138 Participants Needed

Radiation Therapy + Atezolizumab for Small Cell Lung Cancer

Recruiting at 414 trial locations
SM
PM
Nataniel H. Lester-Coll, MD | Central ...
Overseen ByNataniel H. Lester-Coll
Age: 18+
Sex: Any
Trial Phase: Phase 2 & 3
Sponsor: National Cancer Institute (NCI)
Must be taking: Atezolizumab
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Breakthrough TherapyThis drug has been fast-tracked for approval by the FDA given its high promise
Approved in 2 JurisdictionsThis treatment is already approved in other countries

Trial Summary

What is the purpose of this trial?

This phase II/III trial compares the effect of adding radiation therapy to the usual maintenance therapy with atezolizumab versus atezolizumab alone in patients who have already received atezolizumab plus chemotherapy for the treatment of small cell lung cancer that has spread outside of the lung or to other parts of the body (extensive stage). Immunotherapy with monoclonal antibodies, such as atezolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Giving radiation therapy in addition to atezolizumab may extend the time without extensive small cell lung cancer growing or spreading compared to atezolizumab alone.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you are on immunosuppressive treatments or steroids above a certain dose, you may not be eligible. It's best to discuss your specific medications with the trial team.

What data supports the effectiveness of the treatment Radiation Therapy + Atezolizumab for Small Cell Lung Cancer?

Research shows that adding atezolizumab to chemotherapy for extensive-stage small cell lung cancer (ES-SCLC) significantly improves survival outcomes compared to chemotherapy alone. Additionally, combining radiotherapy with immunotherapy like atezolizumab may enhance the body's immune response against tumors.12345

Is the combination of atezolizumab and radiation therapy safe for humans?

The combination of atezolizumab and radiation therapy has been studied in various trials and is generally well tolerated in humans. In a phase I trial for non-small cell lung cancer, the treatment was well tolerated, and the maximum tolerated dose of atezolizumab was established. Additionally, a study on bladder cancer also evaluated the safety of this combination, indicating it is safe for use in humans.13467

How is the treatment of radiation therapy combined with the drug atezolizumab unique for small cell lung cancer?

This treatment is unique because it combines atezolizumab, an immune checkpoint inhibitor that helps the immune system attack cancer cells, with radiation therapy, which may enhance the immune response against the tumor. This combination aims to improve outcomes for patients with small cell lung cancer by leveraging the potential synergistic effects of both therapies.34578

Research Team

QN

Quynh-Nhu Nguyen

Principal Investigator

NRG Oncology

Eligibility Criteria

This trial is for adults with extensive stage small cell lung cancer who've had some success (partial response or stable disease) after initial treatment with chemotherapy and Atezolizumab. They should have a good performance status, controlled HIV if present, no more than three liver metastases, and adequate organ function. Pregnant women, those with severe other diseases or conditions that could affect the trial's outcomes are excluded.

Inclusion Criteria

Study-specific informed consent provided by patient or legally authorized representative
My small cell lung cancer is confirmed and has spread.
I have had whole brain radiation for my brain metastases.
See 10 more

Exclusion Criteria

My autoimmune disease has been inactive for over 3 years or is under stable treatment.
I do not have recent heart issues or significant lung disease.
I have a condition that weakens my immune system or COPD needing long-term oral steroids.
See 6 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive atezolizumab intravenously every 21 days, with or without radiation therapy for 5 weeks

5 weeks
Weekly visits for radiation therapy, every 21 days for atezolizumab

Follow-up

Participants are monitored for safety and effectiveness after treatment

Up to 6 years
Every 3 months for 2 years, every 6 months for 3 years, then annually

Treatment Details

Interventions

  • Atezolizumab
  • Radiation Therapy
Trial OverviewThe RAPTOR trial is examining whether adding radiation therapy to standard immune therapy (Atezolizumab) improves outcomes in patients with extensive stage small cell lung cancer. It's a phase II/III study comparing the effects of combined radiation and Atezolizumab versus Atezolizumab alone after initial successful treatment.
Participant Groups
2Treatment groups
Experimental Treatment
Active Control
Group I: Arm II (atezolizumab, radiation therapy)Experimental Treatment6 Interventions
Patients receive atezolizumab IV over 30 minutes +/- 10 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo radiation therapy QD on days 1-5 during weeks 1-5 only. Patients undergo PET/CT scan, CT, and MRI throughout the trial. Patients also undergo blood and tissue collection throughout the trial.
Group II: Arm I (atezolizumab)Active Control5 Interventions
Patients receive atezolizumab IV over 30 minutes +/- 10 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo PET/CT scan, CT, and MRI throughout the trial. Patients also undergo blood and tissue collection throughout the trial.

Atezolizumab is already approved in United States, European Union for the following indications:

🇺🇸
Approved in United States as Tecentriq for:
  • Melanoma
  • Hepatocellular carcinoma
  • Small cell lung cancer
  • Non-small cell lung cancer
  • Urothelial carcinoma
🇪🇺
Approved in European Union as Tecentriq for:
  • Melanoma
  • Hepatocellular carcinoma
  • Small cell lung cancer
  • Non-small cell lung cancer
  • Urothelial carcinoma

Find a Clinic Near You

Who Is Running the Clinical Trial?

National Cancer Institute (NCI)

Lead Sponsor

Trials
14,080
Recruited
41,180,000+

NRG Oncology

Collaborator

Trials
242
Recruited
105,000+

Findings from Research

In a phase I study involving 20 patients with early-stage non-small cell lung cancer, the combination of stereotactic ablative radiotherapy (SABR) and the immune-checkpoint inhibitor atezolizumab was well tolerated, with the maximum tolerated dose established at 1200 mg.
Early efficacy signals were observed, with 17% of patients showing responses after two cycles of atezolizumab before starting SABR, and specific biomarkers indicating T cell activation were found to be predictive of treatment benefit.
Atezolizumab plus stereotactic ablative radiotherapy for medically inoperable patients with early-stage non-small cell lung cancer: a multi-institutional phase I trial.Monjazeb, AM., Daly, ME., Luxardi, G., et al.[2023]
In a study of 99 previously untreated patients with extensive disease small cell lung cancer (ED-SCLC), adding atezolizumab to the standard carboplatin and etoposide regimen significantly improved overall survival, extending it to 20.8 months compared to 12.1 months for those receiving carboplatin and etoposide alone.
While there was no significant difference in progression-free survival between the two treatment groups, certain subgroups (such as older patients, males, and those with better health status) showed particularly enhanced survival benefits from the addition of atezolizumab, indicating its potential for personalized treatment approaches.
Atezolizumab addition to platinum doublet: evaluating survival outcomes for patients with extensive disease small cell lung cancer.Kubo, S., Kobayashi, N., Matsumoto, H., et al.[2023]
In a phase I trial involving 38 patients with extensive-stage small cell lung cancer, the combination of pembrolizumab and thoracic radiotherapy was found to be safe, with no dose-limiting toxicities observed in the first 35 days of treatment.
The median progression-free survival was 6.1 months and overall survival was 8.4 months, suggesting that while the safety profile is promising, further studies are needed to fully understand the efficacy of this combined treatment approach.
Phase I Trial of Pembrolizumab and Radiation Therapy after Induction Chemotherapy for Extensive-Stage Small Cell Lung Cancer.Welsh, JW., Heymach, JV., Chen, D., et al.[2023]

References

Atezolizumab plus stereotactic ablative radiotherapy for medically inoperable patients with early-stage non-small cell lung cancer: a multi-institutional phase I trial. [2023]
Atezolizumab addition to platinum doublet: evaluating survival outcomes for patients with extensive disease small cell lung cancer. [2023]
Phase I Trial of Pembrolizumab and Radiation Therapy after Induction Chemotherapy for Extensive-Stage Small Cell Lung Cancer. [2023]
Protocol of the TREASURE study: Thoracic RadiothErapy with Atezolizumab in Small cell lUng canceR Extensive disease - a randomized, open-label, multicenter phase II trial. [2022]
Atezolizumab: A Review in Extensive-Stage SCLC. [2021]
Efficacy and Safety of Bladder Preservation Therapy in Combination with Atezolizumab and Radiation Therapy (BPT-ART) for Invasive Bladder Cancer: Interim Analysis from a Multicenter, Open-label, Prospective Phase 2 Trial. [2023]
A Pilot Study of Atezolizumab Plus Hypofractionated Image Guided Radiation Therapy for the Treatment of Advanced Non-Small Cell Lung Cancer. [2021]
8.Czech Republicpubmed.ncbi.nlm.nih.gov
Advances in the therapy of small cell lung cancer. [2021]