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Multiple Therapies for Stage III Non-Small Cell Lung Cancer

Phase 3
Recruiting
Research Sponsored by Hoffmann-La Roche
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Documented ALK fusion positivity by an eligible result from: centralized multiplex molecular testing of tumor tissue at the Sponsor's designated central laboratory under Study BX43361 or available results from a Sponsor pre-approved local, appropriately validated ALK fusion test on tumor tissue performed in a Clinical Laboratory Improvement Amendments certified or equivalent laboratory
Histologically or cytologically documented locally advanced, unresectable Stage III NSCLC of either squamous or non-squamous histology
Must not have
Grade >/= 2 peripheral neuropathy
Grade >/= 3 toxicities due to any prior therapy (e.g., RT) (excluding alopecia) that have not shown improvement or are not stable and are considered to interfere with current study drug
Timeline
Screening 3 weeks
Treatment Varies
Follow Up up to 5 years
Awards & highlights
No Placebo-Only Group
Pivotal Trial

Summary

This trial is testing different treatments to see how well they work and how safe they are. It focuses on patients with advanced lung cancer that cannot be removed by surgery and have specific biological markers. The goal is to find out if these treatments can stop the cancer from growing or spreading and improve patients' health.

Who is the study for?
This trial is for adults with Stage III Non-Small Cell Lung Cancer (NSCLC) who can swallow pills, have had prior chemo and radiotherapy without disease progression, and are expected to live at least 12 weeks. They must not be pregnant or planning pregnancy, agree to use contraception, and have no history of certain bone disorders or severe allergies.
What is being tested?
The study tests the effectiveness and safety of Entrectinib, Durvalumab, Alectinib in NSCLC patients with specific biomarkers. It requires a PET/CT scan for staging and uses electronic patient-reported outcomes for monitoring.
What are the potential side effects?
Potential side effects may include liver issues, digestive disturbances that affect medication absorption, nerve damage symptoms like peripheral neuropathy, immune system reactions leading to inflammation in various organs including lungs (pneumonitis), fatigue from anemia or other blood disorders.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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My cancer has a confirmed ALK fusion from an approved test.
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My lung cancer is at an advanced stage and cannot be removed by surgery.
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My cancer did not worsen during or after platinum-based chemo.
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My cancer has a ROS1 fusion confirmed by a specific test.
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I can take care of myself and am up and about more than half of my waking hours.
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I have had at least two rounds of platinum-based chemo with or before radiotherapy.
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My radiation therapy was between 54 Gy and 66 Gy, using advanced techniques.
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I can swallow pills whole without breaking them.
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I weigh at least 30 kg.
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My cancer's PD-L1 status is known, tested by a specific method.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I have moderate to severe numbness, tingling, or pain in my hands or feet.
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I have severe side effects from previous treatments that haven't improved.
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I have a family or personal history of bone disorders.
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I haven't had a severe infection or been hospitalized for one in the last 4 weeks.
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I have no major side effects from previous cancer treatments.
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I am not currently on any cancer treatments like chemotherapy.
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I cannot swallow pills.
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I have a hereditary sugar digestion problem.
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I haven't taken any strong immune system suppressing drugs in the last 2 weeks.
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I have severe liver problems, including issues with liver function or hepatitis.
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My lung cancer has a specific genetic change in the EGFR gene.
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I have been newly diagnosed with Stage III lung cancer that cannot be surgically removed.
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I have had severe lung inflammation from previous radiation therapy.
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I have fully recovered from any past surgeries before starting the study treatment.
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I have a stomach or bowel condition that affects how I absorb pills.
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I haven't had major surgery in the last 4 weeks and don't expect to need one during the study.
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I have been treated with ALK inhibitors before.
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I have previously been treated with specific immune therapies.
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I experience symptoms due to a very slow heartbeat.
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I have had severe side effects from past immunotherapy.
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I have lung conditions that affect my daily activities or need treatment.
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My NSCLC has specific ALK mutations.
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I have a hereditary condition that affects how my body processes certain sugars.
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I have active tuberculosis.
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I have a history of specific lung conditions or signs of lung inflammation on my recent chest scan.
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My cancer has spread to other parts of my body, such as the brain, bones, or lungs.
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I have had a previous transplant of stem cells or an organ.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~up to 5 years
This trial's timeline: 3 weeks for screening, Varies for treatment, and up to 5 years for reporting.

Treatment Details

Side effects data

From 2018 Phase 3 trial • 119 Patients • NCT02604342
21%
Constipation
16%
Anaemia
14%
Oedema peripheral
14%
Myalgia
13%
Back pain
12%
Asthenia
12%
Dyspnoea
10%
Cough
9%
Decreased appetite
9%
Upper Respiratory Tract Infection
8%
Blood bilirubin increased
8%
Pneumonia
6%
Diarrhoea
6%
Fatigue
6%
Headache
6%
Abdominal Pain
6%
Blood Creatinine Increased
6%
Bronchitis
5%
Arthralgia
5%
Electrocardiogram QT Prolonged
5%
Nasopharyngitis
4%
Nausea
4%
Pyrexia
4%
Vomiting
4%
Dizziness
3%
Acute kidney injury
3%
Musculoskeletal Chest Pain
3%
Pain in extremity
3%
Tinnitus
1%
Jaw fracture
1%
Ankle fracture
1%
Depression
1%
Blood creatine phosphokinase increased
1%
Deep vein thrombosis
1%
Cholelithiasis
1%
Haemoptysis
1%
Syncope
1%
Abscess jaw
1%
Skull fractured base
1%
Paraesthesia
1%
Death
1%
Myocardial infarction
1%
Cerebellar ataxia
1%
Osteoporotic fracture
1%
Invasive ductal breast carcinoma
1%
Diverticulitis
1%
Erysipelas
1%
H1N1 Influenza
1%
Pharyngitis
1%
Wound Complication
1%
Neuropathy peripheral
1%
Alopecia
1%
Epilepsy
1%
Abdominal pain
1%
Hypertension
100%
80%
60%
40%
20%
0%
Study treatment Arm
Experimental: Alectinib
Active Comparator: Premetrexed/Docetaxel

Awards & Highlights

No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.
Pivotal Trial
The final step before approval, pivotal trials feature drugs that have already shown basic safety & efficacy.

Trial Design

4Treatment groups
Experimental Treatment
Active Control
Group I: Cohort A2: ROS 1-positive (entrectinib arm)Experimental Treatment1 Intervention
Participants will receive entrectinib 600 mg orally once daily until completion of treatment period (3 years), or until disease progression, unacceptable toxicity, patient or physician decision to discontinue, or death, whichever occurs first. Cohort A2 has been closed to enrollment.
Group II: Cohort A1: ALK-Positive (alectinib arm)Experimental Treatment1 Intervention
Participants will receive alectinib 600 mg orally twice daily until completion of treatment period (3 years), or until disease progression, unacceptable toxicity, patient or physician decision to discontinue, or death, whichever occurs first
Group III: Cohort A2: ROS 1-positive (durvalumab arm)Active Control1 Intervention
Participants will receive 1500 mg of IV durvalumab every 4 weeks until completion of treatment period (1 year) or until disease progression, unacceptable toxicity, patient or physician decision to discontinue, or death, whichever occurs first Cohort A2 has been closed to enrollment.
Group IV: Cohort A1: ALK-positive (durvalumab arm)Active Control1 Intervention
Participants will receive 1500 mg of intravenous (IV) durvalumab every 4 weeks until completion of treatment period (1 year) or until disease progression, unacceptable toxicity, patient or physician decision to discontinue, or death, whichever occurs first
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Alectinib
2019
Completed Phase 3
~2810
Entrectinib
2014
Completed Phase 2
~360

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.
Mechanism Of Action
Side Effect Profile
Prior Approvals
Other Research
The most common treatments for Non-Small Cell Lung Cancer (NSCLC) include targeted therapies and immunotherapies. Targeted therapies focus on specific genetic mutations or biomarkers in cancer cells, such as EGFR mutations or ALK rearrangements, to inhibit their growth and spread while sparing normal cells. Immunotherapies, such as PD-1/PD-L1 inhibitors, boost the immune system's ability to recognize and attack cancer cells by preventing them from evading immune detection. These mechanisms are important for NSCLC patients as they enable personalized treatment approaches, potentially leading to better outcomes and fewer side effects.
Radiation-induced bystander and abscopal effects: important lessons from preclinical models.Mechanisms of tumor immunotherapy, with a focus on thoracic cancers.

Find a Location

Who is running the clinical trial?

Hoffmann-La RocheLead Sponsor
2,463 Previous Clinical Trials
1,103,006 Total Patients Enrolled
Clinical TrialsStudy DirectorHoffmann-La Roche
2,233 Previous Clinical Trials
902,116 Total Patients Enrolled

Media Library

Alectinib (Other) Clinical Trial Eligibility Overview. Trial Name: NCT05170204 — Phase 3
Non-Small Cell Lung Cancer Research Study Groups: Cohort A2: ROS 1-positive (entrectinib arm), Cohort A2: ROS 1-positive (durvalumab arm), Cohort A1: ALK-positive (durvalumab arm), Cohort A1: ALK-Positive (alectinib arm)
Non-Small Cell Lung Cancer Clinical Trial 2023: Alectinib Highlights & Side Effects. Trial Name: NCT05170204 — Phase 3
Alectinib (Other) 2023 Treatment Timeline for Medical Study. Trial Name: NCT05170204 — Phase 3
~81 spots leftby Aug 2032