A Study to Evaluate the Efficacy and Safety of Multiple Targeted Therapies as Treatments for Participants With Non-Small Cell Lung Cancer (NSCLC) (B-FAST)
Non-Small Cell Lung Cancer
About this trial
This is an interventional treatment trial for Non-Small Cell Lung Cancer
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed diagnosis of unresectable Stage IIIb not amenable to treatment with combined modality chemoradiation (advanced) or Stage IV (metastatic) NSCLC
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2
- Measurable disease
- Adequate recovery from most recent systemic or local treatment for cancer
- Adequate organ function
- Life expectancy greater than or equal to (>/=) 12 weeks
- For female participants of childbearing potential and male participants, willingness to use acceptable methods of contraception
Exclusion Criteria:
- Inability to swallow oral medication
- Women who are pregnant or lactating
- Symptomatic, untreated CNS metastases
- History of malignancy other than NSCLC within 5 years prior to screening with the exception of malignancies with negligible risk of metastasis or death
- Significant cardiovascular disease, such as New York Heart Association cardiac disease (Class II or greater), myocardial infarction, or cerebrovascular accident within 3 months prior to randomization, unstable arrhythmias, or unstable angina
- Known human immunodeficiency virus (HIV) positivity or autoimmune deficiency syndrome (AIDS)-related illness
- Either a concurrent condition or history of a prior condition that places the patient at unacceptable risk if he/she were treated with the study drug or confounds the ability to interpret data from the study
- Inability to comply with other requirements of the protocol
Sites / Locations
- University of California San Diego
- UC Davis; Comprehensive Cancer Center
- Rocky Mountain Cancer Center
- Eastern Connecticut Hematology and Oncology Associates; (ECHO)
- SCRI Florida Cancer Specialists South
- Florida Cancer Specialist, North Region
- University Cancer & Blood Center, LLC; Research
- Illinois Cancer Care
- University of Kentucky; Markey Cancer Center
- University of Michigan Comprehensive Cancer Center
- Henry Ford Health System; Hematology/OncologyRecruiting
- Comprehensive Cancer Centers of Nevada
- Dartmouth Hitchcock Medical CenterRecruiting
- Cancer Inst. of New Jersey
- Montefiore Medical CenterRecruiting
- Weill Cornell Medical College-New York Presbyterian Hospital
- Ohio State University
- Oregon HSU
- St. Luke's University Health network
- SCRI Tennessee Oncology Chattanooga
- Tennessee Oncology PLLC - Nashville (20th Ave)Recruiting
- Texas Oncology - South Austin
- Oncology Consultants PA
- Virginia Cancer Specialists, PC
- University of Washington Seattle Cancer Care Alliance
- Fundación CENIT para la Investigación en NeurocienciasRecruiting
- Hospital ItalianoRecruiting
- Hospital Britanico de Buenos AiresRecruiting
- Centro Oncologico Riojano Integral (CORI)Recruiting
- Royal North Shore Hospital; Department of Medical Oncology
- The Prince Charles Hospital; Oncology Dept.
- Ashford Cancer Center Research
- Austin Hospital; Medical OncologyRecruiting
- Sir Charles Gairdner Hospital
- UZ BrusselRecruiting
- Cliniques Universitaires St-Luc
- UZ Leuven GasthuisbergRecruiting
- Instituto Nacional de Cancer - INCa; OncologiaRecruiting
- Oncosite - Centro de Pesquisa Clinica Em Oncologia LtdaRecruiting
- Hospital Sao Lucas - PUCRSRecruiting
- Instituto do Cancer do Estado de Sao Paulo - ICESPRecruiting
- Cross Cancer InstituteRecruiting
- CancerCare Manitoba; Department of Medical OncologyRecruiting
- Royal Victoria Regional Health Centre; c/o Oncology Clinical Trials
- William Osler Health System Brampton Civic HospitalRecruiting
- London Health Sciences Centre · Victoria Hospital; Department of Medicine
- Lakeridge Health Center; R. S. MacLaughlin Durham Regional Cancer CenterRecruiting
- Sunnybrook Health Sciences CentreRecruiting
- Princess Margaret Cancer CenterRecruiting
- Jewish General HospitalRecruiting
- IUCPQ (Hôpital Laval)
- Saskatoon Cancer CentreRecruiting
- BiocenterRecruiting
- Bradford Hill Centro de Investigaciones ClinicasRecruiting
- Beijing Cancer HospitalRecruiting
- Jilin Cancer HospitalRecruiting
- Hunan Cancer HospitalRecruiting
- The second Xiangya hospital of central south universityRecruiting
- Sichuan Cancer HospitalRecruiting
- West China Hospital - Sichuan UniversityRecruiting
- The First Affiliated Hospital of Guangzhou Medical University PharmacyRecruiting
- Zhejiang Cancer Hospital; Zhejiang Cancer Hospital cancer departmentRecruiting
- Harbin Medical University Cancer HospitalRecruiting
- Shandong Cancer HospitalRecruiting
- The Second Affiliated Hospital to Nanchang UniversityRecruiting
- Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical SchoolRecruiting
- Fudan Unviversity Shanghai Cancer CenterRecruiting
- Xiehe Hospital, Tongji Medical College Huazhong University of Science & TechnologyRecruiting
- First Affiliated Hospital of Medical College of Xi'an Jiaotong UniversityRecruiting
- The First Affiliated Hospital of Zhengzhou UniversityRecruiting
- Clinica CIMCARecruiting
- Institut Bergonie CLCC Bordeaux
- Centre Francois Baclesse; Radiologie
- Centre Oscar Lambret
- Centre Léon BérardRecruiting
- Hopital Caremeau; PneumologieRecruiting
- Hopital Bichat Claude Bernard; Oncologie Serv.
- Hôpital Européen Georges PompidouRecruiting
- Hopital Tenon;Pneumologie
- CHU Poitiers
- Hopital Pontchaillou
- CHU de Toulouse - Hôpital Larrey; Service de pneumologie et oncologie pneumologique
- Hopital Bretonneau; Pneumologie Oncologie
- Hopital Robert Schuman; PneumologieRecruiting
- Klinikum Chemnitz gGmbH
- Universitätsklinikum Düsseldorf; Klinik für Kardiologie, Pneumologie und Angiologie
- Universitätsklinikum Essen; Innere Klinik (Tumorforschung)
- Klinikum Esslingen; Klinik für Kardiologie, Angiologie und Pneumologie
- Asklepios-Fachklinik Muenchen-Gauting; Klinik Für Pneumologie
- Robert Bosch Krankenhaus; Pneumologie und pneumologische Onkologie
- Thoraxklinik Heidelberg gGmbH
- HSK Dr.-Horst-Schmidt-Kliniken Klinik für Innere Medizin III Onkologie Hämatologie und Palliativmed
- Pamela Youde Nethersole Eastern Hospital
- Queen Mary Hospital; Medicine & Respiratory
- Prince of Wales Hosp; Dept. Of Clinical OncRecruiting
- Soroka Medical Center; Oncology DeptRecruiting
- Rambam Health Care Campus; OncologyRecruiting
- Meir Medical Center; OncologyRecruiting
- Rabin MC; Davidof Center - Oncology InstituteRecruiting
- Chaim Sheba Medical Center; Oncology DeptRecruiting
- Sourasky / Ichilov Hospital; Dept. of OncologyRecruiting
- Istituto Nazionale per lo Studio e la Cura dei Tumori Fondazione G. PascaleRecruiting
- IRST Istituto Scientifico Romagnolo Per Lo Studio E Cura Dei Tumori, Sede Meldola; Oncologia MedicaRecruiting
- Irccs Centro Di Riferimento Oncologico (CRO)Recruiting
- Azienda Ospedaliera San Camillo ForlaniniRecruiting
- Asst Papa Giovanni XXIII; Oncologia MedicaRecruiting
- ASST di Cremona - Azienda Socio Sanitaria Territoriale di CremonaRecruiting
- Irccs Istituto Europeo di Oncologia (IEO); Divisione di OncologiaRecruiting
- Asst Di MonzaRecruiting
- Azienda Sanitaria Ospedaliera S Luigi Gonzaga; S.C.D.U. di Oncologia ToracicaRecruiting
- Fujita Health University Hospital
- National Cancer Center Hospital East
- Shikoku Cancer Center
- National Hospital Organization Kyushu Medical Center
- National Hospital Organization Kyushu Cancer Center
- Kyushu University Hospital
- Hiroshima University Hospital
- Kanazawa University Hospital
- Kanagawa Cancer Center
- University Hospital Kyoto Prefectural University of Medicine
- Kyoto University Hospital
- Sendai Kousei Hospital
- Tohoku University Hospital
- Niigata University Medical & Dental Hospital
- Niigata Cancer Center Hospital
- Okayama University Hospital
- Kindai University Hospital
- Saga University Hospital
- Shizuoka Cancer Center
- Juntendo University Hospital
- Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital
- The Cancer Institute Hospital of JFCR
- Kyorin University Hospital
- Wakayama Medical University Hospital
- National Hospital Organization Yamaguchi - Ube Medical Center
- National Cancer CenterRecruiting
- Chonnam National University Hwasun HospitalRecruiting
- Seoul National University HospitalRecruiting
- Asan Medical CenterRecruiting
- Yonsei University Health System/Severance HospitalRecruiting
- Hospital Angeles TijuanaRecruiting
- Health Pharma Professional ResearchRecruiting
- AVIX Investigación Clínica S.CRecruiting
- Oncologico Potosino
- UMCG
- Erasmus MC
- Auckland City HospitalRecruiting
- Hemato Oncología de Panamá Especializada
- Hospital Nacional Edgardo Rebagliati Martins; OncologiaRecruiting
- Instituto Nacional de Enfermedades NeoplasicasRecruiting
- Clinica Ricardo PalmaRecruiting
- Uniwersyteckie Centrum Kliniczne, Klinika Onkologii i RadioterapiiRecruiting
- Krakowski Szpital Specjalistyczny im sw.Jana Pawla IIRecruiting
- Warminsko-Mazurskie Centrum Chorób P?uc w Olsztynie; Oddzial onkologii z pododdzialem chemioterapiiRecruiting
- Mazowieckie Centrum Leczenia Chorob Pluc I Gruzlicy; Oddzial IiiRecruiting
- Wielkopolskie Centrum Pulmonologii i Torakochirurgii w PoznaniuRecruiting
- Narod.Inst.Onkol. im. M.Sklodowskiej - Curie-Panst.Inst.Bad; Klinika Nowot.Pluca i Klatki PiersRecruiting
- Moscow City Oncology Hospital #62
- Principal Military Clinical Hospital n.a. N.N. Burdenko
- FSBI Russian Oncology Research Center n.a. Blokhin of MOH RF
- S-Pb clinical scientific practical center of specialized kinds of medical care (oncological)Recruiting
- Saint-Petersburg City Clinical Oncology Dispensary
- Clinical Oncology Dispensary; Chemotherapy
- Clinical Center of SerbiaRecruiting
- University Hospital Medical Center Bezanijska kosaRecruiting
- Clinical Center Nis
- Institute for Pulmonary Diseases of Vojvodina; Clinic for Pulmonary OncologyRecruiting
- National University Hospital; National University Cancer Institute, Singapore (NCIS)
- National Cancer Centre; Medical OncologyRecruiting
- Insititut Catala D'OncologiaRecruiting
- Complejo Hospitalario Universitario de Santiago (CHUS) ; Servicio de OncologiaRecruiting
- Hospital Universitario Puerta de Hierro; Servicio de OncologiaRecruiting
- Hospital Quiron de Madrid; Servicio de OncologiaRecruiting
- Clinica Universitaria de Navarra; Servicio de OncologiaRecruiting
- Hospital General Univ. de AlicanteRecruiting
- Hospital Universitari Vall d'Hebron; OncologyRecruiting
- Hospital Clínic i Provincial; Servicio de Hematología y Oncología
- ICO Badalona - Hospital Germans Trias i PujolRecruiting
- Hospital General Universitario Gregorio Marañon; Servicio de OncologiaRecruiting
- Hospital Ramon y Cajal; Servicio de OncologiaRecruiting
- Hospital Universitario 12 de Octubre; Servicio de OncologiaRecruiting
- Centro Integral Oncologico Clara Campal; Servicio de OncologíaRecruiting
- Hospital Regional Universitario Carlos Haya; Servicio de OncologiaRecruiting
- Hospital Universitario Virgen del Rocio; Servicio de OncologiaRecruiting
- Hospital Clínico Universitario de Valencia; Servicio de OncologíaRecruiting
- Kaohsiung Chang Gung Memorial Hospital; Dept of Internal MedicineRecruiting
- National Taiwan Uni Hospital; Internal MedicineRecruiting
- Taipei Medical University HospitalRecruiting
- Taipei Veterans General Hospital; Chest Dept , Section of Thoracic OncologyRecruiting
- Chang Gung Medical Foundation - Linkou; Chest DeptRecruiting
- Chulalongkorn Hospital; Medical OncologyRecruiting
- Ramathibodi Hospital; Dept of Med.-Div. of Med. OncRecruiting
- Faculty of Med. Siriraj Hosp.; Med.-Div. of Med. OncologyRecruiting
- Prince of Songkla University; Division of Pulmonary Disease, Department of MedicineRecruiting
- Baskent University Adana Dr. Turgut Noyan Practice and Research Hospital; Medical OncologyRecruiting
- Akdeniz University Medical Faculty; Medical Oncology DepartmentRecruiting
- Trakya University Medical Faculty Research And Practice Hospital Medical Oncology DepartmentRecruiting
- Medipol University Medical Faculty; Oncology DepartmentRecruiting
- Marmara University Pendik Training and Research Hospital; Medikal OnkolojiRecruiting
- Medikal Park Izmir HospitalRecruiting
- Hacettepe Uni Medical Faculty Hospital; Oncology DeptRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Arm 8
Arm 9
Arm 10
Experimental
Experimental
Experimental
Experimental
Active Comparator
Active Comparator
Experimental
Experimental
Experimental
Experimental
Cohort A: Alectinib 600 Milligrams (mg)
Cohort B: Dose Finding Phase (DFP) Alectinib
Cohort B: Dose Expansion Phase (DEP) Alectinib
Cohort C: Atezolizumab 1200 mg
Cohort C: Pemetrexed, Cisplatin or Carboplatin
Cohort C: Gemcitabine, Cisplatin or Carboplatin
Cohort D: Entrectinib 600 Milligrams (mg)
Cohort E: Atezolizumab, Vemurafenib, and Cobimetinib
Cohort F: Atezolizumab, Bevacizumab, Carboplatin, and Pemetrexed
Cohort G: GDC-6036 or Docetaxel
This cohort includes participants with anaplastic lymphoma kinase (ALK) positive NSCLC. Participants will receive alectinib 600 mg orally twice in a day (BID) until disease progression, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort A is complete.
This cohort includes participants with rearranged during transfection (RET) positive NSCLC. Participants may receive alectinib 900 or 1200 mg orally BID until disease progression, unacceptable toxicity, withdrawal of consent or death if the recommended phase 2 dose (RP2D) is not established in any other clinical study. Participants may receive 750 mg or 600 mg, if it is unsafe to pursue the higher starting dose. Enrollment to Cohort B is complete.
This cohort includes participants with RET positive NSCLC. Participants will receive alectinib at the RP2D established in the DFP of Cohort B or a separate clinical study. Participants will continue receiving study treatment until disease progression, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort B is complete.
This cohort includes participants with bTMB positive NSCLC. Participants will receive atezolizumab at a dose of 1200 mg administered by IV infusion every 21 days (Q21D) until disease progression, loss of clinical benefit, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort C is complete.
This cohort includes participants with bTMB positive, non-squamous NSCLC. Participants will receive 4 or 6 cycles of treatment, with each cycle being 21 days in duration. Carboplatin at a dose of area under the concentration-time curve (AUC) of 5 or 6 IV or cisplatin at a dose of 75 milligrams per meter square (mg/m^2) IV on Day 1 of each cycle combined with pemetrexed at a dose of 500 mg/m^2 IV on Day 1 of each cycle. Pemetrexed may be continued as maintenance therapy every 21 days (Q21D) as per local standard of care. Enrollment to Cohort C is complete.
This cohort includes participants with bTMB positive, squamous NSCLC. Participants will receive 4 or 6 cycles of treatment, with each cycle being 21 days in duration. Gemcitabine 1250 mg/m^2 IV on Days 1 and 8 of every cycle and cisplatin 75 mg/m^2 IV on Day 1 Q21D or gemcitabine 1000 mg/m^2 IV on Days 1 and 8 of every cycle and carboplatin AUC 5 IV on Day 1 Q21D. Enrollment to Cohort C is complete.
This cohort includes participants with c-ros oncogene 1 positive (ROS1+) NSCLC. Participants will receive entrectinib 600 mg orally once a day (QD) until disease progression, unacceptable toxicity, withdrawal of consent or death. Enrollment to Cohort D is complete.
This cohort includes participants with BRAF V600 mutation. Participants will receive: atezolizumab 1680 mg IV Q4W after the run-in period; cobimetinib 60 mg orally (PO) QD on Days 1-21 of each cycle during the run-in and triple-combination periods; and vemurafenib 960 mg PO twice daily (BID) on Days 1-21 of the initial run-in period, then 720 mg PO BID on Days 1-22 of the initial run-in period and on Days 1-28 of each cycle during the triple-combination period. Enrollment to Cohort E is complete.
This cohort includes participants with EGFR exon 20+ NSCLC. Participants will receive atezolizumab + bevacizumab + carboplatin + pemetrexed for 4 or 6 induction cycles (cycle = 21 days). After induction therapy, participants will continue maintenance treatment with atezolizumab + bevacizumab + pemetrexed until disease progression, unacceptable toxicity, withdrawal of consent, or death. Enrollment to Cohort F is complete.
This cohort includes participants with KRAS G12C mutation. Participants will receive GDC-6036 PO QD or IV docetaxel Q3W (75 mg/m^2) until disease progression or unacceptable toxicity