Atezolizumab for Small cell lung cancer | Extensive-stage small cell lung cancer

Inclusion criteria

• {"criterion_text":"-Diagnosis of small-cell lung cancer (SCLC) (according to WHO classification 2015) confirmed at pathology (histology or cytology)."}
• {"criterion_text":"-Normal baseline laboratory values"}
• {"criterion_text":"-Stable medical condition, including the absence of acute exacerbations of chronic illnesses, serious infections, or major surgery within 4 weeks before registration, and otherwise noted in other inclusion/exclusion criteria"}
• {"criterion_text":"-Recovered (i.e., ≤ Grade 1 toxicity) from effects of prior anticancer therapy, except alopecia"}
• {"criterion_text":"-Prior radiotherapy is allowed provided that it has been completed more than 2 weeks before starting protocol treatment and patients have recovered from AEs related to radiotherapy to < grade 1"}
• {"criterion_text":"-Ability to comply with protocol requirements"}
• {"criterion_text":"-The patient or the patient’s legal representative has to be able to provide written informed consent. Voluntary written consent must be given before performance of any study-related procedure not part of standard medical care, with the understanding that consent may be withdrawn by the patient at any time without prejudice to future medical care"}
• {"criterion_text":"-Male or female and ≥ 18 years of age"}
• {"criterion_text":"-Life expectancy ≥ 12 weeks"}
• {"criterion_text":"-Disease progression at least 60 days after the completion of first-line chemotherapy consisting of at least 4 cycles of platinum-etoposide plus either atezolizumab or durvalumab and have not received any other treatment (except for immunotherapy as maintenance treatment); the 60 day-interval is calculated from the date of the last chemotherapy administration to the date of the first radiologically documented progressive disease"}
• {"criterion_text":"-No previous radiotherapy on the only one site of disease progression, unless that lesion had subsequent evidence of progressive disease"}
• {"criterion_text":"-Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≤2"}
• {"criterion_text":"-Patients with treated brain metastases (or untreated but asymptomatic) and off steroids or on a stable dose of steroids (≤10 mg of prednisone-equivalent) are also eligible. Radiotherapy must have been completed a minimum of 14 days prior to registration, and patients must have recovered from AEs related to radiotherapy to < grade 1 (except alopecia)"}
• {"criterion_text":"-For Females: must be postmenopausal (defined as occurring 12 months after last menstrual period) before the screening visit, or are surgically sterile. If they are of childbearing potential, a negative serum pregnancy test prior to study entry has to be documented; furthermore, they agree to practice 2 effective methods of contraception, at the same time, from the time of signing the informed consent form (ICF) through 5 months after the last dose of study drug, or agree to practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject"}
• {"criterion_text":"-For Males: even if surgically sterilized (i.e. post-vasectomy status) agree to practice effective barrier contraception during the entire study treatment period and through 6 months after the last dose of study drug, or practice true abstinence, when this is in line with the preferred and usual lifestyle of the subject"}

Exclusion criteria

• {"criterion_text":"-More than 1 line of prior treatment for SCLC"}
• {"criterion_text":"-Surgery within 4 weeks (or 2 weeks for a minor surgery) before study enrolment and not fully recovered to baseline or to a stable clinical status. Insertion of a vascular device is allowed."}
• {"criterion_text":"-Patients who experienced medically significant or NCI CTCAE Grade ≥3 or higher toxicities in response to first-line immunotherapy"}
• {"criterion_text":"-First-line treatment without either atezolizumab or durvalumab"}
• {"criterion_text":"-Unwilling or unable to comply with the protocol or cooperate fully with the investigator and site personnel."}
• {"criterion_text":"-First-line chemotherapy different from platinum-etoposide"}
• {"criterion_text":"-Less than 4 cycles of first-line platinum-etoposide"}
• {"criterion_text":"-Presence of resistant relapse (progressive disease within 60 days from the end of first-line chemotherapy) or refractory disease (progressive disease during the first 4 cycles of first-line chemoimmunotherapy)."}
• {"criterion_text":"-Symptomatic brain metastases or spinal cord compression (CT or MRI of the head is required within 4 weeks prior to randomization) requiring immediate radiotherapy for palliation. Patients with treated brain metastases (or untreated but asymptomatic) and off steroids or on a stable dose of steroids (≤10 mg of prednisone-equivalent) are also eligible provided that all of the following criteria are met:"}
• {"criterion_text":"-If treated, at least 14 days between the end of stereotactic radiotherapy or whole brain radiotherapy and initiation of study treatment and recovery from Aes related to radiotherapy to ≤ grade 1 (except alopecia), or at least 28 days between neurosurgical resection and initiation of study treatment; o Anticonvulsant therapy at a stable dose is permitted; o Metastases are limited to the cerebellum or the supratentorial region (i.e., no metastases to the midbrain, pons, medulla or spinal cord); o There is no evidence of interim progression between completion of CNS directed therapy (if administered) and initiation of study treatment."}
• {"criterion_text":"-Evidence of leptomeningeal disease."}
• {"criterion_text":"-Treatment with systemic immunostimulatory agents (including, but not limited to, interferon and interleukin 2 [IL-2]) within 4 weeks or 5 drug elimination half-lives (whichever is longer) prior to initiation of study treatment except for PD-L1 inhibitor maintenance as part of first-line treatment."}
• {"criterion_text":"-Patient has received a live-virus vaccination within 30 days of planned treatment start. Seasonal flu vaccines that do not contain live virus are permitted. Note: Patients, if enrolled, should not receive live vaccine whilst receiving IP and up to 30 days after the last dose of IP."}
• {"criterion_text":"-Any comorbid condition or unresolved toxicity that would preclude administration of second-line chemotherapy"}
• {"criterion_text":"-Any condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications within 14 days of randomization. The following are exceptions to this criterion: o Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection); o Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent; o Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication)."}
• {"criterion_text":"-Diagnosed with or treated for another malignancy within 3 years before the first dose of study drug, or previously diagnosed with another malignancy and have any evidence of residual disease. Patients with non-melanoma skin cancer or carcinoma in situ of any type may be enrolled in the study if they have undergone complete resection and no evidence of active disease is present."}
• {"criterion_text":"-Any concurrent chemotherapy, IP, biologic, or hormonal therapy for cancer treatment other than those in the present study. Concurrent use of hormonal therapy for non-cancer-related conditions (e.g., hormone replacement therapy) is acceptable."}
• {"criterion_text":"-Treatment with any other investigational agent within 30 days prior to starting study treatment, or concurrent enrolment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study."}
• {"criterion_text":"-Infection requiring intravenous antibiotic therapy or other serious infection within 14 days before the first dose of study drug."}
• {"criterion_text":"-Prior allogeneic stem cell or solid organ transplantation."}
• {"criterion_text":"-For female subjects: positive serum pregnancy test, pregnancy, or breastfeeding."}

Primary endpoints

• {"endpoint_text":"-overall survival (OS), defined as the time from the date of enrollment registration to the date of death from any cause. Patients still alive at the time of analysis are censored at the last time they are known to be alive.","definition_or_measurement_approach":"Defined as the time from the date of enrollment registration to the date of death from any cause; patients alive at analysis are censored at last known alive date."}

Secondary endpoints

• {"endpoint_text":"-Toxicity: the assessment of safety will be based mainly on the frequency of adverse events; toxicity will be measured according to NCI Common Toxicity Criteria Adverse Event (CTCAE), version 5.0.","definition_or_measurement_approach":"Safety assessed by frequency of adverse events; toxicity graded per NCI CTCAE v5.0."}
• {"endpoint_text":"-Progression Free Survival (PFS) defined as the time from the patient enrollment registration to the evidence of progressive disease, or death, or the last date the patient was known to be progression-free or alive.","definition_or_measurement_approach":"Time from enrollment to documented progressive disease or death; censoring at last date known progression-free/alive."}
• {"endpoint_text":"-Objective response rate (ORR): the sum of RECIST v1.1-defined CR and PR out of the number of assessable patients with measurable disease at baseline.","definition_or_measurement_approach":"ORR = (CR + PR) per RECIST v1.1 among assessable patients with measurable disease at baseline."}

Italy

Latest Decision Or Authorization Date

26-11-2025

Number Of Sites

25

Number Of Participants

142

Primary sponsor

Full Name

G.O.I.R.C. Gruppo Oncologico Italiano Di Ricerca Clinica

Organisation Type

Patient organisation/association

Country Of Registered Address

Italy

Third parties

• {"country":"","full_name":"ROCHE S.P.A.","duties_or_roles":"Monetary support","organisation_type":""}