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Trial record 1 of 1 for:    NCT02763579
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A Study of Carboplatin Plus Etoposide With or Without Atezolizumab in Participants With Untreated Extensive-Stage (ES) Small Cell Lung Cancer (SCLC) (IMpower133)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02763579
Recruitment Status : Active, not recruiting
First Posted : May 5, 2016
Results First Posted : June 13, 2019
Last Update Posted : September 18, 2019
Sponsor:
Information provided by (Responsible Party):
Hoffmann-La Roche

Brief Summary:
This randomized, Phase I/III, multicenter, double-blinded, placebo-controlled study was designed to evaluate the safety and efficacy of atezolizumab (anti-programmed death-ligand 1 [PD-L1] antibody) in combination with carboplatin plus (+) etoposide compared with treatment with placebo + carboplatin + etoposide in chemotherapy-naive participants with ES-SCLC. Participants will be randomized in a 1:1 ratio to receive either atezolizumab + carboplatin + etoposide or placebo + carboplatin + etoposide on 21-day cycles for four cycles in the induction phase followed by maintenance with atezolizumab or placebo until progressive disease (PD) as assessed by the investigator using Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1). Treatment can be continued until persistent radiographic PD or symptomatic deterioration.

Condition or disease Intervention/treatment Phase
Small Cell Lung Carcinoma Drug: Atezolizumab (MPDL3280A), an engineered anti-PD-L1 antibody Drug: Carboplatin Drug: Etoposide Drug: Placebo Phase 3

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 403 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase I/III, Randomized, Double-Blind, Placebo-Controlled Study of Carboplatin Plus Etoposide With or Without Atezolizumab (Anti-PD-L1 Antibody) in Patients With Untreated Extensive-Stage Small Cell Lung Cancer
Actual Study Start Date : June 7, 2016
Actual Primary Completion Date : April 24, 2018
Estimated Study Completion Date : March 24, 2020


Arm Intervention/treatment
Experimental: Atezolizumab + Carboplatin + Etoposide
Participants received intravenous infusions of atezolizumab 1200 milligrams (mg) in combination with carboplatin to achieve an initial target area under the concentration-time curve (AUC) of 5 milligrams per milliliter per minute (mg/mL/min) followed by etoposide 100 milligrams per square meter (mg/m^2) on Day 1 of every 21-day cycle during the induction phase (Cycles 1-4). On Days 2 and 3 of every 21-day cycle during the induction phase (Cycles 1-4), etoposide 100 mg/m^2 was administered alone. Thereafter, participants received maintenance (Cycle 5 onward) atezolizumab 1200 mg on Day 1 of every 21-day cycle until persistent radiographic PD, symptomatic deterioration, intolerable toxicity, withdrawal of consent, death, or study termination by the Sponsor.
Drug: Atezolizumab (MPDL3280A), an engineered anti-PD-L1 antibody
Atezolizumab intravenous infusion was administered at a dose of 1200 mg on Day 1 of each 21-day cycle during the induction phase (Cycles 1-4) and maintenance phase (Cycle 5 onward).
Other Name: MPDL3280A, RO5541267, Tecentriq

Drug: Carboplatin
Carboplatin intravenous infusion to achieve an initial target AUC of 5 mg/mL/min was administered on Day 1 of each 21-day cycle during the induction phase (Cycles 1-4).

Drug: Etoposide
Etoposide intravenous infusion was administered at a dose of 100 mg/m^2 on Days 1, 2, and 3 of each 21-day cycle during the induction phase (Cycles 1-4).

Active Comparator: Placebo + Carboplatin + Etoposide
Participants received intravenous infusions of placebo in combination with carboplatin to achieve an initial target AUC of 5 mg/mL/min followed by etoposide 100 mg/m^2 on Day 1 of every 21-day cycle during the induction phase (Cycles 1-4). On Days 2 and 3 of every 21-day cycle during the induction phase (Cycles 1-4), etoposide 100 mg/m^2 was administered alone. Thereafter, participants received maintenance (Cycle 5 onward) placebo on Day 1 of every 21-day cycle until persistent radiographic PD, symptomatic deterioration, intolerable toxicity, withdrawal of consent, death, or study termination by the Sponsor.
Drug: Carboplatin
Carboplatin intravenous infusion to achieve an initial target AUC of 5 mg/mL/min was administered on Day 1 of each 21-day cycle during the induction phase (Cycles 1-4).

Drug: Etoposide
Etoposide intravenous infusion was administered at a dose of 100 mg/m^2 on Days 1, 2, and 3 of each 21-day cycle during the induction phase (Cycles 1-4).

Drug: Placebo
Placebo intravenous infusion was administered on Day 1 of each 21-day cycle during the induction phase (Cycles 1-4) and maintenance phase (Cycle 5 onward).




Primary Outcome Measures :
  1. Duration of Progression-Free Survival (PFS) as Assessed by the Investigator Using RECIST v1.1 [ Time Frame: Baseline until PD or death, whichever occurs first (up to approximately 23 months) ]
    Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as at least 20% increase in the sum of the longest diameter of target lesions compared to baseline, or unequivocal progression in non-target lesion(s), or the appearance of new lesion(s).

  2. Duration of Overall Survival (OS) [ Time Frame: Baseline until death from any cause (up to approximately 23 months) ]

Secondary Outcome Measures :
  1. Percentage of Participants With Objective Response (OR) as Assessed by the Investigator Using RECIST v1.1 [ Time Frame: Baseline until partial response (PR) or complete response (CR), whichever occurs first (up to approximately 46 months) ]
  2. Duration of Response (DOR) as Assessed by the Investigator Using RECIST v1.1 [ Time Frame: First occurrence of PR or CR until PD or death, whichever occurs first (up to approximately 46 months) ]
  3. Percentage of Participants Alive and Without PD, as Assessed by the Investigator Using RECIST v1.1, at 6 Months and 1 Year [ Time Frame: 6 months, 1 year (up to approximately 46 months) ]
  4. Percentage of Participants Alive at 1 Year and 2 Years [ Time Frame: 1 year, 2 years (up to approximately 46 months) ]
  5. Time to Deterioration (TTD) Per European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Core 30 (C30) Score [ Time Frame: Baseline until deterioration per symptom subscale (up to approximately 46 months) ]
  6. TTD Per EORTC QLQ Lung Cancer Module (LC13) Score [ Time Frame: Baseline until deterioration per symptom subscale (up to approximately 46 months) ]
  7. Percentage of Participants With Adverse Events [ Time Frame: Baseline until up to 90 days after end of treatment (up to approximately 46 months) ]
  8. Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) [ Time Frame: Predose (0 hours [H]) on Day (D) 1 of Cycles (C) 1, 2, 3, 4, 8, 16, and every 8 cycles (Q8C) thereafter (cycle = 21 days) until treatment discontinuation (up to 46 months) and 120 days after last dose (up to approximately 46 months overall) ]
  9. Maximum Observed Serum Concentration (Cmax) of Atezolizumab [ Time Frame: Predose (0 H) and postdose (0.5 H) on D1 of C1; predose (0 H) on D1 of C2, 3, 4, 8, 16, and Q8C thereafter (cycle = 21 days) until treatment discontinuation (up to 46 months) and 120 days after last dose (up to approximately 46 months overall) ]
    Atezolizumab infusion duration is 60 minutes for the first infusion and 30 minutes for subsequent infusions.

  10. Minimum Observed Serum Concentration (Cmin) of Atezolizumab [ Time Frame: Predose (0 H) on D1 of C1, 2, 3, 4, 8, 16, and Q8C thereafter (cycle = 21 days) until treatment discontinuation (up to 46 months) and 120 days after last dose (up to approximately 46 months overall) ]
    Atezolizumab infusion duration is 60 minutes for the first infusion and 30 minutes for subsequent infusions.

  11. Plasma Concentration of Carboplatin [ Time Frame: Predose (0 H) and 5-10 minutes before end/1 H after end of carboplatin infusion (infusion duration = 1 H) on D1 of C1 and C3 (cycle = 21 days)(up to approximately 46 months) ]
  12. Plasma Concentration of Etoposide [ Time Frame: Predose (0 H) and 5-10 minutes before end/1 H and 4H after end of etoposide infusion (infusion duration = 1 H) on D1 of C1 and C3 (cycle = 21 days)(up to approximately 46 months) ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically or cytologically confirmed ES-SCLC (per the Veterans Administration Lung Study Group [VALG] staging system)
  • No prior systemic treatment for ES-SCLC
  • Eastern Cooperative Oncology Group performance status of 0 or 1
  • Measurable disease, as defined by RECIST v1.1
  • Adequate hematologic and end organ function
  • Treatment-free for at least 6 months since last chemo/radiotherapy, among those treated (with curative intent) with prior chemo/radiotherapy for limited-stage SCLC

Exclusion Criteria:

  • Active or untreated central nervous system (CNS) metastases as determined by computed tomography (CT) or magnetic resonance imaging (MRI) evaluation
  • Malignancies other than SCLC within 5 years prior to randomization, with the exception of those with a negligible risk of metastasis or death treated with expected curative outcome
  • Pregnant or lactating women
  • History of autoimmune disease
  • History of idiopathic pulmonary fibrosis, organizing pneumonia, drug-induced pneumonitis, idiopathic pneumonitis, or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted.
  • Positive test result for human immunodeficiency virus (HIV)
  • Active hepatitis B or hepatitis C
  • Severe infections at the time of randomization
  • Significant cardiovascular disease
  • Prior treatment with cluster of differentiation (CD) 137 agonists or immune checkpoint blockade therapies, anti-programmed death-1 (PD-1), and anti-PD-L1 therapeutic antibody
  • History of severe (or known) hypersensitivity to chimeric or humanized antibodies or fusion proteins or any component of atezolizumab formulation.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02763579


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Locations
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United States, District of Columbia
Georgetown University
Washington, District of Columbia, United States, 20007
United States, Florida
Florida Cancer Specialists - Fort Myers (Broadway)
Fort Myers, Florida, United States, 33916
Florida Hospital
Orlando, Florida, United States, 32804
Florida Cancer Specialists.
Saint Petersburg, Florida, United States, 33705
United States, Georgia
Northwest Georgia Oncology Centers PC - Marietta
Marietta, Georgia, United States, 30060
United States, Illinois
Rush University Medical Center
Chicago, Illinois, United States, 60612-3244
Illinois Cancer Care
Peoria, Illinois, United States, 61615
Cancer Treatment Centers of America - Midwestern Regional Medical Center
Zion, Illinois, United States, 60099
United States, Kentucky
Louisville Oncology
Louisville, Kentucky, United States, 40202
United States, Maine
New England Cancer Specialists
Scarborough, Maine, United States, 04074
United States, Maryland
Weinberg CA Inst Franklin Sq
Baltimore, Maryland, United States, 21237
United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
United States, Nevada
Comprehensive Cancer Centers of Nevada - Eastern Avenue
Las Vegas, Nevada, United States, 89169
United States, New Jersey
The Valley Hospital
Paramus, New Jersey, United States, 07652
United States, New York
Broome Oncology - Binghamton
Binghamton, New York, United States, 13905
United States, North Carolina
Levine Cancer Institute
Charlotte, North Carolina, United States, 28204
United States, Ohio
Oncology Hematology Care Inc
Cincinnati, Ohio, United States, 45242
United States, Pennsylvania
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States, 15213
United States, Tennessee
Chattanooga Oncology and Hematology Associates, PC
Chattanooga, Tennessee, United States, 37404
Tennessee Oncology PLLC - Nashville (20th Ave)
Nashville, Tennessee, United States, 37203
Vanderbilt Medical Center
Nashville, Tennessee, United States, 37232-7610
United States, Virginia
Virginia Cancer Specialists, PC
Fairfax, Virginia, United States, 22031
Blue Ridge Cancer Care
Roanoke, Virginia, United States, 24014
United States, Washington
Northwest Medical Specialties
Tacoma, Washington, United States, 98405
United States, Wisconsin
University of Wisconsin
Madison, Wisconsin, United States, 53792
Australia, New South Wales
Chris O'Brien Lifehouse
Camperdown, New South Wales, Australia, 2050
Australia, Queensland
The Prince Charles Hospital; Oncology Dept.
Chermside, Queensland, Australia, 4032
Australia, Victoria
Royal Melbourne Hospital; Hematology and Medical Oncology
Parkville, Victoria, Australia, 3052
Austria
Kepler Universitätskliniken GmbH - Med Campus III; Abt. für Lungenkrankheiten
Linz, Austria, 4020
Salzburger Landeskliniken; Universitätsklinik für Pneumologie/ Lungenheilkunde
Salzburg, Austria, 5020
SMZ - Baumgartner Hohe, Otto-Wagner-Spital; 2.Interne Lungenabteilung
Wien, Austria, 1140
Krankenhaus Nord - Klinik Floridsdorf; Abteilung Pulmologie
Wien, Austria, 1210
Brazil
Santa Casa de Misericordia de Salvador
Salvador, BA, Brazil, 40050-410
Hospital Bruno Born
Lajeado, RS, Brazil, 95900-000
Hospital das Clinicas - UFRGS
Porto Alegre, RS, Brazil, 90035-003
Instituto do Cancer do Estado de Sao Paulo - ICESP
Sao Paulo, SP, Brazil, 01246-000
Chile
Bradford Hill Centro de Investigaciones Clinicas; Bradford Hill Centro de Investigaciones Clinicas
Recoleta, Chile, 8420383
Health & Care SPA
Santiago, Chile, 7500006
Sociedad de Investigaciones Medicas Ltda (SIM)
Temuco, Chile, 4810469
China
Beijing Cancer Hospital
Beijing, China, 100142
Jilin Cancer Hospital
Changchun, China, 130012
The First Affiliated Hospital of Guangzhou Medical University
Guangzhou, China, 510120
Zhejiang Cancer Hospital
Hangzhou, China, 310022
Harbin Medical University Cancer Hospital
Harbin, China, 150081
Jiangsu Cancer Hospital
Nanjing, China, 210009
Fudan University Shanghai Cancer Center
Shanghai, China, 200032
Zhongshan Hospital Fudan University
Shanghai, China, 200032
The Second Affiliated Hospital of The Fourth Military Medical University (Tangdu Hospital)
Xi'an, China, 710038
Henan Cancer Hospital
Zhengzhou, China, 450008
Czechia
Fakultni nemocnice Olomouc
Olomouc, Czechia, 775 20
Thomayerova nemocnice
Praha 4 - Krc, Czechia, 140 59
Fakultni nemocnice Na Bulovce
Praha 8, Czechia, 180 81
France
Institut Bergonie; Oncologie
Bordeaux, France, 33076
Centre Francois Baclesse; Oncologie
Caen, France, 14076
Hopital Calmette; Pneumologie Oncologie Ouest
Lille, France, 59037
Hôpital Nord - AP-HM Marseille#
Marseille, France, 13915
CH de Mulhouse Hôpital Emile Muller
Mulhouse, France, 68070
Germany
Asklepios-Fachklinik Muenchen-Gauting; Klinik Für Pneumologie
Gauting, Germany, 82131
LungenClinic Großhansdorf GmbH
Großhansdorf, Germany, 22927
Krankenhaus Martha-Maria Halle-Doelau gGmbH; Klinik fuer Innere Medizin II
Halle, Germany, 06120
Thoraxklinik Heidelberg gGmbH
Heidelberg, Germany, 69126
Fachklinik für Lungenerkrankungen
Immenhausen, Germany, 34376
Greece
Sotiria Chest Hospital of Athens
Athens, Greece, 11527
Agioi Anargyroi; 3Rd Dept. of Medical Oncology
Athens, Greece, 145 64
University Hospital of Patras Medical Oncology
Patras, Greece, 265 04
Hong Kong
Princess Margaret Hospital, Oncology; Department of Oncology
Hong Kong, Hong Kong
Prince of Wales Hosp; Dept. Of Clinical Onc
Shatin, Hong Kong
Hungary
Semmelweis Egyetem, AOK, Pulmonologiai Klinika
Budapest, Hungary, 1083
Orszagos Koranyi TBC es Pulmonologiai Intezet
Budapest, Hungary, 1121
Debreceni Egyetem, Klinikai Kozpont, Tudogyogyaszati Klinika
Debrecen, Hungary, 4032
Tudogyogyintezet Torokbalint
Torokbalint, Hungary, 2045
Italy
Az. Osp. Cardarelli; Divisione Di Oncologia
Napoli, Campania, Italy, 80131
A.O. Universitaria Di Parma
Parma, Emilia-Romagna, Italy, 43100
Policlinico Universitario Campus Biomedico; Uoc Oncologia Medica
Roma, Lazio, Italy, 00128
Fondazione IRCCS Istituto Nazionale dei Tumori
Milano, Lombardia, Italy, 20133
Irccs Istituto Europeo di Oncologia (IEO); Divisione di Oncologia
Milano, Lombardia, Italy, 20141
IRCCS Ospedale Casa Sollievo Della Sofferenza; Oncologia
San Giovanni Rotondo, Puglia, Italy, 71013
Azienda Ospedaliera Universitaria Pisana - Ospedale Cisanello; Dipartimento Cardio Toraco Vascolare
Pisa, Toscana, Italy, 56124
Japan
Nagoya University Hospital; Respiratory Medicine
Aichi, Japan, 466-8560
Kyushu University Hospital; Respiratory
Fukuoka, Japan, 812-8582
National Hospital Organization Himeji Medical Center
Hyogo, Japan, 670-8520
Kanagawa Cancer Center;Thoracic Oncology
Kanagawa, Japan, 241-8515
University Hospital Kyoto Prefectural University of Medicine, Pulmonary Medicine
Kyoto, Japan, 602-8566
Sendai Kousei Hospital; Pulmonary Medicine
Miyagi, Japan, 980-0873
Kurashiki Central Hospital; Respiratory Medicine
Okayama, Japan, 710-8602
Kindai University Hospital; Medical Oncology
Osaka, Japan, 589-8511
National Hospital Organization Kinki-Chuo Chest Medical Center; Internal Medicine
Osaka, Japan, 591-8555
Saitama Cancer Center; Thoracic Oncology
Saitama, Japan, 362-0806
Shizuoka Cancer Center; Thoracic Oncology
Shizuoka, Japan, 411-8777
Tokyo Metropolitan Komagome Hospital; Thoracic Oncology and Respiratory Medicine
Tokyo, Japan, 113-8677
The Cancer Institute Hospital of JFCR, Respiratory Medicine
Tokyo, Japan, 135-8550
Wakayama Medical University Hospital; Respiratory Medicine and Medical Oncology
Wakayama, Japan, 641-8509
Korea, Republic of
Seoul National University Bundang Hospital
Gyeonggi-do, Korea, Republic of, 13620
Seoul National University Hospital
Seoul, Korea, Republic of, 03080
Asan Medical Center - Oncology
Seoul, Korea, Republic of, 05505
Samsung Medical Center
Seoul, Korea, Republic of, 6351
Mexico
Centro Hospitalario Mac
Irapuato, Guanajuato, Mexico, 36520
Health Pharma Professional Research
CD Mexico, Mexico CITY (federal District), Mexico, 03810
Hospital Merlose; Centro oncologico Samadhi
Ciudad de Mexico, Mexico, 04739
Poland
Medical University of Gdansk
Gdansk, Poland, 80-211
Wojewódzkie Wielospecjalistyczne Centrum Onkologii i Traumatologii im. M. Kopernika w Lodzi
Lodz, Poland, 93-513
Samodzielny Publiczny Zespol Gruzlicy i Chorob Pluc; Oddzial V Chemioterapii Nowotworow Pluc
Olsztyn, Poland, 10-357
Mazowieckie Centrum Leczenia Chorob Pluc i Gruzlicy
Otwock, Poland, 05-400
Wielkopolskie Centrum Pulmonologii i Torakochirurgii w Poznaniu
Poznan, Poland, 60-569
Centrum Onkologii - Inst.Im. Marii Sklodowskiej-Curie; Oncology
Warszawa, Poland, 02-781
Russian Federation
Moscow City Oncology Hospital #62
Moscovskaya Oblast, Moskovskaja Oblast, Russian Federation, 143423
N.N.Burdenko Main Military Clinical Hospital; Oncology Dept
Moscow, Russian Federation, 105229
Russian Oncology Research Center n.a. N.N. Blokhin
Moscow, Russian Federation, 115478
City Clinical Hospital No. 1
Novosibirsk, Russian Federation, 630047
City Clinical Onc.
Saint-Petersburg, Russian Federation, 198255
Scientific Research Oncology Institute named after N.N. Petrov; Oncology
St. Petersburg, Russian Federation, 197758
Serbia
Clinical Center of Serbia
Belgrade, Serbia, 11000
Clinical Center Bezanijska Kosa
Belgrade, Serbia, 11070
Clinical Center Nis; Clinic for pulmonary diseases
Nis, Serbia, 18 000
Institute for pulmonary diseases of Vojvodina
Sremska Kamenica, Serbia, 21204
Spain
Hospital Univ Vall d'Hebron; Servicio de Oncologia
Barcelona, Spain, 08035
Hospital Ramon y Cajal; Servicio de Oncologia
Madrid, Spain, 28034
Hospital Universitario La Paz; Servicio de Oncologia
Madrid, Spain, 28046
Hospital Clinico Universitario Virgen de la Victoria; Servicio de Oncologia
Malaga, Spain, 29010
Hospital Universitario Virgen del Rocio; Servicio de Oncologia
Sevilla, Spain, 41013
Hosp Clinico Univ Lozano Blesa; División De Oncología Médica
Zaragoza, Spain, 50009
Taiwan
National Taiwan Uni Hospital; Internal Medicine
Taipei, Taiwan, 100
Taipei Veterans General Hospital; Chest Dept , Section of Thoracic Oncology
Taipei, Taiwan, 112
Chang Gung Medical Foundation - Linkou; Chest Dept
Taoyuan, Taiwan, 333
United Kingdom
Aberdeen Royal Infirmary; Medical Oncology Dept
Aberdeen, United Kingdom, AB25 2ZN
Royal Devon & Exeter Hospital; Oncology Centre
Exeter, United Kingdom, EX2 5DW
Barts and the London NHS Trust.
London, United Kingdom, EC1A 7BE
Guys and St Thomas NHS Foundation Trust, Guys Hospital
London, United Kingdom, SE1 9RT
Christie Hospital Nhs Trust; Medical Oncology
Manchester, United Kingdom, M2O 4BX
Singleton Hospital; Pharmacy
Swansea, United Kingdom, SA2 8QA
Sponsors and Collaborators
Hoffmann-La Roche
Investigators
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Study Director: Clinical Trials Hoffmann-La Roche
  Study Documents (Full-Text)

Documents provided by Hoffmann-La Roche:

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Hoffmann-La Roche
ClinicalTrials.gov Identifier: NCT02763579     History of Changes
Other Study ID Numbers: GO30081
2015-004861-97 ( EudraCT Number )
First Posted: May 5, 2016    Key Record Dates
Results First Posted: June 13, 2019
Last Update Posted: September 18, 2019
Last Verified: September 2019
Additional relevant MeSH terms:
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Small Cell Lung Carcinoma
Carcinoma, Bronchogenic
Bronchial Neoplasms
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Carboplatin
Etoposide
Etoposide phosphate
Atezolizumab
Antibodies
Immunoglobulins
Antibodies, Monoclonal
Immunologic Factors
Physiological Effects of Drugs
Antineoplastic Agents
Antineoplastic Agents, Phytogenic
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action