NAUTIKA1: Multicenter, Phase II, Neoadjuvant and Adjuvant Study of Multiple Therapies in Biomarker-Selected Patients With Resectable Stages IB-III Non-Small Cell Lung Cancer

Who is this study for? Patients with operable Stage IIA, IIB, IIIA, and select IIIB resectable and untreated non-small cell lung cancer tumors with selected molecular alterations
Status: Recruiting
Location: See all (39) locations...
Intervention Type: Drug, Procedure
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

This trial will evaluate the efficacy and safety of various therapies in patients with Stage IB, IIA, IIB, IIIA, or selected IIIB resectable and untreated non-small cell lung cancer (NSCLC) tumors that meet protocol-specified biomarker criteria

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Pathologically documented NSCLC:

• Newly diagnosed early-stage NSCLC stages IB, IIA, IIB, IIIA, or selected IIIB (T3N2 only) NSCLC of squamous or non-squamous histology. Staging should be based on the 8th edition of the American Joint Committee on Cancer (AJCC)/Union Internationale Contre le Cancer (UICC) NSCLC staging system.

• T4 primary NSCLC will be allowed only on the basis of size. Invasion of the diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina, and separate tumor nodules in a different ipsilateral lobe is not permitted.

• All patients will undergo clinical staging using CT and PET scanning, as well as brain imaging using MRI. Invasive mediastinal staging by either mediastinoscopyor endo- bronchial ultrasonography is highly encouraged for patients with radiographically suspected mediastinal nodal disease (ie, N2) but not mandated if the CT or PET scans showed no evidence of N2 disease.

• Molecular testing results from CLIA-certified laboratories and showing at least one of the following abnormalities: ALK fusion, ROS1 fusion, NTRK1/2/3 fusion; BRAF V600 mutation (enrollment closed); RET fusion (enrollment closed), PD-L1, KRAS G12C expression in ≥ 1% tumor cells as determined by FDA-approved test.

• Measurable disease, as defined by RECIST v1.1

• NSCLC must have a solid or subsolid appearance on CT scan and cannot have a purely ground glass opacity appearance. For subsolid lesions, the tumor size (i.e., clinical T stage) should be measured based on the solid component only, exclusive of the ground glass opacity component.

• Evaluated by the attending surgeon prior to study enrollment to verify that the primary tumor and any involved lymph nodes are technically completely resectable and verify that the participant is medically operable

• Adequate pulmonary function to be eligible for surgical resection with curative intent

• Adequate cardiac function to be eligible for surgical resection with curative intent

• Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1

• Adequate hematologic and end-organ function

• Negative hepatitis B surface antigen (HBsAg) test at screening for cohort

• Negative total hepatitits B core antibody (HBcAb) test at screening for cohort, or positive total HBcAb test followed by a negative hepatitis B virus (HBV) DNA test at screening

• Negative hepatitis C virus (HCV) antibody test at screening, or positive HCV antibody test followed by a negative HCV RNA test at screening

• Male participants must be willing to use acceptable methods of contraception

• Female participants of childbearing potential must agree to use acceptable methods of contraception

• Participants whose tumors lack radiographic progression

• ECOG Performance Status of 0 or 1

• Adequate hematologic and end-organ function

Locations
United States
California
City of Hope Comprehensive Cancer Center
WITHDRAWN
Duarte
City of Hope Comprehensive Cancer Center
RECRUITING
Duarte
City of Hope - Orange County Lennar Foundation Cancer Center
RECRUITING
Irvine
Cedars-Sinai Medical Center
WITHDRAWN
Los Angeles
University of California Los Angeles - Jonsson Comprehensive Cancer Center
RECRUITING
Los Angeles
USC Norris Cancer Center
WITHDRAWN
Los Angeles
The Center for Cancer Prevention and Treatment at St.Joseph Hospital of Orange
RECRUITING
Orange
UC Davis Comprehensive Cancer Center
RECRUITING
Sacramento
UCSF Helen Diller Family CCC
RECRUITING
San Francisco
Colorado
University of Colorado - Anschutz Medical Campus (University of Colorado Health Sciences Center)
RECRUITING
Aurora
Connecticut
Yale Cancer Center
RECRUITING
New Haven
Washington, D.c.
MedStar Georgetown University Hospital (Lombardi Comprehensive Cancer Center)
RECRUITING
Washington D.c.
Florida
Moffitt Cancer Center
RECRUITING
Tampa
Illinois
Northwestern University
RECRUITING
Chicago
Northwestern Medicine Cancer Center Kishwaukee
WITHDRAWN
Dekalb
Northwestern Medicine Cancer Center Delnor
WITHDRAWN
Geneva
Northwestern Medicine Cancer Center Warrenville
WITHDRAWN
Warrenville
Massachusetts
Boston Medical Center
RECRUITING
Boston
Dana-Farber Cancer Institute
RECRUITING
Boston
Michigan
University of Michigan
RECRUITING
Ann Arbor
Karmanos Cancer Institute - Farmington Hills/Weisberg Cancer Treatment Center
WITHDRAWN
Farmington Hills
Minnesota
Mayo Clinic
RECRUITING
Rochester
Missouri
Ellis Fischel Cancer Center
RECRUITING
Columbia
Siteman Cancer Center - Washington University Medical Campus
RECRUITING
St Louis
New Hampshire
Dartmouth Hitchcock Medical Center
RECRUITING
Lebanon
New York
Columbia University Medical Center
RECRUITING
New York
Laura and ISAAC Perlmutter Cancer Center at NYU Langone.
RECRUITING
New York
Memorial Sloan Kettering Cancer Center
RECRUITING
New York
Ohio
University Hospitals Cleveland Medical Center
WITHDRAWN
Cleveland
Ohio State University
RECRUITING
Columbus
Pennsylvania
AHN Cancer Institute ? Allegheny General Hospital
RECRUITING
Pittsburgh
Tennessee
Baptist Clinical Research Institute
RECRUITING
Memphis
Tennessee Oncology - Nashville
WITHDRAWN
Nashville
Texas
Baylor College of Medicine
RECRUITING
Houston
Kelsey Seybold Clnic
RECRUITING
Houston
University of Texas MD Anderson Cancer Center
RECRUITING
Houston
Lumi Research
WITHDRAWN
Kingwood
Virginia
Virginia Cancer Specialists (Fairfax) - USOR
RECRUITING
Fairfax
Washington
Seattle Cancer Care Alliance
WITHDRAWN
Seattle
Contact Information
Primary
Reference Study ID Number: ML41591 https://forpatients.roche.com/
global-roche-genentech-trials@gene.com
888-662-6728
Time Frame
Start Date: 2020-11-06
Estimated Completion Date: 2029-03-06
Participants
Target number of participants: 125
Treatments
Experimental: ALK Cohort
Participants will receive up to 8 weeks of alectinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with alectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of alectinib.
Experimental: ROS 1 Cohort
Participants will receive up to 8 weeks of entrectinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with entrectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of entrectinib.
Experimental: NTRK Cohort
Participants will receive up to 8 weeks of entrectinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with entrectinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of entrectinib.
Experimental: BRAF Cohort (Enrollment closed, no participants enrolled)
Participants will receive up to 8 weeks of vemurafenib plus cobimetinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with vemurafenib plus cobimetinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of of vemurafenib plus cobimetinib.~Enrollment closed.
Experimental: RET Cohort (Enrollment closed)
Participants will receive up to 8 weeks of pralsetinib neoadjuvant treatment before undergoing surgical resection per standard of care. All participants that undergo surgical resection and whose tumors have pathological response or lack radiographic progression will be eligible for the Adjuvant Treatment Phase with pralsetinib. Adjuvant therapy will consist of 4 cycles of chemotherapy followed by up to 2 years of pralsetinib.~Enrollment closed.
Experimental: PD-L1 Cohort
Participants with positive PD-L1 in ≥1% tumor cells will receive 4 cycles of atezolizumab neoadjuvant treatment. During neoadjuvant Cycle 1 of atezolizumab, patients will also receive low-dose SBRT (8Gy X 3). Adjuvant treatment consists of SOC treatment as determined by the investigator, per NCCN guidelines
Experimental: KRAS G12C Cohort
Participants will receive up to 8 weeks of divarasib as neoadjuvant treatment before undergoing surgical resection per standard of care. PD-L1 negative patients whose tumors have pathological response or lack radiographic progression will be have the option of continuing divarasib for up to 2 years as adjuvant therapy. For patients who test positive PD-L1, they will have the option to receive Atezolizumab for up to 16 cycles.
Sponsors
Leads: Genentech, Inc.

This content was sourced from clinicaltrials.gov