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TerminatedNCT03663166Updated Feb 15, 2023Results posted

Radiation and Chemotherapy With Ipilimumab Followed by Nivolumab for Patients With Stage III Unresectable Non-Small Cell Lung Cancer (NSCLC)

A Phase 1/2 interventional study of Thoracic Radiotherapy and Platinum Based Chemotherapy in Carcinoma, Non-Small-Cell Lung, sponsored by H. Lee Moffitt Cancer Center and Research Institute. Terminated at 3 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-02-15.

Sponsored by H. Lee Moffitt Cancer Center and Research Institute · Phase 1/2, Interventional, and Treatment

Why this study was terminated
Increased SAE occurrence per PI
Phase
Phase 1/2
Study type
Interventional
Enrollment
19
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
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Study summary

This study is to determine if Stage III NSCLC patients treated with ipilimumab with thoracic radiation therapy followed by nivolumab monotherapy every 4 weeks for up to 12 months show an improved 12-month Progression Free Survival (PFS) rate compared with a 12-month historical PFS rate of 49% among patients treated in a similar fashion with concurrent chemoradiotherapy.

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Conditions studied

  • Carcinoma, Non-Small-Cell Lung

Keywords

  • Lung
  • Unresectable NSCLC
  • Radiation
03

In context

Carcinoma, Non-Small-Cell Lung

6,488 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,632 are open to participants now.

This study's enrollment of 19 is below the median of 62 across 5,213 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

H. Lee Moffitt Cancer Center and Research Institute is the lead sponsor of 533 studies on the registry; 74 are open to participants now.

Of its 99 completed or terminated interventional studies of FDA-regulated products, 57 (58%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Over 18 years of age
  • Participants must have signed and dated a written informed consent form.
  • Participants must be willing and able to comply with proposed visit and treatment schedule.
  • Patients with NSCLC documented by histology or cytology from brushing, washing, or needle aspiration of a defined lesion, but not from sputum cytology alone.
  • Patients must have presented at initial diagnosis with Stage III disease according to American Joint Committee on Cancer (AJCC) Staging Manual, 8th Edition;
  • Patients must be deemed by the treating investigator to be surgically unresectable. I
  • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0 or 1
  • Patients must initiate study treatment 60 days from the date of pathologic diagnosis.
  • Tumor biopsy specimen including at least formalin-fixed, paraffin-embedded (FFPE) tumor tissue block or 10 unstained slides of tumor sample (archival or recent) for biomarker evaluation must be available for submission to the central lab for correlative studies.
  • Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test within 14 days prior to the start of thoracic radiation therapy.
  • Male participants must be willing to refrain from sperm donation during the entire study and for 5 half-lives of study drug plus 90 days (duration of sperm turnover).
  • Investigators shall counsel WOCBP and male participants who are sexually active with WOCBP on the importance of pregnancy prevention and the implications of an unexpected pregnancy. Investigators shall advise on the use of highly effective methods of contraception which have a failure rate of \</= 1% when used consistently and correctly. Azoospermic males are exempt from contraceptive requirements.
  • WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment with study drug(s) plus 5 half-lives of study drug (half-life up to 25 days) plus 30 days (duration of ovulatory cycle) for a total of 5 months post-treatment completion.
  • WOCBP who are continuously not heterosexually active are exempt from contraception requirements. However, they must still undergo pregnancy testing as described in this section.
  • Males who are sexually active with WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment with study drug (s) plus 5 half-lives of the study drug (half-life up to 25 days) plus 90 days (duration of sperm turnover) for a total of 7 months post-treatment completion

Exclusion criteria

Exclusion Criteria:

  • All toxicities attributed to prior anti-cancer therapy must have been resolved to Grade 1 (NCI CTCAE Version 4) or baseline before administration of study drug(s). Exceptions may apply.
  • Women who are pregnant or breastfeeding
  • Active, known, or suspected autoimmune disease. Patients with an autoimmune paraneoplastic syndrome requiring concurrent immunosuppressive treatment are excluded. Patients with type I diabetes mellitus, hypothyroidism only requiring hormone replacement, skin disorders (such as vitiligo, psoriasis, or alopecia) not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll
  • A condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of study initiation. Corticosteroids with minimal systemic absorption (inhaled or topical steroids) and adrenal replacement steroid doses > 10 mg daily prednisone equivalent are permitted in the absence of active autoimmune disease
  • Prior therapy with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-CTLA-4 antibody
  • Interstitial lung disease that is symptomatic or may interfere with the detection or management of suspected drug-related pulmonary toxicity.
  • Any patient requiring supplemental oxygen therapy.
  • Previous malignancies (except non-melanoma skin cancers, and some in situ cancers) unless a complete remission was achieved at least 2 years prior to study entry AND no additional therapy is required during the study period.
  • Known medical condition that, in the investigator's opinion, would increase the risk associated with study participation or study drug(s) administration or interfere with the interpretation of safety results
  • Major surgery or significant traumatic injury that is not recovered at least 14 days before the initiation of thoracic radiation therapy.
  • Positive test for hepatitis B virus (HBV) using HBV surface antigen (HBVsAg) test or positive test for hepatitis C virus (HCV) using HCV ribonucleic acid (RNA) or HCV antibody test indicating acute or chronic infection. Individuals with a positive test for HCV antibody but no detection of HCV RNA indicating no current infection are eligible.
  • Known medical history of testing positive for human immunodeficiency virus (HIV) or known medical history of acquired immunodeficiency syndrome (AIDS)
  • Inadequate hematologic function.
  • Inadequate hepatic function.
  • Inadequate pancreatic function.
  • History of allergy or hypersensitivity to any of the study drugs or study drug components
05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Sequential assignment
Masking
None (open label)
Enrollment
19 participants (actual)

Study arms

  • Experimental
    Radiation and Chemotherapy

    Thoracic Radiotherapy with cytotoxic platinum based chemotherapy with cytotoxic platinum based chemotherapy including cisplatin and etoposide, carboplatin and paclitaxel or cisplatin and pemetrexed (for patients with non-squamous histology) and Ipilimumab.

    Radiation: Thoracic Radiotherapy · Drug: Platinum Based Chemotherapy · Drug: ipilimumab

  • Experimental
    Nivolumab

    Nivolumab 480 mg (30 minute IV infusion) after completion of radiation and chemotherapy for up to 12 cycles until progression.

    Drug: Nivolumab

Interventions

  • RadiationThoracic Radiotherapy

    2 Gy in 30 fractions directed at all sites of suspected disease

  • DrugPlatinum Based Chemotherapy

    Platinum based chemotherapy including cisplatin and etoposide, carboplatin and paclitaxel or cisplatin and pemetrexed (for patients with non-squamous histology).

  • Drugipilimumab

    ipilimumab 1mg/kg delivered concurrently with initiation of chemoradiotherapy and in week 4 of chemoradiotherapy

  • DrugNivolumab

    Nivolumab 480 mg (30 minute IV infusion) at least 7 days but no more than 21 days after completion of radiation and chemotherapy every 4 weeks for up to 12 cycles.

06

What researchers measure

Primary outcomes

  1. Unacceptable Toxicity Status at the End of 8-week Safety Observation Period

    Unacceptable toxicity defined as: * Any grade 4 immune related adverse event (irAE) * Any grade 3 irAE, excluding pneumonitis, that does not downgrade to grade 2 within 7 days after onset of the event despite optimal medical management including systemic corticosteroids or does not downgrade to ≤ grade 1 or baseline within 14 days * Liver transaminase elevation \> 8 × ULN or total bilirubin \> 5 × ULN, * Any ≥ grade 3 non-irAE, with some exclusions. Result is provided as number of participants with unacceptable toxicity within 8 weeks of commencing study therapy.

    Time frame: At 8 weeks of treatment

  2. Percentage of Participants Without Disease Progression at 12 Months

    Disease Progression defined as the duration from date of registration to date of first documentation of progression as defined using Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1 and assessed by local investigator or symptomatic deterioration (as defined in Outcome 1) or death due to any cause. Patients last known to be alive without report of progression are censored at date of last disease assessment. For patients with a missing scan (or consecutive missing scans) whose subsequent scan determines progression, the expected date of the first missing scan (as defined by the disease assessment schedule) will be used as the date of progression.

    Time frame: 12 months post treatment

Secondary outcomes

  1. Percentage of Participants Who Experienced 12 Month Distant Metastasis Free Survival (DMFS)

    DMFS is defined as the duration from date of registration to date of first documentation of distant metastatic progression beyond the primary tumor site as well as regional lymph nodes assessed by local investigator or symptomatic deterioration (as defined in Outcome 1) or death due to any cause. Patients last known to be alive without report of distant metastatic progression are censored at date of last disease assessment.

    Time frame: 12 months post treatment

  2. Objective Response Rate (ORR) at 6 Months

    ORR is defined as the proportion of all treated subjects whose best overall response is either a complete response or partial response according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Best Objective Response (BOR) will also be reported Complete Response (CR) or Partial Response (PR) determinations included in the assessment must be confirmed by a consecutive second (confirmatory) evaluation meeting the criteria for response that is performed at least 4 weeks after the criteria for response are first met. When Stable Disease (SD) is believed to be the best response, it must meet a minimum SD duration of 49 days. Measurements must have met the SD criteria at least once after study entry.

    Time frame: 6 months

07

Results

Posted Feb 15, 2023

Participant flow

Participant flow — Overall Study
MilestoneRadiation and Chemotherapy, Followed by Nivolumab
Started19
Completed18
Not completed1
Withdrew: Withdrawal by subject1

Outcome measures

PrimaryUnacceptable Toxicity Status at the End of 8-week Safety Observation Period

Unacceptable toxicity defined as: * Any grade 4 immune related adverse event (irAE) * Any grade 3 irAE, excluding pneumonitis, that does not downgrade to grade 2 within 7 days after onset of the event despite optimal medical management including systemic corticosteroids or does not downgrade to ≤ grade 1 or baseline within 14 days * Liver transaminase elevation \> 8 × ULN or total bilirubin \> 5 × ULN, * Any ≥ grade 3 non-irAE, with some exclusions. Result is provided as number of participants with unacceptable toxicity within 8 weeks of commencing study therapy.

Time frame:
At 8 weeks of treatment
Reported as:
Count of participants · Participants
Unacceptable Toxicity Status at the End of 8-week Safety Observation Period
ParticipantsRadiation and Chemotherapy, Followed by Nivolumab
Unacceptable Toxicity Status at the End of 8-week Safety Observation Period6
PrimaryPercentage of Participants Without Disease Progression at 12 Months

Disease Progression defined as the duration from date of registration to date of first documentation of progression as defined using Response Evaluation Criteria in Solid Tumors (RECIST) v 1.1 and assessed by local investigator or symptomatic deterioration (as defined in Outcome 1) or death due to any cause. Patients last known to be alive without report of progression are censored at date of last disease assessment. For patients with a missing scan (or consecutive missing scans) whose subsequent scan determines progression, the expected date of the first missing scan (as defined by the disease assessment schedule) will be used as the date of progression.

Time frame:
12 months post treatment
Reported as:
Number · percentage of participants
Percentage of Participants Without Disease Progression at 12 Months
percentage of participantsRadiation and Chemotherapy, Followed by Nivolumab
Percentage of Participants Without Disease Progression at 12 Months58 (33 to 76)
SecondaryPercentage of Participants Who Experienced 12 Month Distant Metastasis Free Survival (DMFS)

DMFS is defined as the duration from date of registration to date of first documentation of distant metastatic progression beyond the primary tumor site as well as regional lymph nodes assessed by local investigator or symptomatic deterioration (as defined in Outcome 1) or death due to any cause. Patients last known to be alive without report of distant metastatic progression are censored at date of last disease assessment.

Time frame:
12 months post treatment
Reported as:
Number · percentage of participants
Percentage of Participants Who Experienced 12 Month Distant Metastasis Free Survival (DMFS)
percentage of participantsRadiation and Chemotherapy, Followed by Nivolumab
Percentage of Participants Who Experienced 12 Month Distant Metastasis Free Survival (DMFS)63.2 (41.7 to 85)
SecondaryObjective Response Rate (ORR) at 6 Months

ORR is defined as the proportion of all treated subjects whose best overall response is either a complete response or partial response according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Best Objective Response (BOR) will also be reported Complete Response (CR) or Partial Response (PR) determinations included in the assessment must be confirmed by a consecutive second (confirmatory) evaluation meeting the criteria for response that is performed at least 4 weeks after the criteria for response are first met. When Stable Disease (SD) is believed to be the best response, it must meet a minimum SD duration of 49 days. Measurements must have met the SD criteria at least once after study entry.

Time frame:
6 months
Reported as:
Number · percentage of participants
Objective Response Rate (ORR) at 6 Months
percentage of participantsRadiation and Chemotherapy, Followed by Nivolumab
Objective Response Rate (ORR) at 6 Months66 (41 to 87)

Adverse events

Collected over Adverse Events collected from on study date to 100 days after study drug discontinuation, approximately 14 months.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Radiation and Chemotherapy, Followed by Nivolumab9/19 (47.4%)13/19 (68.4%)19/19 (100%)
Most frequent serious events
Showing 10 of 26
Most frequent serious events
EventRadiation and Chemotherapy, Followed by Nivolumab
PneumonitisRespiratory, thoracic and mediastinal disorders4/19
Lung infectionInfections and infestations3/19
Respiratory failureRespiratory, thoracic and mediastinal disorders3/19
DehydrationGastrointestinal disorders2/19
Atrial fibrilationCardiac disorders2/19
Thromboembolic eventVascular disorders2/19
AnemiaBlood and lymphatic system disorders2/19
HypoxiaRespiratory, thoracic and mediastinal disorders2/19
Febrile neutropeniaBlood and lymphatic system disorders2/19
Sinus tachycardiaCardiac disorders2/19
Most frequent other events
Showing 10 of 134
Most frequent other events
EventRadiation and Chemotherapy, Followed by Nivolumab
EsophagitisGastrointestinal disorders13/19
FatigueGeneral disorders12/19
PneumonitisRespiratory, thoracic and mediastinal disorders10/19
ConstipationGastrointestinal disorders9/19
DysphagiaGastrointestinal disorders8/19
AnorexiaMetabolism and nutrition disorders8/19
AnxietyPsychiatric disorders8/19
InsomniaPsychiatric disorders8/19
AnemiaBlood and lymphatic system disorders8/19
NauseaGastrointestinal disorders7/19

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Radiation and Chemotherapy, Followed by Nivolumab
<=18 years0
Between 18 and 65 years9
>=65 years10
Sex: Female, Male
Sex: Female, Male(Participants)Radiation and Chemotherapy, Followed by Nivolumab
Female9
Male10
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Radiation and Chemotherapy, Followed by Nivolumab
Hispanic or Latino1
Not Hispanic or Latino17
Unknown or Not Reported1
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Radiation and Chemotherapy, Followed by Nivolumab
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White17
More than one race0
Unknown or Not Reported1
Region of Enrollment
Region of Enrollment(participants)Radiation and Chemotherapy, Followed by Nivolumab
United States19
08

Study locations

3 sites
  • H. Lee Moffitt Cancer Center and Research Institute
    Tampa, Florida 33612, United States
  • UNC Limeberger Comprehensive Cancer Center
    Chapel Hill, North Carolina 27599, United States
  • Duke University
    Durham, North Carolina 27710, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Oct 3, 2019

Documents are hosted by the registry — open the source record to download them.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 15, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03663166
Lead sponsor
H. Lee Moffitt Cancer Center and Research Institute
Responsible party
Sponsor
First posted
Sep 10, 2018
Start date
Nov 20, 2018
Primary completion
Oct 22, 2021
Completion
Oct 22, 2021
Results posted
Feb 15, 2023
Last update
Feb 15, 2023

Study contacts

Bradford Perez, MD
principal investigator · H. Lee Moffitt Cancer Center and Research Institute

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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