ClinicalTrials.gg
RecruitingNCT04105270Updated Sep 17, 2026

RMT in Combination With Durvalumab + Chemo in Untreated Adenocarcinoma NSCLC. A Randomized Double Blind Phase II Trial

A Phase 2 interventional study of Oral Restorative Microbiota Therapy (RMT) Capsules and Durvalumab 1500 mg IV in Adenocarcinoma of Lung and Lung Cancer, sponsored by Masonic Cancer Center, University of Minnesota. Recruiting at 10 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-17.

Sponsored by Masonic Cancer Center, University of Minnesota · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Nov 2022; still recruiting 3 years 11 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
82
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a randomized, active-controlled, parallel-group, double-blind Phase II trial, of oral restorative microbiota therapy (RMT) or placebo combined with intravenous (IV) durvalumab (MEDI4736) plus chemotherapy in patients with treatment naïve advanced or metastatic adenocarcinoma non-small cell lung cancer (NSCLC)

02

Conditions studied

  • Adenocarcinoma of Lung
  • Lung Cancer
03

In context

Adenocarcinoma of Lung

418 studies on the registry are indexed under Adenocarcinoma of Lung; 79 are open to participants now.

This study's planned enrollment of 82 is above the median of 60 across 293 interventional studies indexed under Adenocarcinoma of Lung.

Browse Adenocarcinoma of Lung studies →

Lead sponsor

Masonic Cancer Center, University of Minnesota is the lead sponsor of 286 studies on the registry; 35 are open to participants now.

Of its 39 completed or terminated interventional studies of FDA-regulated products, 28 (72%) have results posted.

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

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • or cytologically confirmed adenocarcinoma of the lung that is unresectable stage IIIB/C or stage IV, does not have an EGFR sensitizing (activating) mutation or ALK or ROS1 translocation. BRAF, RET, NTRK, MET ex 14 splice site mutation
  • based on 1.1
  • Tumor sample requirements

    • Mandatory provision of an unstained, archived tumor tissue sample in a quantity sufficient to allow for biomarker and genomic analysis. A minimum of 10 unstained slides should be available for evaluation.
    • Known TC expression status assayed by Ventana SP263. Patients who have known PDL-1 as assayed by PharmDx 22C3 assay may be eligible; however, available will be used to assay with Ventana SP263 test.
  • Prior chemotherapy or immunotherapy as therapy for lung cancer is permitted as long as it has been >6 months from last dose at the time of enrollment. Local treatment of isolated lesions, excluding target lesions, for palliative intent is acceptable (e.g. by local surgery or radiotherapy). Prior systemic therapy for advanced/ NSCLC makes the patient ineligible for this study.
  • Patients with treated are eligible as long as they have stable symptoms, are more than 2 weeks from completion of therapy, and do not require more than 10mg of daily prednisone or equivalent.
  • Performance status of 0 or 1
  • Body weight of >30 kg
  • Adequate organ function within 14 days of study enrollment defined as:

    • ≥ 9.0 g/dL
    • ≥1,500/mcL
    • ≥ 100,000/mcL
    • Total ≤1.5x (ULN) - this will not apply to patients with confirmed Gilbert's syndrome (persistent or recurrent hyperbilirubinemia that is predominantly unconjugated in the absence of hemolysis or hepatic pathology), who will be allowed only in consultation with their physician.
    • (SGOT) and ALT (SGPT) ≤2.5 x institutional ULN unless liver metastases are present, in which case it must be ≤5x ULN
    • Measured (CL) >40 mL/min or calculated creatinine CL>40 mL/min by the Cockcroft-Gault formula (Cockcroft and Gault 1976) or by 24-hour urine collection for determination of creatinine clearance:
  • Expected of at least 12 weeks in the opinion of the enrolling investigator as documented in the medical record
  • Women of and men with partners of child-bearing potential must agree to use effective for the time of screening to the duration of treatment and 3 months after the last dose of study drug
  • Provide voluntary written consent prior to the performance of any research related tests or procedures.

Exclusion criteria

Exclusion Criteria:

  • Not pregnant or breast feeding. Evidence of status, or negative urine or serum pregnancy test for female pre-menopausal patients. Women will be considered postmenopausal if they have amenorrhea for 12 months without an alternative medical explanation
  • Dysphagia or inability to swallow medications
  • Squamous cell, large cell, or NSCLC NOS (not otherwise specified) histology or mixed tumors
  • Has untreated or active
  • Has a known sensitivity to any component of therapeutic agents used in this study
  • Receipt of any immunotherapy or drug within 4 weeks prior to the first dose of study drug; and in the case of monoclonal antibodies 6 weeks prior to the first dose of study drug
  • Prior treatment with any other , or PD-L1, including durvalumab or an anti-PD-L2 agent or an antibody or a small molecule targeting other immuno-regulatory receptors except as therapy for NSCLC so long as it has been greater than six months since the last treatment
  • Current or prior use of medication within 28 days before the first dose of study drug, with the exceptions of intranasal and inhaled or systemic corticosteroids at physiological doses, which are not to exceed 10 mg/day of prednisone, or an equivalent corticosteroid
  • Recent major surgery within 4 weeks prior to entry into the study (excluding the placement of vascular access) that would prevent administration of study drug
  • Active or prior documented disease within the past 2 years requiring systemic treatment (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Patients with vitiligo, Grave's disease, or psoriasis not requiring systemic treatment (within the past 2 years) are not excluded. Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
  • Active documented inflammatory bowel disease (eg, Crohn's disease, ulcerative colitis) who require immunosuppression or patients who exceed 10 mg/day of prednisone, or an equivalent corticosteroid are excluded
  • History of primary immunodeficiency
  • History of organ transplant that requires therapeutic immunosuppression
  • Taking daily probiotics (patients with last probiotic > 4weeks prior to first dose of RMT are eligible)
  • History of (HIV) (known HIV 1/2 antibodies positive) who are on anti-retroviral treatment for \< 6 months and absolute \<500 (patients with HIV not meeting these criteria are eligible)
  • Has known active or C. Active Hepatitis B is defined as a known positive HBsAg, and positive hepatitis B virus quantification assay (patients with history of Hepatitis B who have seroconversion i.e. Hepatitis B core antibody positive and Hepatitis B surface antibody positive are eligible). Active is defined by a known positive Hep C Ab result and positive quantitative HCV RNA results (Patients with Hepatitis C who are on anti-viral suppressive therapy and negative quantitative HCV RNA results are eligible)
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, active peptic ulcer disease or gastritis, active bleeding diatheses
  • Myocardial infarction or stroke within 3 months prior to enrollment
  • History of systolic or diastolic heart failure with (NYHA) class III or IV symptoms (refer to Appendix II)
  • Has active or prior history of (non-infectious) pneumonitis that required steroids or patients with interstitial lung disease
  • Psychiatric illness/social situations that would limit compliance with study requirements or compromise the ability of the patient to give written
  • Known history of active tuberculosis. Patients with prior history of latent TB could be included if they have been treated previously with isoniazid.
  • Patients who are on chronic systemic antibiotic therapy (antibiotics for ≥60 consecutive days within 12 weeks of enrollment). Patients who receive systemic antibiotics between enrollment and start of RMT are eligible
  • Receipt of within 30 days prior to study entry or within 30 days of receiving RMT
  • History of another primary (excluding non-melanoma skin cancer) within 5 years prior to starting RMT, except if the patient has undergone potentially curative therapy with no evidence of disease recurrence for 5 years since initiation of that therapy
  • Any condition that, in the opinion of the investigator, would interfere with evaluation of the study drug or interpretation of patient safety or study results
Terms in these criteria, in plain language(33)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CD4 count

The number of CD4 cells, a type of white blood cell, in a given amount of blood. It is used to follow how well the immune system is doing in HIV.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
82 participants (estimated)

Study arms

  • Experimental
    Arm A (RMT)

    Drug: Oral Restorative Microbiota Therapy (RMT) Capsules · Drug: Durvalumab 1500 mg IV · Drug: Cisplatin/pemetrexed or Carboplatin/pemetrexed

  • Experimental
    Arm B (Placebo)

    Drug: Durvalumab 1500 mg IV · Drug: Cisplatin/pemetrexed or Carboplatin/pemetrexed · Other: Placebo

  • Experimental
    Safety Run-in

    10 patients are enrolled in this safety run-in arm. Patients are directly assigned to RMT treatment arm. After safety- run-in period of 4 weeks after the first dose of RMT, in the 10 patients if no new safety signal are seen enrollment moves to randomization

    Drug: Oral Restorative Microbiota Therapy (RMT) Capsules · Drug: Durvalumab 1500 mg IV · Drug: Cisplatin/pemetrexed or Carboplatin/pemetrexed

Interventions

  • DrugOral Restorative Microbiota Therapy (RMT) Capsules

    Patients with PD-L1 TC expression will receive sixteen doses of oral RMT capsules weekly

    Also known as: RMT

  • Patients with PD-L1 TC expression receive durvalumab 1500 mg IV every 4 weeks (Q4W) until disease progression or for a maximum of two years from the 1st dose of durvalumab

  • DrugCisplatin/pemetrexed or Carboplatin/pemetrexed

    Patients with PD-L1 TC receive cisplatin/pemetrexed or carboplatin/pemetrexed given every 3 weeks (Q3W) for 4 cycles followed by pemetrexed maintenance given Q3W

  • OtherPlacebo

    Sixteen doses of oral placebo capsules given weekly

06

What researchers measure

Primary outcomes

  1. Number of patients experiencing Progression Free Survival (PFS)

    Incidence of PFS using RECIST 1.1 in each treatment arm to evaluate the efficacy of restorative microbiota therapy

    Time frame: 3 Years

  2. Safety and tolerability of RMT

    Safety and tolerability of RMT in combination with durvalumab or durvalumab + chemotherapy as assessed by the incidence of adverse events

    Time frame: 2 Years

Secondary outcomes

  1. Objective Response Rate (ORR) RECIST 1.1

    ORR of treatment with RMT in each treatment arm per RECIST 1.1

    Time frame: 2 Years

  2. Duration of Response (DOR)

    DOR of treatment with RMT in each treatment arm per RECIST 1.1

    Time frame: 2 Years

  3. Overall Survival (OS)

    Incidence of OS using RECIST 1.1 in each treatment arm

    Time frame: 3 Years

  4. Immune mediated Adverse Events imAE

    Rate of immune mediated adverse events (imAE) in each treatment arm

    Time frame: 2 Years

  5. Objective Response Rate (ORR) (iRECIST)

    ORR using immune response evaluation criteria in solid tumors (iRECIST)

    Time frame: 2 Years

  6. Health-related quality of life (QoL)

    Difference in health-related quality of life (QoL) using European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ-30)

    Time frame: 2 Years

  7. Health-related quality of life (QoL)

    Difference in health-related quality of life (QoL) using lung cancer module (LC-13)

    Time frame: 2 Years

07

Study locations

9 of 10 sites recruiting
  • Dr. Amit Kulkarni
    Phoenix, Arizona 85338, United States
    Not yet recruiting
    • Amit Kulkarni · Contact(623) 220-5456
  • MNCCTN Essentia Health St. Joseph's Brainerd Medical Center
    Brainerd, Minnesota 56401, United States
    Recruiting
  • MNCCTN Essentia Health Deer River
    Deer River, Minnesota 56636, United States
    Recruiting
  • MNCCTN Essentia Health St. Mary's Detroit Lakes Clinic
    Detroit Lakes, Minnesota 56501, United States
    Recruiting
  • MNCCTN Essentia Health Duluth
    Duluth, Minnesota 55805, United States
    Recruiting
  • MNCCTN Essentia Health Fosston
    Fosston, Minnesota 56542, United States
    Recruiting
  • MNCCTN Essentia Health Hibbing Clinic
    Hibbing, Minnesota 55746, United States
    Recruiting
  • Masonic Cancer Center, University of Minnesota
    Minneapolis, Minnesota 55455, United States
    Recruiting
  • MNCCTN Essentia Health Sandstone
    Sandstone, Minnesota 550723, United States
    Recruiting
  • MNCCTN Essentia Health Virginia Clinic
    Virginia, Minnesota 55792, United States
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 17, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT04105270
Responsible party
Sponsor
First posted
Sep 26, 2019
Start date
Nov 30, 2022
Primary completion
Jan 2028 (estimated)
Completion
Jan 2028 (estimated)
Last update
Sep 17, 2026

Study contacts

Cancer Center Clinical Trials Office
Contact
ccinfo@umn.edu
612 624 2620
Manish Patel, DO
principal investigator · University of Minnesota, Division of Hematology, Oncology and Transplantation

Oversight

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

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