NCT02194738
Genetic Testing in Screening Patients With Stage IB-IIIA Non-small Cell Lung Cancer That Has Been or Will Be Removed by Surgery (The ALCHEMIST Screening Trial)
NA
RECRUITING
NCT02194738
INTERVENTIONAL
Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trial (ALCHEMIST)
This ALCHEMIST trial studies genetic testing in screening patients with stage IB-IIIA non-small cell lung cancer that has been or will be removed by surgery. Studying the genes in a patient's tumor cells may help doctors select the best treatment for patients that have certain genetic changes.
Inclusion Criteria:
* PATIENT PRE-REGISTRATION ELIGIBILITY CRITERIA:
* For pre-surgical patients
* Suspected diagnosis of resectable non-small cell lung cancer; cancers with a histology of "adenosquamous" are considered a type of adenocarcinoma and thus a "nonsquamous" histology; patients with squamous cell carcinoma are eligible
* Suspected clinical stage of IIIA, II (IIA or IIB) or large IB (defined as size \>= 4 cm); Note: IB tumors \< 4 cm are NOT eligible; stage IB cancer based on pleural invasion is not eligible unless the tumor size is \>= 4 cm; the 7th edition of American Joint Committee on Cancer (AJCC) staging will be utilized
* For post-surgical patients
* Completely resected non-small cell lung cancer with negative margins (R0); patients with squamous cell carcinoma are eligible only if they have not received adjuvant therapy
* Pathologic stage IIIA, II (IIA or IIB) or large IB (defined as size \>= 4 cm); Note: IB tumors \< 4 cm are NOT eligible; stage IB cancer based on pleural invasion is not eligible unless the tumor size is \>= 4 cm; the 7th edition of AJCC staging will be utilized
* Eastern Cooperative Oncology Group (ECOG) performance status 0-1
* Age ≥ 18 years
* No patients who have received neoadjuvant therapy (chemo- or radio-therapy) for this lung cancer
* No locally advanced or metastatic cancer requiring systemic therapy within 5 years prior to registration; no secondary primary lung cancer diagnosed concurrently or within 2 year prior to registration
* No prior treatment with agents targeting EGFR mutation, ALK rearrangement, and PD-1/PD-L1/CTLA-4
* No patients known to be pregnant or lactating
* Patients who have had local genotyping are eligible, regardless of the local result
* No patients with recurrence of lung cancer after prior resection
* Note: Post-surgical patients should proceed to registration immediately following preregistration
* PATIENT REGISTRATION ELIGIBILITY CRITERIA:
* Tissue available for the required analyses (either clinical tissue block or slides and scrolls)
* Completely resected NSCLC with negative margins (R0); cancers with a histology of "adenosquamous" are considered a type of adenocarcinoma and thus a "nonsquamous" histology
* Pathologic stage IIIA, IIA or IIB, or large IB (defined as size \>= 4 cm); Note: IB tumors \< 4 cm are NOT eligible; stage IB cancer based on pleural invasion is not eligible unless the tumor size is \>= 4 cm; the 7th edition of AJCC staging will be utilized
* Patients with squamous cell carcinoma are eligible only if they have not received adjuvant therapy
* In order to allow for time for central genotyping and eligibility for the ALCHEMIST treatment trial, patients must register within the following eligibility windows:
* Squamous patients:
* No adjuvant therapy permitted, register patient within 77 days following surgery
* Non-squamous patients:
* If no adjuvant therapy, register patient within 75 days following surgery
* If adjuvant chemotherapy or radiotherapy only, register patient within 225 days following surgery
* If adjuvant chemotherapy and radiation, register patient within 285 days following surgery
Stage IB Lung Non-Small Cell Carcinoma AJCC v7
Stage II Lung Non-Small Cell Cancer AJCC v7
Stage IIA Lung Cancer AJCC v8
Stage IIB Lung Cancer AJCC v8
Stage IIIA Lung Cancer AJCC v8
Stage IIIA Lung Non-Small Cell Cancer AJCC v7
Stage IIIB Lung Cancer AJCC v8
- SCREENING
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- Type: PROCEDURE
- Name: Biospecimen Collection
- Description: Undergo collection of blood samples
- Arm Group Labels: EA5142 Arm I (nivolumab), EA5142 Arm II (observation)
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- Type: DRUG
- Name: Carboplatin
- Description: Given IV
- Arm Group Labels: A081801 Arm A (platinum doublet, observation), A081801 Arm B (platinum doublet, sequential pembrolizumab), A081801 Arm C (platinum doublet, combination pembrolizumab)
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- Type: DRUG
- Name: Cisplatin
- Description: Given IV
- Arm Group Labels: A081801 Arm A (platinum doublet, observation), A081801 Arm B (platinum doublet, sequential pembrolizumab), A081801 Arm C (platinum doublet, combination pembrolizumab)
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- Type: OTHER
- Name: Clinical Observation
- Description: Undergo observation
- Arm Group Labels: A081105 Arm D (observation), A081801 Arm A (platinum doublet, observation), E4512 Arm B (observation), EA5142 Arm II (observation)
-
- Type: PROCEDURE
- Name: Computed Tomography
- Description: Undergo CT or PET/CT
- Arm Group Labels: EA5142 Arm I (nivolumab), EA5142 Arm II (observation)
-
- Type: DRUG
- Name: Crizotinib
- Description: Given PO
- Arm Group Labels: E4512 Arm A (crizotinib)
-
- Type: OTHER
- Name: Cytology Specimen Collection Procedure
- Description: Undergo collection of blood and tissue
- Arm Group Labels: A081105 Arm A (blinded erlotinib hydrochloride), A081105 Arm B (placebo), A081105 Arm C (unblinded erlotinib hydrochloride), A081105 Arm D (observation), E4512 Arm A (crizotinib), E4512 Arm B (observation), EA5142 Arm I (nivolumab), EA5142 Arm II (observation)
-
- Type: PROCEDURE
- Name: Echocardiography
- Description: Undergo ECHO
- Arm Group Labels: EA5142 Arm I (nivolumab), EA5142 Arm II (observation)
-
- Type: DRUG
- Name: Erlotinib
- Description: Given PO
- Arm Group Labels: A081105 Arm C (unblinded erlotinib hydrochloride)
-
- Type: DRUG
- Name: Gemcitabine Hydrochloride
- Description: Given IV
- Arm Group Labels: A081801 Arm A (platinum doublet, observation), A081801 Arm B (platinum doublet, sequential pembrolizumab), A081801 Arm C (platinum doublet, combination pembrolizumab)
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- Type: BIOLOGICAL
- Name: Nivolumab
- Description: Given IV
- Arm Group Labels: EA5142 Arm I (nivolumab)
-
- Type: DRUG
- Name: Paclitaxel
- Description: Given IV
- Arm Group Labels: A081801 Arm A (platinum doublet, observation), A081801 Arm B (platinum doublet, sequential pembrolizumab), A081801 Arm C (platinum doublet, combination pembrolizumab)
-
- Type: BIOLOGICAL
- Name: Pembrolizumab
- Description: Given IV
- Arm Group Labels: A081801 Arm B (platinum doublet, sequential pembrolizumab), A081801 Arm C (platinum doublet, combination pembrolizumab)
-
- Type: DRUG
- Name: Pemetrexed
- Description: Given IV
- Arm Group Labels: A081801 Arm A (platinum doublet, observation), A081801 Arm B (platinum doublet, sequential pembrolizumab), A081801 Arm C (platinum doublet, combination pembrolizumab)
-
- Type: DRUG
- Name: Pemetrexed Disodium
- Description: Given IV
- Arm Group Labels: A081801 Arm A (platinum doublet, observation), A081801 Arm B (platinum doublet, sequential pembrolizumab), A081801 Arm C (platinum doublet, combination pembrolizumab)
-
- Type: OTHER
- Name: Placebo Administration
- Description: Given PO
- Arm Group Labels: A081105 Arm B (placebo)
-
- Type: PROCEDURE
- Name: Positron Emission Tomography
- Description: Undergo PET/CT
- Arm Group Labels: EA5142 Arm I (nivolumab), EA5142 Arm II (observation)
- National Cancer Institute (NCI)