Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2024-10080 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| S2409 | Other Identifier | SWOG | |
| S2409 | Other Identifier | CTEP | |
| U10CA180888 | U.S. NIH Grant/Contract | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
Not provided
Not provided
Not provided
Not provided
This phase II trial tests how well biomarker tests on patients tumor tissue works in selecting personalized treatments for patients with extensive stage small cell lung cancer (ES-SCLC). Biomarker tests look for certain features in cancer cells that may give doctors more information about what is driving cancer and how to treat it. Based on the biomarker test results, study doctors can determine the subtype of ES-SCLC that study treatments can target. This study also tests different types of maintenance treatment for ES-SCLC with drugs durvalumab, saruparib, ceralasertib or monalizumab. Maintenance treatment is given after initial treatment and is given to help keep the cancer under control and prevent it from getting worse. Immunotherapy with monoclonal antibodies, such as durvalumab and monalizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Saruparib is a PARP inhibitor. PARP is a protein that helps repair damaged deoxyribonucleic acid (DNA). Blocking PARP may prevent cancer cells from repairing their damaged DNA, causing them to die. PARP inhibitors are a type of targeted therapy. Ceralasertib may stop the growth of tumor cells and may kill them by blocking some of the enzymes needed for tumor cell growth. Giving biomarker selected personalized maintenance treatment with durvalumab, saruparib, ceralasertib or monalizumab may work better in treating patients with ES-SCLC.
PRIMARY OBJECTIVES:
I. To test participants' tissue specimens to determine their eligibility to 1 of the 3 treatment cohorts created based on their small cell lung cancer (SCLC) subtype and SLFN11 status. (Screening) II. To compare progression-free survival (PFS) in participants with extensive stage SCLC (ES-SCLC) (subtypes A or N & SLFN11 positive) or ES-SCLC (subtype P) randomized to durvalumab (MEDI4736) with or without saruparib (AZD5305) as maintenance therapy following induction chemoimmunotherapy with platinum, etoposide, and durvalumab (MEDI4736). (Cohort A) III. To compare PFS in participants with ES-SCLC subtypes A or N & SLFN11 negative randomized to durvalumab with or without ceralasertib (AZD6738) as maintenance therapy following induction chemoimmunotherapy with cisplatin or carboplatin, etoposide, and durvalumab (MEDI4736). (Cohort B) IV. To compare PFS participants with ES-SCLC subtype I randomized to durvalumab (MEDI4736) with or without monalizumab (IPH2201) as maintenance therapy following induction chemoimmunotherapy with cisplatin or carboplatin, etoposide, and durvalumab (MEDI4736). (Cohort C)
SECONDARY OBJECTIVES:
I. To evaluate the percentage of participant tissue that are able to have SCLC subtype status determined. (Screening) II. To evaluate the percentage of participant tissue that are able to have SLFN11 status determined. (Screening) III. To estimate the percentage of participants assigned to a cohort that register to be randomized. (Screening) IV. To evaluate the safety of saruparib (AZD5305) in combination with durvalumab by estimating the rate of dose limiting toxicities reported during the first cycle of treatment in the safety-run-in population. (Cohort A) V. To compare PFS between the arms in the subset of participants with A or N subtype and SLFN11 positive. (Cohort A) VI. To compare overall survival (OS) between the arms. (Cohort A) VII. To evaluate the frequency and severity of toxicities by Common Terminology Criteria for Adverse Events (CTCAE) within each treatment arm. (Cohort A) VIII. To compare OS between the arms. (Cohort B) IX. To evaluate the frequency and severity of toxicities by CTCAE within each arm. (Cohort B) X. To compare OS between the arms. (Cohort C) XI. To evaluate the frequency and severity of toxicities by CTCAE within each arm. (Cohort C)
TRANSLATIONAL MEDICINE OBJECTIVE:
I. To bank specimens for future correlative studies.
OUTLINE:
INDUCTION: Patients may receive a platinum compound plus etoposide per standard care as well as durvalumab intravenously (IV) over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days for 4-6 cycles in the absence of disease progression or unacceptable toxicity.
CONSOLIDATION: Patients may undergo thoracic radiation as clinically indicated.
MAINTENANCE: Patients are assigned to 1 of 3 cohorts and then randomized to 1 of 2 arms within each cohort to which they were assigned.
COHORT A: Patients with ES-SCLC determined to be subtype A or N, and to be SLFN11 positive or patients with subtype P ES-SCLC.
ARM 1: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
ARM 2: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle and saruparib orally (PO) once daily (QD) on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
COHORT B: Patients with ES-SCLC determined to be subtype A or N, and to be SLFN11 negative.
ARM 1: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
ARM 2: Patients receive durvalumab IV over 60 minutes on day 8 and ceralasertib PO twice daily (BID) on days 1-7 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
COHORT C: Patients with ES-SCLC determined to be subtype I.
ARM 1: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
ARM 2: Patients receive durvalumab IV over 60 minutes on day 1 and monalizumab IV over 60 minutes on days 1 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Additionally, patients undergo computed tomography (CT) scan or positron emission tomography (PET)/CT scan and CT scan or magnetic resonance imaging (MRI) throughout the study. Patients also undergo tissue sample collection during screening and may undergo blood sample collection throughout the study.
After completion of study treatment, patients are followed up to 3 years.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort A, Arm 1 (durvalumab) | Experimental | Patients with ES-SCLC determined to be subtype A or N, and to be SLFN11 positive or patients with subtype P ES-SCLC. INDUCTION: Patients may receive a platinum compound plus etoposide per standard care as well as durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days for 4-6 cycles in the absence of disease progression or unacceptable toxicity. CONSOLIDATION: Patients may undergo thoracic radiation as clinically indicated. MAINTENANCE: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT scan or PET/CT scan and CT scan or MRI throughout the study. Patients also undergo tissue sample collection during screening and may undergo blood sample collection throughout the study. |
|
| Cohort A, Arm 2 (durvalumab, saruparib) | Experimental | Patients with ES-SCLC determined to be subtype A or N, and to be SLFN11 positive or patients with subtype P ES-SCLC. INDUCTION: Patients may receive a platinum compound plus etoposide per standard care as well as durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days for 4-6 cycles in the absence of disease progression or unacceptable toxicity. CONSOLIDATION: Patients may undergo thoracic radiation as clinically indicated. MAINTENANCE: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle and saruparib PO QD on days 1-28. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT scan or PET/CT scan and CT scan or MRI throughout the study. Patients also undergo tissue sample collection during screening and may undergo blood sample collection throughout the study. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Biospecimen Collection | Procedure | Undergo tissue and blood sample collection |
|
| Measure | Description | Time Frame |
|---|---|---|
| Screen success rate (Screening) | Will test participants' tissue specimens to determine their eligibility to 1 of the 3 treatment cohorts created based on their small cell lung cancer (SCLC) subtype and SLFN11 status. Will evaluate rate of participants who successfully get a cohort assignment based on SCLC subtype and SLNFN11 status, as appropriate. | Up to 3 years |
| Progression-free survival (PFS) (Cohort A) | Will compare PFS in participants with extensive stage SCLC (ES-SCLC) (subtypes A or N & SLFN11 positive) or ES-SCLC (subtype P) randomized to durvalumab (MEDI4736) with or without saruparib (AZD5305) as maintenance therapy following induction chemoimmunotherapy with platinum, etoposide, and durvalumab (MEDI4736). Will be estimated using the Kaplan-Meier method. Associated confidence intervals about the median will be performed using the Brookmeyer-Crowley method. Binary proportions and associated confidence intervals will be calculated. | From date of randomization to treatment within a cohort to date of first documentation of progression, symptomatic deterioration, or death due to any cause, assessed up to 3 years |
| PFS (Cohort B) | Will compare PFS in participants with ES-SCLC subtypes A or N and SLFN11 negative randomized to durvalumab with or without ceralasertib (AZD6738) as maintenance therapy following induction chemoimmunotherapy with cisplatin or carboplatin, etoposide, and durvalumab (MEDI4736). Will be estimated using the Kaplan-Meier method. Associated confidence intervals about the median will be performed using the Brookmeyer-Crowley method. | From date of randomization to treatment within a cohort to date of first documentation of progression, symptomatic deterioration, or death due to any cause, assessed up to 3 years |
| PFS (Cohort C) | Will compare PFS participants with ES-SCLC subtype I randomized to durvalumab (MEDI4736) with or without monalizumab (IPH2201) as maintenance therapy following induction chemoimmunotherapy with cisplatin or carboplatin, etoposide, and durvalumab (MEDI4736). Will be estimated using the Kaplan-Meier method. Associated confidence intervals about the median will be performed using the Brookmeyer-Crowley method. |
| Measure | Description | Time Frame |
|---|---|---|
| SCLC subtype status (Screening) | Will evaluate the percentage of participant tissue that are able to have SCLC subtype status determined. | Up to 3 years |
| SLFN11 status (Screening) | Will evaluate the percentage of participant tissue that are able to have SLFN11 status determined. |
| Measure | Description | Time Frame |
|---|---|---|
| Bank specimens | Will bank specimens for future correlative studies. | Up to 3 years |
Inclusion Criteria:
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have a prior or concurrent malignancy whose natural history or treatment (in the opinion of the treating physician) has the potential to interfere with the safety or efficacy assessment of the investigational regimen
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have a history of limited stage small cell lung cancer
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must meet 1 of the following criteria prior to step 1:
Treatment naïve and planning to receive frontline induction treatment with platinum plus etoposide in combination with durvalumab, OR,
Have initiated frontline induction therapy and completed at least 1 (≥ 1) cycle and at most 3 (≤ 3) cycles of platinum and etoposide. At most 2 (≤ 2) of these cycles could have been given without durvalumab
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have received any anti PD-1 or anti PD-L1 (including durvalumab [MEDI4736]) treatment for SCLC prior to starting frontline induction treatment for ES-SCLC
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have received anti PD-1 or anti PD-L1 other than durvalumab (MEDI4736) as part of frontline induction treatment for ES-SCLC. Participants must have not received atezolizumab, pembrolizumab, or nivolumab as part of frontline induction treatment
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have received any investigational agent for the treatment of ES-SCLC
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not be planning to receive any concurrent non-protocol directed chemotherapy, immunotherapy, biologic or hormonal therapy for SCLC treatment while receiving treatment on this study
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have any unresolved toxicity National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) grade ≥ 2 from previous anticancer therapy with the exception of alopecia, and vitiligo
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must be ≥ 18 years old at the time of step 1 registration
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must be able to safely receive the frontline induction treatment with platinum plus etoposide in combination with durvalumab, per the current Food and Drug Administration (FDA)-approved package insert(s), institutional guidelines, and the treating investigator's discretion
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must have Zubrod performance status of 0-2 within 28 days prior to step 1 registration
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must have fully recovered from the effects of prior surgery in the opinion of the treating investigator within 28 days prior to step 1 registration
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have had an allogenic organ transplantation
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not have medical contraindications to receiving immunotherapy, including history of non-infectious pneumonitis that required steroids or active autoimmune disease that has required systemic treatment with disease modifying agents, corticosteroids or immunosuppressive drugs in the past two years. Replacement therapy (e.g. thyroxine for pre-existing hypothyroidism, insulin for type I diabetes mellitus, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. Intra-articular steroid injections are allowed
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must not be pregnant or nursing (nursing includes breast milk fed to an infant by any means, including from the breast, milk expressed by hand, or pumped). Individuals who are of reproductive potential must have agreed to use an effective contraceptive method during protocol therapy and for 6 months following completion of protocol therapy with details provided as a part of the consent process. A person who has had menses at any time in the preceding 12 consecutive months or who has semen likely to contain sperm is considered to be of "reproductive potential." In addition to routine contraceptive methods, "effective contraception" also includes refraining from sexual activity that might result in pregnancy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) including hysterectomy, bilateral oophorectomy, bilateral tubal ligation/occlusion, and vasectomy with testing showing no sperm in the semen. Participants should not breastfeed during protocol therapy and for 6 months following completion of protocol therapy
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: Participants must have adequate tumor tissue available from SCLC and agree to have these tissue specimens submitted. Participants must agree to have any leftover tissue (tissue that remains after subtype and biomarker testing) retained for the use of future correlative studies.
STEP 1: SCREENING AND INDUCTION TREATMENT REGISTRATION: NOTE: 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.
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Site must have received notification from the SWOG Statistics and Data Management Center (SDMC) of the participant's SLFN11 testing results and have been determined to have subtype A, N, I, or P: confirmed by BostonGene and assigned to a cohort
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants may have measurable or non-measurable disease per Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) and must have their disease assessed by CT of chest/abdomen/pelvis (with contrast unless contraindicated) within 28 days prior to step 2 for measurable disease or within 42 days prior to step 2 for non-measurable disease. All known sites of disease must be assessed and documented on the baseline tumor assessment form (RECIST 1.1). Any lesions assessed using a non-diagnostic PET/CT of chest/abdomen/pelvis will be considered non-measurable lesions
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must have a CT or MRI scan of the brain to evaluate for central nervous system (CNS) disease within 42 days prior to step 2 randomization. Participant must not have leptomeningeal disease, spinal cord compression, or symptomatic brain metastases unless: (1) metastases have been locally treated and have remained clinically controlled and asymptomatic for at least 14 days following treatment, and prior to step 2 randomization, AND (2) participant has no residual neurological dysfunction and has been off corticosteroids for at least 24 hours prior to step 2 randomization
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants with untreated brain metastases must be asymptomatic and stable off steroids prior to step 2 randomization.
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must not have experienced disease progression in the opinion of treating investigator during induction treatment and prior to step 2
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must have completed frontline induction therapy. Induction therapy must have included 4-6 cycles of platinum plus etoposide and 4 cycles of durvalumab (MEDI4736); at most 2 (≤ 2) cycles of platinum plus etoposide may have been given without durvalumab (MEDI4736). Durvalumab (MEDI4736) must have been given in combination with platinum plus etoposide
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants who received consolidation thoracic radiation therapy must have completed all radiation therapy at least 14 days prior to step 2
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: For participants not receiving consolidation thoracic radiation, step 2 registration must occur at least 3 weeks but not more than 6 weeks after the last dose of frontline induction therapy (platinum plus etoposide in combination with durvalumab [MEDI4736])
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: For participants receiving consolidation thoracic radiation after induction therapy, step 2 registration must occur at least 3 weeks but no more than 8 weeks after the last dose of frontline induction therapy (platinum plus etoposide in combination with durvalumab [MEDI4736])
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must not have received atezolizumab, pembrolizumab, or nivolumab as part of their frontline induction treatment. Participants must not have received prophylactic cranial irradiation (PCI)
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must have a complete medical history and physical within 28 days prior to step 2
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must have body weight > 30 kg
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must have Zubrod performance status of 0-2 within 28 days prior to step 2
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Hemoglobin > 9.0 g/dL (within 28 days prior to step 2)
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Absolute neutrophil count ≥ 1.5 x 10^3/uL (within 28 days prior to step 2)
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Platelets ≥ 100 x 10^3/uL (within 28 days prior to step 2)
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Total bilirubin ≤ institutional upper limit of normal (ULN) unless history of Gilbert's disease. Participants with history of Gilbert's disease must have total bilirubin ≤ 5 x institutional ULN (within 28 days prior to step 2)
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Aspartate aminotransferase (AST)/alanine transaminase (ALT) ≤ 5 × institutional ULN (within 28 days prior to step 2)
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must have creatinine ≤ 1.5x the institutional upper limit of normal (IULN) OR measured OR calculated creatinine clearance ≥ 45 mL/min using the following Cockcroft-Gault Formula For creatinine clearance formula see the tools on the Cancer Research and Biostatistics (CRA) Workbench https://txwb.crab.org/TXWB/Tools.aspx
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants with a known history of human immunodeficiency virus (HIV)-infection must be on effective anti-retroviral therapy at registration and have undetectable viral load test on the most recent test results obtained within 6 months prior to step 2 registration
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants with a known history of chronic hepatitis B virus (HBV) infection must have undetectable HBV viral load while on suppressive therapy on the most recent test results obtained within 6 months prior to randomization, if indicated
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants with a known history of hepatitis C virus (HCV) infection must have been treated and cured or currently be receiving treatment for HVC. Participants currently being treated for HCV infection must have undetectable HCV viral load test on the most recent test results obtained within 6 months prior to randomization, if indicated
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must not have experienced the following during induction treatment: Any grade 3 or worse immune-mediated adverse event (irAE) (except asymptomatic nonbullous/nonexfoliative rash) or any unresolved grade 2 irAE, nor have experienced a toxicity that led to permanent discontinuation of prior durvalumab (MEDI4736). Toxicity of any grade that requires replacement therapy and has stabilized on therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is allowed
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must not be pregnant or nursing (nursing includes breast milk fed to an infant by any means, including from the breast, milk expressed by hand, or pumped). Individuals who are of reproductive potential must have agreed to use an effective contraceptive method during protocol therapy and for 6 months following completion of protocol therapy with details provided as a part of the consent process. A person who has had menses at any time in the preceding 12 consecutive months or who has semen likely to contain sperm is considered to be of "reproductive potential." In addition to routine contraceptive methods, "effective contraception" also includes refraining from sexual activity that might result in pregnancy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) including hysterectomy, bilateral oophorectomy, bilateral tubal ligation/occlusion, and vasectomy with testing showing no sperm in the semen. Participants should not breastfeed during protocol therapy and for 6 months following completion of protocol therapy
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must not have received a live or live attenuated vaccine within 30 days prior to step 2. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster, yellow fever rabies, Bacillus Calmette-Guerin (BCG) and typhoid vaccine. Seasonal influenza vaccines and COVID-19 vaccines are allowed, however, intranasal influenza vaccines (e.g. Flu-Mist) are live attenuated, and are not allowed
STEP 2: COHORT REGISTRATION AND MAINTENANCE RANDOMIZATION: Participants must be offered the opportunity to participate in specimen banking
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Anne C Chiang | SWOG Cancer Research Network | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Loma Linda University Medical Center | Recruiting | Loma Linda | California | 92354 | United States |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Cohort B, Arm 1 (durvalumab) | Experimental | Patients with ES-SCLC determined to be subtype A or N, and to be SLFN11 negative. INDUCTION: Patients may receive a platinum compound plus etoposide per standard care as well as durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days for 4-6 cycles in the absence of disease progression or unacceptable toxicity. CONSOLIDATION: Patients may undergo thoracic radiation as clinically indicated. MAINTENANCE: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT scan or PET/CT scan and CT scan or MRI throughout the study. Patients also undergo tissue sample collection during screening and may undergo blood sample collection throughout the study. |
|
| Cohort B, Arm 2 (durvalumab, ceralasertib) | Experimental | Patients with ES-SCLC determined to be subtype A or N, and to be SLFN11 negative. INDUCTION: Patients may receive a platinum compound plus etoposide per standard care as well as durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days for 4-6 cycles in the absence of disease progression or unacceptable toxicity. CONSOLIDATION: Patients may undergo thoracic radiation as clinically indicated. MAINTENANCE: Patients receive durvalumab IV over 60 minutes on day 8 and ceralasertib PO BID on days 1-7 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT scan or PET/CT scan and CT scan or MRI throughout the study. Patients also undergo tissue sample collection during screening and may undergo blood sample collection throughout the study. |
|
| Cohort C, Arm 1 (durvalumab) | Experimental | Patients with ES-SCLC determined to be subtype I. INDUCTION: Patients may receive a platinum compound plus etoposide per standard care as well as durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days for 4-6 cycles in the absence of disease progression or unacceptable toxicity. CONSOLIDATION: Patients may undergo thoracic radiation as clinically indicated. MAINTENANCE: Patients receive durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT scan or PET/CT scan and CT scan or MRI throughout the study. Patients also undergo tissue sample collection during screening and may undergo blood sample collection throughout the study. |
|
| Cohort C, Arm 2 (durvalumab, monalizumab) | Experimental | Patients with ES-SCLC determined to be subtype I. INDUCTION: Patients may receive a platinum compound plus etoposide per standard care as well as durvalumab IV over 60 minutes on day 1 of each cycle. Cycles repeat every 28 days for 4-6 cycles in the absence of disease progression or unacceptable toxicity. CONSOLIDATION: Patients may undergo thoracic radiation as clinically indicated. MAINTENANCE: Patients receive durvalumab IV over 60 minutes on day 1 and monalizumab IV over 60 minutes on days 1 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo CT scan or PET/CT scan and CT scan or MRI throughout the study. Patients also undergo tissue sample collection during screening and may undergo blood sample collection throughout the study. |
|
|
| Ceralasertib | Drug | Given PO |
|
|
| Computed Tomography | Procedure | Undergo CT scan |
|
|
| Durvalumab | Biological | Given IV |
|
|
| Etoposide | Drug | Given etoposide |
|
|
| Magnetic Resonance Imaging | Procedure | Undergo MRI |
|
|
| Monalizumab | Biological | Given IV |
|
|
| Platinum Compound | Drug | Given platinum compound |
|
|
| Positron Emission Tomography | Procedure | Undergo PET/CT scan |
|
|
| Saruparib | Drug | Given PO |
|
|
| Thoracic Radiation Therapy | Radiation | Undergo thoracic radiation |
|
|
| From date of randomization to treatment within a cohort to date of first documentation of progression, symptomatic deterioration, or death due to any cause, assessed up to 3 years |
| Up to 3 years |
| Assigned to a cohort and register to be randomized (Screening) | Will estimate the percentage of participants assigned to a cohort that register to be randomized. | Up to 3 years |
| Incidence of dose limiting toxicity (DLT) (Cohort A, safety run-in) | Will evaluate the safety of saruparib (AZD5305) in combination with durvalumab by estimating the rate of DLTs in the safety-run-in population. Will be assessed by treatment-related grade 3 or higher non hematologic toxicity, treatment-related grade 4 or higher hematologic toxicity, or any grade of treatment-related toxicity that in the opinion of the treating physician directly leads to that participant decision to drug discontinuation. | During the first cycle of treatment (each cycle is 28 days) |
| PFS (Cohort A) | Will compare PFS between the arms in the subset of participants with A or N subtype and SLFN11 positive. Will be estimated using the Kaplan-Meier method. Associated confidence intervals about the median will be performed using the Brookmeyer-Crowley method. Binary proportions and associated confidence intervals will be calculated. | From date of randomization to treatment within a cohort to date of first documentation of progression, symptomatic deterioration, or death due to any cause, assessed up to 3 years |
| Overall survival (OS) (Cohort A) | Will compare OS between the arms. Will be estimated using the Kaplan-Meier method. Associated confidence intervals about the median will be performed using the Brookmeyer-Crowley method. Binary proportions and associated confidence intervals will be calculated. | From date of randomization to treatment within a cohort to date of death due to any cause, assessed up to 3 years |
| Incidence of adverse events (Cohort A) | Will evaluate the frequency and severity of toxicities by Common Terminology Criteria for Adverse Events(CTCAE) within each treatment arm. | Up to 3 years |
| OS (Cohort B) | Will compare OS between the arms. Will be estimated using the Kaplan-Meier method. Associated confidence intervals about the median will be performed using the Brookmeyer-Crowley method. | From date of randomization to treatment within a cohort to date of death due to any cause, assessed up to 3 years |
| Incidence of adverse events (Cohort B) | Will evaluate the frequency and severity of toxicities by CTCAE within each arm. | Up to 3 years |
| OS (Cohort C) | Will compare OS between the arms. Will be estimated using the Kaplan-Meier method. Associated confidence intervals about the median will be performed using the Brookmeyer-Crowley method. | From date of randomization to treatment within a cohort to date of death due to any cause, assessed up to 3 years |
| Incidence of adverse events (Cohort C) | Will evaluate the frequency and severity of toxicities by CTCAE within each arm. | Up to 3 years |
| Eisenhower Medical Center | Recruiting | Rancho Mirage | California | 92270 | United States |
|
| University of California Davis Comprehensive Cancer Center | Recruiting | Sacramento | California | 95817 | United States |
|
| UCHealth University of Colorado Hospital | Recruiting | Aurora | Colorado | 80045 | United States |
|
| UCHealth Memorial Hospital Central | Recruiting | Colorado Springs | Colorado | 80909 | United States |
|
| Memorial Hospital North | Recruiting | Colorado Springs | Colorado | 80920 | United States |
|
| Poudre Valley Hospital | Recruiting | Fort Collins | Colorado | 80524 | United States |
|
| Cancer Care and Hematology-Fort Collins | Recruiting | Fort Collins | Colorado | 80528 | United States |
|
| Lutheran Hospital - Cancer Centers of Colorado | Recruiting | Golden | Colorado | 80401 | United States |
|
| UCHealth Greeley Hospital | Recruiting | Greeley | Colorado | 80631 | United States |
|
| Medical Center of the Rockies | Recruiting | Loveland | Colorado | 80538 | United States |
|
| Smilow Cancer Hospital-Derby Care Center | Recruiting | Derby | Connecticut | 06418 | United States |
|
| Smilow Cancer Hospital Care Center-Fairfield | Recruiting | Fairfield | Connecticut | 06824 | United States |
|
| Smilow Cancer Hospital Care Center - Guilford | Recruiting | Guilford | Connecticut | 06437 | United States |
|
| Yale University | Recruiting | New Haven | Connecticut | 06520 | United States |
|
| Yale-New Haven Hospital North Haven Medical Center | Recruiting | North Haven | Connecticut | 06473 | United States |
|
| Smilow Cancer Hospital-Torrington Care Center | Recruiting | Torrington | Connecticut | 06790 | United States |
|
| Smilow Cancer Hospital Care Center-Trumbull | Recruiting | Trumbull | Connecticut | 06611 | United States |
|
| Smilow Cancer Hospital-Waterbury Care Center | Recruiting | Waterbury | Connecticut | 06708 | United States |
|
| Smilow Cancer Hospital Care Center - Waterford | Recruiting | Waterford | Connecticut | 06385 | United States |
|
| Helen F Graham Cancer Center | Recruiting | Newark | Delaware | 19713 | United States |
|
| Medical Oncology Hematology Consultants PA | Recruiting | Newark | Delaware | 19713 | United States |
|
| Lewis Cancer and Research Pavilion at Saint Joseph's/Candler | Recruiting | Savannah | Georgia | 31405 | United States |
|
| Kootenai Health - Coeur d'Alene | Recruiting | Coeur d'Alene | Idaho | 83814 | United States |
|
| Saint Alphonsus Cancer Care Center-Nampa | Recruiting | Nampa | Idaho | 83687 | United States |
|
| Kootenai Clinic Cancer Services - Post Falls | Recruiting | Post Falls | Idaho | 83854 | United States |
|
| Kootenai Clinic Cancer Services - Sandpoint | Recruiting | Sandpoint | Idaho | 83864 | United States |
|
| Northwestern University | Recruiting | Chicago | Illinois | 60611 | United States |
|
| Northwestern Medicine Cancer Center Kishwaukee | Recruiting | DeKalb | Illinois | 60115 | United States |
|
| Northwestern Medicine Cancer Center Delnor | Recruiting | Geneva | Illinois | 60134 | United States |
|
| Northwestern Medicine Glenview Outpatient Center | Recruiting | Glenview | Illinois | 60026 | United States |
|
| Northwestern Medicine Grayslake Outpatient Center | Recruiting | Grayslake | Illinois | 60030 | United States |
|
| Northwestern Medicine Lake Forest Hospital | Recruiting | Lake Forest | Illinois | 60045 | United States |
|
| Loyola University Medical Center | Recruiting | Maywood | Illinois | 60153 | United States |
|
| Northwestern Medicine Oak Brook | Recruiting | Oak Brook | Illinois | 60523 | United States |
|
| Northwestern Medicine Orland Park | Recruiting | Orland Park | Illinois | 60462 | United States |
|
| Northwestern Medicine Cancer Center Warrenville | Recruiting | Warrenville | Illinois | 60555 | United States |
|
| Mary Greeley Medical Center | Recruiting | Ames | Iowa | 50010 | United States |
|
| McFarland Clinic - Ames | Recruiting | Ames | Iowa | 50010 | United States |
|
| UI Health Care Mission Cancer and Blood - Ankeny Clinic | Recruiting | Ankeny | Iowa | 50023 | United States |
|
| McFarland Clinic - Boone | Suspended | Boone | Iowa | 50036 | United States |
| Mercy Hospital | Recruiting | Cedar Rapids | Iowa | 52403 | United States |
|
| Oncology Associates at Mercy Medical Center | Recruiting | Cedar Rapids | Iowa | 52403 | United States |
|
| UI Health Care Mission Cancer and Blood - West Des Moines Clinic | Recruiting | Clive | Iowa | 50325 | United States |
|
| Iowa Methodist Medical Center | Recruiting | Des Moines | Iowa | 50309 | United States |
|
| UI Health Care Mission Cancer and Blood - Des Moines Clinic | Recruiting | Des Moines | Iowa | 50309 | United States |
|
| Mercy Medical Center - Des Moines | Recruiting | Des Moines | Iowa | 50314 | United States |
|
| UI Health Care Mission Cancer and Blood - Laurel Clinic | Recruiting | Des Moines | Iowa | 50314 | United States |
|
| McFarland Clinic - Trinity Cancer Center | Recruiting | Fort Dodge | Iowa | 50501 | United States |
|
| McFarland Clinic - Jefferson | Suspended | Jefferson | Iowa | 50129 | United States |
| McFarland Clinic - Marshalltown | Recruiting | Marshalltown | Iowa | 50158 | United States |
|
| UI Health Care Mission Cancer and Blood - Waukee Clinic | Recruiting | Waukee | Iowa | 50263 | United States |
|
| The Iowa Clinic PC | Recruiting | West Des Moines | Iowa | 50266 | United States |
|
| University of Kansas Clinical Research Center | Recruiting | Fairway | Kansas | 66205 | United States |
|
| University of Kansas Cancer Center | Recruiting | Kansas City | Kansas | 66160 | United States |
|
| The University of Kansas Cancer Center - Olathe | Recruiting | Olathe | Kansas | 66061 | United States |
|
| University of Kansas Cancer Center-Overland Park | Recruiting | Overland Park | Kansas | 66210 | United States |
|
| Salina Regional Health Center | Recruiting | Salina | Kansas | 67401 | United States |
|
| University of Kansas Hospital-Westwood Cancer Center | Recruiting | Westwood | Kansas | 66205 | United States |
|
| Baptist Health Corbin | Recruiting | Corbin | Kentucky | 40701 | United States |
|
| Baptist Health Lexington | Recruiting | Lexington | Kentucky | 40503 | United States |
|
| Baptist Health Hamburg | Recruiting | Lexington | Kentucky | 40509 | United States |
|
| University of Maryland/Greenebaum Cancer Center | Recruiting | Baltimore | Maryland | 21201 | United States |
|
| Tufts Medical Center | Recruiting | Boston | Massachusetts | 02111 | United States |
|
| Lahey Hospital and Medical Center | Recruiting | Burlington | Massachusetts | 01805 | United States |
|
| Lahey Medical Center-Peabody | Recruiting | Peabody | Massachusetts | 01960 | United States |
|
| Trinity Health IHA Medical Group Hematology Oncology - Brighton | Recruiting | Brighton | Michigan | 48114 | United States |
|
| Trinity Health IHA Medical Group Hematology Oncology - Canton | Recruiting | Canton | Michigan | 48188 | United States |
|
| Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital | Recruiting | Chelsea | Michigan | 48118 | United States |
|
| Henry Ford Health Saint John Hospital | Recruiting | Detroit | Michigan | 48236 | United States |
|
| Henry Ford River District Hospital | Recruiting | East China Township | Michigan | 48054 | United States |
|
| Henry Ford Saint John Hospital - Academic | Recruiting | Grosse Pointe Woods | Michigan | 48236 | United States |
|
| Henry Ford Saint John Hospital - Breast | Recruiting | Grosse Pointe Woods | Michigan | 48236 | United States |
|
| Henry Ford Saint John Hospital - Van Elslander | Recruiting | Grosse Pointe Woods | Michigan | 48236 | United States |
|
| University of Michigan Health - Sparrow Lansing | Recruiting | Lansing | Michigan | 48912 | United States |
|
| Trinity Health Saint Mary Mercy Livonia Hospital | Recruiting | Livonia | Michigan | 48154 | United States |
|
| Henry Ford Saint John Hospital - Macomb Medical | Recruiting | Macomb | Michigan | 48044 | United States |
|
| Henry Ford Warren Hospital - Breast Macomb | Recruiting | Macomb | Michigan | 48044 | United States |
|
| Trinity Health Saint Joseph Mercy Oakland Hospital | Recruiting | Pontiac | Michigan | 48341 | United States |
|
| Henry Ford Health Warren Hospital | Recruiting | Warren | Michigan | 48093 | United States |
|
| Henry Ford Madison Heights Hospital - Breast | Recruiting | Warren | Michigan | 48093 | United States |
|
| Henry Ford Warren Hospital - GLCMS | Recruiting | Warren | Michigan | 48093 | United States |
|
| Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus | Recruiting | Ypsilanti | Michigan | 48197 | United States |
|
| Sanford Joe Lueken Cancer Center | Recruiting | Bemidji | Minnesota | 56601 | United States |
|
| Essentia Health Saint Joseph's Medical Center | Recruiting | Brainerd | Minnesota | 56401 | United States |
|
| Mercy Hospital | Recruiting | Coon Rapids | Minnesota | 55433 | United States |
|
| Essentia Health - Deer River Clinic | Recruiting | Deer River | Minnesota | 56636 | United States |
|
| Essentia Health Cancer Center | Recruiting | Duluth | Minnesota | 55805 | United States |
|
| Fairview Southdale Hospital | Recruiting | Edina | Minnesota | 55435 | United States |
|
| Essentia Health Hibbing Clinic | Recruiting | Hibbing | Minnesota | 55746 | United States |
|
| Saint John's Hospital - Healtheast | Recruiting | Maplewood | Minnesota | 55109 | United States |
|
| Abbott-Northwestern Hospital | Recruiting | Minneapolis | Minnesota | 55407 | United States |
|
| Hennepin County Medical Center | Recruiting | Minneapolis | Minnesota | 55415 | United States |
|
| New Ulm Medical Center | Recruiting | New Ulm | Minnesota | 56073 | United States |
|
| Park Nicollet Clinic - Saint Louis Park | Recruiting | Saint Louis Park | Minnesota | 55416 | United States |
|
| Regions Hospital | Recruiting | Saint Paul | Minnesota | 55101 | United States |
|
| United Hospital | Recruiting | Saint Paul | Minnesota | 55102 | United States |
|
| Essentia Health Sandstone | Recruiting | Sandstone | Minnesota | 55072 | United States |
|
| Essentia Health Virginia Clinic | Recruiting | Virginia | Minnesota | 55792 | United States |
|
| University of Kansas Cancer Center - Briarcliff | Recruiting | Kansas City | Missouri | 64116 | United States |
|
| University of Kansas Cancer Center - North | Recruiting | Kansas City | Missouri | 64154 | United States |
|
| University of Kansas Cancer Center - Lee's Summit | Recruiting | Lee's Summit | Missouri | 64064 | United States |
|
| Mercy Hospital South | Recruiting | St Louis | Missouri | 63128 | United States |
|
| Mercy Hospital Saint Louis | Recruiting | St Louis | Missouri | 63141 | United States |
|
| Community Hospital of Anaconda | Recruiting | Anaconda | Montana | 59711 | United States |
|
| Billings Clinic Cancer Center | Recruiting | Billings | Montana | 59101 | United States |
|
| Bozeman Health Deaconess Hospital | Recruiting | Bozeman | Montana | 59715 | United States |
|
| Benefis Sletten Cancer Institute | Recruiting | Great Falls | Montana | 59405 | United States |
|
| Community Medical Center | Recruiting | Missoula | Montana | 59804 | United States |
|
| Roswell Park Cancer Institute | Recruiting | Buffalo | New York | 14263 | United States |
|
| University of Rochester | Recruiting | Rochester | New York | 14642 | United States |
|
| Wilmot Cancer Institute at Webster | Recruiting | Webster | New York | 14580 | United States |
|
| FirstHealth of the Carolinas-Moore Regional Hospital | Recruiting | Pinehurst | North Carolina | 28374 | United States |
|
| Sanford Bismarck Medical Center | Recruiting | Bismarck | North Dakota | 58501 | United States |
|
| Essentia Health Cancer Center-South University Clinic | Recruiting | Fargo | North Dakota | 58103 | United States |
|
| Sanford Broadway Medical Center | Recruiting | Fargo | North Dakota | 58122 | United States |
|
| Sanford Roger Maris Cancer Center | Recruiting | Fargo | North Dakota | 58122 | United States |
|
| Aultman Health Foundation | Recruiting | Canton | Ohio | 44710 | United States |
|
| Miami Valley Hospital South | Recruiting | Centerville | Ohio | 45459 | United States |
|
| Miami Valley Hospital | Recruiting | Dayton | Ohio | 45409 | United States |
|
| Premier Blood and Cancer Center | Recruiting | Dayton | Ohio | 45409 | United States |
|
| Miami Valley Hospital North | Recruiting | Dayton | Ohio | 45415 | United States |
|
| Atrium Medical Center-Middletown Regional Hospital | Recruiting | Franklin | Ohio | 45005-1066 | United States |
|
| Miami Valley Cancer Care and Infusion | Recruiting | Greenville | Ohio | 45331 | United States |
|
| Upper Valley Medical Center | Recruiting | Troy | Ohio | 45373 | United States |
|
| University of Oklahoma Health Sciences Center | Recruiting | Oklahoma City | Oklahoma | 73104 | United States |
|
| Providence Newberg Medical Center | Recruiting | Newberg | Oregon | 97132 | United States |
|
| Providence Willamette Falls Medical Center | Recruiting | Oregon City | Oregon | 97045 | United States |
|
| Providence Portland Medical Center | Recruiting | Portland | Oregon | 97213 | United States |
|
| Providence Saint Vincent Medical Center | Recruiting | Portland | Oregon | 97225 | United States |
|
| Saint Joseph's/Candler - Bluffton Campus | Recruiting | Bluffton | South Carolina | 29910 | United States |
|
| Prisma Health Cancer Institute - Spartanburg | Recruiting | Boiling Springs | South Carolina | 29316 | United States |
|
| Prisma Health Cancer Institute - Easley | Recruiting | Easley | South Carolina | 29640 | United States |
|
| Tidelands Georgetown Memorial Hospital | Recruiting | Georgetown | South Carolina | 29440 | United States |
|
| Prisma Health Cancer Institute - Butternut | Recruiting | Greenville | South Carolina | 29605 | United States |
|
| Prisma Health Cancer Institute - Faris | Recruiting | Greenville | South Carolina | 29605 | United States |
|
| Prisma Health Cancer Institute - Eastside | Recruiting | Greenville | South Carolina | 29615 | United States |
|
| Prisma Health Cancer Institute - Greer | Recruiting | Greer | South Carolina | 29650 | United States |
|
| Prisma Health Cancer Institute - Seneca | Recruiting | Seneca | South Carolina | 29672 | United States |
|
| Sanford Cancer Center Oncology Clinic | Recruiting | Sioux Falls | South Dakota | 57104 | United States |
|
| Sanford USD Medical Center - Sioux Falls | Recruiting | Sioux Falls | South Dakota | 57117-5134 | United States |
|
| M D Anderson Cancer Center | Recruiting | Houston | Texas | 77030 | United States |
|
| VCU Massey Cancer Center at Stony Point | Recruiting | Richmond | Virginia | 23235 | United States |
|
| VCU Massey Comprehensive Cancer Center | Recruiting | Richmond | Virginia | 23298 | United States |
|
| VCU Community Memorial Health Center | Recruiting | South Hill | Virginia | 23970 | United States |
|
| VCU Health Tappahannock Hospital | Recruiting | Tappahannock | Virginia | 22560 | United States |
|
| Duluth Clinic Ashland | Recruiting | Ashland | Wisconsin | 54806 | United States |
|
| Gundersen Lutheran Medical Center | Recruiting | La Crosse | Wisconsin | 54601 | United States |
|
| ID | Term |
|---|---|
| D055752 | Small Cell Lung Carcinoma |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| C000611951 | ceralasertib |
| C000613593 | durvalumab |
| D007074 | Immunoglobulin G |
| D004220 | Disulfides |
| D005047 | Etoposide |
| D009682 | Magnetic Resonance Spectroscopy |
| C000709515 | monalizumab |
| D055654 | NK Cell Lectin-Like Receptor Subfamily C |
| D061067 | Antibodies, Monoclonal, Humanized |
| D017671 | Platinum Compounds |
| C000722772 | AZD5305 |
| ID | Term |
|---|---|
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D008919 | Investigative Techniques |
| D007132 | Immunoglobulin Isotypes |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D013440 | Sulfides |
| D000838 | Anions |
| D007477 | Ions |
| D004573 | Electrolytes |
| D007287 | Inorganic Chemicals |
| D006862 | Hydrogen Sulfide |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D011034 | Podophyllotoxin |
| D013764 | Tetrahydronaphthalenes |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D005960 | Glucosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D013057 | Spectrum Analysis |
| D002623 | Chemistry Techniques, Analytical |
| D055630 | Receptors, NK Cell Lectin-Like |
| D055607 | Receptors, Natural Killer Cell |
| D011971 | Receptors, Immunologic |
| D011956 | Receptors, Cell Surface |
| D008565 | Membrane Proteins |
| D000911 | Antibodies, Monoclonal |
Not provided
Not provided