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Brief Title: Anti-PD-L1 in Stage IIIA(N2) Non-small Cell Lung Cancer (NSCLC)
Official Title: Anti-PD-L1 Antibody MEDI4736 in Addition to Neoadjuvant Chemotherapy in Patients With Stage IIIA(N2) Non-small Cell Lung Cancer (NSCLC). A Multicenter Single-arm Phase II Trial.
Study ID: NCT02572843
Brief Summary: The objective of the trial is to demonstrate that the addition of neoadjuvant and adjuvant immunotherapy (with the anti-PD-L1 antibody MEDI4736) to standard neoadjuvant chemotherapy (with cisplatin/docetaxel) in primary resectable stage IIIA(N2) NSCLC is efficacious and feasible.
Detailed Description: Despite multimodal therapy, the cure rate of patients with stage IIIA NSCLC is poor and therapy outcome failed to improve during the past years. The addition of immunotherapy with the anti-PD-L1 antibody MEDI4736 as a novel treatment modality has the potential to improve the outcome without adding substantial toxicity to an otherwise intensive multimodality treatment, as MEDI4736 has been generally well tolerated. Based on the current evidence on immune checkpoint inhibition, there is a strong rationale to test this novel treatment modality also in the curative setting in order to improve local tumor control and prevent distant metastasis to improve the cure rate in this patient population. The trial investigates the addition of pre- and post-operative immune checkpoint inhibition with MEDI4736 to the previously established standard of care for stage IIIA(N2) patients, which is based on the trials SAKK16/96 and SAKK16/00. Patients whose tumor is deemed resectable at diagnosis will receive 3 cycles (21 days each) of standard chemotherapy with cisplatin (100 mg/m2) / docetaxel (85 mg/m2), followed by 2 cycles (14 days each) of neoadjuvant immunotherapy with MEDI4736 750 mg. Following surgery, patients with complete resection (R0) of their tumor will be administered adjuvant treatment with MEDI4736 750 mg for up to one year or until recurrence, death, unacceptable toxicity or consent withdrawal (whichever occurs first). Patients with incomplete R1/R2 resection, including patients with extracapsular spread of mediastinal lymph node metastases, may undergo standard radiotherapy prior to adjuvant treatment with MEDI4736.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Stadtspital Triemli, Zürich, Zurich, Switzerland
Kantonsspital Aarau, Aarau, , Switzerland
Kantonsspital Baden, Baden, , Switzerland
St. Claraspital Basel, Basel, , Switzerland
Universitaetsspital Basel, Basel, , Switzerland
IOSI Ospedale Regionale di Bellinzona e Valli, Bellinzona, , Switzerland
Inselspital Bern, Bern, , Switzerland
Kantonsspital Graubuenden, Chur, , Switzerland
Spital Thurgau AG, Frauenfeld, , Switzerland
Hopital Fribourgeois HFR, Fribourg, , Switzerland
Hopital Cantonal Universitaire de Geneve, Geneva, , Switzerland
CCAC Lausanne, Lausanne, , Switzerland
Centre hospitalier universitaire vaudois CHUV, Lausanne, , Switzerland
Luzerner Kantonsspital, Luzern, , Switzerland
Kantonsspital St. Gallen, St. Gallen, , Switzerland
Regionalspital, Thun, , Switzerland
Kantonsspital Winterthur, Winterthur, , Switzerland
Klinik Hirslanden Onkozentrum Zürich, Zurich, , Switzerland
UniversitaetsSpital Zuerich, Zurich, , Switzerland
Name: Sacha Rothschild, MD, PhD
Affiliation: University Hospital, Basel, Switzerland
Role: STUDY_CHAIR