Actively Recruiting
Randomized Trial Comparing Standard of Care Versus Immune- Based Combination in Relapsed Stage III Non-small-cell Lung Cancer (NSCLC) Pretreated With Chemoradiotherapy and Durvalumab
Led by Fondazione Ricerca Traslazionale · Updated on 2025-12-01
176
Participants Needed
1
Research Sites
260 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
This is a randomized, non-comparative, phase II study investigating whether: 1) the addition of durvalumab to investigator's choice second line chemotherapy prolongs survival versus investigator's choice second line chemotherapy in NSCLC patients with locally advanced disease progressing on durvalumab given after concomitant chemoradiotherapy; 2) whether the addition of olaparib to durvalumab improves survival over durvalumab alone after induction chemoimmunotherapy in patients relapsing after completing durvalumab maintenance therapy for stage III disease. After evaluation of inclusion and exclusion criteria and after consent form signature, all eligible patients progressing during durvalumab therapy will be in the Part A of the trial randomized to in a 1:1 ratio to investigator's choice single-agent chemotherapy plus durvalumab (Arm A: experimental arm) or to investigator's choice single-agent chemotherapy (Arm B: standard arm). In the clinical trial's Part B, patients progressing after completion of durvalumab therapy will be further randomized in a 1:1.7 ratio to investigator's choice platinum doublet chemotherapy plus durvalumab for 4 cycles followed by maintenance durvalumab plus olaparib (Arm C: experimental arm) or to investigator's choice platinum doublet chemotherapy plus durvalumab for 4 cycles followed by durvalumab (Arm D: experimental arm). Therapy will be continued up to disease progression, toxicity or patient refusal.
CONDITIONS
Official Title
Randomized Trial Comparing Standard of Care Versus Immune- Based Combination in Relapsed Stage III Non-small-cell Lung Cancer (NSCLC) Pretreated With Chemoradiotherapy and Durvalumab
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Body weight greater than 30 kg
- Recurrent or metastatic NSCLC relapsed during or after chemoradiotherapy with curative intent and durvalumab maintenance for stage III disease
- At least two cycles of platinum-based chemotherapy or radical radiotherapy received
- Tumor tissue available for biomarker testing
- Evidence of disease progression during or after durvalumab maintenance therapy, excluding progression within first 3 months
- ECOG performance status of 0 or 1
- Willing and able to comply with study protocol including treatments and visits
- Age 18 years or older
- Capable of giving signed informed consent
- Life expectancy of at least 16 weeks
- Normal organ and bone marrow function within 28 days before treatment
- Female patients using effective contraception or abstaining from sexual intercourse during and after treatment
- Negative pregnancy test for women of childbearing potential within 28 days before treatment
- Male patients using condoms during treatment and for 3 months after last olaparib dose and partners using contraception
You will not qualify if you...
- No evidence of disease progression
- Receiving systemic chemotherapy or radiotherapy within 3 weeks before study treatment (except palliative)
- Not pretreated with durvalumab with curative intent
- Treated with non-radical or non-conventional radiotherapy
- More than 4 cycles of platinum-based chemotherapy
- Progression within first 3 months of durvalumab treatment
- Ineligible for investigator's choice chemotherapy regimens
- Persistent toxicities greater than grade 2 from prior cancer therapy, excluding alopecia
- Myelodysplastic syndrome or acute myeloid leukemia
- Tumor tissue not available
- Presence of EGFR mutations or ALK or ROS1 rearrangements
- ECOG performance status greater than 1
- Brain metastases allowed only if asymptomatic and pretreated
- Diagnosis of other cancers in last 3 years except certain in situ or skin carcinomas
- Spinal cord compression without stable disease after treatment
- Leptomeningeal disease
- Uncontrolled or reversible cardiac conditions
- Uncontrolled pleural, pericardial effusion, or ascites requiring frequent drainage
- Malignancies other than NSCLC within 5 years except low-risk treated cancers
- Severe allergies or hypersensitivity to durvalumab, olaparib, or related substances
- History of autoimmune diseases except certain controlled conditions
- Poor medical risk due to serious uncontrolled disorders or infections
- Unable to swallow oral medication or with gastrointestinal disorders affecting absorption
- History of certain lung diseases or active pneumonitis
- Positive HIV test
- Active hepatitis B or C infection
- Active tuberculosis
- Use of strong or moderate CYP3A inhibitors or inducers without required washout
- Major surgery within 2 weeks before treatment
- Previous allogenic bone marrow or double umbilical cord blood transplant
- Pregnant or breastfeeding women
AI-Screening
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Trial Site Locations
Total: 1 location
1
Istituti Fisioterapici Ospitalieri- Ifo - Istituto Regina Elena
Roma, RM, Italy, 00144
Actively Recruiting
Research Team
F
Federico Cappuzzo, MD
CONTACT
L
Lorenza Landi, MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
4
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