- Male or female subject aged ≥ 18 years.
- Histologically or cytologically confirmed metastatic non-squamous non-small cell lung
- Patient has measurable disease as defined by RECIST 1.1 as assessed by either CT or
- Chemoimmunotherapy naïve (including durvalumab).
- ECOG Performance Status ≤ 2.
--Note: If performance status = 2, ensure that there is a slot available prior to
registration as only 20 PS = 2 patients will be enrolled on the protocol.
- Must have a life expectancy of at least 12 weeks.
- Adequate organ function as defined as:
- White blood cell count > 2.0 g/dL
- Platelet count ≥ 100,000/mm3
- Hemoglobin ≥ 9 g/dL
- Absolute neutrophil count (ANC) ≥ 1,500/mm3
- Total Bilirubin ≤ 1.5 x institutional upper limit of normal (ULN)
- Except for patients with Gilbert's syndrome.
- AST(SGOT)/ALT(SGPT) ≤ 2.5 × institutional ULN or ≤ 5 × institutional ULN if
liver metastases are present
- eGFR ≥ 30 mL/min/1.73m2 or creatinine clearance ≥ 30 mL/min by
- Males: ((140-age)×weight[kg])/(serum creatinine [mg/dL]×72)
- Females: (((140-age)×weight[kg])/(serum creatinine [mg/dL]×72))×0.85
- Concurrent enrollment in the study, "Rethinking Measurement of Performance Status in
Cancer Patients," IRB 112529.
- Concurrent enrollment in the study, "An Observational Study Assessing the Clinical
Effectiveness of the VeriStrat® Test and Validating Immunotherapy Tests in Subjects
with Non-Small Cell Lung Cancer," IRB 100314.
- Evidence of post-menopausal status or negative urinary or serum pregnancy test for
female pre-menopausal patients. Women will be considered post-menopausal if they have
been amenorrheic for 12 months without an alternative medical cause. The following
age-specific requirements apply:
- Women <50 years of age would be considered post-menopausal if they have been
amenorrheic for 12 months or more following cessation of exogenous hormonal
treatments and if they have luteinizing hormone and follicle-stimulating hormone
levels in the post-menopausal range for the institution or underwent surgical
sterilization (bilateral oophorectomy or hysterectomy).
- Women ≥50 years of age would be considered post-menopausal if they have been
amenorrheic for 12 months or more following cessation of all exogenous hormonal
treatments, had radiation-induced menopause with last menses >1 year ago, had
chemotherapy-induced menopause with last menses >1 year ago, or underwent
surgical sterilization (bilateral oophorectomy, bilateral salpingectomy or
- Highly effective contraception for both male and female subjects throughout the study
and for at least 3 months after the last dose of study therapy.
- Recovery to baseline or ≤ Grade 1 CTCAE v.5 from toxicities related to any prior
treatments, unless AE(s) are clinically nonsignificant and/or stable on supportive
- Patient is willing and able to comply with the protocol for the duration of the study
including undergoing treatment and scheduled visits and examinations including follow
- Capable of giving signed informed consent which includes compliance with the
requirements and restrictions listed in the informed consent form (ICF) and in this
protocol. Written informed consent and any locally required authorization (eg, Health
Insurance Portability and Accountability Act in the US, European Union [EU] Data
Privacy Directive in the EU) obtained from the patient/legal representative prior to
performing any protocol-related procedures, including screening evaluations.
- ALK or EGFR non-squamous non-small cell lung cancer.
- Prior radiation therapy within 2 weeks prior to cycle one day one.
-Exception: Prior palliative radiotherapy is permitted, provided it has been completed
at least 2 days prior to study enrollment and no clinically significant toxicities are
- Major surgical procedure (as defined by the Investigator) within 28 days prior to the
first dose of IP.
-Note: Local surgery of isolated lesions for palliative intent is acceptable.
- History of allogenic organ transplantation.
- Active or prior documented autoimmune or inflammatory disorders (including
inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with
the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome,
or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid
arthritis, hypophysitis, uveitis, etc]). The following are exceptions to this
- Patients with vitiligo or alopecia
- Patients with hypothyroidism (e.g., following Hashimoto syndrome) stable on
- Any chronic skin condition that does not require systemic therapy
- Patients without active disease in the last 5 years may be included but only
after consultation with the principal investigator
- Patients with celiac disease controlled by diet alone
- Current or prior use of immunosuppressive medication within 14 days of cycle one day
one, EXCEPT for the following permitted steroids:
--Intranasal, inhaled, topical steroids, eye drops or local steroid injection
- Systemic corticosteroids at physiologic doses ≤ 10mg/day of prednisone or
- Steroids as premedication for hypersensitivity reactions (eg, computed tomography
(CT) scan premedication).
- History of active primary immunodeficiency
- Diagnosis of any other malignancy within 2 years prior to study enrollment, except for
adequately treated basal cell or squamous cell skin cancer, carcinoma in situ of the
breast, bladder or of the cervix, and low-grade (Gleason 6 or below) prostate cancer
on surveillance with no plans for treatment intervention (eg, surgery, radiation, or
castration) or prostate cancer that has been adequately treated with prostatectomy or
radiotherapy and currently with no evidence of disease or symptoms is allowed.
- Uncontrolled CNS metastases; subjects with previously treated brain metastases will be
allowed if the brain metastases have been treated, toxicities have resolved to grade 1
or baseline and steroids are no longer required.
--Patients with asymptomatic brain metastasis are allowed if previous steroid
treatment was discontinued ≥ 6 weeks.
- History of leptomeningeal carcinomatosis
- Uncontrolled intercurrent illness, including but not limited to, ongoing or active
infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable
angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic
gastrointestinal conditions associated with diarrhea, or psychiatric illness/social
situations that would limit compliance with study requirement, substantially increase
risk of incurring AEs or compromise the ability of the patient to give written
- Known HIV infection with a detectable viral load within 6 months of the anticipated
start of treatment.
-Note: Patients on effective anti-retroviral therapy with an undetectable viral load
within 6 months of the anticipated start of treatment are eligible for this trial.
- Active infection including: tuberculosis (clinical evaluation that includes clinical
history, physical examination and radiographic findings, and TB testing in line with
local practice), hepatitis B (known positive HBV surface antigen (HBsAg) result), or
-Note: Patients with a past or resolved HBV infection (defined as the presence of
hepatitis B core antibody [anti-HBc] and absence of HBsAg) are eligible. Patients
positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction
is negative for HCV RNA.
- Vaccination with a live vaccine within 30 days of cycle one day one and while on trial
is prohibited except for administration of inactivated vaccines.
- Female patients who are pregnant or breastfeeding or male or female patients of
reproductive potential who are not willing to employ effective birth control from
screening to 90 days after the last dose of durvalumab monotherapy
- Known prior severe hypersensitivity to investigational product or any component in its
formulations, including known severe hypersensitivity reactions to monoclonal
antibodies, cisplatin, other platinum-containing compounds, or mannitol. (NCI CTCAE
v5.0 Grade ≥ 3).
- Subjects taking prohibited medications as described in Section 6.5.2. A washout period
of prohibited medications for a period of at least 5 half-lives or as clinically
indicated should occur prior to the start of treatment.