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Study of Nivolumab-Ipilimumab and cfDNA in Lung Cancer (ATLAS)

Primary Purpose

Non Small Cell Lung Cancer

Status
Recruiting
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
cfDNA blood test
Nivolumab
Ipilimumab
Platinum-based Chemotherapy
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non Small Cell Lung Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age ≥ 18 years at the time of screening or age of consent.
  • Written informed consent obtained from the subject prior to performing any protocol-related procedures, including screening evaluations.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Weight ≥ 35 kg.
  • Must have a life expectancy of at least 12 weeks.
  • Recurrent or newly diagnosed metastatic non-small cell lung cancer
  • Tumor PDL1 status <50%.
  • Non-Squamous and squamous histologies are eligible
  • Histologies with targetable mutations are not eligible, regardless of prior treatment with tyrosine kinase inhibitors
  • No prior radiation, surgery or chemotherapy is allowed for the current diagnosis of non-small cell lung cancer
  • Adequate organ and marrow function

Exclusion Criteria:

  • Receipt of any conventional or investigational anticancer therapy within 21 days or palliative radiotherapy within 14 days prior to the scheduled first dose of study treatment.
  • Prior receipt of any immune-mediated therapy.
  • Incomplete surgical resection
  • Concurrent enrolment in another therapeutic clinical study. Enrolment in observational studies will be allowed.
  • Any toxicity (excluding alopecia) from prior standard therapy that has not been completely resolved to baseline at the time of consent.
  • Participants with prior history of myocardial infarction, transient ischemic attack, congestive heart failure ≥ Class 3 based on New York Heart Association Functional Classification or stroke within the past 3 months prior to the scheduled first dose of study treatment.
  • Active or prior documented autoimmune disorders within the past 3 years prior to the scheduled first dose of study treatment with exceptions.
  • Participants with confirmed human immunodeficiency virus (even if viral load is undetectable), chronic or active hepatitis B or C, or active hepatitis A.
  • History of primary immunodeficiency, solid organ transplantation, or active tuberculosis (by clinical evaluation that includes clinical history, physical examination and radiographic findings, and tuberculosis testing in line with local practice).
  • Other invasive malignancy within 2 years. Non-invasive malignancies (i.e., cervical carcinoma in situ, in situ prostate cancer, non-melanomatous carcinoma of the skin, ductal carcinoma in situ of the breast that has been surgically cured) are excluded from this definition.
  • Known allergy or hypersensitivity to investigational product formulations.
  • History of more than one event of infusion related reactions requiring permanent discontinuation of intravenous drug treatment.
  • Uncontrolled intercurrent illness including, but not limited to ongoing or active infection requiring antibiotic therapy, uncontrolled hypertension, bleeding diatheses, or psychiatric illness/social situations that would limit compliance with study requirements, substantially increase risk of incurring adverse events, or compromise the ability of the subject to give written informed consent.
  • Current or prior use of immunosuppressive medication within 14 days prior to the scheduled first dose of study treatment with exceptions.
  • Receipt of live, attenuated vaccine within 30 days prior to the scheduled first dose of study treatment - Major surgery within 28 days prior to scheduled first dose of study treatment or still recovering from prior surgery.
  • Females who are pregnant, lactating, or intend to become pregnant during their participation in the study.
  • Participants who are involuntarily incarcerated or are unable to willingly provide consent or are unable to comply with the protocol procedures.
  • Any condition that, in the opinion of the investigator, would interfere with safe administration or evaluation of the investigational products or interpretation of subject safety or study results.

Sites / Locations

  • Princess Margaret Cancer CentreRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Non-Small cell Lung Cancer

Arm Description

Nivolumab, intravenously (given by vein), once every 3 weeks Ipilimumab, intravenously (given by vein), once every 6 weeks Participants will have blood samples taken for cell free deoxyribonucleic acid (cfDNA) testing. If there is an increasing or stable tumor cfDNA, platinum-doublet chemotherapy will be given.

Outcomes

Primary Outcome Measures

Percentage of participants whose disease does not worsen (progression-free survival rate) at 6 months

Secondary Outcome Measures

Average percentage of tumor cfDNA detected in the blood (tumor cfDNA clearance rate) at 3 weeks
Average percentage of tumor cfDNA detected in the blood (tumor cfDNA clearance rate) at 12 weeks
Number participants with adverse events
Average time from the date of study enrolment until death (overall survival)

Full Information

First Posted
July 8, 2021
Last Updated
June 9, 2023
Sponsor
University Health Network, Toronto
Collaborators
Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT04966676
Brief Title
Study of Nivolumab-Ipilimumab and cfDNA in Lung Cancer
Acronym
ATLAS
Official Title
Beyond Chemotherapy: Nivolumab-Ipilimumab With cfDNA-guided Treatment Intensification as a Chemotherapy-sparing Strategy in Metastatic Non-small Cell Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 24, 2022 (Actual)
Primary Completion Date
November 1, 2025 (Anticipated)
Study Completion Date
November 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto
Collaborators
Bristol-Myers Squibb

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this research study is to look at how effective two drugs, nivolumab and ipilimumab, are for people with non-small lung cancer that has metastasized (has spread to other parts of the body) and to see what effects these drugs have on these tumors.
Detailed Description
The study will use a special blood test to evaluate the response of the cancer to treatment. This blood test will analyze tumor DNA present in the blood (deoxyribonucleic acid, molecules that contain instructions for the development and function of cells). Patients that do not have evidence of a good response using this blood test will also undergo a short course of chemotherapy in addition to nivolumab and ipilimumab.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non Small Cell Lung Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Non-Small cell Lung Cancer
Arm Type
Experimental
Arm Description
Nivolumab, intravenously (given by vein), once every 3 weeks Ipilimumab, intravenously (given by vein), once every 6 weeks Participants will have blood samples taken for cell free deoxyribonucleic acid (cfDNA) testing. If there is an increasing or stable tumor cfDNA, platinum-doublet chemotherapy will be given.
Intervention Type
Diagnostic Test
Intervention Name(s)
cfDNA blood test
Intervention Description
Blood sample will be taken for cfDNA testing
Intervention Type
Drug
Intervention Name(s)
Nivolumab
Intervention Description
Antineoplastic agent
Intervention Type
Drug
Intervention Name(s)
Ipilimumab
Intervention Description
Antineoplastic agent
Intervention Type
Combination Product
Intervention Name(s)
Platinum-based Chemotherapy
Intervention Description
May include carboplatin with gemcitabine, or paclitaxel or pemetrexed
Primary Outcome Measure Information:
Title
Percentage of participants whose disease does not worsen (progression-free survival rate) at 6 months
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Average percentage of tumor cfDNA detected in the blood (tumor cfDNA clearance rate) at 3 weeks
Time Frame
3 weeks
Title
Average percentage of tumor cfDNA detected in the blood (tumor cfDNA clearance rate) at 12 weeks
Time Frame
12 weeks
Title
Number participants with adverse events
Time Frame
4 years
Title
Average time from the date of study enrolment until death (overall survival)
Time Frame
4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years at the time of screening or age of consent. Written informed consent obtained from the subject prior to performing any protocol-related procedures, including screening evaluations. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Weight ≥ 35 kg. Must have a life expectancy of at least 12 weeks. Recurrent or newly diagnosed metastatic non-small cell lung cancer Tumor PDL1 status <50%. Non-Squamous and squamous histologies are eligible Histologies with targetable mutations (EGFR, ALK, ROS1) are not eligible, regardless of prior treatment with tyrosine kinase inhibitors No prior radiation, surgery or chemotherapy is allowed for the current diagnosis of non-small cell lung cancer Adequate organ and marrow function Exclusion Criteria: Receipt of any conventional or investigational anticancer therapy within 21 days or palliative radiotherapy within 14 days prior to the scheduled first dose of study treatment. Prior receipt of any immune-mediated therapy. Incomplete surgical resection Concurrent enrolment in another therapeutic clinical study. Enrolment in observational studies will be allowed. Any toxicity (excluding alopecia) from prior standard therapy that has not been completely resolved to baseline at the time of consent. Participants with prior history of myocardial infarction, transient ischemic attack, congestive heart failure ≥ Class 3 based on New York Heart Association Functional Classification or stroke within the past 3 months prior to the scheduled first dose of study treatment. Active or prior documented autoimmune disorders within the past 3 years prior to the scheduled first dose of study treatment with exceptions. Participants with confirmed human immunodeficiency virus (even if viral load is undetectable), chronic or active hepatitis B or C, or active hepatitis A. History of primary immunodeficiency, solid organ transplantation, or active tuberculosis (by clinical evaluation that includes clinical history, physical examination and radiographic findings, and tuberculosis testing in line with local practice). Other invasive malignancy within 2 years. Non-invasive malignancies (i.e., cervical carcinoma in situ, in situ prostate cancer, non-melanomatous carcinoma of the skin, ductal carcinoma in situ of the breast that has been surgically cured) are excluded from this definition. Known allergy or hypersensitivity to investigational product formulations. History of more than one event of infusion related reactions requiring permanent discontinuation of intravenous drug treatment. Uncontrolled intercurrent illness including, but not limited to ongoing or active infection requiring antibiotic therapy, uncontrolled hypertension, bleeding diatheses, or psychiatric illness/social situations that would limit compliance with study requirements, substantially increase risk of incurring adverse events, or compromise the ability of the subject to give written informed consent. Current or prior use of immunosuppressive medication within 14 days prior to the scheduled first dose of study treatment with exceptions. Receipt of live, attenuated vaccine within 30 days prior to the scheduled first dose of study treatment - Major surgery within 28 days prior to scheduled first dose of study treatment or still recovering from prior surgery. Females who are pregnant, lactating, or intend to become pregnant during their participation in the study. Participants who are involuntarily incarcerated or are unable to willingly provide consent or are unable to comply with the protocol procedures. Any condition that, in the opinion of the investigator, would interfere with safe administration or evaluation of the investigational products or interpretation of subject safety or study results.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Adrian Sacher, M.D.
Phone
416-946-4501
Ext
3550
Email
adrian.sacher@uhn.ca
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adrian Sacher, M.D.
Organizational Affiliation
Princess Margaret Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Adrian Sacher, M.D.
Phone
416-946-4501
Ext
3550
First Name & Middle Initial & Last Name & Degree
Adrian Sacher, M.D.

12. IPD Sharing Statement

Learn more about this trial

Study of Nivolumab-Ipilimumab and cfDNA in Lung Cancer

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