Testing the Addition of a New Immunotherapy Drug, Atezolizumab (MPDL3280A), to the Usual Chemoradiation (CRT) Therapy Treatment for Limited Stage Small Cell Lung Cancer (LS-SCLC)
Limited Stage Lung Small Cell Carcinoma, Stage I Lung Cancer AJCC v8, Stage II Lung Cancer AJCC v8
About this trial
This is an interventional treatment trial for Limited Stage Lung Small Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Pathologically (histologically or cytologically) proven diagnosis of limited stage small cell lung cancer (Stage Tx, T1-T4, N0-3, M0, American Joint Committee on Cancer [AJCC] staging, 8th edition [Ed.]), within 60 days prior to registration
- Patients must have received one cycle of platinum/etoposide chemotherapy pre-registration (prior to study entry). Study registration must be within 21 days from day 1 of the pre-registration cycle of chemotherapy.
- Patients must have had measurable disease (per Response Evaluation Criteria in Solid Tumors [RECIST], version 1.1) prior to the required pre-registration cycle of platinum/etoposide chemotherapy
Minimal staging requirements include:
- History/physical examination within 30 days prior to registration
- Positron emission tomography (PET)/computed tomography (CT) scan for staging within 60 days prior to registration
CT chest and CT abdomen with IV contrast (unless contraindicated based on kidney function) within 60 days prior to registration; magnetic resonance imaging (MRI) abdomen with IV contrast allowed in place of CT abdomen
- Note: If contrast allergy exists, premedication per institutional guidelines should be performed prior to obtaining CT with contrast. The only exception to this is a documented life-threatening allergy
- MRI scan of the brain with contrast (preferred) or CT scan of the brain with contrast (allowable if there is a contraindication with MRI with contrast) within 30 days prior to registration
- Age >= 18
- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 within 30 days prior to registration
- Absolute neutrophil count (ANC) >= 1,500/cells/mm^3 (prior to pre-registration cycle)
- Platelet count >= 100,000 cells/mm^3 (prior to pre-registration cycle)
- Hemoglobin >= 9 g/dL (prior to pre-registration cycle)
- Total bilirubin =< 1.5 x upper limit of normal (ULN) (prior to pre-registration cycle)
- Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.0 x ULN (prior to pre-registration cycle)
- Adequate renal function within 30 days prior to registration defined as follows: Creatinine clearance >= 30 mL/min by the Cockcroft-Gault (C-G) equation
- Patients presenting with a pleural effusion will be eligible if thoracentesis is cytologically negative and non-bloody or if pleural fluid is too small a volume to effectively sample by thoracentesis and does not show increased metabolic activity on CT/PET imaging
- Negative serum pregnancy test within 14 days of registration for pre-menopausal women of childbearing potential
- The patient or a legally authorized representative must provide study-specific informed consent prior to study entry
- Hepatitis B/C testing prior to enrollment for patients that have not been tested before. Note: This is required even if the patient has never shown or had symptoms of hepatitis
- Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial
Exclusion Criteria:
- Definitive clinical or radiologic evidence of metastatic disease
- Definitive surgical resection of small cell lung cancer
- Prior invasive malignancy (except non-melanomatous skin cancer, localized prostate cancer, or any early stage cancer treated with curative intent resection) unless disease free for a minimum of 2 years (carcinoma in situ of the breast, oral cavity, or cervix are all permissible)
- More than 1 cycle of prior platinum-based chemotherapy for SCLC prior to enrollment; note that prior chemotherapy for a different cancer is allowable
- Any prior atezolizumab or other immunotherapy agent
- Prior radiotherapy to the lungs or mediastinum that would result in clinically significant overlap of radiation therapy fields; prior tangent fields for breast cancer with minimal overlap with target volumes are allowed per approval of study principal investigators (PIs)
- Patients with cytologically positive pleural or pericardial fluid are not eligible
- An active, known or suspected autoimmune disease. Patients are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger
- Active or prior documented inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis)
- History of allogeneic organ transplant
- History of primary immunodeficiency
Severe, active co-morbidity defined as follows:
- Known clinically significant liver disease, including active viral, alcoholic, or other hepatitis, cirrhosis, fatty liver, and inherited liver disease
- Any other diseases, metabolic dysfunction, physical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of an investigational drug or that may affect the interpretation of the results or render the patient at high risk from treatment complications
- Active tuberculosis
Active hepatitis B (chronic or acute) or hepatitis C infection. Note that if hepatitis status is unknown, hepatitis B/C testing is required
- Patients with past or resolved hepatitis B infection (defined as having a negative hepatitis B surface antigen [HBsAg]) test, a positive anti-HBc (antibody to hepatitis B core antigen), and a negative viral deoxyribonucleic acid (DNA) test (only obtained if HBsAg is found positive) are eligible
- Patients positive for hepatitis C virus (HCV) antibody are eligible only if polymerase chain reaction (PCR) is negative for HCV ribonucleic acid (RNA). (The HCV RNA test must be performed for patients who have a positive HCV antibody test.)
- Known immunosuppressive disease, for example history of bone marrow transplant or chronic lymphocytic leukemia (CLL)
- Chronic obstructive pulmonary disease (COPD) requiring chronic oral steroid therapy of > 10 mg prednisone daily or equivalent at the time of registration. Inhaled corticosteroids are not exclusionary
- Unstable angina and/or congestive heart failure requiring hospitalization within the last 3 months
- Transmural myocardial infarction within the last 3 months
- Clinically significant interstitial lung disease
- A condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses > 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease
- Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception for the duration of study treatment and for 180 days after the last dose of study drug (Arm 2); this exclusion is necessary because the treatment involved in this study may be significantly teratogenic
Sites / Locations
- University of Alabama at Birmingham Cancer Center
- Fairbanks Memorial Hospital
- Banner MD Anderson Cancer Center
- CTCA at Western Regional Medical Center
- Banner University Medical Center - Tucson
- University of Arizona Cancer Center-North Campus
- NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
- University of Arkansas for Medical Sciences
- Sutter Auburn Faith Hospital
- Alta Bates Summit Medical Center-Herrick Campus
- City of Hope Comprehensive Cancer Center
- Los Angeles County-USC Medical Center
- USC / Norris Comprehensive Cancer Center
- Memorial Medical Center
- UC Irvine Health/Chao Family Comprehensive Cancer Center
- Sutter Roseville Medical Center
- Sutter Medical Center Sacramento
- University of California Davis Comprehensive Cancer Center
- California Pacific Medical Center-Pacific Campus
- Gene Upshaw Memorial Tahoe Forest Cancer Center
- UCHealth University of Colorado Hospital
- Penrose-Saint Francis Healthcare
- UCHealth Memorial Hospital Central
- Memorial Hospital North
- Porter Adventist Hospital
- Poudre Valley Hospital
- Cancer Care and Hematology-Fort Collins
- UCHealth Greeley Hospital
- Littleton Adventist Hospital
- Medical Center of the Rockies
- Parker Adventist Hospital
- Beebe South Coastal Health Campus
- Helen F Graham Cancer Center
- Medical Oncology Hematology Consultants PA
- Beebe Health Campus
- GenesisCare USA - Aventura FP
- GenesisCare USA - Aventura
- Boca Raton Regional Hospital
- UM Sylvester Comprehensive Cancer Center at Coral Gables
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
- Holy Cross HospitalRecruiting
- Lee Memorial Health System
- Regional Cancer Center-Lee Memorial Health System
- University of Florida Health Science Center - Gainesville
- The Watson Clinic
- University of Miami Miller School of Medicine-Sylvester Cancer Center
- Miami Cancer Institute
- Orlando Health Cancer Institute
- Sacred Heart Hospital
- UM Sylvester Comprehensive Cancer Center at Plantation
- Moffitt Cancer Center
- Grady Health System
- Emory University Hospital Midtown
- Piedmont Hospital
- Emory University Hospital/Winship Cancer Institute
- Emory Saint Joseph's Hospital
- Piedmont Fayette Hospital
- CTCA at Southeastern Regional Medical Center
- Piedmont Newnan Hospital
- Memorial Health University Medical Center
- Lewis Cancer and Research Pavilion at Saint Joseph's/Candler
- Hawaii Cancer Care - Westridge
- Pali Momi Medical Center
- The Cancer Center of Hawaii-Pali Momi
- Hawaii Cancer Care Inc - Waterfront Plaza
- Queen's Cancer Cenrer - POB I
- Queen's Medical Center
- Straub Clinic and Hospital
- Kuakini Medical Center
- Queen's Cancer Center - Kuakini
- The Cancer Center of Hawaii-Liliha
- Saint Alphonsus Cancer Care Center-Boise
- Saint Luke's Cancer Institute - Boise
- Saint Alphonsus Cancer Care Center-Caldwell
- Saint Luke's Cancer Institute - Fruitland
- Saint Luke's Cancer Institute - Meridian
- Saint Luke's Cancer Institute - Nampa
- Saint Alphonsus Cancer Care Center-Nampa
- Saint Luke's Cancer Institute - Twin Falls
- Alton Memorial Hospital
- Rush - Copley Medical Center
- Illinois CancerCare-Bloomington
- Illinois CancerCare-Canton
- Illinois CancerCare-Carthage
- Northwestern University
- Rush University Medical Center
- University of Illinois
- Advocate Illinois Masonic Medical Center
- AMG Crystal Lake - Oncology
- Carle at The Riverfront
- Decatur Memorial Hospital
- Advocate Good Samaritan Hospital
- Carle Physician Group-Effingham
- Crossroads Cancer Center
- Elmhurst Memorial Hospital
- Illinois CancerCare-Eureka
- NorthShore University HealthSystem-Evanston Hospital
- Illinois CancerCare-Galesburg
- Western Illinois Cancer Treatment Center
- NorthShore University HealthSystem-Glenbrook Hospital
- Ingalls Memorial Hospital
- Advocate South Suburban Hospital
- NorthShore University HealthSystem-Highland Park Hospital
- Illinois CancerCare-Kewanee Clinic
- Northwestern Medicine Lake Forest Hospital
- AMG Libertyville - Oncology
- Illinois CancerCare-Macomb
- Carle Physician Group-Mattoon/Charleston
- Loyola University Medical Center
- Good Samaritan Regional Health Center
- Edward Hospital/Cancer Center
- Advocate Christ Medical Center
- Illinois CancerCare-Ottawa Clinic
- Advocate Lutheran General Hospital
- Illinois CancerCare-Pekin
- Illinois CancerCare-Peoria
- OSF Saint Francis Radiation Oncology at Peoria Cancer Center
- Methodist Medical Center of Illinois
- OSF Saint Francis Medical Center
- Illinois CancerCare-Peru
- Edward Hospital/Cancer Center?Plainfield
- Illinois CancerCare-Princeton
- Memorial Medical Center
- Carle Cancer Center
- Illinois CancerCare - Washington
- Midwestern Regional Medical Center
- IU Health North Hospital
- Parkview Regional Medical Center
- Goshen Center for Cancer Care
- Indiana University/Melvin and Bren Simon Cancer Center
- Community Cancer Center East
- Community Cancer Center South
- Franciscan Health Indianapolis
- Community Cancer Center North
- Community Howard Regional Health
- Franciscan Health Mooresville
- Baptist Health Floyd
- McFarland Clinic - Ames
- Physicians' Clinic of Iowa PC
- Mercy Hospital
- Oncology Associates at Mercy Medical Center
- Medical Oncology and Hematology Associates-West Des Moines
- Mercy Cancer Center-West Lakes
- Greater Regional Medical Center
- Mercy Medical Center - Des Moines
- Mission Cancer and Blood - Laurel
- Mercy Medical Center-West Lakes
- University of Kansas Cancer Center
- Olathe Health Cancer Center
- University of Kansas Cancer Center-Overland Park
- Salina Regional Health Center
- University of Kansas Health System Saint Francis Campus
- University of Kansas Hospital-Westwood Cancer Center
- Ascension Via Christi Hospitals Wichita
- Saint Elizabeth Healthcare Edgewood
- Baptist Health Hardin
- Baptist Health Lexington
- Saint Joseph Hospital East
- Norton Hospital Pavilion and Medical Campus
- The James Graham Brown Cancer Center at University of Louisville
- Baptist Health Louisville
- Norton Audubon Hospital and Medical Campus
- Norton Brownsboro Hospital and Medical Campus
- Baptist Health Paducah
- LSU Health Baton Rouge-North Clinic
- Louisiana Hematology Oncology Associates LLC
- Mary Bird Perkins Cancer Center
- Our Lady of the Lake Physicians Group - Medical Oncology
- Medical Center of Baton Rouge
- Mary Bird Perkins Cancer Center - Covington
- Mary Bird Perkins Cancer Center - Houma
- Terrebonne General Medical Center
- University Medical Center New Orleans
- Ochsner Medical Center Jefferson
- MaineHealth Coastal Cancer Treatment Center
- Waldo County General Hospital
- MaineHealth/SMHC Cancer Care and Blood Disorders-Biddeford
- Stephens Memorial Hospital
- Maine Medical Center-Bramhall Campus
- Penobscot Bay Medical Center
- MaineHealth Cancer Care Center of York County
- MaineHealth/SMHC Cancer Care and Blood Disorders-Sanford
- Maine Medical Center- Scarborough Campus
- Maine Medical Partners - South Portland
- University of Maryland/Greenebaum Cancer Center
- Saint Agnes Hospital
- UM Upper Chesapeake Medical Center
- Central Maryland Radiation Oncology in Howard County
- UM Baltimore Washington Medical Center/Tate Cancer Center
- Dana-Farber Cancer Institute
- Steward Saint Elizabeth's Medical Center
- UMass Memorial Medical Center - University Campus
- Saint Joseph Mercy Hospital
- Bronson Battle Creek
- McLaren Cancer Institute-Bay City
- Saint Joseph Mercy Brighton
- Henry Ford Cancer Institute-Downriver
- Saint Joseph Mercy Canton
- Caro Cancer Center
- Saint Joseph Mercy Chelsea
- McLaren Cancer Institute-Clarkston
- Michigan Healthcare Professionals Clarkston
- Henry Ford Macomb Hospital-Clinton Township
- Beaumont Hospital - Dearborn
- Henry Ford Hospital
- Ascension Saint John Hospital
- Michigan Healthcare Professionals Farmington
- Beaumont Hospital - Farmington Hills
- Genesys Hurley Cancer Institute
- McLaren Cancer Institute-Flint
- Singh and Arora Hematology Oncology PC
- Spectrum Health at Butterworth Campus
- Allegiance Health
- West Michigan Cancer Center
- Karmanos Cancer Institute at McLaren Greater Lansing
- Mid-Michigan Physicians-Lansing
- Sparrow Hospital
- McLaren Cancer Institute-Lapeer Region
- Trinity Health Saint Mary Mercy Livonia Hospital
- Michigan Healthcare Professionals Macomb
- Michigan Healthcare Professionals Madison Heights
- McLaren Cancer Institute-Macomb
- Trinity Health Muskegon Hospital
- Cancer and Hematology Centers of Western Michigan - Norton Shores
- Ascension Providence Hospitals - Novi
- McLaren Cancer Institute-Northern Michigan
- 21st Century Oncology-Pontiac
- McLaren-Port Huron
- William Beaumont Hospital-Royal Oak
- Ascension Saint Mary's Hospital
- Oncology Hematology Associates of Saginaw Valley PC
- Lakeland Medical Center Saint Joseph
- Marie Yeager Cancer Center
- Henry Ford Macomb Health Center - Shelby Township
- Ascension Providence Hospitals - Southfield
- Ascension Saint Joseph Hospital
- William Beaumont Hospital - Troy
- GenesisCare USA - Troy
- Saint John Macomb-Oakland Hospital
- Saint Mary's Oncology/Hematology Associates of West Branch
- University of Michigan Health - West
- Mayo Clinic Health System in Albert Lea
- Sanford Joe Lueken Cancer Center
- Fairview Ridges Hospital
- Minnesota Oncology - Burnsville
- Mercy Hospital
- Saint Luke's Hospital of Duluth
- Fairview Southdale Hospital
- Unity Hospital
- Mayo Clinic Health Systems-Mankato
- Minnesota Oncology Hematology PA-Maplewood
- Abbott-Northwestern Hospital
- Hennepin County Medical Center
- North Memorial Medical Health Center
- Mayo Clinic in Rochester
- Coborn Cancer Center at Saint Cloud Hospital
- Park Nicollet Clinic - Saint Louis Park
- Regions Hospital
- United Hospital
- Baptist Cancer Center-Grenada
- Baptist Memorial Hospital and Cancer Center-Union County
- Baptist Memorial Hospital and Cancer Center-Oxford
- Baptist Memorial Hospital and Cancer Center-Desoto
- Parkland Health Center-Bonne Terre
- Saint Francis Medical Center
- Saint Luke's Hospital
- Siteman Cancer Center at West County Hospital
- Parkland Health Center - Farmington
- Capital Region Southwest Campus
- Freeman Health System
- University of Kansas Cancer Center - North
- University of Kansas Cancer Center - Lee's Summit
- University of Kansas Cancer Center at North Kansas City Hospital
- Delbert Day Cancer Institute at PCRMC
- Heartland Regional Medical Center
- Washington University School of Medicine
- Siteman Cancer Center-South County
- Missouri Baptist Medical Center
- Siteman Cancer Center at Christian Hospital
- Mercy Hospital Saint Louis
- Siteman Cancer Center at Saint Peters Hospital
- Sainte Genevieve County Memorial Hospital
- Mercy Hospital Springfield
- CoxHealth South Hospital
- Missouri Baptist Sullivan Hospital
- Missouri Baptist Outpatient Center-Sunset Hills
- Billings Clinic Cancer Center
- Bozeman Deaconess Hospital
- Saint James Community Hospital and Cancer Treatment Center
- Benefis Healthcare- Sletten Cancer Institute
- Kalispell Regional Medical Center
- CHI Health Saint Francis
- CHI Health Good Samaritan
- Cancer Partners of Nebraska - Pine Lake
- Southeast Nebraska Cancer Center - 68th Street Place
- Nebraska Methodist Hospital
- Alegent Health Immanuel Medical Center
- Alegent Health Bergan Mercy Medical Center
- University of Nebraska Medical Center
- OptumCare Cancer Care at Charleston
- Radiation Oncology Centers of Nevada Central
- Radiation Oncology Centers of Nevada Southeast
- OptumCare Cancer Care at Fort Apache
- Renown Regional Medical Center
- New Hampshire Oncology Hematology PA-Concord
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
- Solinsky Center for Cancer Care
- Ocean University Medical Center
- The Cancer Institute of New Jersey Hamilton
- Monmouth Medical Center Southern Campus
- Monmouth Medical Center
- Southern Ocean County Medical Center
- Jersey Shore Medical Center
- Rutgers Cancer Institute of New Jersey
- Capital Health Medical Center-Hopewell
- Riverview Medical Center/Booker Cancer Center
- Robert Wood Johnson University Hospital Somerset
- Community Medical Center
- University of New Mexico Cancer Center
- Montefiore Medical Center-Einstein Campus
- Montefiore Medical Center - Moses Campus
- Cancer Institute at Saint Francis Hospital
- Hematology Oncology Associates of Central New York-East Syracuse
- Arnot Ogden Medical Center/Falck Cancer Center
- Glens Falls Hospital
- Mount Sinai Chelsea
- Mount Sinai West
- Mount Sinai Hospital
- University of Rochester
- State University of New York Upstate Medical University
- Good Samaritan Hospital Medical Center
- Atrium Health Stanly/LCI-Albemarle
- Randolph Hospital
- Messino Cancer Centers
- Cone Health Cancer Center at Alamance Regional
- Carolinas Medical Center/Levine Cancer Institute
- Novant Health Presbyterian Medical Center
- Atrium Health Pineville/LCI-Pineville
- Levine Cancer Institute-SouthPark
- Atrium Health University City/LCI-University
- Levine Cancer Institute-Ballantyne
- Atrium Health Cabarrus/LCI-Concord
- Cone Health Cancer Center
- Margaret R Pardee Memorial Hospital
- Novant Health Cancer Institute - Kernersville
- Atrium Health Union/LCI-Union
- Novant Health Cancer Institute - Mount Airy
- FirstHealth of the Carolinas-Moore Regional Hospital
- Novant Health Cancer Institute - Statesville
- Novant Health Cancer Institute - Thomasville
- Novant Health Cancer Institute - Wilkesboro
- Novant Health Forsyth Medical Center
- Wake Forest University Health Sciences
- Sanford Bismarck Medical Center
- Sanford Roger Maris Cancer Center
- Altru Cancer Center
- Trinity Cancer Care Center
- Summa Health System - Akron Campus
- Summa Health System - Barberton Campus
- UHHS-Chagrin Highlands Medical Center
- Cleveland Clinic Mercy Hospital
- Aultman Health Foundation
- Geauga Hospital
- Adena Regional Medical Center
- University of Cincinnati Cancer Center-UC Medical Center
- Case Western Reserve University
- MetroHealth Medical Center
- Cleveland Clinic Cancer Center/Fairview Hospital
- Cleveland Clinic Foundation
- Ohio State University Comprehensive Cancer Center
- Mount Carmel East Hospital
- Riverside Methodist Hospital
- Grant Medical Center
- The Mark H Zangmeister Center
- Mount Carmel Health Center West
- Doctors Hospital
- Delaware Health Center-Grady Cancer Center
- Dublin Methodist Hospital
- Mount Carmel Grove City Hospital
- Cleveland Clinic Cancer Center Independence
- Saint Rita's Medical Center
- OhioHealth Mansfield Hospital
- Cleveland Clinic Cancer Center Mansfield
- Marietta Memorial Hospital
- Hillcrest Hospital Cancer Center
- Summa Health Medina Medical Center
- UH Seidman Cancer Center at Lake Health Mentor Campus
- UH Seidman Cancer Center at Southwest General Hospital
- Licking Memorial Hospital
- University Hospitals Parma Medical Center
- Mercy Health Perrysburg Cancer Center
- Southern Ohio Medical Center
- University Hospitals Portage Medical Center
- North Coast Cancer Care
- UH Seidman Cancer Center at Firelands Regional Medical Center
- Cleveland Clinic Cancer Center Strongsville
- Saint Vincent Mercy Medical Center
- Mercy Health - Saint Anne Hospital
- University Hospitals Sharon Health Center
- University of Cincinnati Cancer Center-West Chester
- Saint Ann's Hospital
- UH Seidman Cancer Center at Saint John Medical Center
- UHHS-Westlake Medical Center
- Cleveland Clinic Wooster Family Health and Surgery Center
- Genesis Healthcare System Cancer Care Center
- Cancer Centers of Southwest Oklahoma Research
- University of Oklahoma Health Sciences Center
- Mercy Hospital Oklahoma City
- Cancer Treatment Centers of America
- Legacy Mount Hood Medical Center
- Providence Newberg Medical Center
- Legacy Good Samaritan Hospital and Medical Center
- Providence Portland Medical Center
- Providence Saint Vincent Medical Center
- Lehigh Valley Hospital-Cedar Crest
- Lehigh Valley Hospital - Muhlenberg
- Crozer-Keystone Regional Cancer Center at Broomall
- Bryn Mawr Hospital
- Carlisle Regional Cancer Center
- Christiana Care Health System-Concord Health Center
- Geisinger Medical Center
- Northeast Radiation Oncology Center
- Ephrata Cancer Center
- UPMC Cancer Center at UPMC Horizon
- Adams Cancer Center
- Crozer Regional Cancer Center at Brinton Lake
- Cherry Tree Cancer Center
- UPMC Pinnacle Cancer Center/Community Osteopathic Campus
- Lancaster General Ann B Barshinger Cancer Institute
- Lancaster General Hospital
- Sechler Family Cancer Center
- Geisinger Medical Oncology-Lewisburg
- UPMC Hillman Cancer Center at Rocco And Nancy Ortenzio Cancer Pavilion
- Riddle Memorial Hospital
- Bryn Mawr Health Center
- Paoli Memorial Hospital
- Thomas Jefferson University Hospital
- Jefferson Torresdale Hospital
- Eastern Regional Medical Center
- Allegheny General Hospital
- University of Pittsburgh Cancer Institute (UPCI)
- UPMC-Shadyside Hospital
- Guthrie Medical Group PC-Robert Packer Hospital
- Reading Hospital
- Geisinger Wyoming Valley/Henry Cancer Center
- Lankenau Medical Center
- WellSpan Health-York Cancer Center
- UPMC Memorial
- Rhode Island Hospital
- AnMed Health Cancer Center
- Saint Joseph's/Candler - Bluffton Campus
- Medical University of South Carolina
- Saint Francis Hospital
- Prisma Health Cancer Institute - Faris
- Saint Francis Cancer Center
- Prisma Health Cancer Institute - Eastside
- Prisma Health Cancer Institute - Greer
- Gibbs Cancer Center-Pelham
- South Carolina Cancer Specialists PC
- The Radiation Oncology Center-Hilton Head/Bluffton
- Carolina Regional Cancer Center
- Rock Hill Radiation Therapy Center
- Levine Cancer Institute-Rock Hill
- Prisma Health Cancer Institute - Seneca
- Spartanburg Medical Center
- Rapid City Regional HospitalRecruiting
- Sanford Cancer Center Oncology Clinic
- Sanford USD Medical Center - Sioux Falls
- Baptist Memorial Hospital and Cancer Center-Collierville
- Thompson Cancer Survival Center
- Baptist Memorial Hospital and Cancer Center-Memphis
- MD Anderson in The Woodlands
- Houston Methodist Hospital
- M D Anderson Cancer Center
- MD Anderson West Houston
- Houston Methodist West Hospital
- MD Anderson League City
- Covenant Medical Center-Lakeside
- Houston Methodist Saint John Hospital
- MD Anderson in Sugar Land
- Houston Methodist Sugar Land Hospital
- Houston Methodist The Woodlands Hospital
- Huntsman Cancer Institute/University of Utah
- Central Vermont Medical Center/National Life Cancer Treatment
- University of Vermont Medical Center
- Norris Cotton Cancer Center-North
- University of Virginia Cancer Center
- Augusta Health Center for Cancer and Blood Disorders
- VCU Massey Cancer Center at Stony Point
- Virginia Commonwealth University/Massey Cancer Center
- Providence Regional Cancer System-Aberdeen
- Harrison HealthPartners Hematology and Oncology-Bremerton
- Harrison Medical Center
- Providence Regional Cancer System-Lacey
- Legacy Salmon Creek Hospital
- Edwards Comprehensive Cancer Center
- West Virginia University Healthcare
- Wheeling Hospital/Schiffler Cancer Center
- Langlade Hospital and Cancer Center
- ThedaCare Regional Cancer Center
- Aurora Cancer Care-Southern Lakes VLCC
- Marshfield Medical Center-EC Cancer Center
- Mayo Clinic Health System-Eau Claire Clinic
- Aurora Health Care Germantown Health Center
- Aurora Cancer Care-Grafton
- Bellin Memorial Hospital
- Aurora BayCare Medical Center
- UW Cancer Center Johnson Creek
- Aurora Cancer Care-Kenosha South
- Gundersen Lutheran Medical Center
- Mayo Clinic Health System-Franciscan Healthcare
- University of Wisconsin Carbone Cancer Center
- Aurora Bay Area Medical Group-Marinette
- Marshfield Medical Center-Marshfield
- Aurora Cancer Care-Milwaukee
- Aurora Saint Luke's Medical Center
- Aurora Sinai Medical Center
- Zablocki Veterans Administration Medical Center
- Marshfield Clinic-Minocqua Center
- ProHealth D N Greenwald Center
- Cancer Center of Western Wisconsin
- ProHealth Oconomowoc Memorial Hospital
- Vince Lombardi Cancer Clinic - Oshkosh
- Aurora Cancer Care-Racine
- Marshfield Medical Center-Rice Lake
- Vince Lombardi Cancer Clinic-Sheboygan
- Marshfield Medical Center-River Region at Stevens Point
- Aurora Medical Center in Summit
- Vince Lombardi Cancer Clinic-Two Rivers
- UW Cancer Center at ProHealth Care
- Aspirus Regional Cancer Center
- Aurora Cancer Care-Milwaukee West
- Aurora West Allis Medical Center
- Diagnostic and Treatment CenterRecruiting
- Marshfield Medical Center - Weston
- Aspirus Cancer Care - Wisconsin Rapids
- Tohoku University School of MedicineRecruiting
- Ehime University HospitalRecruiting
- Hokkaido University Hospital
- Kagoshima City HospitalRecruiting
- Gunma University HospitalRecruiting
- Niigata University Medical and Dental HospitalRecruiting
- Kyorin University HospitalRecruiting
- Hiroshima University HospitalRecruiting
- Shikoku Cancer CenterRecruiting
- Saitama Medical University International Medical CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Arm I (etoposide, cisplatin, carboplatin, radiation therapy)
Arm II (etoposide, cisplatin, carboplatin, radiation therapy)
Patients receive etoposide IV on days 1-3 and cisplatin IV or carboplatin IV on day 1. Cycles repeat every 21 days for 3 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo 3D-CRT or IMRT BID for approximately 3 weeks or QD for approximately 6-7 weeks in the absence of disease progression or unacceptable toxicity. Patients undergo blood specimen collection throughout the trial.
Patients receive treatment as in Arm I. Patients also receive atezolizumab IV over 30-60 minutes on day 1 or 2 of each chemotherapy cycle. Cycles repeat every 3 weeks for 17 cycles (1 year) in the absence of disease progression or unacceptable toxicity. Patients undergo blood specimen collection throughout the trial.