New combo therapy offers hope for frail lung cancer patients
NCT ID NCT04310020
First seen Jun 27, 2026 · Last updated Aug 25, 2026 · Updated 9 times
Summary
This phase II trial tests a shorter, higher-dose radiation therapy followed by the immunotherapy drug atezolizumab in 47 patients with stage II or III non-small cell lung cancer who have borderline health. The goal is to see if this approach is safe and effective for people who cannot tolerate standard treatments. The study tracks side effects and tumor response.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- Atezolizumab (immunotherapy drug) and hypofractionated radiation therapy
- What this could lead to
- If it works, this could offer a safer, effective treatment option for lung cancer patients who are too frail for standard therapy.
- What could go wrong
- This is a small, early-phase pilot study (47 people) focused on safety. It may not show clear benefit, and side effects from the combination could still be significant.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
-
Phase 2
Tests whether the treatment actually works, and watches for side effects, in a larger group.
- Participants
-
About 47 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Jan 2021
- Expected to finish
-
Jun 2027
An estimate. End dates often move.
- Lead sponsor
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A government research agency
The lead sponsor is the US National Institutes of Health.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 years and older
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * REGISTRATION STEP 1: Participants must have pathologic (cytological or histological) proof of non-small cell lung cancer (NSCLC) * REGISTRATION STEP 1: Participants must have stage III NSCLC with Zubrod performance status of 2 or stage II NSCLC with Zubrod performance status of 0-2 * REGISTRATION STEP 1: Participants must not be candidates for surgical resection in the opinion of the treating investigator. Participants whose disease was previously resected must have experienced local or regional recurrence at least 12 months after resection * REGISTRATION STEP 1: Participants must not be candidates for concurrent chemoradiation in the opinion of the treating investigator * REGISTRATION STEP 1: Participants must have measurable or non-measurable disease documented by CT or MRI. Measurable disease must be assessed within 28 days prior to Registration Step 1. Non-measurable disease must be assessed within 42 days prior to Step 1 registration. The CT from a combined positron emission tomography (PET)/CT may be used only if it is of diagnostic quality. All known sites of disease must be assessed and documented on the Baseline Tumor Assessment Form (RECIST 1.1) * REGISTRATION STEP 1: Participants must have an MRI or CT scan of the brain with contrast within 28 days prior to Registration Step 1 * REGISTRATION STEP 1: Participants' disease must fit within the radiation constraints in the opinion of a local radiation oncologist * REGISTRATION STEP 1: Participants may have received prior treatment for their lung cancer, including surgery, chemotherapy, targeted agents, and/or radiation treatment. At least 12 months must have elapsed since last treatment * REGISTRATION STEP 1: Participants may have had prior radiation therapy as long as the irradiated area does not overlap with the radiation field targeted for this study * REGISTRATION STEP 1: Participants must have recovered from any adverse effects of prior major surgery to the satisfaction of the treating physician. Biopsies and central IV access placement are not considered major surgery * REGISTRATION STEP 1: Absolute neutrophil count (ANC) \>= 1500/mcl (obtained within 28 days prior to Registration Step 1) * REGISTRATION STEP 1: Platelet count \>= 100,000/mcl (obtained within 28 days prior to Registration Step 1) * REGISTRATION STEP 1: Hemoglobin \>= 9 grams/dL (obtained within 28 days prior to Registration Step 1) * REGISTRATION STEP 1: Total bilirubin =\< 1.5 x institutional upper limit of normal (IULN) (obtained within 28 days prior to Registration Step 1) * REGISTRATION STEP 1: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 2.5 x IULN (obtained within 28 days prior to Registration Step 1) * REGISTRATION STEP 1: Serum creatinine =\< 1.5 x IULN OR measured or calculated creatinine clearance \>= 40 mL/min (obtained within 28 days prior to Registration Step 1) * REGISTRATION STEP 1: Participants must have percent predicted diffusing capacity of the lungs for carbon monoxide (DLCO) of at least 40% documented within 90 days prior to Registration Step 1 * REGISTRATION STEP 1: Patient must not have had a prior history of interstitial lung disease or \> grade 2 (Common Terminology Criteria for Adverse Events \[CTCAE\] version 5) pneumonitis * REGISTRATION STEP 1: Participants must not have active autoimmune disease requiring therapy within the past 6 months * REGISTRATION STEP 1: Participants must not have an active infection requiring therapy * REGISTRATION STEP 1: Participants must be ≥ 18 years old * REGISTRATION STEP 1: Participants must not be pregnant or nursing because atezolizumab has not been studied in pregnant or nursing women and the mechanism of action is expected to cause fetal harm. Women/men of reproductive potential must have agreed to use an effective contraceptive method while on protocol treatment and for five months after last dose of atezolizumab. A woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months. In addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation. However, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures * REGISTRATION STEP 1: Participants with known human immunodeficiency virus (HIV) infection must be on effective anti-retroviral therapy and must have undetectable viral load at their most recent viral load test and within 6 months prior to Registration Step 1 * REGISTRATION STEP 1: Patient must be tested for hepatitis B within 28 days prior to Registration Step 1. Patient must not have active (chronic or acute) hepatitis B virus (HBV) infection. Patients may have past or resolved HBV infection. Active HBV is defined as having a positive hepatitis B surface antigen (HBsAg) test. Past or resolved HBV is defined as having a negative HBsAG test and a positive total hepatitis B core antibody (HBcAb) test * REGISTRATION STEP 1: Patients must not have active hepatitis C virus (HCV) infection. Active HCV is defined as having a positive HCV antibody test followed by a positive HCV ribonucleic acid (RNA) test. Patient must have an HCV antibody test within 28 days prior to Registration Step 1. If the HCV antibody test is positive, the patient must also have an HCV quantitative RNA test within 28 days prior to Registration Step 1 * REGISTRATION STEP 1: No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated Stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease free for three years. Participants with localized prostate cancer who are being followed by an active surveillance program are also eligible * REGISTRATION STEP 1: Participants must be offered optional participation in banking of specimens for future research * REGISTRATION STEP 1: Participants must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines * REGISTRATION STEP 1: As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system * REGISTRATION STEP 2: Participants must be registered to Step 2 within 42 days after completion of radiation treatment. Participants must have received at least 44 Gy of radiation treatment * REGISTRATION STEP 2: Participants must have no evidence of progression per RECIST 1.1 on CT scan of the chest, abdomen, and pelvis performed between 2 and 5 weeks after completion of radiation therapy * REGISTRATION STEP 2: Any toxicities from radiation therapy must have resolved to \< grade 2 * REGISTRATION STEP 2: ANC \>= 1.5 x 10\^3/uL (obtained within 28 days prior to Registration Step 2) * REGISTRATION STEP 2: Platelet count \>= 100 x 10\^3/uL (obtained within 28 days prior to Registration Step 2) * REGISTRATION STEP 2: Hemoglobin \>= 9 grams/dL (obtained within 28 days prior to Registration Step 2) * REGISTRATION STEP 2: Total bilirubin =\< 1.5 x institutional upper limit of normal (IULN) (obtained within 28 days prior to Registration Step 2) * REGISTRATION STEP 2: AST and ALT =\< 2.5 x IULN (obtained within 28 days prior to Registration Step 2) * REGISTRATION STEP 2: Serum creatinine =\< 1.5 x IULN OR measured or calculated creatinine clearance \>= 40 mL/min (obtained within 28 days prior to Registration Step 2) * REGISTRATION STEP 2: Participants must not have received steroids in doses of more than prednisone 10 mg daily or equivalent within 14 days prior to Registration Step 2 * REGISTRATION STEP 2: Participants must not have received a live vaccine within 28 days prior to Registration Step 2
Get updates
Get notified about this study
Sign up to get updates when this study changes or when new studies for Lung non-small cell carcinoma are added.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
Contacts and locations
Locations
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Addison Gilbert Hospital
Gloucester, Massachusetts, 01930, United States
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AdventHealth Littleton
Littleton, Colorado, 80122, United States
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AdventHealth Parker
Parker, Colorado, 80138, United States
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AdventHealth Porter
Denver, Colorado, 80210, United States
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Alaska Breast Care and Surgery LLC
Anchorage, Alaska, 99508, United States
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Alaska Oncology and Hematology LLC
Anchorage, Alaska, 99508, United States
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Alaska Women's Cancer Care
Anchorage, Alaska, 99508, United States
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Anchorage Associates in Radiation Medicine
Anchorage, Alaska, 98508, United States
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Ascension All Saints Hospital-Spring Street-Racine
Racine, Wisconsin, 53405, United States
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Ascension Calumet Hospital-Chilton
Chilton, Wisconsin, 53014, United States
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Ascension Columbia Saint Mary's Hospital-Milwaukee Campus
Milwaukee, Wisconsin, 53211, United States
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Ascension Columbia Saint Mary's Hospital-Ozaukee Campus-Mequon
Mequon, Wisconsin, 53097, United States
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Ascension Northeast Wisconsin-Mercy Hospital-Oshkosh
Oshkosh, Wisconsin, 54904, United States
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Ascension Northeast Wisconsin-Saint Elizabeth Cancer Center-Appleton
Appleton, Wisconsin, 54915, United States
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Ascension Saint Francis Hospital-Milwaukee
Milwaukee, Wisconsin, 53215, United States
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Ascension Southeast Wisconsin Hospital - Franklin
Franklin, Wisconsin, 53132, United States
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Ascension Southeast Wisconsin Hospital-Elmbrook Campus-Brookfield
Brookfield, Wisconsin, 53045, United States
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Ascension Southeast Wisconsin Hospital-Mayfair Road-Wauwatosa
Wauwatosa, Wisconsin, 53226, United States
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Ascension Southeast Wisconsin Hospital-Saint Joseph-Milwaukee
Milwaukee, Wisconsin, 53210, United States
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Atrium Medical Center-Middletown Regional Hospital
Franklin, Ohio, 45005-1066, United States
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Augusta University Medical Center
Augusta, Georgia, 30912, United States
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Baptist Memorial Hospital and Cancer Center-Collierville
Collierville, Tennessee, 38017, United States
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Baptist Memorial Hospital and Cancer Center-Desoto
Southhaven, Mississippi, 38671, United States
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Baptist Memorial Hospital and Cancer Center-Memphis
Memphis, Tennessee, 38120, United States
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Benefis Sletten Cancer Institute
Great Falls, Montana, 59405, United States
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Beth Israel Deaconess Medical Center/Winchester Center for Cancer Care
Winchester, Massachusetts, 01890, United States
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Beverly Hospital
Beverly, Massachusetts, 01915, United States
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Bozeman Health Deaconess Hospital
Bozeman, Montana, 59715, United States
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Broadlawns Medical Center
Des Moines, Iowa, 50314, United States
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CTCA at Southeastern Regional Medical Center
Newnan, Georgia, 30265, United States
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Cancer Care Center of O'Fallon
O'Fallon, Illinois, 62269, United States
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Cancer Care Specialists of Illinois - Decatur
Decatur, Illinois, 62526, United States
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Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017, United States
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Cancer Centers of Southwest Oklahoma Research
Lawton, Oklahoma, 73505, United States
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Carle Cancer Center
Urbana, Illinois, 61801, United States
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Carle Physician Group-Effingham
Effingham, Illinois, 62401, United States
-
Carle Physician Group-Mattoon/Charleston
Mattoon, Illinois, 61938, United States
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Carle at The Riverfront
Danville, Illinois, 61832, United States
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Centralia Oncology Clinic
Centralia, Illinois, 62801, United States
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Clackamas Radiation Oncology Center
Clackamas, Oregon, 97015, United States
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CommonSpirit Saint Joseph Hospital - Lexington
Lexington, Kentucky, 40504, United States
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CommonSpirit Saint Joseph Medical Center - East Lexington
Lexington, Kentucky, 40509, United States
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Crossroads Cancer Center
Effingham, Illinois, 62401, United States
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Dayton Physician LLC - Englewood
Dayton, Ohio, 45415, United States
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Dayton Physicians LLC - Troy
Troy, Ohio, 45373, United States
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Dayton Physicians LLC-Miami Valley South
Centerville, Ohio, 45459, United States
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Decatur Memorial Hospital
Decatur, Illinois, 62526, United States
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Fairview Southdale Hospital
Edina, Minnesota, 55435, United States
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Greater Regional Medical Center
Creston, Iowa, 50801, United States
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HSHS Saint Elizabeth's Hospital
O'Fallon, Illinois, 62269, United States
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Hawaii Cancer Care - Westridge
‘Aiea, Hawaii, 96701, United States
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Hawaii Cancer Care Inc - Waterfront Plaza
Honolulu, Hawaii, 96813, United States
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Hawaii Cancer Care Inc-Liliha
Honolulu, Hawaii, 96817, United States
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Health Partners Inc
Minneapolis, Minnesota, 55454, United States
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Hennepin County Medical Center
Minneapolis, Minnesota, 55415, United States
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Henry Ford Health Providence Novi Hospital
Novi, Michigan, 48374, United States
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Henry Ford Health Providence Southfield Hospital
Southfield, Michigan, 48075, United States
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Illinois CancerCare - Washington
Washington, Illinois, 61571, United States
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Illinois CancerCare-Bloomington
Bloomington, Illinois, 61704, United States
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Illinois CancerCare-Canton
Canton, Illinois, 61520, United States
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Illinois CancerCare-Carthage
Carthage, Illinois, 62321, United States
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Illinois CancerCare-Eureka
Eureka, Illinois, 61530, United States
-
Illinois CancerCare-Galesburg
Galesburg, Illinois, 61401, United States
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Illinois CancerCare-Kewanee Clinic
Kewanee, Illinois, 61443, United States
-
Illinois CancerCare-Macomb
Macomb, Illinois, 61455, United States
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Illinois CancerCare-Ottawa Clinic
Ottawa, Illinois, 61350, United States
-
Illinois CancerCare-Pekin
Pekin, Illinois, 61554, United States
-
Illinois CancerCare-Peoria
Peoria, Illinois, 61615, United States
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Illinois CancerCare-Peru
Peru, Illinois, 61354, United States
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Illinois CancerCare-Princeton
Princeton, Illinois, 61356, United States
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Iowa Lutheran Hospital
Des Moines, Iowa, 50316, United States
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Iowa Methodist Medical Center
Des Moines, Iowa, 50309, United States
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Island Urology
Honolulu, Hawaii, 96813, United States
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Jesse Brown Veterans Affairs Medical Center
Chicago, Illinois, 60612, United States
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Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, 96826, United States
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Katmai Oncology Group
Anchorage, Alaska, 99508, United States
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Lahey Clinic
Burlington, Massachusetts, 01805, United States
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Lahey Clinic Peabody
Peabody, Massachusetts, 01960, United States
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Lakeview Hospital
Stillwater, Minnesota, 55082, United States
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Logan Health Medical Center
Kalispell, Montana, 59901, United States
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Marshfield Medical Center - Minocqua
Minocqua, Wisconsin, 54548, United States
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Marshfield Medical Center - Weston
Weston, Wisconsin, 54476, United States
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Marshfield Medical Center-EC Cancer Center
Eau Claire, Wisconsin, 54701, United States
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Marshfield Medical Center-Marshfield
Marshfield, Wisconsin, 54449, United States
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Marshfield Medical Center-Rice Lake
Rice Lake, Wisconsin, 54868, United States
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Marshfield Medical Center-River Region at Stevens Point
Stevens Point, Wisconsin, 54482, United States
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Mary Greeley Medical Center
Ames, Iowa, 50010, United States
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McFarland Clinic - Ames
Ames, Iowa, 50010, United States
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Mercy Cancer Center-West Lakes
Clive, Iowa, 50325, United States
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Mercy Clinic-Rolla-Cancer and Hematology
Rolla, Missouri, 65401, United States
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Mercy Hospital Springfield
Springfield, Missouri, 65804, United States
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Mercy Medical Center - Des Moines
Des Moines, Iowa, 50314, United States
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Mercy Medical Center-West Lakes
West Des Moines, Iowa, 50266, United States
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Methodist Medical Center of Illinois
Peoria, Illinois, 61636, United States
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Methodist West Hospital
West Des Moines, Iowa, 50266-7700, United States
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Miami Valley Cancer Care and Infusion
Greenville, Ohio, 45331, United States
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Miami Valley Hospital
Dayton, Ohio, 45409, United States
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Miami Valley Hospital North
Dayton, Ohio, 45415, United States
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Miami Valley Hospital South
Centerville, Ohio, 45459, United States
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Missouri Baptist Medical Center
St Louis, Missouri, 63131, United States
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Missouri Baptist Sullivan Hospital
Sullivan, Missouri, 63080, United States
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Montefiore Medical Center - Moses Campus
The Bronx, New York, 10467, United States
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Montefiore Medical Center-Einstein Campus
The Bronx, New York, 10461, United States
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Montefiore Medical Center-Weiler Hospital
The Bronx, New York, 10461, United States
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Mount Sinai Comprehensive Cancer Center at Aventura
Aventura, Florida, 33180, United States
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Mount Sinai Medical Center
Miami Beach, Florida, 33140, United States
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NEA Baptist Memorial Hospital and Fowler Family Cancer Center - Jonesboro
Jonesboro, Arkansas, 72401, United States
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Oregon Health and Science University
Portland, Oregon, 97239, United States
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Pali Momi Medical Center
‘Aiea, Hawaii, 96701, United States
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Parkland Health Center - Farmington
Farmington, Missouri, 63640, United States
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Parkland Memorial Hospital
Dallas, Texas, 75235, United States
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Phelps Health Delbert Day Cancer Institute
Rolla, Missouri, 65401, United States
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Premier Blood and Cancer Center
Dayton, Ohio, 45409, United States
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Providence Alaska Medical Center
Anchorage, Alaska, 99508, United States
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Providence Portland Medical Center
Portland, Oregon, 97213, United States
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Providence Saint Vincent Medical Center
Portland, Oregon, 97225, United States
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Queen's Cancer Cenrer - POB I
Honolulu, Hawaii, 96813, United States
-
Queen's Cancer Center - Kuakini
Honolulu, Hawaii, 96817, United States
-
Queen's Cancer Center - Pearlridge
‘Aiea, Hawaii, 96701, United States
-
Queen's Medical Center
Honolulu, Hawaii, 96813, United States
-
Regions Hospital
Saint Paul, Minnesota, 55101, United States
-
Reiman Cancer Center-Ascension Wisconsin Health Center-Rawson
Franklin, Wisconsin, 53132, United States
-
Saint Alphonsus Cancer Care Center-Nampa
Nampa, Idaho, 83687, United States
-
Saint Francis Medical Center
Cape Girardeau, Missouri, 63703, United States
-
Saint Joseph Radiation Oncology Resource Center
Lexington, Kentucky, 40504, United States
-
Saint Mary's Hospital
Centralia, Illinois, 62801, United States
-
Sainte Genevieve County Memorial Hospital
Sainte Genevieve, Missouri, 63670, United States
-
Southern Illinois University School of Medicine
Springfield, Illinois, 62702, United States
-
Springfield Clinic
Springfield, Illinois, 62702, United States
-
Springfield Memorial Hospital
Springfield, Illinois, 62781, United States
-
Straub Clinic and Hospital
Honolulu, Hawaii, 96813, United States
-
Swedish Medical Center-Ballard Campus
Seattle, Washington, 98107, United States
-
Swedish Medical Center-Cherry Hill
Seattle, Washington, 98122-5711, United States
-
Swedish Medical Center-First Hill
Seattle, Washington, 98122, United States
-
The Cancer Center of Hawaii-Liliha
Honolulu, Hawaii, 96817, United States
-
The Cancer Center of Hawaii-Pali Momi
‘Aiea, Hawaii, 96701, United States
-
The Carle Foundation Hospital
Urbana, Illinois, 61801, United States
-
UI Health Care Mission Cancer and Blood - Ankeny Clinic
Ankeny, Iowa, 50023, United States
-
UI Health Care Mission Cancer and Blood - Des Moines Clinic
Des Moines, Iowa, 50309, United States
-
UI Health Care Mission Cancer and Blood - Laurel Clinic
Des Moines, Iowa, 50314, United States
-
UI Health Care Mission Cancer and Blood - Waukee Clinic
Waukee, Iowa, 50263, United States
-
UI Health Care Mission Cancer and Blood - West Des Moines Clinic
Clive, Iowa, 50325, United States
-
UPMC Cancer Center - Monroeville
Monroeville, Pennsylvania, 15146, United States
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UPMC Cancer Center at UPMC Horizon
Farrell, Pennsylvania, 16121, United States
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UPMC Cancer Center at UPMC Northwest
Seneca, Pennsylvania, 16346, United States
-
UPMC Cancer Center-Washington
Washington, Pennsylvania, 15301, United States
-
UPMC Cancer Centers - Arnold Palmer Pavilion
Greensburg, Pennsylvania, 15601, United States
-
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania, 15232, United States
-
UPMC Hillman Cancer Center - Monroeville
Monroeville, Pennsylvania, 15146, United States
-
UPMC Hillman Cancer Center - New Castle
New Castle, Pennsylvania, 16105, United States
-
UPMC Hillman Cancer Center Erie
Erie, Pennsylvania, 16505, United States
-
UPMC Hillman Cancer Center in Greenville/UPMC Horizon
Greenville, Pennsylvania, 16125, United States
-
UPMC Washington Hospital Radiation Oncology
Washington, Pennsylvania, 15301, United States
-
UPMC-Passavant Hospital
Pittsburgh, Pennsylvania, 15237, United States
-
UPMC-Saint Clair Hospital Cancer Center
Pittsburgh, Pennsylvania, 15243, United States
-
UPMC-Saint Margaret
Pittsburgh, Pennsylvania, 15215, United States
-
UPMC-Shadyside Hospital
Pittsburgh, Pennsylvania, 15232, United States
-
UT Southwestern Clinical Center at Richardson/Plano
Richardson, Texas, 75080, United States
-
UT Southwestern Simmons Cancer Center - RedBird
Dallas, Texas, 75237, United States
-
UT Southwestern/Simmons Cancer Center-Dallas
Dallas, Texas, 75390, United States
-
UT Southwestern/Simmons Cancer Center-Fort Worth
Fort Worth, Texas, 76104, United States
-
University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233, United States
-
University of California Davis Comprehensive Cancer Center
Sacramento, California, 95817, United States
-
University of Hawaii Cancer Center
Honolulu, Hawaii, 96813, United States
-
University of Illinois
Chicago, Illinois, 60612, United States
-
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106, United States
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University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104, United States
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University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229, United States
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Upper Valley Medical Center
Troy, Ohio, 45373, United States
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Wilcox Memorial Hospital and Kauai Medical Clinic
Lihue, Hawaii, 96766, United States
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