PALACE: Cemiplimab Trial According to ctDNA Levels

NCT ID: NCT06917573

Last Updated: 2025-11-19

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-29

Study Completion Date

2031-12-30

Brief Summary

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This is an open-label, non-randomised, phase II, multicenter clinical trial. 63 stage IV or stage IIIB/C not candidates for definitive chemo/radiotherapy or surgical resection non-small cell lung cancer (NSCLC) per the 8th edition TNM with no prior systemic anti-cancer therapy will be enrolled in this trial to determine whether therapy decision making based on ctDNA analysis improves overall survival.

Detailed Description

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This is an open-label, non-randomised, phase II, multicenter clinical trial. The total sample size is 63 patients. The population to be included are stage IV or stage IIIB/C not candidates for definitive chemo/radiotherapy or surgical resection non-small cell lung cancer (NSCLC) per the 8th edition TNM with no prior systemic anti-cancer therap.

Patients will be treated with Cemiplimab for 2 cycles and after response evaluation and ctDNA levels analysis, patients will be treated with Cemiplimab plus chemotherapy or cemiplimab monotherapy depending on response and ctDNA levels.

The primary research goal is to determine whether therapy decision making based on ctDNA analysis improves overall survival.

Patient accrual is expected to be completed within 1.5 years excluding a run-in-period of 4-6 months. An estimated treatment period of 2 years, 2 years of follow-up and the preparation of the final report and the close out visit are expected to extend the study duration to a total of 6.5 years.

Conditions

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Non Small Cell Lung Cancer Metastatic Lung Diseases Stage IV Non-small Cell Lung Cancer Stage III Non-small Cell Lung Cancer Respiratory Tract Neoplasms Thoracic Neoplasms

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental

A. Cemiplimab monotherapy

\- Cemiplimab

Cemiplimab will be administered in monotherapy for 2 cycles. After 2 cycles of treatment and after response evaluation according to RECIST criteria and ctDNA quantification, patient will receive cemiplimab + chemotherapy or continue treatment with cemiplimab monotherapy

Cemiplimab monotherapy will be administered until disease progression, unacceptable toxicity, loss of clinical benefit as judged by the investigator or up to a maximum of 2 years of treatment.

B. Cemiplimab + chemotherapy

The treatment with chemotherapy will be selected according to investigator's choice. Carboplatin and Pemetrexed or Carboplatin plus taxanes is recommended.

Group Type EXPERIMENTAL

Cemiplimab

Intervention Type DRUG

Patients will receive Cemiplimab administered by IV infusion over 30 minutes every 28 days (Q3W) until disease progression, unacceptable toxicity, loss of clinical benefit as judged by the investigator or up to a maximum of 2 years of treatment.

Structure: is a high affinity hinge-stabilized IgG4P human antibody to the PD-1receptor (PDCD1, CD279) that blocks PD 1/PD L1 mediated T cell inhibition. Binding of the PD-1 ligands PD-L1 and PD-L2, to the PD-1 receptor found on T cells, inhibits T-cell proliferation and cytokine production. Upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway can contribute to inhibition of active T-cell immune surveillance of tumors.

Route of administration: Intravenous infusion.

Carboplatin

Intervention Type DRUG

Patients will receive Carboplatin administered by IV infusion for 2 cycles.

Structure: The cis-diamino (cyclobutane-1, 1 dicarboxylate) platin.

Stability: 24 hours at ambient temperature in 5% glucose, glucosaline or physiologic saline. It is recommended not to dilute with chlorinated solutions since this could affect the carboplatin.

Route of administration: Intravenous infusion.

Paclitaxel

Intervention Type DRUG

Patients will receive Paclitaxel administered by IV infusion for 2 cycles.

Structure: A diterpene whose composition is: 5b, 20- epoxy-1, 2a, 4,7b, 10b, 13a-hexahidroxytax-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 than 27 hours at ambient temperature (25ºC approximately).

The intact vial must be stored between 15º and 25ºC.

Guidelines of 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.

Interventions

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Cemiplimab

Patients will receive Cemiplimab administered by IV infusion over 30 minutes every 28 days (Q3W) until disease progression, unacceptable toxicity, loss of clinical benefit as judged by the investigator or up to a maximum of 2 years of treatment.

Structure: is a high affinity hinge-stabilized IgG4P human antibody to the PD-1receptor (PDCD1, CD279) that blocks PD 1/PD L1 mediated T cell inhibition. Binding of the PD-1 ligands PD-L1 and PD-L2, to the PD-1 receptor found on T cells, inhibits T-cell proliferation and cytokine production. Upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway can contribute to inhibition of active T-cell immune surveillance of tumors.

Route of administration: Intravenous infusion.

Intervention Type DRUG

Carboplatin

Patients will receive Carboplatin administered by IV infusion for 2 cycles.

Structure: The cis-diamino (cyclobutane-1, 1 dicarboxylate) platin.

Stability: 24 hours at ambient temperature in 5% glucose, glucosaline or physiologic saline. It is recommended not to dilute with chlorinated solutions since this could affect the carboplatin.

Route of administration: Intravenous infusion.

Intervention Type DRUG

Paclitaxel

Patients will receive Paclitaxel administered by IV infusion for 2 cycles.

Structure: A diterpene whose composition is: 5b, 20- epoxy-1, 2a, 4,7b, 10b, 13a-hexahidroxytax-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 than 27 hours at ambient temperature (25ºC approximately).

The intact vial must be stored between 15º and 25ºC.

Guidelines of 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

Other Intervention Names

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REGN2810 Paraplatin Carboplatine Taxol

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed stage IV or stage IIIB/C not candidates for definitive chemo/radiotherapy or surgical resection non-small cell lung cancer (NSCLC) per the 8th edition TNM with no prior systemic anti-cancer therapy
* PDL1 ≥50%
* ECOG performance status 0-1
* Patients aged ≥ 18 years
* Prior adjuvant or neoadjuvant chemotherapy for early stage is permitted if completed at least 6 months prior to enrolment
* Presence of at least one measurable lesion by CT-scan per RECIST version 1.1
* Anticipated life expectancy \>12 weeks
* Correct hematological, hepatic and renal function
* Patient consent must be obtained in the appropriate manner as established in the applicable local and regulatory requirements
* Patients must be accessible for treatment and follow-up
* 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 3 days before enrolment.
* All sexually active men and women of childbearing potential must use a highly effective contraceptive method during the study treatment and for a period of at least 4 months following the last administration of trial drugs

* Patients who have received prior neo-adjuvant, adjuvant chemotherapy, radiotherapy, or chemo-radiotherapy with curative intent for non-metastatic disease less than 6 months before enrollment since the last chemotherapy, radiotherapy, or chemo-radiotherapy
* Patients with a combination of small cell lung cancer and non-small cell lung cancer, a carcinoid lung tumor or large cell neuroendocrine carcinoma
* Has known allergy or hypersensitivity to components of study drug
* Significant comorbidities that preclude the administration of chemotherapy according to the investigator's criteria
* Ongoing or recent evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments
* Untreated brain metastasis(es) that may be considered active
* Immunosuppressive corticosteroid doses within 4 weeks prior to the first dose of cemiplimab
* Uncontrolled infection with hepatitis B or hepatitis C or human immunodeficiency virus; or diagnosis of immunodeficiency
* History of interstitial lung disease or active, noninfectious pneumonitis that required immune-suppressive doses of glucocorticoids to assist with management.
* History of documented allergic reactions or acute hypersensitivity reactions attributed to antibody treatments
* Patients with a history of solid organ transplant
* Receipt of live vaccines within 30 days of first study treatment
* Women of childbearing potential, or sexually active men, who are unwilling to practice highly effective contraception prior to the initial dose/start of the first treatment prior to the start of the first treatment, during the study, and for at least 4 months after the last dose.

Exclusion Criteria

* Patients whose tumors harbor an activating mutation in EGFR, ALK translocation, or ROS Proto-Oncogene 1 (ROS1) rearrangements sensitive to available targeted inhibitor therapy
* Patients with grade ≥2 neuropathy
* Pregnant or breastfeeding women
* Patients with a weight loss \>10% within the previous 3 months
* Patients with carcinomatous meningitis
* Patients with a history of other malignant diseases within the past 3 years
* Patients must have recovered from a major surgery at least 14 days prior to enrolment
* Patients with active or uncontrolled infections or with serious medical conditions or disorders that may not allow patient management as established in the protocol
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundación GECP

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Mariano Provencio, MD

Role: STUDY_CHAIR

Fundación GECP President

Locations

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Hospital General de Alicante

Alicante, Alicante, Spain

Site Status RECRUITING

Hospital General de Elche

Elche, Alicante, Spain

Site Status RECRUITING

ICO Badalona, Hospital Germans Trias i Pujol

Badalona, Barcelona, Spain

Site Status RECRUITING

Hospital Universitari Vall d' Hebron

Barcelona, Barcelona, Spain

Site Status RECRUITING

Hospital de la Santa Creu i Sant Pau

Barcelona, Barcelona, Spain

Site Status RECRUITING

ICO Hospitalet

L'Hospitalet de Llobregat, Barcelona, Spain

Site Status RECRUITING

Hospital De Basurto

Bilbao, Bilbao, Spain

Site Status RECRUITING

Hospital Universitario Jerez De La Frontera

Jerez de la Frontera, Cádiz, Spain

Site Status NOT_YET_RECRUITING

Hospital Dr. Josep Trueta

Girona, Girona, Spain

Site Status RECRUITING

Hospitalario Universitario A Coruña

A Coruña, La Coruña, Spain

Site Status RECRUITING

Hospital Universitario Dr. Negrín

Las Palmas de Gran Canaria, Las Palmas, Spain

Site Status RECRUITING

Hospital Universitario Severo Ochoa

Leganés, Madrid, Spain

Site Status RECRUITING

Hospital Clínico San Carlos

Madrid, Madrid, Spain

Site Status RECRUITING

Hospital Universitario Fundación Jiménez Díaz

Madrid, Madrid, Spain

Site Status RECRUITING

Hospital Puerta de Hierro

Madrid, Madrid, Spain

Site Status RECRUITING

Hospital Universitario Son Espases

Palma de Mallorca, Mallorca, Spain

Site Status RECRUITING

Hospital Universitario Regional de Málaga

Málaga, Málaga, Spain

Site Status RECRUITING

Hospital Universitari Son Llatzer

Palma de Mallorca, Palma de Mallorca, Spain

Site Status RECRUITING

Hospital Universitario Salamanca

Salamanca, Salamanca, Spain

Site Status RECRUITING

Hospital General de Valencia

Valencia, Valencia, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Eva Pereira

Role: CONTACT

+34934302006

Facility Contacts

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Bartomeu Massutí, MD

Role: primary

Javier David Benitez Fuentes, MD

Role: primary

Marc Cucurull, MD

Role: primary

Patricia Iranzo, MD

Role: primary

Sergio Martínez Recio, MD

Role: primary

Ernest Nadal, MD

Role: primary

Mª Angeles Sala González, MD

Role: primary

Mª Ángeles Moreno, MD

Role: primary

Joaquim Bosch, MD

Role: primary

Rosario García Campelo, MD

Role: primary

David Aguiar, MD

Role: primary

Ana López, MD

Role: primary

Carlos Aguado, MD

Role: primary

Manuel Dómine, MD

Role: primary

Virginia Calvo, MD

Role: primary

Raquel Marsé

Role: primary

Vanesa Gutiérrez, MD

Role: primary

Juan Coves Sarto, MD

Role: primary

Alejandro Olivares Hernández, MD

Role: primary

Paula Espinosa, MD

Role: primary

Related Links

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http://www.gecp.org

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

Other Identifiers

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2024-518812-38-00

Identifier Type: CTIS

Identifier Source: secondary_id

GECP 22/01_PALACE

Identifier Type: -

Identifier Source: org_study_id

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