A Study of [177Lu]Lu-DOTA-TATE in Newly Diagnosed ES-SCLC Patients in Combination With Carboplatin, Etoposide and Atezolizumab

NCT ID: NCT05142696

Last Updated: 2026-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-13

Study Completion Date

2029-03-23

Brief Summary

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This study aims to establish a safe and well tolerated dose of \[177Lu\]Lu-DOTA-TATE in combination with carboplatin, etoposide and atezolizumab in this setting and to assess preliminary efficacy of this combination treatment versus the combination of carboplatin, etoposide, and atezolizumab.The study will be essential to assess a new potential therapeutic option in participants with this aggressive cancer type.

Detailed Description

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The study for each participant consists of a Screening period, a Treatment period that includes an Induction treatment period and a Maintenance treatment period, and a Follow-up period.

The study will consist of a Phase Ib dose escalation with concurrent backfill part and a randomised controlled Phase II part.

During the screening period of up to 28 days before starting SCLC treatment, each participant will be assessed for somatostatin receptor (SSTR) expression by \[68Ga\]Ga-DOTA-TATE imaging PET/scan.

The dose escalation part in this study will be guided by the dose limiting toxicity (DLT) rate observed during the DLT period. To achieve a more robust dataset and to aid dose decisions, additional participants may be backfilled in each dose level.

Upon declaring RD, a 1:1 randomised Phase II with approximately 140 participants with newly diagnosed ES-SCLC will be enrolled and receive either \[177Lu\]Lu-DOTA-TATE at the RD in combination with carboplatin, etoposide and atezolizumab (experimental arm) or carboplatin, etoposide and atezolizumab alone (control arm).

Conditions

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Extensive Stage Small Cell Lung Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dose Level 1 (DL1)

Dose Level 1 (DL1): \[177Lu\]Lu-DOTA-TATE 100 mCi with carboplatin AUC 5 D1, etoposide 100 mg/m2 D1-3, and atezolizumab 1200 mg in induction period, then \[177Lu\]Lu-DOTA-TATE 100 mCi plus atezolizumab 1200 mg in the maintenance period.

Group Type EXPERIMENTAL

[177Lu]Lu-DOTA-TATE

Intervention Type DRUG

Solution for infusion of \[177Lu\]Lu-DOTA-TATE will be administered as follows:

* 2 administrations during the induction period on either Day 3, 4 or 5 of Week 1 and on Week 7 Day 3
* 1 to 4 administrations during the maintenance period on Week 13 Day 1, Week 16 Day 1, Week 19 Day 1 and Week 22 Day 1, depending on the dose assessed

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Dose Level 2a (DL2a)

Dose Level 2a (DL2a): \[177Lu\]Lu-DOTA-TATE 150 mCi with carboplatin AUC 5 D1, etoposide 100 mg/m2 D1-3 and atezolizumab 1200 mg in induction period, then \[177Lu\]Lu-DOTA-TATE 150 mCi plus atezolizumab 1200 mg in the maintenance period.

Group Type EXPERIMENTAL

[177Lu]Lu-DOTA-TATE

Intervention Type DRUG

Solution for infusion of \[177Lu\]Lu-DOTA-TATE will be administered as follows:

* 2 administrations during the induction period on either Day 3, 4 or 5 of Week 1 and on Week 7 Day 3
* 1 to 4 administrations during the maintenance period on Week 13 Day 1, Week 16 Day 1, Week 19 Day 1 and Week 22 Day 1, depending on the dose assessed

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Dose Level 2b (DL2b)

Dose Level 2b (DL2b): \[177Lu\]Lu-DOTA-TATE 150 mCi with carboplatin AUC 5 D1, etoposide 100 mg/m2 D1-3 and atezolizumad 1200 mg in induction period, then \[177Lu\]Lu-DOTA-TATE 200 mCi plus atezolizumab 1200 in the maintenance period.

Group Type EXPERIMENTAL

[177Lu]Lu-DOTA-TATE

Intervention Type DRUG

Solution for infusion of \[177Lu\]Lu-DOTA-TATE will be administered as follows:

* 2 administrations during the induction period on either Day 3, 4 or 5 of Week 1 and on Week 7 Day 3
* 1 to 4 administrations during the maintenance period on Week 13 Day 1, Week 16 Day 1, Week 19 Day 1 and Week 22 Day 1, depending on the dose assessed

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Dose Level 3a (DL3a)

Dose Level 3a (DL3a): \[177Lu\]Lu-DOTA-TATE 200 mCi with carboplatin AUC 5 D1, etoposide 100 mg/m2 D1-3, and atezolizumab 1200 mg in induction period, then \[177Lu\]Lu-DOTA-TATE 200 mCi plus atezolizumab 1200 mg in the maintenance period.

Group Type EXPERIMENTAL

[177Lu]Lu-DOTA-TATE

Intervention Type DRUG

Solution for infusion of \[177Lu\]Lu-DOTA-TATE will be administered as follows:

* 2 administrations during the induction period on either Day 3, 4 or 5 of Week 1 and on Week 7 Day 3
* 1 to 4 administrations during the maintenance period on Week 13 Day 1, Week 16 Day 1, Week 19 Day 1 and Week 22 Day 1, depending on the dose assessed

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Dose Level 3b (DL3b)

Dose Level 3b (DL3b): \[177Lu\]Lu-DOTA-TATE 200 mCi with carboplatin AUC 5 D1, etoposide 100 mg/m2 D1-3, and atezolizumab 1200 mg in induction period, then \[177Lu\]Lu-DOTA-TATE 250 mCi plus atezolizumab 1200 mg in the maintenance period.

Group Type EXPERIMENTAL

[177Lu]Lu-DOTA-TATE

Intervention Type DRUG

Solution for infusion of \[177Lu\]Lu-DOTA-TATE will be administered as follows:

* 2 administrations during the induction period on either Day 3, 4 or 5 of Week 1 and on Week 7 Day 3
* 1 to 4 administrations during the maintenance period on Week 13 Day 1, Week 16 Day 1, Week 19 Day 1 and Week 22 Day 1, depending on the dose assessed

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Dose Level 4 (DL4)

Dose Level 4 (DL4): \[177Lu\]Lu-DOTA-TATE 250 mCi with carboplatin AUC 5 D1, etoposide 100 mg/m2 D1-3 and atezolizumab 1200 mg in induction period, then \[177Lu\]Lu-DOTA-TATE 250 mCi plus atezolizumab 1200 mg in the maintenance period.

Group Type EXPERIMENTAL

[177Lu]Lu-DOTA-TATE

Intervention Type DRUG

Solution for infusion of \[177Lu\]Lu-DOTA-TATE will be administered as follows:

* 2 administrations during the induction period on either Day 3, 4 or 5 of Week 1 and on Week 7 Day 3
* 1 to 4 administrations during the maintenance period on Week 13 Day 1, Week 16 Day 1, Week 19 Day 1 and Week 22 Day 1, depending on the dose assessed

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Phase II Experimental arm

\[177Lu\]Lu-DOTA-TATE at recommended dose declared in phase I part in combination with carboplatin, etoposide and atezolizumab (experimental arm)

Group Type EXPERIMENTAL

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Phase II Control arm

Carboplatin, etoposide and atezolizumab alone (control arm)

Group Type OTHER

Atezolizumab

Intervention Type DRUG

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

[68Ga]Ga-DOTA-TATE

Intervention Type DRUG

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Carboplatin

Intervention Type OTHER

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Etoposide

Intervention Type OTHER

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Interventions

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[177Lu]Lu-DOTA-TATE

Solution for infusion of \[177Lu\]Lu-DOTA-TATE will be administered as follows:

* 2 administrations during the induction period on either Day 3, 4 or 5 of Week 1 and on Week 7 Day 3
* 1 to 4 administrations during the maintenance period on Week 13 Day 1, Week 16 Day 1, Week 19 Day 1 and Week 22 Day 1, depending on the dose assessed

Intervention Type DRUG

Atezolizumab

Atezolizumab 1200 mg on Day 1 from Cycle 2 every 3 weeks in induction and maintenance period

Intervention Type DRUG

[68Ga]Ga-DOTA-TATE

2 MBq/kg of body weight (0.054 mCi/kg), with a minimum dose of 100 MBq (2.7 mCi) and maximum dose of 200 MBq (5.4 mCi)

Intervention Type DRUG

Carboplatin

Four cycles of carboplatin AUC 5 on Day 1 every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Intervention Type OTHER

Etoposide

Four cycles of etoposide 100 mg/m2 on Day 1-3, every 3 weeks (Weeks 1, 4, 7 and 10) in induction period

Intervention Type OTHER

Other Intervention Names

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Lutathera Lutetium (177Lu) oxodotreotide Lutetium Lu 177 dotatate

Eligibility Criteria

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Inclusion Criteria

* Participant is \>= 18 years on the day of signing informed consent form
* Histologically or cytologically confirmed ES-SCLC
* Presence of measurable disease
* No prior systemic treatment for ES-SCLC (except the first cycle of chemotherapy with or without atezolizumab of the induction period
* ECOG status =\< 1
* Provision of tumor tissue to support exploratory biomarker analysis
* Life expectancy of \>= 6 months

Exclusion Criteria

* Participant has received prior therapy with an antibody or drug against immune checkpoint pathways
* Active autoimmune diseases or history of autoimmune diseases that may relapse
* Severe chronic or active infections (including active tuberculosis, HBV, or HCV infection) requiring systemic antibacterial, antifungal or antiviral therapy within 2 weeks before Cycle 1 Day 1
* Any major surgical procedure requiring general anesthesia =\< 28 days before Cycle 1 Day 1
* History or current diagnosis of electrocardiogram (ECG) abnormalities indicating significant risk of safety for participants participating in the study
* Known hypersensitivity to the active substances or any of the excipients of the study drugs
* Concurrent participation in another therapeutic clinical study
Minimum Eligible Age

18 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Novartis Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Novartis Pharmaceuticals

Role: STUDY_DIRECTOR

Novartis Pharmaceuticals

Locations

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Georgetown University Lombardi Cancer Center

Washington D.C., District of Columbia, United States

Site Status

Advent Health Cancer Institute

Orlando, Florida, United States

Site Status

University Cancer and Blood Center LLC

Athens, Georgia, United States

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University of Kentucky

Lexington, Kentucky, United States

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St. Louis University

St Louis, Missouri, United States

Site Status

Hackensack Meridian Health

Edison, New Jersey, United States

Site Status

University Hospitals Of Cleveland

Cleveland, Ohio, United States

Site Status

Fox Chase Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

Vanderbilt University Medical Ctr

Nashville, Tennessee, United States

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Novartis Investigative Site

Innsbruck, Tyrol, Austria

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Novartis Investigative Site

Linz, Upper Austria, Austria

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Novartis Investigative Site

Vienna, , Austria

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Novartis Investigative Site

Toronto, Ontario, Canada

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Novartis Investigative Site

Montreal, Quebec, Canada

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Novartis Investigative Site

Montreal, Quebec, Canada

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Novartis Investigative Site

Beijing, , China

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Novartis Investigative Site

Shanghai, , China

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Olomouc, , Czechia

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Novartis Investigative Site

Bron, , France

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Lille, , France

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Marseille, , France

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Montpellier, , France

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Nantes, , France

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Villejuif, , France

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Novartis Investigative Site

Cologne, North Rhine-Westphalia, Germany

Site Status

Novartis Investigative Site

Essen, , Germany

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Novartis Investigative Site

Hong Kong, , Hong Kong

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Novartis Investigative Site

Beersheba, , Israel

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Haifa, , Israel

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Ramat Gan, , Israel

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Tel Aviv, , Israel

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Milan, MI, Italy

Site Status

Novartis Investigative Site

Napoli, , Italy

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Novartis Investigative Site

Amersfoort, , Netherlands

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Novartis Investigative Site

Utrecht, , Netherlands

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Novartis Investigative Site

Singapore, , Singapore

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Novartis Investigative Site

Seoul, , South Korea

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Novartis Investigative Site

Seoul, , South Korea

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Novartis Investigative Site

Salamanca, Castille and León, Spain

Site Status

Novartis Investigative Site

Barcelona, Catalonia, Spain

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Novartis Investigative Site

Madrid, , Spain

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Novartis Investigative Site

Madrid, , Spain

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Novartis Investigative Site

Madrid, , Spain

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Novartis Investigative Site

Málaga, , Spain

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Novartis Investigative Site

Taichung, Taiwan ROC, Taiwan

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Novartis Investigative Site

Taipei, , Taiwan

Site Status

Novartis Investigative Site

Taoyuan District, , Taiwan

Site Status

Novartis Investigative Site

Guildford, Surrey, United Kingdom

Site Status

Countries

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United States Austria Canada China Czechia France Germany Hong Kong Israel Italy Netherlands Singapore South Korea Spain Taiwan United Kingdom

Other Identifiers

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2021-004155-16

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

2024-513185-19-00

Identifier Type: OTHER

Identifier Source: secondary_id

CAAA601A42101

Identifier Type: -

Identifier Source: org_study_id

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