Description:
This phase II trial studies how well durvalumab and tremelimumab works in treating patients
with stage IV lung cancer that has come back after previous treatment. Monoclonal antibodies,
such as durvalumab and tremelimumab, may interfere with the ability of tumor cells to grow
and spread.
Title
- Brief Title: Durvalumab and Tremelimumab in Treating Patients With Recurrent Stage IV Lung Cancer
- Official Title: A Phase II Study of MEDI4736 (Durvalumab) Plus Tremelimumab as Therapy for Patients With Previously Treated Anti-PD-1/PD-L1 Resistant Stage IV Squamous Cell Lung Cancer (Lung-Map Non-Match Sub-Study)
Clinical Trial IDs
- ORG STUDY ID:
S1400F
- SECONDARY ID:
NCI-2016-01597
- SECONDARY ID:
S1400F
- SECONDARY ID:
S1400F
- SECONDARY ID:
S1400F
- SECONDARY ID:
U10CA180888
- NCT ID:
NCT03373760
Conditions
- Recurrent Squamous Cell Lung Carcinoma
- Stage IV Squamous Cell Lung Carcinoma AJCC v7
Interventions
Drug | Synonyms | Arms |
---|
Durvalumab | Imfinzi, Immunoglobulin G1, Anti-(Human Protein B7-H1) (Human Monoclonal MEDI4736 Heavy Chain), Disulfide with Human Monoclonal MEDI4736 Kappa-chain, Dimer, MEDI-4736, MEDI4736 | Treatment (tremelimumab, durvalumab) |
Tremelimumab | Anti-CTLA4 Human Monoclonal Antibody CP-675,206, CP-675, CP-675,206, CP-675206, ticilimumab | Treatment (tremelimumab, durvalumab) |
Purpose
This phase II trial studies how well durvalumab and tremelimumab works in treating patients
with stage IV lung cancer that has come back after previous treatment. Monoclonal antibodies,
such as durvalumab and tremelimumab, may interfere with the ability of tumor cells to grow
and spread.
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate the objective response rate (confirmed and unconfirmed, complete and partial)
by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 among patients treated with
durvalumab (MEDI4736) plus tremelimumab.
SECONDARY OBJECTIVES:
I. To estimate the duration of response (DoR) among patients who achieve a complete response
(CR) or partial response (PR) (confirmed and unconfirmed) by RECIST 1.1.
II. To estimate the duration of response (DoR) per immune-related response criteria among
patients who achieve a complete response (CR) or partial response (PR) (confirmed and
unconfirmed) by RECIST 1.1.
III. To evaluate overall survival (OS) among patients treated with durvalumab (MEDI4736) plus
tremelimumab.
IV. To evaluate investigator-assessed progression-free survival (IA-PFS) among patients
treated with durvalumab (MEDI4736) plus tremelimumab.
V. To evaluate IA-PFS assessed by immune-related response criteria (irRC-IA-PFS) among
patients treated with durvalumab (MEDI4736) plus tremelimumab.
VI. To evaluate the frequency and severity of toxicities associated with durvalumab
(MEDI4736) plus tremelimumab.
TERTIARY OBJECTIVES:
I. To explore the association of potential predictive markers identified in S1400A, with
response and progression-free survival (PFS).
II. To explore the association of PD-L1 expression status with response and PFS.
III. To contribute to an ongoing serum and tumor bank in S1400.
OUTLINE:
Patients receive tremelimumab intravenously (IV) over 60 minutes on day 1 for courses 1-4 and
durvalumab IV over 60 minutes on day 1. Courses repeat every 28 days in the absence of
disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 6 months for 2 years, and
then at the end of year 3.
Trial Arms
Name | Type | Description | Interventions |
---|
Treatment (tremelimumab, durvalumab) | Experimental | Patients receive tremelimumab IV over 60 minutes on day 1 for courses 1-4 and durvalumab IV over 60 minutes on day 1. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. | |
Eligibility Criteria
Inclusion Criteria:
- Patients must have been assigned to S1400F
- Patients must have progressed during or after prior platinum-based chemotherapy;
patients whose only prior platinum-based chemotherapy regimen was for stage I-III
disease (i.e. patient has not received any platinum-based chemotherapy for stage IV or
recurrent disease), disease progression on platinum-based chemotherapy must have
occurred within one year from the last date that patient received that therapy;
patients must have experienced disease progression during or after prior anti-PD-1 or
anti-PD-L1 antibody monotherapy as their most recent line of treatment; prior
PD-1/PD-L1 combination therapy is not permitted
- Prior exposure to CTLA-4 inhibitors (ipilimumab and tremelimumab) is not permitted;
prior exposure to the following is allowed: attenuated vaccines, anti-EGFR agents, and
granulocyte-macrophage colony-stimulating factor (GM-CSF)
- Patients must not have received nitrosoureas or mitomycin-C within 42 days prior to
sub-study registration
- Patients must not have any prior documented autoimmune or inflammatory disease
(including inflammatory bowel disease, diverticulitis with the exception of
diverticulosis, celiac disease, irritable bowel disease; Wegner syndrome; Hashimoto
syndrome) within 3 years prior to sub-study registration; patients with vitiligo,
immune-mediated alopecia, Grave?s disease, or psoriasis requiring systemic treatment
within the past 2 years are not eligible; patients with hypothyroidism (e.g. post
Hashimoto syndrome) who are stable on hormone replacement therapy are eligible
- Patients must not have any history of primary immunodeficiency
- Patients must not have received any immunosuppressive medication within 28 days prior
to sub-study registration and must not be planning to receive these medications while
on protocol therapy; systemic corticosteroids must be stopped at least 24 hours prior
to sub-study registration; however, intranasal and inhaled corticosteroids are allowed
at any time before and during protocol therapy
- Patients must not have experienced a grade 3 or worse immune-related adverse event
(irAE) (except asymptomatic nonbullous/nonexfoliative rash) or any unresolved irAE
grade 2, nor have experienced a toxicity that led to permanent discontinuation of
prior anti-PD-1/PD-L1 immunotherapy
- Patients must not have any history of organ transplant that requires use of
immunosuppressives
- Patients must not have any known allergy or reaction to any component of the
durvalumab (MEDI4736) and/or tremelimumab formulation
- Patients must not have clinical signs or symptoms of active tuberculosis infection
- Patients must not have received a live attenuated vaccination within 28 days prior to
sub-study registration
- Patients must not have known human immunodeficiency virus (HIV), or a known positive
test for hepatitis B virus surface antigen (HBV sAg), or hepatitis C virus ribonucleic
acid (HCV antibody) indicating current acute or chronic infection; patients with a
positive hepatitis C antibody with a negative viral load are allowed
- Patients must have a thyroid-stimulating hormone (TSH) with reflex free T3/free T4 (if
TSH is out of normal range) and electrocardiogram (EKG) obtained within 7 days prior
to sub-study registration
- Patients must also be offered participation in banking and in the correlative studies
for collection and future use of specimens
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | N/A |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Objective response rate assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | Estimated within 13% with 95% confidence. |
Secondary Outcome Measures
Measure: | Duration of response (DOR) |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | Will be estimated using the method of Kaplan-Meier. The Brookmeyer-Crowley method will be used to calculate confidence intervals for median DOR. |
Measure: | Immune-Related Response Criteria investigator-assessed progression-free survival (irRC-IA-PFS) assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 |
Time Frame: | From date of registration to date of first documentation of irRC progression or death due to any cause, assessed up to 3 years |
Safety Issue: | |
Description: | Will be estimated using the method of Kaplan-Meier. |
Measure: | Incidence of adverse events assessed by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 |
Time Frame: | Up to 3 years |
Safety Issue: | |
Description: | Toxicity rates can be estimated within 13% with 95% confidence. Any toxicity with at least 5% prevalence has at least a 95% chance of being observed. |
Measure: | Investigator-assessed progression-free survival (IA-PFS) |
Time Frame: | 6 months after completion of accrual |
Safety Issue: | |
Description: | Will be estimated using the method of Kaplan-Meier. The Brookmeyer-Crowley method will be used to calculate confidence intervals for median IA-PFS. |
Measure: | Overall survival (OS) |
Time Frame: | 6 months after completion of accrual |
Safety Issue: | |
Description: | Will be estimated using the method of Kaplan-Meier. The Brookmeyer-Crowley method will be used to calculate confidence intervals for median OS. |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Southwest Oncology Group |
Last Updated
May 13, 2021