DUMAS: Neo-Adjuvant Immunotherapy for Pancoast Tumors

NCT ID: NCT05684276

Last Updated: 2025-04-10

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-12

Study Completion Date

2028-06-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The goal of this clinical trial is to test the efficacy of induction treatment of immunotherapy and chemotherapy depending on the resection status for the treatment of non small cell lung cancer patients diagnosed with pancoast tumor.

The main objectives it aims to answer are:

* Complete resection rate after induction treatment with chemotherapy plus nivolumab
* Overall Survival and Progression Free Survival at 24 months

The sample size is 40 patients.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This is an open-label, phase II, single-arm, multi-centre clinical trial.

The total sample size is 40 patients. The population to be included are previously untreated patients with histologically- or cytologically- documented NSCLC diagnosed with Pancoast tumor.

Patients will receive Nivolumab 360mg + Paclitaxel 200mg/m2 + Carboplatin AUC6 for 3 cycles every 21 days (+/- 3 days) as neoadjuvant treatment followed by surgery and 6 months of adjuvant treatment with Nivolumab 480 mg Q4W (+/- 3 days) if applicable and depending on surgery results. Patients that will not receive adjuvant treatment will start follow up phase after end of treatment visit. Follow up for all patients must be done for 2 years.

The primary objective is to evaluate the complete resection (R0) rate after induction treatment defined as the absence of residual tumor in patients treated with neoadjuvant chemo-immunotherapy.Secondary objectives and endpoint are Overall survival rate at 24 months and disease-free survival rate at 24 months.

Patient accrual is expected to be completed within 2 years excluding a run-in-period of 3 months. Treatment and follow-up are expected to extend the study duration to a total of 5 years. The study will end once survival follow-up has concluded.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

NSCLC Pancoast Tumor

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Experimental: Neodjuvant treatment + Adjuvant maintenance treatment

Neodjuvant treatment:

Nivolumab: 360 mg intravenous Q3W Paclitaxel: 200mg/m2 infusion over 3 hours Carboplatin: AUC6 at the end of the Paclitaxel infusion

Neoadjuvant treatment will start within 1-3 days from enrollment. 3 cycles will be administered at 21-day (+/- 3 days) intervals (QW3) prior to surgery. Before surgery a tumor assessment will be done. Patients must leave the study if there is evidence of progression. Patients with stable disease or partial response may be considered for surgery.

Surgery: Surgery must be done within the 3rd-4th week (+7 days) from day 21 cycle 3 of neoadjuvant treatment (day 42-49 after day 1 of cycle 3)

Depending on surgery results the patient will receive:

* Patients with degree of resection 'R0': Adjuvant treatment for 6 months with Nivolumab 480mg QW4
* Patients with degree of resection 'R1' or 'R2': standard treatment according to local guidelines

Group Type EXPERIMENTAL

Carboplatin

Intervention Type DRUG

Structure: The cis-diamino (cyclobutane-1, 1 dicarboxylate) plating. Stability: 24 hours at ambient temperature in 5% glucose, sodium chloride and glucose 5% solution solution or physiologic saline. It is recommended not to dilute with chlorinated solutions for this could affect the carboplatin.

Route of administration: Intravenous infusion. Guidelines of Carboplatin administration: According to the standard of ech center.

Paclitaxel

Intervention Type DRUG

Structure: A diterpene whose composition is: 5b, 20-epoxy-1, 2a, 4,7b, 10b, 13a-hexa-hydroxy-11-en 9 one 4,10-diacetate 2-benzoate 13-ester with (2R,3S)- N-benzoyl-3-phenylisoserine.

Stability: Concentrations of 0.3-1.2 mg/ml in 5% dextrose or normal saline have demonstrated chemical and physical stability for more that 27 hours at ambient temperature (25ºC approximately). The intact vial must be stored between 15º and 25ºC.

Guidelines on Paclitaxel administration: Paclitaxel must be administered by infusion over 3 hours in dextrose (D5W) or normal saline (NS). The concentration must not exceed 1.2 mg/ml.

Nivolumab

Intervention Type DRUG

Structure: Nivolumab is a soluble protein consisting of 4 polypeptide chains. Route of administration: Intravenous infusion. Product Description: Nivolumab (BMS-936558-01) Injection drug product is a sterile, non-pyrogenic, single-use, isotonic aqueous solution formulated in 10 mg/ml.

Storage Conditions: It must be stored at 2 to 8 degrees Cº and protected from light and freezing.

Guidelines: The administration of nivolumab infusion must be completed within 24 hours of preparation.The dose of Nivolumab for the adjuvant treatment is 360 mg administered as an intravenous infusion over 30 minutes every 3 weeks (+/-3 days) for 3 cycles.

For the maintenance adjuvant treatment the dose is nivolumab 480 mg Q4W (+/-3 days) over 30 minutes for 6 months (6 cycles).

Subjects should be carefully monitored during nivolumab administration to follow infusion reactions. Doses of nivolumab may be interrupted, delayed, or discontinued depending on how well the subject tolerates the treatment.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Carboplatin

Structure: The cis-diamino (cyclobutane-1, 1 dicarboxylate) plating. Stability: 24 hours at ambient temperature in 5% glucose, sodium chloride and glucose 5% solution solution or physiologic saline. It is recommended not to dilute with chlorinated solutions for this could affect the carboplatin.

Route of administration: Intravenous infusion. Guidelines of Carboplatin administration: According to the standard of ech center.

Intervention Type DRUG

Paclitaxel

Structure: A diterpene whose composition is: 5b, 20-epoxy-1, 2a, 4,7b, 10b, 13a-hexa-hydroxy-11-en 9 one 4,10-diacetate 2-benzoate 13-ester with (2R,3S)- N-benzoyl-3-phenylisoserine.

Stability: Concentrations of 0.3-1.2 mg/ml in 5% dextrose or normal saline have demonstrated chemical and physical stability for more that 27 hours at ambient temperature (25ºC approximately). The intact vial must be stored between 15º and 25ºC.

Guidelines on Paclitaxel administration: Paclitaxel must be administered by infusion over 3 hours in dextrose (D5W) or normal saline (NS). The concentration must not exceed 1.2 mg/ml.

Intervention Type DRUG

Nivolumab

Structure: Nivolumab is a soluble protein consisting of 4 polypeptide chains. Route of administration: Intravenous infusion. Product Description: Nivolumab (BMS-936558-01) Injection drug product is a sterile, non-pyrogenic, single-use, isotonic aqueous solution formulated in 10 mg/ml.

Storage Conditions: It must be stored at 2 to 8 degrees Cº and protected from light and freezing.

Guidelines: The administration of nivolumab infusion must be completed within 24 hours of preparation.The dose of Nivolumab for the adjuvant treatment is 360 mg administered as an intravenous infusion over 30 minutes every 3 weeks (+/-3 days) for 3 cycles.

For the maintenance adjuvant treatment the dose is nivolumab 480 mg Q4W (+/-3 days) over 30 minutes for 6 months (6 cycles).

Subjects should be carefully monitored during nivolumab administration to follow infusion reactions. Doses of nivolumab may be interrupted, delayed, or discontinued depending on how well the subject tolerates the treatment.

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Paraplatin Taxol Opdivo

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* 1\. Previously untreated patients with histologically- or cytologically- documented NSCLC diagnosed with Pancoast tumor according to 8th edition of the TNM (stages IIB, IIIA and T3N2 (IIIB) patients)
* 2\. PET/CT including IV contrast (CT of diagnostic quality) will be performed at baseline (28 days +10 before enrollment) to rule out the presence of distant disease. Also, a brain CT-SCAN or brain MRI will be done at baseline
* 3\. Positive mediastinal lymph nodes by PET-CT must be confirmed histologically. Mediastinal involvement may be considered without the need for histological confirmation when there is a mass of lymph nodes in which the margins cannot be distinguished
* 4\. Measurable or evaluable disease (according to RECIST 1.1 criteria)
* 5\. ECOG (Performance status) 0-2
* 6\. Patients with a life expectancy of at least more than 12 weeks
* 7\. Patients aged \> 18 years and ≤ 75 years
* 8 Screening laboratory values must meet the study criteria and should be obtained within 14 days prior to enrollment
* 9\. Correct lung function without bronchodilators, defined by forced expiratory volume in 1 second (FEV1) \>40% of the predicted normal volume, and a pulmonary diffusing capacity for carbon monoxide (DLCO) \>40% of the predicted normal value
* 10\. All patients are notified of the investigational nature of this study and signed a written informed consent in accordance with institutional and national guidelines, including the Declaration of Helsinki prior to any trial-related intervention
* 11\. Women of childbearing potential, including women who had their last menstrual period in the last 2 years, must have a negative serum or urine pregnancy test within 7 days before enrollment.
* 12\. All sexually active men and women of childbearing potential must use an effective contraceptive method during the study treatment and for a period of at least 12 months following the last administration of trial drugs
* 13\. Patient capable of proper therapeutic compliance and accessible for correct follow-up.

Exclusion Criteria

* 1\. Patients that receive previous treatment with antineoplastic drugs, chest radiotherapy, or previous surgery for lung cancer or for another reason
* 2\. Pleural or pericardial effusion: Both will be considered indicative of metastatic disease unless proven otherwise. Those that, even being cytologically negative for malignancy, are exudates, will also be excluded. Patients with pleural effusion not visible on chest X-ray or too small to perform diagnostic puncture safely may be included.
* 3\. Patients with a weight loss \>10% in the 3 months prior to the study entry
* 4\. All patients carrying activating mutations in the TK domain of EGFR or any variety of alterations in the ALK gene or ROS1 mutations.
* 5\. Patients with active, known or suspected autoimmune disease. Subjects with vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune thyroiditis only requiring hormone replacement or unexpected conditions of recurrence in the absence of an external trigger are allowed to be included.
* 6\. Patients with symptomatic neuropathy \> grade 1 according to the CTCAE v5.0 and that were not related to the tumor
* 7\. Patients with a condition requiring systemic treatment with either corticosteroids (\>10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of enrollment. Inhaled or topical steroids, and adrenal replacement steroid doses \> 10 mg daily prednisone equivalent, are permitted in the absence of active autoimmune disease.
* 8\. Patients with a history of interstitial lung disease cannot be included if they have symptomatic ILD (Grade 3-4) and/or poor lung function. In case of doubt please contact trial team.
* 9\. Patients with other active malignancy requiring concurrent intervention and/or concurrent treatment with other investigational drugs or anticancer therapy
* 10\. Patients with uncontrolled comorbidities that may affect the clinical trial compliance
* 11\. Patients with previous malignancies (except non-melanoma skin cancers, and the following in situ cancers: bladder, gastric, colon, endometrial, cervical/dysplasia, melanoma, or breast) are excluded unless a complete remission was achieved at least 5 years prior to study entry and no additional therapy is required during the study period.
* 12\. Any medical, mental, neurological or psychological condition which in the opinion of the investigator would not permit the patient to complete the study or understand the patient information sheet.
* 13\. Patients in any psychological, familiar, sociological or geographical situation that may hinder compliance with the study protocol and/or the follow up
* 14\. Patients who have had prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways
* 15\. Patients with positive test for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV antibody) indicating acute or chronic infection
* 16\. Patients with known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS).
* 17\. Patients with know hypersensitivity to drugs with a structure similar to the study drug and/or history of allergy to study drug components excipients
* 18\. Women who are pregnant or in the period of breastfeeding
* 19\. Sexually active men and women of childbearing potential who are not willing to use an effective contraceptive method during the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Fundación GECP

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Mariano Provencio, MD

Role: STUDY_CHAIR

Fundación GECP President

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Hospital De Mataro

Mataró, Barcelona, Spain

Site Status RECRUITING

Hospital Universitario Jerez De La Frontera

Jerez de la Frontera, Cádiz, Spain

Site Status RECRUITING

Hospital Universitario Puerta de Hierro

Majadahonda, Madrid, Spain

Site Status RECRUITING

Hospital General Universitario de Elche

Alicante, , Spain

Site Status RECRUITING

Hospital Universitari Quiron Dexeus

Barcelona, , Spain

Site Status RECRUITING

Hospital Universitari Vall d' Hebron

Barcelona, , Spain

Site Status RECRUITING

Hospital Clínic De Barcelona

Barcelona, , Spain

Site Status RECRUITING

Hospital Parc Taulí

Barcelona, , Spain

Site Status RECRUITING

Hospital Universitario de Cruces

Bilbao, , Spain

Site Status RECRUITING

Hospital San Pedro De Alcántara

Cáceres, , Spain

Site Status RECRUITING

Hospital Josep Trueta

Girona, , Spain

Site Status RECRUITING

Hospital Universitario de Jaén

Jaén, , Spain

Site Status RECRUITING

Hospital Universitario Lucus Augusti

Lugo, , Spain

Site Status RECRUITING

Hospital Clínico San Carlos

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Fundación Jiménez Díaz

Madrid, , Spain

Site Status RECRUITING

Hospital 12 De Octubre

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario la Paz

Madrid, , Spain

Site Status RECRUITING

Fundació Althaïa

Manresa, , Spain

Site Status RECRUITING

Hospital Universitario Regional de Málaga

Málaga, , Spain

Site Status RECRUITING

Hospital Son Espases

Palma de Mallorca, , Spain

Site Status RECRUITING

Hospital Universitario Salamanca

Salamanca, , Spain

Site Status RECRUITING

Hospital Universitario Virgen Del Rocio

Seville, , Spain

Site Status RECRUITING

Consorci Sanitari de Terrassa

Terrassa, , Spain

Site Status RECRUITING

Hospital Clínico de Valencia

Valencia, , Spain

Site Status RECRUITING

Hospital General Universitario de Valencia

Valencia, , Spain

Site Status RECRUITING

Hospital Universitario Dr. Peset

Valencia, , Spain

Site Status RECRUITING

Hospital Universitario La Fe

Valencia, , Spain

Site Status RECRUITING

Hospital Clínico Universitario de Valladolid

Valladolid, , Spain

Site Status RECRUITING

Complexo Hospitalario Universitario De Vigo

Vigo, , Spain

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Spain

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Eva Pereira

Role: CONTACT

+34934302006

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Laura Puntí, MD

Role: primary

Mª Ángeles Moreno, MD

Role: primary

Mariano Provencio, MD

Role: primary

María Guirado, MD

Role: primary

Andrés Aguilar, MD

Role: primary

Alex Martínez, MD

Role: primary

Noemí Reguart

Role: primary

Julia Giner, MD

Role: primary

Eider Azkona Uribelarrea, MD

Role: primary

Rubén Alonso Calderón, MD

Role: primary

Elia Sais Girona, MD

Role: primary

Ana Laura Ortega Granados, MD

Role: primary

Begoña Campos, MD

Role: primary

Carlos Aguado, MD

Role: primary

Manuel Dómine, MD

Role: primary

Luis Paz-Ares, MD

Role: primary

Javier De Castro, MD

Role: primary

Silvia Catot, MD

Role: primary

José Miguel Jurado, MD

Role: primary

Raquel Marsé, MD

Role: primary

Edel del Barco, MD

Role: primary

Miriram Alonso, MD

Role: primary

Marc Campayo, MD

Role: primary

Amelia Insa, MD

Role: primary

Paula Espinosa, MD

Role: primary

Inmaculada Maestu, MD

Role: primary

Francisco Aparisi, MD

Role: primary

Rafael López, MD

Role: primary

Martín Lázaro, MD

Role: primary

Related Links

Access external resources that provide additional context or updates about the study.

http://www.gecp.org

Web page of the sponsor where users can find more information about Fundación GECP studies

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2022-003717-11

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

GECP 22/02_DUMAS

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

NADIM II: Neo-Adjuvant Immunotherapy
NCT03838159 ACTIVE_NOT_RECRUITING PHASE2
BMS-986012 in Relapsed/Refractory SCLC
NCT02247349 COMPLETED PHASE1/PHASE2