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
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.
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 →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.
Exclusion Criteria:
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
Nivolumab 480 mg (30 minute IV infusion) after completion of radiation and chemotherapy for up to 12 cycles until progression.
Drug: Nivolumab
2 Gy in 30 fractions directed at all sites of suspected disease
Platinum based chemotherapy including cisplatin and etoposide, carboplatin and paclitaxel or cisplatin and pemetrexed (for patients with non-squamous histology).
ipilimumab 1mg/kg delivered concurrently with initiation of chemoradiotherapy and in week 4 of chemoradiotherapy
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.
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
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
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
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
| Milestone | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| Started | 19 |
| Completed | 18 |
| Not completed | 1 |
| Withdrew: Withdrawal by subject | 1 |
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.
| Participants | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| Unacceptable Toxicity Status at the End of 8-week Safety Observation Period | 6 |
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.
| percentage of participants | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| Percentage of Participants Without Disease Progression at 12 Months | 58 (33 to 76) |
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.
| percentage of participants | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| Percentage of Participants Who Experienced 12 Month Distant Metastasis Free Survival (DMFS) | 63.2 (41.7 to 85) |
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.
| percentage of participants | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| Objective Response Rate (ORR) at 6 Months | 66 (41 to 87) |
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.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Radiation and Chemotherapy, Followed by Nivolumab | 9/19 (47.4%) | 13/19 (68.4%) | 19/19 (100%) |
| Event | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| PneumonitisRespiratory, thoracic and mediastinal disorders | 4/19 |
| Lung infectionInfections and infestations | 3/19 |
| Respiratory failureRespiratory, thoracic and mediastinal disorders | 3/19 |
| DehydrationGastrointestinal disorders | 2/19 |
| Atrial fibrilationCardiac disorders | 2/19 |
| Thromboembolic eventVascular disorders | 2/19 |
| AnemiaBlood and lymphatic system disorders | 2/19 |
| HypoxiaRespiratory, thoracic and mediastinal disorders | 2/19 |
| Febrile neutropeniaBlood and lymphatic system disorders | 2/19 |
| Sinus tachycardiaCardiac disorders | 2/19 |
| Event | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| EsophagitisGastrointestinal disorders | 13/19 |
| FatigueGeneral disorders | 12/19 |
| PneumonitisRespiratory, thoracic and mediastinal disorders | 10/19 |
| ConstipationGastrointestinal disorders | 9/19 |
| DysphagiaGastrointestinal disorders | 8/19 |
| AnorexiaMetabolism and nutrition disorders | 8/19 |
| AnxietyPsychiatric disorders | 8/19 |
| InsomniaPsychiatric disorders | 8/19 |
| AnemiaBlood and lymphatic system disorders | 8/19 |
| NauseaGastrointestinal disorders | 7/19 |
| Age, Categorical(Participants) | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| <=18 years | 0 |
| Between 18 and 65 years | 9 |
| >=65 years | 10 |
| Sex: Female, Male(Participants) | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| Female | 9 |
| Male | 10 |
| Ethnicity (NIH/OMB)(Participants) | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| Hispanic or Latino | 1 |
| Not Hispanic or Latino | 17 |
| Unknown or Not Reported | 1 |
| Race (NIH/OMB)(Participants) | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 0 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 1 |
| White | 17 |
| More than one race | 0 |
| Unknown or Not Reported | 1 |
| Region of Enrollment(participants) | Radiation and Chemotherapy, Followed by Nivolumab |
|---|---|
| United States | 19 |
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Carcinoma, Non-Small-Cell Lung→
H. Lee Moffitt Cancer Center and Research Institute