Study to Assess Safety and Efficacy of Atezolizumab (MPDL3280A) Compared to Best Supportive Care Following Chemotherapy in Patients With Lung Cancer [IMpower010]

Not Recruiting

Trial ID: NCT02486718


This is a Phase III, global, multicenter, open-label, randomized study to compare the efficacy and safety of 16 cycles (1 cycle duration=21 days) of atezolizumab (MPDL3280A) treatment compared with best supportive care (BSC) in participants with Stage IB-Stage IIIA non-small cell lung cancer (NSCLC) following resection and adjuvant chemotherapy, as measured by disease-free survival (DFS) as assessed by the investigator and overall survival (OS). Participants, after completing up to 4 cycles of adjuvant cisplatin-based chemotherapy, will be randomized in a 1:1 ratio to receive atezolizumab for 16 cycles or BSC.

Official Title

A Phase III, Open-Label, Randomized Study to Investigate the Efficacy and Safety of Atezolizumab (Anti-PD-L1 Antibody) Compared With Best Supportive Care Following Adjuvant Cisplatin-Based Chemotherapy in Patients With Completely Resected Stage IB-IIIA Non-Small Cell Lung Cancer

Stanford Investigator(s)

Heather Wakelee
Heather Wakelee

Winston Chen and Phyllis Huang Professor

Joel Neal, MD, PhD
Joel Neal, MD, PhD

Associate Professor of Medicine (Oncology)

Kavitha Ramchandran
Kavitha Ramchandran

Clinical Professor, Medicine - Oncology

Millie Das
Millie Das

Clinical Professor, Medicine - Oncology


Inclusion Criteria:

Inclusion Criteria for Enrollment Phase

   - Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

   - Histological or cytological diagnosis of Stage IB (tumors greater than or equal to
   [>/=] 4 centimeters [cm])-IIIA (T2-3 N0, T1-3 N1, T1-3 N2, T4 N0-1) NSCLC (per the
   Union Internationale Contre le Cancer staging system (UICC)/American Joint Committee
   on Cancer staging system (AJCC) staging system, 7th edition; Detterbeck et al. 2009)

   - Participants must have had complete resection of NSCLC 4-12 weeks (>/=28 days and less
   than or equal to [   from surgery

   - If mediastinoscopy was not performed preoperatively, it is required that, at a
   minimum, mediastinal lymph node systematic sampling will have occurred. Systematic
   sampling is defined as removal of at least one representative lymph node at specified
   levels. MLND entails resection of all lymph nodes at those same levels. For a right
   thoracotomy, sampling or MLND is required at levels 4 and 7 and for a left
   thoracotomy, levels 5 and/or 6 and 7. Exceptions will be granted if there is clear
   documentation in the operative report or in a separately submitted addendum by the
   surgeon of exploration of the required lymph node areas, the participant will be
   considered eligible if no lymph nodes are found in those areas; if participants have
   documented N2 disease in one level (per the UICC/AJCC staging system, 7th edition;
   Detterbeck et al. 2009), not all levels need to be sampled; if the preoperative
   staging imaging results (contrast computed tomography [CT] and positron emission
   tomography [PET] scans) do not suggest evidence of disease in the mediastinum, the
   participant will be considered eligible if N2 nodal sampling is not performed per
   surgeon's decision

   - Eligible to receive a cisplatin-based chemotherapy regimen

   - Adequate hematologic and end-organ function

   - Women who are not postmenopausal (>/=12 months of non-therapy-induced amenorrhea) or
   surgically sterile must have a negative serum pregnancy test result within 14 days
   prior to initiation of cisplatin-based chemotherapy

Inclusion Criteria for Randomized Phase - Women who are not postmenopausal (>/=12 months of
non-therapy-induced amenorrhea) or surgically sterile must have a negative serum pregnancy
test result within 14 days prior to initiation of atezolizumab or BSC

Exclusion Criteria:

Exclusion Criteria for Enrollment Phase

   - Illness or condition that may interfere with a participant's capacity to understand,
   follow, and/or comply with study procedures

   - Pregnant and lactating women

   - Treatment with prior systemic chemotherapy: Chemotherapy for early stage of malignancy
   with curative intent, provided that the last dose received was more than 5 years prior
   to enrollment and low-dose chemotherapy for non-malignant conditions may be allowed
   upon approval by the Medical Monitor

   - Hormonal cancer therapy or radiation therapy as prior cancer treatment within 5 years
   before enrollment

   - Treatment with any other investigational agent with therapeutic intent within 28 days
   prior to enrollment

   - Participants with hearing impairment

   - Known sensitivity to any component of the chemotherapy regimen the participant will be
   assigned to, or to mannitol

   - Prior treatment with cluster of differentiation (CD) 137 (CD137) agonists or immune
   checkpoint blockade therapies, anti-programmed death-1 (PD-1), and anti programmed
   death ligand 1 (PD-L1) therapeutic antibodies

   - Malignancies other than NSCLC within 5 years prior to randomization, with the
   exception of those with a negligible risk of metastasis or death (e.g., expected
   5-year OS greater than [>] 90 percent [%]) treated with expected curative outcome
   (such as adequately treated carcinoma in situ of the cervix, basal or squamous cell
   skin cancer, localized prostate cancer treated surgically with curative intent, ductal
   carcinoma in situ treated surgically with curative intent)

   - History of severe allergic, anaphylactic, or other hypersensitivity reactions to
   chimeric or humanized antibodies or fusion proteins

   - Known hypersensitivity to biopharmaceuticals produced in Chinese hamster ovary cells
   or any component of the atezolizumab formulation

   - History of autoimmune disease, including but not limited to myasthenia gravis,
   myositis, autoimmune hepatitis, systemic lupus erythematosus, rheumatoid arthritis,
   inflammatory bowel disease, vascular thrombosis associated with antiphospholipid
   syndrome, Wegener's granulomatosis, Sjögren's syndrome, Guillain-Barré syndrome,
   multiple sclerosis, vasculitis, or glomerulonephritis

   - Positive test for human immunodeficiency virus (HIV)

   - Participants with active hepatitis B (chronic or acute; defined as having a positive
   hepatitis B surface antigen [HBsAg] test at screening) or hepatitis C

   - Active tuberculosis

   - Significant cardiovascular disease, such as New York Heart Association cardiac disease
   (Class II or greater), myocardial infarction, or cerebrovascular accident within the
   previous 3 months, unstable arrhythmias, or unstable angina

   - History of idiopathic pulmonary fibrosis, organizing pneumonia (e.g., bronchiolitis
   obliterans), drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active
   pneumonitis on screening chest CT scan

   - Prior allogeneic bone marrow transplantation or solid organ transplant

   - Any other diseases, metabolic dysfunction, physical examination finding, or clinical
   laboratory finding giving reasonable suspicion of a disease or condition that
   contraindicates the use of an investigational drug or that may affect the
   interpretation of the results or render the participant at high risk from treatment

   - Known tumor PD-L1 expression status as determined by an immunohistochemistry (IHC)
   assay from other clinical studies (e.g., participants whose PD-L1 expression status
   was determined during screening for entry into a study with anti-PD-1 or anti-PD-L1
   antibodies but were not eligible are excluded)

Specific Exclusions for Pemetrexed Treatment

- Participants with squamous cell histology

Exclusion Criteria for Randomized Phase

   - Signs or symptoms of infection within 14 days prior to randomization (severe infection
   within 28 days prior to randomization), including but not limited to hospitalization
   for complications of infection, bacteremia, or severe pneumonia

   - Received therapeutic oral or intravenous (IV) antibiotics within 14 days prior to

   - Major surgical procedure within 28 days prior to randomization or anticipation of need
   for a major surgical procedure during the course of the study

   - Administration of a live, attenuated vaccine within 4 weeks prior to initiation of
   study treatment or anticipation that such a live attenuated vaccine will be required
   during the study

   - Treatment with systemic immunostimulatory agents (including but not limited to
   interferons or interleukin-2) within 4 weeks or 5 half-lives of the drug, whichever is
   longer, prior to randomization: Prior treatment with cancer vaccines is allowed

   - Treatment with systemic corticosteroids or other immunosuppressive medications
   (including but not limited to prednisone, dexamethasone, cyclophosphamide,
   azathioprine, methotrexate, thalidomide, and anti-tumor necrosis factor [anti-TNF]
   agents) within 14 days prior to randomization


drug: Atezolizumab

drug: Cisplatin

drug: Vinorelbine

drug: Docetaxel

drug: Gemcitabine

drug: Pemetrexed

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305

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