Immunotherapy + SBRT for Advanced Lung Cancer

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Overseen BySusan Wildman, BSN, RN
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: Wake Forest University Health Sciences
Must be taking: Chemo-immunotherapy
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
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 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if combining immunotherapy with precise radiation treatment is more effective than immunotherapy alone for advanced lung cancer. Specifically, it examines patient responses to pembrolizumab, an immunotherapy drug that aids the immune system in attacking cancer, either alone or with stereotactic body radiation therapy (SBRT), which targets tumors with high precision. Patients with stage IV non-small cell lung cancer who have already received some initial treatment might be suitable candidates, especially if they have a tumor that can be targeted by radiation. The trial seeks to improve treatment options for those facing this aggressive form of lung cancer. As a Phase 3 trial, it represents the final step before FDA approval, offering patients a chance to contribute to potentially groundbreaking treatment advancements.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor to get a clear answer.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that using stereotactic body radiation therapy (SBRT) with pembrolizumab is generally safe. One study found that this combination can be administered together if care is taken to protect normal tissue, suggesting manageable side effects.

For pembrolizumab alone, studies indicate it is well-tolerated by many patients with advanced non-small cell lung cancer (NSCLC) and is associated with longer survival compared to some other treatments.

Overall, past research has demonstrated that both treatment options in the trial are reasonably safe. Always consult a healthcare professional to understand what this means personally.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for advanced lung cancer because they offer a new approach to tackling the disease. Unlike traditional treatments such as chemotherapy and surgery, the combination of pembrolizumab with Stereotactic Body Radiation Therapy (SBRT) leverages the immune system to fight cancer more precisely. Pembrolizumab is an immunotherapy drug that stimulates the body's immune cells to target and attack cancer cells. When combined with SBRT, which delivers high doses of radiation to cancer cells with pinpoint accuracy, it potentially enhances the immune response and improves treatment outcomes. This innovative strategy could lead to more effective and less invasive treatment options for patients with advanced lung cancer.

What evidence suggests that this trial's treatments could be effective for advanced lung cancer?

Research shows that combining pembrolizumab with stereotactic body radiation therapy (SBRT) can enhance the immune response against tumors in non-small cell lung cancer. In this trial, one arm will receive this combination, which studies have found to better control cancer locally and potentially improve survival rates. SBRT precisely targets tumors, minimizing damage to normal tissue, while pembrolizumab aids the immune system in fighting cancer cells. Previous research has shown positive survival outcomes for patients treated with this combination in advanced lung cancer cases.

Another arm of this trial will receive pembrolizumab alone, which has already improved outcomes for patients with advanced non-small cell lung cancer, especially those with certain protein markers (PD-L1). The KEYNOTE-024 trial demonstrated that pembrolizumab significantly increased survival compared to traditional chemotherapy. Additionally, long-term data suggests that some patients continue to benefit from pembrolizumab over time. These findings provide strong evidence for the effectiveness of both pembrolizumab alone and in combination with SBRT in treating advanced lung cancer.23678

Who Is on the Research Team?

Michael Farris, MD | Wake Forest ...

Michael K. Farris

Principal Investigator

Wake Forest University Health Sciences

Are You a Good Fit for This Trial?

This trial is for adults with stage IV non-small cell lung cancer that has spread and can be targeted by radiation. They must have had at least 4 cycles of systemic therapy without disease progression, be within 180 days from their first dose of this therapy, and have a performance status of 0-2. Pregnant women or those treated for other cancers (with some exceptions) in the last three years are excluded.

Inclusion Criteria

I had early-stage lung cancer, treated it, but now have cancer in distant areas and have completed 4 cycles of treatment for this recurrence.
My remaining cancer can be targeted with radiation according to my radiation oncologist.
I can take care of myself and am up and about more than 50% of my waking hours.
See 4 more

Exclusion Criteria

It has been over 6 months since I started my standard cancer treatment.
My cancer does not have major EGFR mutations or ROS1/ALK rearrangements.
I haven't been treated for cancer in the last 3 years, except for certain low-risk or early-stage cancers.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive pembrolizumab IV every 3-4 weeks for 1 year, with or without stereotactic body radiation therapy (SBRT) consisting of 3-10 treatments

1 year
Every 3-4 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment completion

5 years
1 month after treatment, then every 3 months for 1 year, every 6 months for 2 years, and annually for 2 years

What Are the Treatments Tested in This Trial?

Interventions

  • Pembrolizumab
  • Stereotactic Body Radiation Therapy
Trial Overview The study compares two approaches: one group receives immunotherapy with pembrolizumab plus stereotactic body radiation therapy (SBRT), while the other gets only pembrolizumab. SBRT delivers precise high-dose radiation to tumors over fewer sessions, potentially improving outcomes when combined with immunotherapy.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Arm 2 Pembrolizumab OnlyExperimental Treatment1 Intervention
Group II: Arm 1 Stereotactic Body Radiation Therapy/PembrolizumabExperimental Treatment2 Interventions

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

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Approved in United States as KEYTRUDA for:
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Approved in European Union as KEYTRUDA for:
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Approved in United Kingdom as KEYTRUDA for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Wake Forest University Health Sciences

Lead Sponsor

Trials
1,432
Recruited
2,506,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Citations

The 5‐year outcomes of the KEYNOTE‐024 trialPembrolizumab monotherapy could provide meaningful improved patient outcomes over platinum‐based chemotherapy for advanced NSCLC patients with PD‐L1 TPS ≥ 50%.
Five-Year Data for Merck's KEYTRUDA® (pembrolizumab ...Five-year overall survival rate of 19.4% and 18.4% for KEYTRUDA plus chemotherapy in KEYNOTE-189 and KEYNOTE-407, respectively.
3.keytrudahcp.comkeytrudahcp.com/efficacy/
Efficacy Data for KEYTRUDA® (pembrolizumab)Health care professionals may review efficacy data for KEYTRUDA® (pembrolizumab), browse the indications and select the corresponding KEYNOTE trials for ...
NCT01295827 | Study of Pembrolizumab (MK-3475) in ...The study will investigate the safety, tolerability, and efficacy of pembrolizumab (2 mg/kg and 10 mg/kg) in participants with advanced or metastatic MEL.
Real-world evidence for pembrolizumab in non-small cell ...Our nationwide study demonstrated a survival benefit over conventional chemotherapy of a similar magnitude as observed in clinical trials.
KEYTRUDA® (pembrolizumab) Demonstrates Long-Term ...Five-year exploratory follow-up analysis of KEYNOTE-671 continued to show clinically meaningful improvements in overall survival and ...
Non–Small Cell Lung Cancer - Clinical Trial ResultsView the clinical trial results for this treatment option for certain people with non–small cell lung cancer.
Five-Year Outcomes With Pembrolizumab Versus ...KEYNOTE-042 is a randomized phase III study that showed significantly longer overall survival (OS) with pembrolizumab monotherapy versus platinum-based ...
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