Comparing two treatments for limited-stage small cell lung cancer
An Open-label, Randomized Study of BMS-986489 (Atigotatug + Nivolumab Fixed-dose Combination) vs Durvalumab as Consolidation Therapy Following Chemoradiotherapy in Limited-stage Small-cell Lung Cancer (TIGOS-LS)
This study is testing whether a new combination treatment for limited-stage small cell lung cancer works better than an existing option after patients have their initial chemotherapy and radiotherapy.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Enrollment | 250 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | SCRI Development Innovations, LLC Academic / other |
| Drugs / interventions | nivolumab, durvalumab, chemotherapy, radiation, prednisone, immunotherapy |
| Locations | 33 sites (Daphne, Alabama and 32 other locations) |
| Trial ID | NCT06773910 on ClinicalTrials.gov |
What this trial studies
This open-label, randomized study evaluates the efficacy and safety of BMS-986489 (a combination of atigotatug and nivolumab) versus durvalumab in patients with limited-stage small cell lung cancer (SCLC). Participants will first undergo standard chemotherapy and radiotherapy, and then be randomly assigned to receive one of the two treatments as consolidation therapy. The goal is to determine which treatment provides better outcomes for patients following initial therapy.
Who should consider this trial
Good fit: Ideal candidates are adults aged 18 and older with histologically confirmed limited-stage small cell lung cancer who have completed initial chemotherapy and radiotherapy without disease progression.
Not a fit: Patients with progressive disease prior to randomization or those with other types of lung cancer may not benefit from this study.
Why it matters
Potential benefit: If successful, this study could lead to improved treatment options and outcomes for patients with limited-stage small cell lung cancer.
How similar studies have performed: Other studies have shown promise with similar immunotherapy approaches, but this specific combination is being evaluated for the first time.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * At least 18 years-of-age at the time of signature of the Informed Consent Form (ICF) * Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1 (Appendix A) * Histologically or cytologically confirmed pulmonary SCLC, evaluable by RECIST v1.1 * Limited-stage (LS) disease as determined by positron emission tomography (PET) scan prior to initiation of chemotherapy and radiation therapy * Completed concurrent chemotherapy and radiotherapy for LS-SCLC without progression per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 (computed tomography \[CT\] scan chest/abdomen/pelvis; Appendix B) within 42 days before date of randomization and first dose of study treatment * Chemotherapy should consist of a platinum and IV etoposide. Participants who received at least 3 cycles of chemotherapy will be eligible to participate. * Radiotherapy should be administered per institutional guidelines * Prophylactic cranial irradiation (PCI) may be delivered at the discretion of the Investigator and institutional guidelines. PCI, if applicable, must be conducted after the end of chemoradiotherapy and completed between 14 and 42 days before date of randomization and first dose of study treatment. * Adequate hematologic and organ function * Willingness to abide by protocol defined contraceptive requirements for the duration of the study. Exclusion Criteria: * Small-cell cancer not pulmonary in origin * Large cell neuroendocrine carcinoma * ES-SCLC * Mixed SCLC and NSCLC histologic features; diagnosis of NSCLC; or EGFR-activating, mutation-positive NSCLC that has transformed to SCLC * History of severe hypersensitivity reaction to monoclonal antibodies * Known hypersensitivity to any excipients of atigotatug, nivolumab, or durvalumab * Grade ≥2 peripheral neuropathy by the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0 * Active, prior, or suspected autoimmune disease, including autoimmune neurologic disorders such as paraneoplastic syndrome involving the CNS, peripheral sensory/motor nerves, or neuromuscular junction. Exceptions to this criterion include: * Type 1 diabetes mellitus * Hypothyroidism requiring only hormone replacement * Skin disorders not requiring systemic treatment * Autoimmune conditions not expected to recur during the study * Diseases or conditions requiring chronic systemic corticosteroids (\>10 mg daily prednisone or equivalent) or other immunosuppressive therapy within 14 days of starting study treatment. Limited-course (\<2 weeks' duration) oral steroids (10 mg prednisone or equivalent) are permitted. Bronchodilators, inhaled or topical steroids, and adrenal replacement steroid doses \>10 mg daily prednisone equivalent are permitted in the absence of active autoimmune disease. * History of solid organ or bone marrow transplantation * History of Grade ≥2 pneumonitis (excepting resolved infective pneumonitis) * Any of the following cardiac criteria, currently or within the last 3 months: * Any clinically important abnormalities (as assessed by the Investigator) in rhythm, conduction, or morphology of resting electrocardiograms (ECGs), e.g., complete left bundle branch block, third-degree heart block, atrial fibrillation not rate controlled. Certain conditions may be considered through discussion with the Medical Monitor. * Congestive heart failure (New York Heart Association \[NYHA\] \> Grade 2) or classified as Class 3 or 4 by the NYHA Functional Classification (Appendix D) * Any factors that increase the risk of QTc prolongation or risk of arrhythmic events such as heart failure, uncontrolled hypokalemia, congenital long QT syndrome, family history of long QT syndrome or unexplained sudden death under 40 years-of-age, or any concomitant medication known to prolong the QT interval (Appendix E). Certain conditions may be considered through discussion with the Medical Monitor. * Participants with a left ventricular ejection fraction \<55% or the lower limit of normal of the institutional standard * Uncontrolled hypertension, defined as systolic blood pressure \>150 mmHg or diastolic blood pressure \>90 mmHg despite optimal medical management * Active coronary artery disease, including unstable or newly diagnosed angina * Myocardial infarction * History of clinically significant arrhythmias (such as ventricular tachycardia, ventricular fibrillation, or Torsade de Pointes) * History or current diagnosis of myocarditis * As judged by the Investigator, participants with serious or uncontrolled medical disorders * Presence of other active invasive cancers. Participants with a previously treated malignancy will be eligible to participate if treatment of that malignancy was completed at least 2 years before date of screening and the participants has no evidence of disease. Exceptions to this criterion include appropriately treated basal cell carcinoma of the skin; in situ carcinoma of uterine cervix; localized prostate cancer that has been definitively treated; or other local tumors considered cured by local treatment. * Received sequential chemotherapy and radiotherapy as a definitive treatment for LS-SCLC * Treatment with any of the following: * Any systemic anticancer chemotherapy, small molecule, biologic, or hormonal agent from a previous treatment regimen or clinical study within 21 days or 5 half-lives (whichever is longer) prior to the first dose of study treatment * Wide-field radiotherapy (including therapeutic radioisotopes such as strontium-89) administered ≤28 days or limited field radiation for palliation ≤7 days prior to starting study treatment or has not recovered from side effects of such therapy * Prior systemic treatment for LS-SCLC, with the exception of chemoradiotherapy and PCI * Prior treatment with an anti-PD-1, anti-PD-L1, anti-programmed cell death ligand 2 (anti-PD-L2), anti-CD137, anti-cytotoxic T-lymphocyte associated protein 4 (anti-CTLA-4) antibody, or any other antibody or drug specifically targeting T-cell costimulation or checkpoint pathways * Prior treatment with fuc-GM-1 vaccine or targeted agent or similar vaccine targeting ganglioside antigens * Current treatment with immunosuppressive medications * Live attenuated vaccine within 100 days before first dose of study treatment * Major surgery (excluding placement of vascular access) within 4 weeks of date of screening * With the exception of alopecia, any unresolved toxicities from prior therapy greater than CTCAE Grade 1 at the time of starting study treatment. Note: Participants with chronic Grade 2 toxicities who are asymptomatic or adequately managed with stable medication may be eligible with approval by the Medical Monitor or Principal Investigator. * Psychological, familial, sociological, or geographical conditions that do not permit compliance with the protocol and/or follow-up procedures outlined in the protocol
Where this trial is running
Daphne, Alabama and 32 other locations
- Southern Cancer Center — Daphne, Alabama, United States (Recruiting)
- Sansum Clinic — Santa Barbara, California, United States (Recruiting)
- Florida Cancer Specialists - South — Fort Myers, Florida, United States (Recruiting)
- University of Miami - Sylvester Cancer Center — Miami, Florida, United States (Active_not_recruiting)
- Ocala Oncology Center — Ocala, Florida, United States (Recruiting)
- Florida Cancer Specialists - North — Orange City, Florida, United States (Recruiting)
- Cancer Care Centers of Brevard — Palm Bay, Florida, United States (Recruiting)
- Florida Cancer Specialists - East — West Palm Beach, Florida, United States (Recruiting)
- Piedmont Healthcare - Atlanta — Atlanta, Georgia, United States (Recruiting)
- Illinois Cancer Specialists — Arlington Heights, Illinois, United States (Recruiting)
- Illinois Cancer Care — Peoria, Illinois, United States (Recruiting)
- Indiana University Simon Cancer Center — Indianapolis, Indiana, United States (Recruiting)
- Baptist Health - Corbin — Corbin, Kentucky, United States (Recruiting)
- Baptist Health - Lexington — Lexington, Kentucky, United States (Recruiting)
- Baptist Health - Louisville — Louisville, Kentucky, United States (Recruiting)
- Minnesota Oncology Hematology — Maple Grove, Minnesota, United States (Recruiting)
- Missouri Cancer Associates — Columbia, Missouri, United States (Recruiting)
- White Plains Hospital Physician Associates — White Plains, New York, United States (Recruiting)
- Carolina Cancer Research Center — Wilson, North Carolina, United States (Recruiting)
- Oncology Hematology Care — Cincinnati, Ohio, United States (Recruiting)
- Mid Ohio Hem/ Onc dba The Mark H Zangmeister Center — Columbus, Ohio, United States (Recruiting)
- Oncology Associates of Oregon (Willamette Valley Cancer Institute and Research Center) — Eugene, Oregon, United States (Recruiting)
- Tennessee Cancer Specialists — Knoxville, Tennessee, United States (Recruiting)
- SCRI Oncology Partners — Nashville, Tennessee, United States (Recruiting)
- Texas Oncology - West Texas — Amarillo, Texas, United States (Recruiting)
- Texas Oncology- Austin — Austin, Texas, United States (Recruiting)
- Texas Oncology - Gulf Coast — Beaumont, Texas, United States (Recruiting)
- Texas Oncology - DFW — Dallas, Texas, United States (Recruiting)
- Texas Oncology - Northeast Texas — Denison, Texas, United States (Recruiting)
- Texas Oncology - San Antonio — San Antonio, Texas, United States (Recruiting)
- Virginia Cancer Specialists — Fairfax, Virginia, United States (Recruiting)
- Virginia Oncology Associates — Norfolk, Virginia, United States (Recruiting)
- Blue Ridge Cancer Center (Oncology & Hematology Associates of Southwest VA) — Salem, Virginia, United States (Recruiting)
Study contacts
- Study coordinator: Sarah Cannon Development Innovations, LLC
- Email: SCRI.InnovationsMedical@scri.com
- Phone: 1-844-710-6157
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.