A Study Evaluating the Safety and Efficacy of Neoadjuvant and Adjuvant Tiragolumab Plus Atezolizumab, With or Without Platinum-Based Chemotherapy, in Participants With Previously Untreated Locally Advanced Resectable Stage II, IIIA, or Select IIIB Non-Small Cell Lung Cancer
Purpose
This study will evaluate the surgical safety and feasibility of atezolizumab plus tiragolumab alone or in combination with platinum-based chemotherapy as neoadjuvant treatment for participants with previously untreated locally advanced non-small cell lung cancer (NSCLC). The study will also evaluate the efficacy, pharmacokinetics, immunogenicity, and safety of atezolizumab plus tiragolumab alone or in combination with platinum-based chemotherapy as neoadjuvant treatment, followed by adjuvant atezolizumab plus tiragolumab or adjuvant platinum-based chemotherapy.
Condition
- Non-Small Cell Lung Cancer (NSCLC)
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- Histologically or cytologically confirmed Stage II, IIIA, or select IIIB (T3N2 only) NSCLC of squamous or non-squamous histology - Eligible for R0 resection with curative intent at the time of screening - Adequate pulmonary function to be eligible for surgical resection with curative intent - Eligible to receive a platinum-based chemotherapy regimen - Measurable disease, as assessed by the investigator per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 - Availability of a representative tumor specimen that is suitable for determination of PD-L1 status - Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 - Normal life expectancy, excluding lung cancer mortality risk - Adequate hematologic and end-organ function - Negative human immunodeficiency virus (HIV) test at screening - Negative serology for active hepatitis B virus (HBV) and active hepatitis C virus (HCV) at screening
Exclusion Criteria
- NSCLC with histology of large cell neuroendocrine carcinoma, sarcomatoid carcinoma, or NSCLC not otherwise specified - Small cell lung cancer (SCLC) histology or NSCLC with any component of SCLC - Any prior therapy for lung cancer - Active or history of autoimmune disease or immune deficiency - History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest computed tomography (CT) scan - Active tuberculosis - Significant cardiovascular disease - NSCLC with an activating EGFR mutation or ALK fusion oncogene - Known c-ros oncogene 1 (ROS1) rearrangement - History of malignancy other than NSCLC within 5 years prior to screening, with the exception of malignancies with negligible risk of metastasis or death - Severe infection within 4 weeks prior to initiation of study treatment or any active infection that, in the opinion of the investigator, could impact patient safety - Prior treatment with CD127 agonists or immune checkpoint blockade therapies, including anti-CTLA-4, anti-PD-1, anti-TIGIT, and anti-PD-L1 therapeutic antibodies - Treatment with systemic immunostimulatory agents - Treatment with systemic immunosuppressive medication - Pregnancy or breastfeeding
Study Design
- Phase
- Phase 2
- Study Type
- Interventional
- Allocation
- Non-Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Treatment
- Masking
- None (Open Label)
Arm Groups
Arm | Description | Assigned Intervention |
---|---|---|
Experimental Cohort A (PD-L1 High) |
Participants with high programmed death-ligand 1 (PD-L1) expression level will be enrolled in Cohort A and receive neoadjuvant atezolizumab plus tiragolumab for 4 cycles, followed by surgical resection and either adjuvant atezolizumab plus tiragolumab for 16 cycles or adjuvant chemotherapy for 4 cycles at the discretion of the investigator. Chemotherapy may include: - cisplatin/carboplatin + pemetrexed (for non-squamous only) - carboplatin + gemcitabine (for squamous only) - carboplatin + paclitaxel |
|
Experimental Cohort B (PD-L1 All Comers) |
All comers, which are participants with any PD-L1 expression level, will be enrolled in Cohort B and receive neoadjuvant atezolizumab plus tiragolumab plus chemotherapy for 4 cycles, followed by surgical resection and adjuvant atezolizumab plus tiragolumab for 16 cycles. Chemotherapy may include: - cisplatin/carboplatin + pemetrexed (for non-squamous only) - carboplatin + gemcitabine (for squamous only) - carboplatin + paclitaxel |
|
More Details
- Status
- Active, not recruiting
- Sponsor
- Hoffmann-La Roche