations

Locations (3)

Temple University; 🇺🇸 Philadelphia, Pennsylvania, United States

Mayo Clinic Rochester; 🇺🇸 Rochester, Minnesota, United States

University of Pennsylvania; 🇺🇸 Philadelphia, Pennsylvania, United States