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Folic Acid Antagonists

Antibodies, Monoclonal

Enzyme Inhibitors

Folic Acid

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Antineoplastic Agents, Immunological

Immunologic Factors

Folinic Acid

Folate

Vitamin B9

Patients receive methoxyamine PO on day 1 of each cycle, pemetrexed IV over 10 minutes on day 1 of each cycle, and cisplatin IV over 60 minutes or carboplatin IV over 30 minutes on day 3 of each cycle. Beginning day 3, patients also undergo radiation therapy daily Monday-Friday. Treatment repeats every 21 days for 2 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-6 weeks after cycle 2, patients receive durvalumab IV over 60 minutes every 2 weeks or monthly for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo CT scan or MRI throughout the trial and PET/CT scan during screening and on study.

Patients receive pemetrexed IV over 10 minutes and cisplatin IV over 60 minutes or carboplatin IV over 30 minutes on day 1 of each cycle. Beginning day 1 of each cycle, patients also undergo radiation therapy daily Monday-Friday. Treatment repeats every 21 days for 2 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-6 weeks after cycle 2, patients receive durvalumab IV over 60 minutes every 2 weeks or monthly for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo CT scan or MRI throughout the trial and PET/CT scan during screening and on study.

Computed Tomography

Magnetic Resonance Imaging

Methoxyamine

Positron Emission Tomography

Radiation Therapy

Site Public Contact

Jyoti Malhotra

Megan E. Daly

Richa Dawar

Salma K. Jabbour

Nitin Ohri

Thomas W. Lycan

Debora S. Bruno

Tithi Biswas

Timothy F. Burns

Avi B. Markowitz

This phase II trial tests whether TRC102 (methoxyamine hydrochloride) in combination usual care treatment comprised of pemetrexed, cisplatin or carboplatin, and radiation therapy followed by durvalumab works better than the usual care treatment alone to shrink tumors in patients with stage III non-squamous non-small cell lung cancer (NSCLC). TRC102 is in a class of drugs called antineoplastic agents. It blocks the ability of a cell to repair damage to its DNA and may kill cancer cells. It may also help some anticancer drugs work better. Pemetrexed is in a class of medications called antifolate antineoplastic agents. It works by stopping cells from using folic acid to make DNA and may kill cancer cells. Chemotherapy drugs, such as cisplatin, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of cancer cells. Immunotherapy with monoclonal antibodies, such as durvalumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Radiation therapy uses high energy sources to kill tumor cells and shrink tumors. Giving TRC102 in combination with usual care treatment may be more effective than usual care treatment alone in stabilizing and lengthening survival time in patients with stage III non-squamous NSCLC.

PRIMARY OBJECTIVE:

I. To improve progression-free survival (PFS) from 56% with current standard of care (chemoradiation followed by consolidative durvalumab) to 75% at one year with the proposed combination followed by consolidative durvalumab.

SECONDARY OBJECTIVES:

I. To determine overall survival with the proposed combination therapy. II. To assess the incidence of grade 3 or higher pneumonitis and other toxicities.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive methoxyamine orally (PO) on day 1 of each cycle, pemetrexed intravenously (IV) over 10 minutes on day 1 of each cycle, and cisplatin IV over 60 minutes or carboplatin IV over 30 minutes on day 3 of each cycle. Beginning day 3, patients also undergo radiation therapy daily Monday-Friday. Treatment repeats every 21 days for 2 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-6 weeks after cycle 2, patients receive durvalumab IV over 60 minutes every 2 weeks or monthly for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo computed tomography (CT) scan or magnetic resonance imaging (MRI) throughout the trial and positron emission tomography (PET)/CT scan during screening and on study.

ARM II: Patients receive pemetrexed IV over 10 minutes and cisplatin IV over 60 minutes or carboplatin IV over 30 minutes on day 1 of each cycle. Beginning day 1 of each cycle, patients also undergo radiation therapy daily Monday-Friday. Treatment repeats every 21 days for 2 cycles in the absence of disease progression or unacceptable toxicity. Beginning 2-6 weeks after cycle 2, patients receive durvalumab IV over 60 minutes every 2 weeks or monthly for up to 1 year in the absence of disease progression or unacceptable toxicity. Patients also undergo CT scan or MRI throughout the trial and PET/CT scan during screening and on study.

After completion of study treatment, patients are followed up at 30 days, and then every 3 months for 2 years, followed by every 6 months for an additional 3 years.

Testing the Addition of an Anti-Cancer Drug, TRC102, to the Usual Chemotherapy Treatment (Pemetrexed, Cisplatin or Carboplatin) During Radiation Therapy for Stage III Non-Squamous Non-Small Cell Lung Cancer

A Phase 2 Randomized Study of the BER Inhibitor TRC102 in Combination With Standard Pemetrexed-Platinum-Radiation in Stage III Non-Squamous Non-Small Cell Lung Cancer

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

PFS primary analysis will be performed using a stratified log-rank test (with the strata being the same as the randomization strata) with a one-sided significance level of 0.10.

The analysis of OS will be performed using Kaplan-Meier method with a stratified log-rank test (with the strata being the same as the randomization strata).

Assessed by organ system, by National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.

National Cancer Institute (NCI)

Carcinoma, Squamous Cell

Carcinoma, Adenosquamous

Adenocarcinoma, Bronchiolo-Alveolar

Dermatologic Agents

Docetaxel

Bevacizumab

Etoposide

Lenograstim

Etoposide phosphate

Podophyllotoxin

Endothelial Growth Factors

Mitogens

Angiogenesis Inhibitors

Growth Inhibitors

Tubulin Modulators

Antimitotic Agents

Adjuvants, Immunologic

Keratolytic Agents

Patients receive cisplatin IV over 1 hour on days 1, 8, 29, and 36 and etoposide IV over 1 hour on days 1-5 and 29-33. Patients undergo concurrent thoracic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, 36-40, and 43-47.

Patients receive cisplatin, etoposide, and thoracic radiotherapy as in group 1. Patients also receive bevacizumab IV over 30-90 minutes on days 15, 36, and 57.

Patients receive cisplatin, etoposide, and thoracic radiotherapy as in group 1. Patients also receive bevacizumab IV over 30-90 minutes on days 1, 22, and 43.

Filgrastim

Pegfilgrastim

Antoinette J Wozniak

This clinical trial studies combination chemotherapy, radiation therapy, and bevacizumab in treating patients with newly diagnosed stage III non-small cell lung cancer that cannot be removed by surgery. Drugs used in chemotherapy, such as cisplatin, etoposide, and docetaxel, work in different ways to stop the growth of \[cancer/tumor\] cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radiation therapy uses high-energy x-rays to kill tumor cells. Monoclonal antibodies, such as bevacizumab, may interfere with the ability of tumor cells to grow and spread. Bevacizumab may also stop the growth of tumor cells by blocking blood flow to the tumor. Giving more than one drug (combination chemotherapy) together with radiation therapy and bevacizumab may kill more tumor cells.

PRIMARY OBJECTIVES:

I. Determine the frequency and severity of toxic effects of induction therapy comprising cisplatin, etoposide, and radiotherapy with or without bevacizumab followed by consolidation therapy comprising docetaxel and bevacizumab, in terms of grade 4 or 5 hemorrhage, in patients with newly diagnosed, unresectable, stage III non-small cell lung cancer.

SECONDARY OBJECTIVES:

I. Determine progression-free and overall survival of patients treated with these regimens.

II. Determine response (confirmed, unconfirmed, partial, and complete) in patients with measurable disease treated with these regimens.

OUTLINE: This is a pilot, multicenter study. Patients are stratified according to risk (high\* vs low).

NOTE: \*High-risk stratum closed to accrual as of 2/20/09.

INDUCTION THERAPY: Patients in each stratum are assigned to 1 of 3 sequential treatment groups.

GROUP 1: Patients receive cisplatin intravenously (IV) over 1 hour on days 1, 8, 29, and 36 and etoposide IV over 1 hour on days 1-5 and 29-33. Patients undergo concurrent thoracic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, 36-40, and 43-47.

GROUP 2: Patients receive cisplatin, etoposide, and thoracic radiotherapy as in group 1. Patients also receive bevacizumab IV over 30-90 minutes on days 15, 36, and 57.

GROUP 3: Patients receive cisplatin, etoposide, and thoracic radiotherapy as in group 1. Patients also receive bevacizumab IV over 30-90 minutes on days 1, 22, and 43.

CONSOLIDATION CHEMOTHERAPY: Beginning 3-6 weeks after completion of induction therapy, all patients receive consolidation chemotherapy comprising docetaxel IV over 1 hour and bevacizumab IV over 30-90 minutes on day 1. Patients also receive filgrastim (G-CSF) subcutaneously (SC) beginning on day 2 and continuing until blood counts recover OR pegfilgrastim SC once on day 2.

Treatment repeats every 21 days for 3 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed periodically for up to 4 years.

Combination Chemotherapy, Radiation Therapy, and Bevacizumab in Treating Patients With Newly Diagnosed Stage III Non-small Cell Lung Cancer That Cannot Be Removed by Surgery

A Pilot Trial of Cisplatin/Etoposide/Radiotherapy Followed by Consolidation Docetaxel and the Addition of Bevacizumab (NSC-704865) in Three Cohorts of Patients With Inoperable Locally Advanced Stage III Non-small Cell Lung Cancer

Only adverse events that are possibly, probably or definitely related to study drug are reported.

From date of registration to time of first documentation of progression or symptomatic deterioration, or death due to any cause. Patients last known to be alive and progression-free are censored at date of last contact.

From date of registration to date of death due to any cause. Patients last known to be alive are censored at date of last contact.

Greater than or equal to 30% decrease under baseline of the sum of longest diameters of all target measurable lesions.

All eligible patients, both low-risk and high-risk strata combined, who received concurrent chemotherapy and radiotherapy.

Concurrent Chemotherapy and Radiotherapy

All eligible patients, both low-risk and high-risk strata combined, who received consolidation therapy with Docetaxel and Bevacizumab.

Consolidation Therapy With Docetaxel and Bevacizumab

Low Risk Patient Stratum

High Risk Patient Stratum

Total

Age, Continuous

Sex: Female, Male

Ethnicity (NIH/OMB)

Race (NIH/OMB)

United States

Region of Enrollment

All eligible patients who received protocol treatment.

Lung Committee Statistician

Acidosis (metabolic or respiratory)

Arthritis (non-septic)

Calcium, serum-low (hypocalcemia)

Carbon monoxide diffusion capacity (DL(co))

Creatinine

Dehydration

Dyspnea (shortness of breath)

Esophagitis

FEV(1)

Febrile neutropenia

Glucose, serum-high (hyperglycemia)

Hemoglobin

Hemorrhage, Respiratory tract NOS

Hemorrhage, GI - Peritoneal cavity

Hemorrhage, pulmonary/upper respiratory - Lung

Hypotension

Hypoxia

INR (of prothrombin time)

Inf (clin/microbio) w/Gr 3-4 neuts - Nose

Inf (clin/microbio) w/Gr 3-4 neuts - Oral cav-gums

Inf (clin/microbio) w/Gr 3-4 neuts - UTI

Inf (clin/microbio) w/Gr 3-4 neuts - Upper airway

Inf w/normal ANC or Gr 1-2 neutrophils - Blood

Inf w/normal ANC or Gr 1-2 neutrophils - Lung

Leukocytes (total WBC)

Lymphopenia

Muscle weakness, not d/t neuropathy - body/general

Nausea

Neutrophils/granulocytes (ANC/AGC)

Pain - Chest wall

Pain - Chest/thorax NOS

Pain - Head/headache

Pain - Joint

Pain - Neck

Pain - Throat/pharynx/larynx

Platelets

Pneumonitis/pulmonary infiltrates

Potassium, serum-low (hypokalemia)

Pulmonary/Upper Respiratory-Other (Specify)

Rash/desquamation

Rash: dermatitis associated w/radiation

Sodium, serum-low (hyponatremia)

Weight loss

Consolidation Therapy With Docetaxel and Bevacizumab.

All eligible patients, both low-risk and high-risk strata combined, who received protocol therapy.

Adverse Events

Patients with non-squamous histology, a primary tumor with no cavitation and not within 1 cm of a major blood vessel, and no history of hemoptysis.

Treatment received was cisplatin IV over 1 hour on days 1, 8, 29, and 36 and etoposide IV over 1 hour on days 1-5 and 29-33. Patients undergo concurrent thoracic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, 36-40, and 43-47.

cisplatin: Given IV

etoposide: Given IV

radiation therapy: Undergo thoracic radiotherapy

docetaxel: Given IV

filgrastim: Given SC

pegfilgrastim: Given SC

Patients with at least one of the following characteristics: squamous histology, a primary tumor with cavitation or within 1 cm of a major blood vessel, a history of hemoptysis.

Treatment received was cisplatin IV over 1 hour on days 1, 8, 29, and 36 and etoposide IV over 1 hour on days 1-5 and 29-33. Patients undergo concurrent thoracic radiotherapy once daily on days 1-5, 8-12, 15-19, 22-26, 29-33, 36-40, and 43-47.

cisplatin: Given IV

etoposide: Given IV

radiation therapy: Undergo thoracic radiotherapy

docetaxel: Given IV

filgrastim: Given SC

pegfilgrastim: Given SC

Progression-free Survival

Overall Survival

Only patients with measurable disease at baseline were included in the analysis of response. Among 15 patients on the Low Risk stratum, 14 had measureable disease at baseline. Among 11 patients on the High Risk stratum, 10 had measureable disease at baseline.

Response Rate (Confirmed or Unconfirmed Partial Response)

Overall Study

Paclitaxel

Albumin-Bound Paclitaxel

Veliparib

Poly(ADP-ribose) Polymerase Inhibitors

Patients undergo 3D-CRT and receive veliparib, carboplatin, and paclitaxel as in Phase I induction and consolidation therapy.

Patients undergo 3D-CRT as in arm I. Patients also receive placebo PO BID on days 1-43 and carboplatin and paclitaxel as in Phase I. Within 4-6 weeks after completion of chemotherapy and radiation therapy, patients receive placebo on days 1-7 and carboplatin and paclitaxel as in Phase I.

3-Dimensional Conformal Radiation Therapy

Laboratory Biomarker Analysis

Placebo Administration

Athanassios (Ethan) Argiris

This phase I/II partially randomized trial studies the side effects and best dose of veliparib when given together with radiation therapy, carboplatin, and paclitaxel and to see how well it works in treating patients with stage III non-small cell lung cancer that cannot be removed by surgery. Veliparib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells either by killing the cells, by stopping them from dividing, or by stopping them from spreading. It is not yet known whether radiation therapy, carboplatin, and paclitaxel are more effective with or without veliparib in treating non-small cell lung cancer.

PRIMARY OBJECTIVES:

I. To establish the maximum tolerated dose (MTD) and the recommended phase II dose of ABT-888 (veliparib) when given concurrently with standard carboplatin/paclitaxel and radiotherapy in patients with unresectable stage III non-small cell lung cancer (NSCLC). (Phase I) II. To assess whether carboplatin/paclitaxel plus ABT-888 compared with carboplatin/paclitaxel plus placebo improves progression-free survival (PFS) in patients with unresectable stage III NSCLC. (Phase II) III. To compare overall survival (OS) in patients treated with carboplatin/paclitaxel and radiotherapy plus ABT-888 to those treated with carboplatin, paclitaxel and radiotherapy plus placebo. (Phase II) IV. To assess the response rate (confirmed and unconfirmed, complete and partial responses) and disease control rate in the subset of patients with measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST) criteria. (Phase II) V. To assess the safety and toxicity profile of the regimen. (Phase II)

SECONDARY OBJECTIVES:

I. To collect tumor tissue from pretreatment biopsies (archival samples) for biomarker studies, including poly (ADP-ribose) polymerase 1 (PARP) activity by measuring the levels of poly-ADP-ribose, gamma-H2A histone family, member X (gamma-H2AX), and messenger ribonucleic acid (mRNA) expression levels of deoxyribonucleic acid (DNA) repair enzymes such as excision repair cross-complementing rodent repair deficiency, complementation group 1 (ERCC1)/x-ray repair complementing defective repair in Chinese hamster cells 1 (XRCC1).

II. To collect blood samples for evaluation of gamma-H2AX (circulating tumor cells) and other relevant future studies.

OUTLINE: This is a phase I, dose-escalation study of veliparib followed by a randomized phase II study.

PHASE I:

INDUCTION THERAPY: Patients undergo 3-dimensional conformal radiation therapy (3D-CRT) once daily (QD), 5 days a week, for 6 weeks. Patients also receive veliparib orally (PO) twice daily (BID) on days 1-43 and carboplatin intravenously (IV) over 30 minutes and paclitaxel IV over 1 hour on days 1, 8, 15, 22, 36, and 43 in the absence of disease progression or unacceptable toxicity. Patients without disease progression after completion of chemoradiotherapy undergo consolidation therapy.

CONSOLIDATION THERAPY: Beginning within 4-6 weeks of chemotherapy and radiation therapy, patients receive veliparib PO BID on days 1-7 (course 1) and 22-28 (course 2) and carboplatin IV over 30 minutes and paclitaxel IV over 3 hours on day 1 and on day 22 of course 2. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity.

PHASE II: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients undergo 3D-CRT and receive veliparib, carboplatin, and paclitaxel as in Phase I induction and consolidation therapy.

ARM II: Patients undergo 3D-CRT as in arm I. Patients also receive placebo PO BID on days 1-43 and carboplatin and paclitaxel as in Phase I. Within 4-6 weeks after completion of chemotherapy and radiation therapy, patients receive placebo on days 1-7 and carboplatin and paclitaxel as in Phase I.

After completion of study treatment, patients are followed up every 4 months for first 2 years and then every 6 months until 5 years.

Veliparib With or Without Radiation Therapy, Carboplatin, and Paclitaxel in Patients With Stage III Non-small Cell Lung Cancer That Cannot Be Removed by Surgery

A Dose Finding Study Followed by Phase II Randomized, Placebo-Controlled Study of Veliparib (ABT-888) Added to Chemoradiotherapy With Carboplatin and Paclitaxel for Unresectable Stage III Non-small Cell Lung Cancer (NSCLC), (NCI Study Number 8811)

DLTs will be graded using National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. DLTs must be attributable (probably, possibly, definitely related) to the study regimen and only occur during RT or 2 weeks after completing RT.

DLTs are defined as:

1. Radiation esophagitis or dermatitis radiation Grade 3 that lasts \> 7 consecutive days or Grade 4
2. Grade 4 neutropenia for \> 7 days or neutropenic fever ( ANC \<500 and temperature \>= 38.5 oC)
3. Grade 4 thrombocytopenia
4. Grade 4 nausea/vomiting despite appropriate antiemetic therapy
5. Delays in radiotherapy or chemotherapy or ABT-888 due to toxicity of \> 3 weeks
6. All other non-hematologic toxicities \>= Grade 3, except

   * anorexia
   * fatigue
   * infection without neutropenia
   * Grade 3 AST/ALT elevations \<= 7 days, infusion reactions
   * Grade 3 or 4 lymphopenia
   * Grade 3 or 4 electrolyte abnormalities that are corrected to \<=Grade 2 in \< 48 hours
   * Grade 3 dehydration lasting \< 7 days

Time from date of registration to date of first documentation of progression or symptomatic deterioration or death due to any cause. Participants last known to be alive are censored at date of last contact.

Assessed by Response Evaluation Criteria in Solid Tumors, RECIST 1.1

From date of registration to date of death due to any cause. Participants last known to be alive are censored at date of last contact.

ORR is defined as the percentage of participants with evidence of a confirmed complete response (CR) or partial response (PR) as per Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1

Adverse Events (AEs) are reported by CTCAE Version 4.0. Only adverse events that are possibly, probably or definitely related to study drug are reported.

Adverse Events (AEs) are reported by CTCAE Version 4.0.

21 participants in phase I and 31 participants in phase II who were eligible and received protocol therapy were assessed for AEs. 1 participant in phase II arm 1 did not receive protocol therapy so was not assessed for AEs. All cause modality analysis will include all eligible participants as participants at risk.

Participants undergo 3D-CRT and receive 40 mg veliparib, carboplatin, and paclitaxel during concurrent radiotherapy

Phase I 40 mg Veliparib Cohort

Participants undergo 3D-CRT and receive 80 mg veliparib, carboplatin, and paclitaxel during concurrent radiotherapy

Phase I 80 mg Veliparib Cohort

Participants undergo 3D-CRT and receive 120 mg veliparib, carboplatin, and paclitaxel during concurrent radiotherapy

Phase I 120 mg Veliparib Cohort

Phase II Arm I (Veliparib, 3D-CRT, Carboplatin, Paclitaxel)

Participants undergo 3D-CRT and receive placebo, carboplatin, and paclitaxel during concurrent radiotherapy

Phase II Arm II (Placebo, 3D-CRT, Carboplatin, Paclitaxel)

Participants receive 80 mg veliparib (PO twice daily, Days 1-7, Days 22-28), carboplatin, and paclitaxel for 2 cycles.

Phase I Consolidation 40mg Cohort

Phase I Consolidation 80mg Cohort

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Testing the Addition of an Anti-Cancer Drug, TRC102, to the Usual Chemotherapy Treatment (Pemetrexed, Cisplatin or Carboplatin) During Radiation Therapy for Stage III Non-Squamous Non-Small Cell Lung Cancer	NCT05198830	Lung Adenocarci... Lung Large Cell... Lung Non-Squamo... Stage III Lung ...	Carboplatin Cisplatin Computed Tomogr... Durvalumab Magnetic Resona... Methoxyamine Pemetrexed Positron Emissi... Radiation Thera...	18 Years -	National Cancer Institute (NCI)
Combination Chemotherapy, Radiation Therapy, and Bevacizumab in Treating Patients With Newly Diagnosed Stage III Non-small Cell Lung Cancer That Cannot Be Removed by Surgery	NCT00334815	Lung Adenocarci... Lung Adenosquam... Lung Large Cell... Lung Squamous C... Minimally Invas... Stage IIIA Lung... Stage IIIB Lung...	Bevacizumab Cisplatin Docetaxel Etoposide Filgrastim Pegfilgrastim Radiation Thera...	18 Years -	National Cancer Institute (NCI)
Veliparib With or Without Radiation Therapy, Carboplatin, and Paclitaxel in Patients With Stage III Non-small Cell Lung Cancer That Cannot Be Removed by Surgery	NCT01386385	Lung Adenocarci... Lung Adenocarci... Lung Large Cell... Lung Squamous C... Minimally Invas... Stage III Lung ... Stage IIIA Lung... Stage IIIB Lung...	3-Dimensional C... Carboplatin Laboratory Biom... Paclitaxel Placebo Adminis... Veliparib	18 Years -	National Cancer Institute (NCI)

Spots Global Cancer Trial Database for lung large cell carcinoma