A Single-arm Trial of Atezolizumab/Platinum/Etoposide for the Treatment of Advanced Large-cell Neuroendocrine Cancer of the Lung (LCNEC-ALPINE)
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ClinicalTrials.gov Identifier: NCT05470595 |
Recruitment Status :
Recruiting
First Posted : July 22, 2022
Last Update Posted : July 22, 2022
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Condition or disease | Intervention/treatment | Phase |
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Large Cell Neuroendocrine Carcinoma of the Lung | Drug: Atezolizumab | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 67 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase II, Single-arm Trial of Atezolizumab/Platinum/Etoposide for the Treatment of Advanced Large-cell Neuroendocrine Cancer of the Lung |
Actual Study Start Date : | January 18, 2022 |
Estimated Primary Completion Date : | January 31, 2028 |
Estimated Study Completion Date : | January 31, 2029 |

Arm | Intervention/treatment |
---|---|
Experimental: Atezolizumab/Platinum/Etoposide
Atezolizumab/Platinum/Etoposide Platinum will be cisplatin or carboplatin at the investigators discretion.
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Drug: Atezolizumab
Atezolizumab (IMP) will be added to Platinum/Etoposide (Standard-of-Care). Four cycles of combined immunochemotherapy 3qw will be follows by maintenance with atezolizumab monotherapy until progression. |
- Overall survival [ Time Frame: appr. 72 months ]To assess the efficacy of Atezolizumab in addition to standard of care chemotherapy (Platinum/Etoposide) in LCNEC as measured by overall survival.
- Objective Response Rate (ORR) [ Time Frame: appr. 72 months ]According to RECIST v1.1 as assessed by local investigator.
- Immune Objective Response Rate (iORR) [ Time Frame: appr. 72 months ]According to iRECIST as assessed by local investigator.
- Disease Control Rate (DCR) [ Time Frame: appr. 72 months ]According to RECIST v1.1 as assessed by local investigator.
- Progression Free Survival (PFS) [ Time Frame: appr. 72 months ]
- Immune Progression Free Survival (iPFS) [ Time Frame: appr. 72 months ]
- Duration of Response (DoR) [ Time Frame: appr. 72 months ]
- Progression Free Survival (PFS) rate at one year [ Time Frame: 1 year ]
- Immune Progression Free Survival (iPFS) rate at one year [ Time Frame: 1 year ]
- Overall survival at one year [ Time Frame: 1 year ]
- Incidence, intensity, seriousness, relationship to Atezolizumab, and outcome of adverse events graded according to NCI CTCAE (v5.0). [ Time Frame: appr. 72 months ]
- Secondary efficacy endpoints in defined molecular subtypes (NSCLC-type / SCLC-type) [ Time Frame: appr. 72 months ]
- Quality of Life assessed by EORTC QLQ-C30. [ Time Frame: appr. 72 months ]
- Quality of Life assessed by EORTC QLQ-LC13. [ Time Frame: appr. 72 months ]
- Immune Effectors [ Time Frame: appr. 72 months ]Changes in cellular and humoral immune effectors in peripheral blood and their correlation with response.
- Mutational Landscape [ Time Frame: appr. 72 months ]Mutational landscape of LCNEC in comparison to SCLC as well as squamous and Adenocarcinoma of the lung. The analysis will be using whole genome sequencing.
- Tumor DNA (tDNA) level [ Time Frame: appr. 72 months ]Dynamics of circulating tumor DNA levels (changes from baseline).
- Therapy Resistance [ Time Frame: appr. 72 months ]Mechanisms of therapy resistance (changes of immune invasion and mutational landscape in tumor re-biopsy upon progression).

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Written informed consent
- Patients with locally advanced or metastatic large-cell neuroendocrine carcinoma of the lung (LCNEC) without curative treatment options (patients with mixed histology are eligible if LCNEC is the predominant histology i.e. ≥50%)
- Previously untreated with systemic therapy (note: patients relapsing after curative radio chemotherapy or adjuvant chemotherapy are eligible if relapse occurs ≥6 months after discontinuation of curative treatment)
- Planned treatment with Carboplatin or Cisplatin and Etoposide (SoC)
- ECOG performance status: 0-2
- age ≥18 years
- measurable disease according to RECIST v1.1
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adequate organ function defined as:
- ALAT/ASAT ≤2.5x ULN or ≤3.5x ULN in case of liver metastases
- Bilirubin ≤1.5x ULN or ≤2.5x ULN in case of liver metastases
- Creatinine ≤1.5x ULN or Creatinine clearance according to Cockroft-Gault >60 ml/min
- Neutrophils ≥1 Gpt/l, Platelets >50 Gpt/l unless caused by bone marrow carcinosis
Exclusion Criteria:
- Symptomatic brain metastases (patients with asymptomatic brain metastases are allowed provided they are stable without steroid treatment for at least 3 weeks)
- Severe autoimmune disease (patients with endocrine autoimmune disorders are allowed as long as they are on stable substitution treatment)
- Severe uncontrolled infection
- Prior treatment with either Atezolizumab or other immune checkpoint inhibitor
- Any prior treatment for metastatic disease

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05470595
Contact: Martin Wermke, MD | +49 351 7566 | martin.wermke@ukdd.de | |
Contact: Felix C Saalfeld, MD | felix.saalfeld@ukdd.de |
Germany | |
Charité - Universitätsklinikum Berlin Centrum 12, Medizinische Klinik | Not yet recruiting |
Berlin, Germany, 10117 | |
Contact: Nikolaj Frost, MD | |
Evangelische Lungenklinik | Recruiting |
Berlin, Germany, 12125 | |
Contact: Christian Grohé, Prof. Dr. | |
Universitätsklinikum Dresden, Medizinische Klinik 1 | Recruiting |
Dresden, Germany, 01307 | |
Contact: Martin Wermke, MD | |
Klinikum der J.W. Goethe Universität, Medizinische Klinik II | Not yet recruiting |
Frankfurt am Main, Germany, 60590 | |
Contact: Jan Alexander Stratmann, MD | |
Asklepios Fachkliniken München-Gauting | Recruiting |
Gauting, Germany, 82131 | |
Contact: Niels Reinmuth, MD | |
LungenClinic Grosshansdorf GmbH | Recruiting |
Großhansdorf, Germany, 22927 | |
Contact: Martin Reck, MD | |
Thoraxklinik Heidelberg gGmbH, Universitätsklinikum Heidelberg | Not yet recruiting |
Heidelberg, Germany, 69126 | |
Contact: Farastuk Bozorgmehr, MD | |
Lungenklinik Hemer des Deutschen Gemeinschafts-Diakonieverbandes GmbH | Not yet recruiting |
Hemer, Germany, 58675 | |
Contact: Monika Serke, MD | |
Lungenfachklinik Immenhausen | Recruiting |
Immenhausen, Germany, 34376 | |
Contact: Achim Rittmeyer, MD | |
Klinikum der Universität zu Köln, Klinik I für Innere Medizin | Not yet recruiting |
Köln, Germany, 50937 | |
Contact: Jürgen Wolf, MD | |
Klinikum der Johannes Gutenberg Universität, III. Med. Klinik und Poliklinik | Not yet recruiting |
Mainz, Germany, 55131 | |
Contact: Jürgen Alt, MD | |
Pius Hospital, Klinik für Hämatologie und Onkologie | Recruiting |
Oldenburg, Germany, 26121 | |
Contact: Frank Griesinger, MD | |
Rems-Murr-Klinikum Winnenden, Klinik für Hämatologie, Onkologie und Palliativmedizin | Not yet recruiting |
Winnenden, Germany, 71364 | |
Contact: Maria Netchaeva | |
Universitätsklinikum Würzburg, Comprehensive Cancer Center Mainfranken | Not yet recruiting |
Würzburg, Germany, 97078 | |
Contact: Pius Jung, MD |
Principal Investigator: | Martin Wermke, MD | Technische Universität Dresden (TUD) |
Responsible Party: | Technische Universität Dresden |
ClinicalTrials.gov Identifier: | NCT05470595 |
Other Study ID Numbers: |
TUD-ALPINE-077 2020-002683-31 ( EudraCT Number ) |
First Posted: | July 22, 2022 Key Record Dates |
Last Update Posted: | July 22, 2022 |
Last Verified: | July 2022 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Lung Cancer LCNEC Neuroendocrine Carcinoma |
Carcinoma, Neuroendocrine Lung Neoplasms Carcinoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal Adenocarcinoma Neoplasms, Nerve Tissue |
Respiratory Tract Neoplasms Thoracic Neoplasms Neoplasms by Site Lung Diseases Respiratory Tract Diseases Atezolizumab Immune Checkpoint Inhibitors Molecular Mechanisms of Pharmacological Action Antineoplastic Agents, Immunological Antineoplastic Agents |