Purpose

This is a phase 2, pragmatic, 1:1 randomized, open-label study that evaluates risk-adapted, proteomic-guided systemic therapy to improve 12-month progression free survival (PFS) among patients with previously untreated advanced non-small cell lung cancer.

Conditions

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Participants must have histologically confirmed non-small cell lung cancer that is metastatic or unresectable (stage IIIC or IV), deemed appropriate to receive standard of care immune checkpoint inhibitor-based therapy given with palliative intent. - Age ≥18 years at the time of consent. - Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (Karnofsky ≥50%). - Ability to understand and willingness to sign the informed consent form (ICF). - Stated ability and willingness to adhere to all protocol requirements while on study

Exclusion Criteria

  • Tumor with known sensitizing alteration in ALK, EGFR, HER2, MET exon 14, NTRK, RET, or ROS1. - Medical comorbidities precluding immune checkpoint inhibitor-based therapy per treating investgator's discretion. - Previous systemic therapy for metastatic Stage IIIC or IV NSCLC. Patients who previously completed systemic therapy for early stage or locally advanced NSCLC ≥ 80 days prior to trial registration are eligible for inclusion. - Any condition that in the opinion of the investigator would interfere with the participant's safety or compliance while on study

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Systemic immune checkpoint inhibitor (ICI)-based therapy informed by PROphet CB and CARG-TT
  • Drug: Systemic (ICI)-based therapy informed by the PROphet CB assay and the CARG-TT assessment.
    Pretreatment assessment with PROphet CB and CARG-TT, which will be used to determine which first-line systemic treatment participants in the intervention arm receive. Systemic treatment will be pre-determined by the trial, according to the results from PROphet CB and CARG-TT.
Active Comparator
Standard of Care
Standard of care (SOC) biomarker assessment and subsequent selection of SOC systemic therapy.
  • Drug: Standard of Care
    Standard of care (SOC) biomarker testing followed by first-line treatment with either anti-PD(L)1 Immune checkpoint inhibitor (ICI) monotherapy or anti-PD(L)1 ICI + chemotherapy.

Recruiting Locations

Enloe Health Regional Cancer Center
Chico, California 95926
Contact:
Ranjan Pathak, MD
530-332-7300
ranjan.pathak@enloe.org

Rideout Cancer Center
Marysville, California 95901
Contact:
Hoa Nguyen, MD
530-749-4400
nguyenh01@ah.org

University of California Davis Comprehensive Cancer Center
Sacramento, California 95817
Contact:
Surbhi Singhal, MD
916-734-3772
susinghal@health.ucdavis.edu

Tahoe Forest Cancer Center
Truckee, California 96161
Contact:
Thomas Semrad, MD
530-582-6450
tsemrad@tfhd.com

More Details

Status
Recruiting
Sponsor
University of California, Davis

Study Contact

Office of Clinical Research
(916) 734-3772
OCRReferral@health.ucdavis.edu

Detailed Description

Participants will be randomized to an intervention arm or a standard of care (SOC) arm. Participants in the intervention arm will undergo pretreatment assessment with PROphet Clinical Benefit (CB) and the Cancer and Aging Research Group Toxicity Tool (CARG-TT); data from the assessments will be used to select systemic therapy, which can be any SOC treatment that incorporates a Programmed death-ligand 1 (PD-(L)1) antibody with or without chemotherapy and/or with or without Cytotoxic T-lymphocyte associated protein 4 (CTLA4) antibody. Participants in the SOC arm will undergo SOC biomarker assessment and subsequent selection of SOC systemic therapy. The primary endpoint is 12-month progression free survival (PFS). The findings will be stratified according to participant performance status and tumor PD-L1 score. The hypothesis is that risk-adapted, proteomic-guided systemic therapy will improve PFS among patients with previously untreated advanced NSCLC compared to SOC systemic therapy.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.