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Treatment for Advanced Non-small Cell Lung Cancer With Actionable Genomic Alterations After Targeted Treatment and Chemotherapy (An Expanded Lung-MAP Treatment Trial)

  • PhasePhase 2
  • StatusRecruiting
  • Planned enrollment117 people
  • Recruiting US sites41
  • SponsorSWOG Cancer Research Network
  • RegistryNCT07393555

Recruitment re-checked on ClinicalTrials.gov Oct 30, 2026. Public record; not medical advice.

Treatment for Advanced Non-small Cell Lung Cancer With Actionable Genomic Alterations After Targeted Treatment and Chemotherapy (An Expanded Lung-MAP Treatment Trial): a one-minute explainerNCT073935551 min

Eligibility

Who can join

The film gives the main points. The full list below is copied from the registry; the study team makes the final decision.

  • Age18 Years to no maximum
  • SexAll
  • Healthy volunteersNo

You may be able to join if

  • Participants must have been assigned to S1900N by the Southwest Oncology Group (SWOG) Statistics and Data Management Center (SDMC). Assignment to S1900N is determined by submission of documentation of NSCLC harboring an actionable genomic alteration (AGA) in the LUNGMAP protocol. AGA is defined in this protocol as an activating driver alteration with an approved targeted therapy for lung cancer in one of the following genes: ALK, EGFR, HER2 (ERBB2), MET, NTRK, RET, and ROS1.
  • Participants must have measurable disease documented by CT or MRI. The CT from a combined positron emission tomography (PET)/CT may be used to document only non-measurable disease unless it is of diagnostic quality. Measurable disease must be assessed within 28 days prior to randomization. Pleural effusions, ascites and laboratory parameters are not acceptable as the only evidence of disease. Non-measurable disease must be assessed within 42 days prior to randomization. All disease must be assessed and documented on the Baseline Tumor Assessment Form. Participants whose only measurable disease is within a previous radiation therapy port must demonstrate clearly progressive disease (in the opinion of the treating investigator) prior to randomization.
  • Participants must have a CT or MRI scan of the brain to evaluate for CNS disease within 42 days prior to randomization.
  • Participants with spinal cord compression or brain metastases must not have residual neurological dysfunction, unless no further recovery is expected, and the participant has been stable on weaning doses of corticosteroids (≤ 10 mg daily prednisone or equivalent) prior to randomization. Participants with spinal cord compression or brain metastases that require local treatment must have received local treatment to these metastases and remained clinically controlled and asymptomatic for at least 7 days following stereotactic radiation and/or 14 days following whole brain radiation, and prior to randomization.
  • Participants must not have leptomeningeal disease that requires CNS-specific treatment prior to randomization and must not be planning to receive the CNS-specific treatment while on study.
  • Participants must have progressed (in the opinion of the treating physician) during or following the most recent line of systemic therapy.
  • Participants must have previously received an appropriate targeted therapy for the lung cancer AGA (ALK, EGFR, HER2 (ERBB2), MET, NTRK, RET, and ROS1).
  • Participants must have previously received platinum-based chemotherapy for stage IV or recurrent disease.
  • Participants must have received no more than (<=) 3 lines of prior cytotoxic therapy (including chemotherapy, antibody-drug conjugates) for NSCLC.
  • Participants must not have received prior TROP2-targeted antibody-drug conjugate or a systemic therapy containing sacituzumab govitecan/SN-38.
  • Participants must not have received prior anti-PD-1 or anti-PD-L1 antibody therapy.
  • Participants must not have received any systemic lung cancer therapy (except orally administered drugs) within 21 days prior to randomization. Orally administered lung cancer therapies must not have been administered within 10 days prior to randomization.
  • Participants must have completed any prior radiation therapy within 7 days prior to randomization.
  • Participants must have recovered (≤ Grade 1) from any side effects of prior therapy (except for alopecia) prior to randomization.
  • Participants must not be planning to receive any concurrent systemic therapy (e.g. chemotherapy, immunotherapy, targeted therapy etc) for lung cancer treatment while receiving treatment on this study.
  • Participants' most recent Zubrod performance status must be 0-1 and be documented within 28 days prior to randomization.
  • Participants must have a complete medical history and physical exam within 28 days prior to randomization.
  • Absolute neutrophil count ≥ 1.5 x 10^3/uL (within 28 days prior to randomization)
  • Hemoglobin >= 10.0 g/dL (within 28 days prior to randomization)
  • Platelets ≥ 100 x 10^3/uL (within 28 days prior to randomization)
  • Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN) unless history of Gilbert's disease (within 28 days prior to randomization). Participants with history of Gilbert's disease must have total bilirubin ≤ 5 x institutional ULN.
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 × institutional ULN (within 28 days prior to randomization). Participants with history of liver metastasis must have AST and ALT ≤ 5 x ULN
  • Participants must have calculated creatinine clearance ≥ 50 mL/min using the following Cockcroft-Gault Formula. This specimen must have been drawn and processed within 28 days prior to randomization.
  • Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, must have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, participants must be class 2B or better.
  • Participants must not have experienced an arterial or venous thrombotic event or hemoptysis within 28 days prior to randomization.
  • Participants must not be planning to receive warfarin (or other coumadin derivatives) while receiving treatment on this study.
  • 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.
  • 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 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 with known human immunodeficiency virus (HIV)-infection must be on effective anti-retroviral therapy and have undetectable viral load test on the most recent test results obtained within 6 months prior to randomization.
  • Participants with evidence 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.
  • Participants with a history of hepatitis C virus (HCV) infection must have been treated and cured. 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.
  • Participants must agree to have blood specimens submitted for circulating tumor DNA (ctDNA)
  • Participants must be offered the opportunity to participate in specimen banking

The treatment

How it is intended to work

This is how the treatment is meant to work. Whether it helps, and how safe it is, is what this trial is testing.

ivonescimab. A bispecific antibody directed against the negative immunoregulatory human cell receptor programmed cell death protein 1 (PD-1; PDCD1; CD279) and the human vascular endothelial growth factor (VEGF), with potential immune checkpoint inhibitory, anti-angiogenic and antineoplastic activities. Upon administration, ivonescimab simultaneously targets and binds to both PD-1 expressed on certain T cells and VEGF expressed on tumor cells. The binding of ivonescimab to PD-1 prevents the activation of PD-1 by its ligands, programmed cell death-1 ligand 1 (PD-L1; CD274) and/or 2 (PD-L2; CD273). This abrogates T-cell inhibition, activates antigen-specific T-lymphocytes and enhances cytotoxic T-lymphocyte (CTL)-mediated tumor cell lysis, which may lead to a reduction in tumor growth. The binding of ivonescimab to VEGF prevents binding of VEGF to its receptor VEGFR, abrogates VEGF/VEGFR-mediated signaling and may lead to the inhibition of vascular endothelial cell proliferation. The inhibition of tumor angiogenesis may further decrease tumor cell proliferation and prevent metastasis. PD-1, a transmembrane protein in the immunoglobulin superfamily (IgSF) expressed on T cells, functions as an immune checkpoint that negatively regulates T-cell activation and effector function when activated by its ligands PD-L1 and/or PD-L2; it plays an important role in tumor evasion from host immunity. VEGF is overexpressed in a variety of cancers and is associated with increased invasiveness and decreased survival. NCI Drug Dictionary

Treatments listed in the registry

  • Biospecimen Collection (Procedure): Undergo collection of blood samples
  • Computed Tomography (Procedure): Undergo CT
  • Ivonescimab (Biological): Given IV
  • Magnetic Resonance Imaging (Procedure): Undergo MRI
  • Sacituzumab Govitecan (Biological): Given IV

The study

Treatment groups

Randomized · Parallel · masking: None

Arm 1 (ivonescimab, sacituzumab govitecan) (Experimental)

Patients receive ivonescimab IV over 1-2 hours on day 1 of each cycle and sacituzumab govitecan IV over 1-3 hours on day 1 and 8 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT or MRI and blood sample collection throughout the study.

Arm 2 (sacituzumab govitecan) (Experimental)

Patients receive sacituzumab govitecan IV over 1-3 hours on day 1 and 8 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT or MRI and blood sample collection throughout the study.

Arm 3 (ivonescimab) (Experimental)

Patients receive ivonescimab IV over 1-2 hours on day 1 of each cycle. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients also undergo CT or MRI and blood sample collection throughout the study.

What it involves

Procedures

As the registry describes them. Requirements to join, such as a tissue sample, are in the eligibility list above even when on-study procedures are optional. Ask the study team which steps apply to you.

  • blood samples: Part of the study plan
  • CT scans: Part of the study plan
  • MRI: Part of the study plan

Goals

What the study measures

Main goals

  • Progression-free survival (PFS) (Comparison between arms) (From date of randomization to date of first documentation of progression, symptomatic deterioration, or death due to any cause, assessed up to 3 years)
  • PFS (Comparison between arms) (From date of randomization to date of first documentation of progression, symptomatic deterioration, or death due to any cause, assessed up to 3 years)
  • Response rate of SG against historical response rates (Single arm evaluation) (Up to 3 years)
  • Response rate of I against historical response rates (Single arm evaluation) (Up to 3 years)
  • Response rate of SG-I against historical response rates (Single arm evaluation) (Up to 3 years)

Other goals

  • Rate of dose-limiting toxicities among participants treated with SG-I in the safety run-in analysis population
  • Response rates
  • Response rates
  • Overall survival (OS)
  • OS
  • Duration of response (DoR)
  • Central nervous system (CNS) PFS
  • Frequency and severity of toxicities
  • Clinical outcomes by EGFR subgroups
  • Clinical outcomes by PD-L1 expression subgroups

Planned enrollment: 117 (estimated).

Where

Recruiting US sites

  • Alta Bates Summit Medical Center-Herrick Campus, Berkeley, California
  • Palo Alto Medical Foundation Health Care, Palo Alto, California
  • University of California Davis Comprehensive Cancer Center, Sacramento, California
  • Northeast Georgia Medical Center-Gainesville, Gainesville, Georgia
  • Kootenai Health - Coeur d'Alene, Coeur d'Alene, Idaho
  • Kootenai Clinic Cancer Services - Post Falls, Post Falls, Idaho
  • Kootenai Clinic Cancer Services - Sandpoint, Sandpoint, Idaho
  • Illinois CancerCare-Bloomington, Bloomington, Illinois
  • Illinois CancerCare-Canton, Canton, Illinois
  • Illinois CancerCare-Carthage, Carthage, Illinois
  • Cancer Care Specialists of Illinois - Decatur, Decatur, Illinois
  • Decatur Memorial Hospital, Decatur, Illinois
  • Illinois CancerCare-Eureka, Eureka, Illinois
  • Illinois CancerCare-Galesburg, Galesburg, Illinois
  • Illinois CancerCare-Kewanee Clinic, Kewanee, Illinois
  • Illinois CancerCare-Macomb, Macomb, Illinois
  • Illinois CancerCare-Ottawa Clinic, Ottawa, Illinois
  • Illinois CancerCare-Pekin, Pekin, Illinois
  • Illinois CancerCare-Peoria, Peoria, Illinois
  • Illinois CancerCare-Peru, Peru, Illinois
  • Illinois CancerCare-Princeton, Princeton, Illinois
  • Southern Illinois University School of Medicine, Springfield, Illinois
  • Springfield Clinic, Springfield, Illinois
  • Springfield Memorial Hospital, Springfield, Illinois
  • Illinois CancerCare - Washington, Washington, Illinois
  • Trinity Health IHA Medical Group Hematology Oncology - Brighton, Brighton, Michigan
  • Trinity Health IHA Medical Group Hematology Oncology - Canton, Canton, Michigan
  • Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital, Chelsea, Michigan
  • University of Michigan Health - Sparrow Lansing, Lansing, Michigan
  • Trinity Health Saint Mary Mercy Livonia Hospital, Livonia, Michigan
  • Trinity Health Saint Joseph Mercy Oakland Hospital, Pontiac, Michigan
  • Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus, Ypsilanti, Michigan
  • Saint Francis Medical Center, Cape Girardeau, Missouri
  • Billings Clinic Cancer Center, Billings, Montana
  • Community Medical Center, Missoula, Montana
  • New Hampshire Oncology Hematology PA-Concord, Concord, New Hampshire
  • Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center, Lebanon, New Hampshire
  • Solinsky Center for Cancer Care, Manchester, New Hampshire
  • ProMedica Flower Hospital, Sylvania, Ohio
  • Dartmouth Cancer Center - North, Saint Johnsbury, Vermont
  • Gundersen Lutheran Medical Center, La Crosse, Wisconsin

Site status as of Oct 30, 2026. Check the live record before contacting a site.

Sources

Where this comes from

Registry record reviewed as fetched Oct 30, 2026, last updated by the sponsor Oct 12, 2026. Public record; not medical advice.

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