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A Study of Alectinib, Entrectinib, or Vemurafenib Plus Cobimetinib in Participants With Stages I-III Non-Small Cell Lung Cancer With ALK, ROS1, NTRK, or BRAF v600E Molecular Alterations

Trial Status: Active

This trial will evaluate the efficacy and safety of targeted therapies in participants with resectable Stage IA2, IB, IIIA, or selected IIIB resectable and untreated non-small cell lung cancer (NSCLC) tumors with selected molecular alterations.

Inclusion Criteria

  • Inclusion Criteria Neoadjuvant Therapy: - Pathologically documented NSCLC - Molecular testing results from Clinical Laboratory Improvement Amendments (CLIA)-certified laboratories and showing at least one of the following abnormalities: ALK gene rearrangement; ROS1 gene rearrangement; NTRK1/2/3 gene rearrangement; BRAF V600 mutation - Molecular testing results used for patient eligibility should be obtained from the most recent tumor biopsy. Alternatively, and for patients with ALK, ROS1, and NTRK1/2/3 molecular alterations, molecular testing results used to determine patient eligibility could have been obtained from a recent blood sample (up to 2 months prior to enrollment) described in the study design - Measurable disease, as defined by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 - NSCLC must have a solid or subsolid appearance on computed tomography (CT) scan and cannot have a purely ground glass opacity appearance. For sub-solid 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 patient 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 - Male patients must be willing to use acceptable methods of contraception. Treatment-specific contraceptive requirements will be in the specific protocol appendix for each study drug - Female patients of childbearing potential must agree to use acceptable methods of contraception. For treatment-specific contraceptive requirements, please see the specific appendix for each study drug Adjuvant Therapy: - Patients whose tumors have pathologic response or lack of 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 - Patients with prior lung cancer that have been in remission for < 2 years with the exception of minimally invasive adenocarcinoma or incidental typical carcinoid tumors - 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 patients with a negligible risk of metastasis or death and with expected curative outcome (such as adequately treated carcinoma in situ of the cervix, basal or squamous cell skin cancer, non-muscle invasive bladder cancer, localized prostate cancer treated surgically with curative intent, or ductal carcinoma in situ treated surgically with curative intent) or undergoing active surveillance per SOC management (e.g., Rai Stage 0 chronic lymphocytic leukemia, prostate cancer with Gleason score </= 6, and prostate-specific antigen (</= 10 ng/mL, etc.) - Treatment with an investigational agent for any condition within 4 weeks prior to Cycle 1, Day 1 (or within 5 half-lives of the investigational product, whichever is longer) - Known HIV positivity or AIDS-related illness - Pregnant or lactating, or intending to become pregnant during the study


City of Hope Comprehensive Cancer Center
Status: ACTIVE
University of California Davis Comprehensive Cancer Center
Status: ACTIVE


Wayne State University / Karmanos Cancer Institute
Status: ACTIVE


Saint Louis
Siteman Cancer Center at Washington University
Status: ACTIVE

New York

New York
NYP / Columbia University Medical Center / Herbert Irving Comprehensive Cancer Center
Status: ACTIVE


Case Comprehensive Cancer Center
Ohio State University Comprehensive Cancer Center


Fred Hutch / University of Washington Cancer Consortium

Trial Phase Phase II

Trial Type Treatment

Lead Organization
Genentech Inc.

  • Primary ID ML41591
  • Secondary IDs NCI-2020-01859
  • ID NCT04302025