The proposed study will evaluate the safety and feasibility of preoperative administration nivolumab in patients with high-risk resectable NSCLC, and will facilitate a comprehensive exploratory characterization of the tumor immune milieu and circulating immune cells and soluble factors in these patients. Data obtained in this study will provide valuable information for planning further prospective clinical trials of anti-PD-1 or anti-PD-L1 in NSCLC, both in the peri-operative and advanced disease setting.
The proposed study will evaluate the safety and feasibility of preoperative administration nivolumab in patients with high-risk resectable NSCLC, and will facilitate a comprehensive exploratory characterization of the tumor immune milieu and circulating immune cells and soluble factors in these patients. Data obtained in this study will provide valuable information for planning further prospective clinical trials of anti-PD-1 or anti-PD-L1 in NSCLC, both in the peri-operative and advanced disease setting. Ultimately, it is highly desirable to discover prospective biomarkers of response and toxicity to allow patients with NSCLC who are most likely to derive benefit to receive anti-PD-1 or anti-PD-L1 treatment, and conversely to minimize the risk of toxicity and ineffective treatment for patients who are unlikely to benefit.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
27
One to four doses of anti-PD-1 or anti-PD-L1 antibody will be administered to enrolled patients on Day -56, Day -42, Day -28, and Day-14 (+/- two days) prior to planned surgery on Day 0 or up to +10 days.
The Second Affiliated Hospital Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
Safety and Adverse effects
Safety will be measured by drawing safety labs. (CBC and a Chemistry Panel will be drawn at 2 week intervals during Nivolumab administration). Grade 3 and 4 lab abnormalities will be recorded from both participating sites. Safety will also be measured by recording Grade 3 and 4 CTCAE 4.03 listed adverse events that occur while a subject is participating in the study.
Time frame: 8 weeks
Rate of Enrollment
Feasibility will be measured by the rate of enrollment of the 40 subjects at the 2 sites.
Time frame: 8 weeks
Pathologic Response
To assess pathologic response to neoadjuvant nivolumab in resected tumor and lymph nodes. The rate of major pathologic response, defined as \<10% residual viable tumor cells in the resection specimen will be compared to historic data with neoadjuvant chemotherapy.
Time frame: 6 weeks
Radiographic Response
To assess radiographic response to neoadjuvant nivolumab using RECIST 1.1.
Time frame: 5 weeks
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