A Study of Multiple Therapies in Biomarker-selected Participants With Resectable Stages IB-III Non-small Cell Lung Cancer (NSCLC)
NAUTIKA1: A Multicenter, Phase II, Neoadjuvant and Adjuvant Study of Multiple Therapies in Biomarker-selected Patients With Resectable Stages IB-III Non-small Cell Lung Cancer
Who can join
As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.
- Age
- 18 Years and older
- Sex
- All sexes
- Healthy volunteers
- Not accepted
- Compensation
- Not stated
Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.
What to expect
No one can promise a trial will help you personally — that is what the research is trying to find out.
What participation involves
Not stated in the study description — ask the study team about visits and procedures.
- Compensation
- Not stated
- Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
- Participants are monitored closely by the research team throughout the study.
- Some participants may receive access to an investigational treatment, which is still being studied.
- Your participation helps researchers learn whether this approach could help future patients.
About this study
In plain language
This study tests how well several treatments work and how safe they are for people with untreated non-small cell lung cancer (NSCLC). It is for people with stages IB through IIIA, or certain stage IIIB cancers, that can be removed by surgery and have specific gene changes or a protein marker.
This trial will evaluate the efficacy and safety of various therapies in participants with Stage IB, IIA, IIB, IIIA, or selected IIIB resectable and untreated NSCLC tumors that meet protocol-specified biomarker criteria.
Compensation is read from the study's own description and may be missing — always confirm with the study team.
Eligibility
Who can join
- Have newly diagnosed NSCLC confirmed by a tissue test, at stage IB, IIA, IIB, IIIA, or selected IIIB (T3N2 only).
- Lab tests must show an ALK, ROS1, NTRK1/2/3, or RET gene fusion; a BRAF V600 or KRAS G12C gene change; or the PD-L1 protein in at least 1% of tumor cells.
- Have cancer that can be measured and looks solid or partly solid on a CT scan, not only hazy.
- Have CT, PET, and brain MRI scans to check the cancer's stage. A surgeon must confirm that all cancer can be removed and that you are fit for surgery.
- Have healthy enough lungs, heart, blood counts, and other organs. Be fully active or able to do light work.
- Meet the study's hepatitis B and C blood test rules, which check for these liver viruses.
- Men and women who could become pregnant must agree to use accepted birth control methods.
- For treatment after surgery in certain study groups: scans must show no cancer growth, blood counts and organs must work well enough, and you must be fully active or able to do light work.
Who can't join
- Have cancer that has grown into certain nearby organs or structures, separate tumor spots in another lobe of the same lung, or stage IIIB cancer with N3 lymph node spread. T4 tumors are allowed only if their size is the reason for that stage.
- Have had lung cancer before, or received any lung cancer treatment within the past 2 years.
- Had major surgery within 28 days before the first study treatment.
- Had another cancer within the past 3 years, unless it has a very low risk of spreading or causing death and is expected to be cured.
- Received an experimental drug for any condition within 4 weeks before the first study treatment.
- Have HIV with a CD4 immune cell count below 350, virus detected in the blood, an infection linked to weak immunity within 12 months, or less than 4 weeks on stable HIV treatment.
- Had a severe infection within 4 weeks before treatment, or have an active infection that the study doctor thinks could make treatment unsafe.
- Are pregnant, breastfeeding, or planning to become pregnant during the study.
Simplified for readability. The official criteria below are what the study team uses.
Official eligibility criteria
Inclusion Criteria for Neoadjuvant Therapy: * Pathologically documented NSCLC: * Newly diagnosed early-stage NSCLC stages IB, IIA, IIB, IIIA, or selected IIIB (T3N2 only) NSCLC of squamous or non-squamous histology. Staging should be based on the 8th edition of the American Joint Committee on Cancer (AJCC)/Union Internationale Contre le Cancer (UICC) NSCLC staging system * T4 primary NSCLC will be allowed only on the basis of size. Invasion of the diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina, and separate tumor nodules in a different ipsilateral lobe is not permitted * All participants will undergo clinical staging using computed tomography (CT) and positron emission tomography (PET) scanning, as well as brain imaging using magnetic resonance imaging (MRI). Invasive mediastinal staging by either mediastinoscopy or endo-bronchial ultrasonography is highly encouraged for participants with radiographically suspected mediastinal nodal disease (i.e., N2) but not mandated if the CT or PET scans showed no evidence of N2 disease * Molecular testing results from clinical laboratory improvement amendments (CLIA)-certified laboratories and showing at least one of the following abnormalities: ALK fusion, ROS1 fusion, NTRK1/2/3 fusion; BRAF V600 mutation, RET fusion, PD-L1 expression in ≥ 1% tumor cells as determined by Food and Drug Administration (FDA)-approved test, KRAS G12C mutation * Measurable disease, as defined by RECIST v1.1 * NSCLC must have a solid or subsolid appearance on CT scan and cannot have a purely ground glass opacity appearance. For subsolid lesions, the tumor size (i.e., clinical T stage) should be measured based on the solid component only, exclusive of the ground glass opacity component * Evaluated by the attending surgeon prior to study enrollment to verify that the primary tumor and any involved lymph nodes are technically completely resectable and verify that the participant is medically operable * Adequate pulmonary function to be eligible for surgical resection with curative intent * Adequate cardiac function to be eligible for surgical resection with curative intent * Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 * Adequate hematologic and end-organ function * Negative hepatitis B surface antigen (HBsAg) test at screening for cohort * Negative total hepatitits B core antibody (HBcAb) test at screening for cohort, or positive total HBcAb test followed by a negative hepatitis B virus (HBV) deoxyribonucleic acid (DNA) test at screening * Negative hepatitis C virus (HCV) antibody test at screening, or positive HCV antibody test followed by a negative HCV ribonucleic acid (RNA) test at screening * Male participants must be willing to use acceptable methods of contraception * Female participants of childbearing potential must agree to use acceptable methods of contraception Inclusion Criteria for Adjuvant Therapy (TKI Cohorts and KRAS G12C cohort \[if continuing on Divarasib\]): * Participants whose tumors lack radiographic progression * ECOG Performance Status of 0 or 1 * Adequate hematologic and end-organ function Exclusion Criteria * NSCLC that is clinically T4 by virtue of mediastinal organ invasion or Stage IIIB by virtue of N3 disease * Any prior therapy for lung cancer, including chemotherapy, targeted therapy, immunotherapy, or radiotherapy, within 2 years * Participants with prior lung cancer * Major surgical procedure within 28 days prior to Cycle 1, Day 1 * Malignancies other than the disease under study within 3 years prior to Cycle 1, Day 1, with the exception of participants with a negligible risk of metastasis or death and with expected curative outcome * Treatment with an investigational agent for any condition within 4 weeks prior to Cycle 1, Day 1 * Participants known to be positive for human immunodeficiency virus (HIV) are excluded if they meet any of the following criteria: cluster of differentiation 4 (CD4)+ T-cell count of \<350 cells/microliters (cells/µL); detectable HIV viral load; history of an opportunistic infection within the past 12 months; on stable antiretroviral therapy for \<4 weeks * Severe infection within 4 weeks prior to initiation of study treatment, including but not limited to hospitalization for complications of infections, or any active infection that, in the opinion of the investigator, could impact participant safety * Pregnant or lactating, or intending to become pregnant during the study
Study sites (38)
CA
- City of Hope Comprehensive Cancer Center · Duarte, CA 91010More trials in Duarte
- City of Hope - Orange County Lennar Foundation Cancer Center · Irvine, CA 92618More trials in Irvine
- USC Norris Cancer Center · Los Angeles, CA 90033More trials in Los Angeles
- Cedars-Sinai Medical Center · Los Angeles, CA 90048More trials in Los Angeles
- University of California Los Angeles - Jonsson Comprehensive Cancer Center · Los Angeles, CA 90095More trials in Los Angeles
- The Center for Cancer Prevention and Treatment at St.Joseph Hospital of Orange · Orange, CA 92868More trials in Orange
- UC Davis Comprehensive Cancer Center · Sacramento, CA 95817More trials in Sacramento
- UCSF Helen Diller Family CCC · San Francisco, CA 94158More trials in San Francisco
CO
- University of Colorado - Anschutz Medical Campus (University of Colorado Health Sciences Center) · Aurora, CO 80045More trials in Aurora
CT
- Yale Cancer Center · New Haven, CT 06511More trials in New Haven
DC
- MedStar Georgetown University Hospital (Lombardi Comprehensive Cancer Center) · Washington D.C., DC 20007More trials in Washington D.C.
FL
- Moffitt Cancer Center · Tampa, FL 33612More trials in Tampa
IL
- Northwestern University · Chicago, IL 60611More trials in Chicago
- Northwestern Medicine Cancer Center Kishwaukee · DeKalb, IL 60115More trials in DeKalb
- Northwestern Medicine Cancer Center Delnor · Geneva, IL 60134More trials in Geneva
- Northwestern Medicine Cancer Center Warrenville · Warrenville, IL 60555More trials in Warrenville
MA
- Boston Medical Center · Boston, MA 02118More trials in Boston
- Dana-Farber Cancer Institute · Boston, MA 02215More trials in Boston
MI
- University of Michigan · Ann Arbor, MI 48109More trials in Ann Arbor
- Karmanos Cancer Institute - Farmington Hills/Weisberg Cancer Treatment Center · Farmington Hills, MI 48334More trials in Farmington Hills
MN
- Mayo Clinic · Rochester, MN 55905More trials in Rochester
MO
- Ellis Fischel Cancer Center · Columbia, MO 65201More trials in Columbia
- Siteman Cancer Center - Washington University Medical Campus · St Louis, MO 63108More trials in St Louis
NH
- Dartmouth Hitchcock Medical Center · Lebanon, NH 03756More trials in Lebanon
NY
- Laura and ISAAC Perlmutter Cancer Center at NYU Langone. · New York, NY 10016More trials in New York
- Columbia University Medical Center · New York, NY 10032More trials in New York
- Memorial Sloan Kettering Cancer Center · New York, NY 10065More trials in New York
OH
- University Hospitals Cleveland Medical Center · Cleveland, OH 44016More trials in Cleveland
- Ohio State University · Columbus, OH 43210More trials in Columbus
PA
- AHN Cancer Institute ? Allegheny General Hospital · Pittsburgh, PA 15212More trials in Pittsburgh
TN
- Baptist Clinical Research Institute · Memphis, TN 38120More trials in Memphis
- Tennessee Oncology - Nashville · Nashville, TN 37203More trials in Nashville
TX
- Kelsey Seybold Clnic · Houston, TX 77025More trials in Houston
- University of Texas MD Anderson Cancer Center · Houston, TX 77030-4008More trials in Houston
- Baylor College of Medicine · Houston, TX 77030More trials in Houston
- Lumi Research · Kingwood, TX 77339More trials in Kingwood
VA
- Virginia Cancer Specialists (Fairfax) - USOR · Fairfax, VA 22031More trials in Fairfax
WA
- Seattle Cancer Care Alliance · Seattle, WA 98109More trials in Seattle