A Study of Multiple Therapies in Biomarker-selected Participants With Resectable Stages IB-III Non-small Cell Lung Cancer (NSCLC)

Last updated: April 2, 2026
Sponsor: Genentech, Inc.
Overall Status: Active - Recruiting

Phase

2

Condition

Non-small Cell Lung Cancer

Treatment

Alectinib

Atezolizumab

Cobimetinib (Enrollment closed)

Clinical Study ID

NCT04302025
ML41591
  • Ages > 18
  • All Genders

Study Summary

This trial will evaluate the efficacy and safety of various therapies in participants with Stage IB, IIA, IIB, IIIA, or selected IIIB resectable and untreated NSCLC tumors that meet protocol-specified biomarker criteria.

Eligibility Criteria

Inclusion

Inclusion Criteria for Neoadjuvant Therapy:

  • Pathologically documented NSCLC:

  • Newly diagnosed early-stage NSCLC stages IB, IIA, IIB, IIIA, or selected IIIB (T3N2 only) NSCLC of squamous or non-squamous histology. Staging should be based on the 8th edition of the American Joint Committee on Cancer (AJCC)/Union Internationale Contre le Cancer (UICC) NSCLC staging system

  • T4 primary NSCLC will be allowed only on the basis of size. Invasion of the diaphragm, mediastinum, heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral body, carina, and separate tumor nodules in a different ipsilateral lobe is not permitted

  • All participants will undergo clinical staging using computed tomography (CT) and positron emission tomography (PET) scanning, as well as brain imaging using magnetic resonance imaging (MRI). Invasive mediastinal staging by either mediastinoscopyor endo- bronchial ultrasonography is highly encouraged for participants with radiographically suspected mediastinal nodal disease (ie, N2) but not mandated if the CT or PET scans showed no evidence of N2 disease

  • Molecular testing results from clinical laboratory improvement amendments (CLIA)-certified laboratories and showing at least one of the following abnormalities: ALK fusion, ROS1 fusion, NTRK1/2/3 fusion; BRAF V600 mutation, RET fusion, PD-L1 expression in ≥ 1% tumor cells as determined by FDA-approved test, KRAS G12C mutation

  • Measurable disease, as defined by RECIST v1.1

  • NSCLC must have a solid or subsolid appearance on CT scan and cannot have a purely ground glass opacity appearance. For subsolid 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 participant 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

  • Negative hepatitis B surface antigen (HBsAg) test at screening for cohort

  • Negative total hepatitits B core antibody (HBcAb) test at screening for cohort, or positive total HBcAb test followed by a negative hepatitis B virus (HBV) deoxyribonucleic acid (DNA) test at screening

  • Negative hepatitis C virus (HCV) antibody test at screening, or positive HCV antibody test followed by a negative HCV ribonucleic acid (RNA) test at screening

  • Male participants must be willing to use acceptable methods of contraception

  • Female participants of childbearing potential must agree to use acceptable methods of contraception

Inclusion Criteria for Adjuvant Therapy (TKI Cohorts and KRAS G12C cohort [if continuing on Divarasib]):

  • Participants whose tumors lack 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

  • Participants with prior lung cancer

  • 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 participants with a negligible risk of metastasis or death and with expected curative outcome

  • Treatment with an investigational agent for any condition within 4 weeks prior to Cycle 1, Day 1

  • Participants known to be positive for human immunodeficiency virus (HIV) are excluded if they meet any of the following criteria: cluster of differentiation 4 (CD4)+ T-cell count of <350 cells/microliters (cells/µL); detectable HIV viral load; history of an opportunistic infection within the past 12 months; on stable antiretroviral therapy for <4 weeks

  • Severe infection within 4 weeks prior to initiation of study treatment, including but not limited to hospitalization for complications of infections, or any active infection that, in the opinion of the investigator, could impact participant safety

  • Pregnant or lactating, or intending to become pregnant during the study

Study Design

Total Participants: 99
Treatment Group(s): 13
Primary Treatment: Alectinib
Phase: 2
Study Start date:
November 06, 2020
Estimated Completion Date:
May 30, 2030

Connect with a study center

  • City of Hope Comprehensive Cancer Center

    Duarte, California 91010
    United States

    Site Not Available

  • City of Hope - Orange County Lennar Foundation Cancer Center

    Irvine, California 92618
    United States

    Site Not Available

  • Cedars-Sinai Medical Center

    Los Angeles, California 90048
    United States

    Site Not Available

  • UCLA Hematology Oncology

    Los Angeles, California 90095
    United States

    Active - Recruiting

  • USC Norris Cancer Center

    Los Angeles, California 90033
    United States

    Site Not Available

  • University of California Los Angeles - Jonsson Comprehensive Cancer Center

    Los Angeles, California 90095
    United States

    Active - Recruiting

  • The Center for Cancer Prevention and Treatment at St.Joseph Hospital of Orange

    Orange, California 92868
    United States

    Active - Recruiting

  • UC Davis Comprehensive Cancer Center

    Sacramento, California 95817
    United States

    Active - Recruiting

  • UCSF

    San Francisco, California 94115
    United States

    Active - Recruiting

  • UCSF Helen Diller Family CCC

    San Francisco, California 94158
    United States

    Site Not Available

  • City of Hope Comprehensive Cancer Center

    Duarte 5344147, California 5332921 91010
    United States

    Site Not Available

  • City of Hope - Orange County Lennar Foundation Cancer Center

    Irvine 5359777, California 5332921 92618
    United States

    Site Not Available

  • Cedars-Sinai Medical Center

    Los Angeles 5368361, California 5332921 90048
    United States

    Site Not Available

  • USC Norris Cancer Center

    Los Angeles 5368361, California 5332921 90033
    United States

    Site Not Available

  • University of California Los Angeles - Jonsson Comprehensive Cancer Center

    Los Angeles 5368361, California 5332921 90095
    United States

    Site Not Available

  • The Center for Cancer Prevention and Treatment at St.Joseph Hospital of Orange

    Orange 5379513, California 5332921 92868
    United States

    Site Not Available

  • UC Davis Comprehensive Cancer Center

    Sacramento 5389489, California 5332921 95817
    United States

    Site Not Available

  • UCSF Helen Diller Family CCC

    San Francisco 5391959, California 5332921 94158
    United States

    Site Not Available

  • University of Colorado - Anschutz Medical Campus (University of Colorado Health Sciences Center)

    Aurora, Colorado 80045
    United States

    Site Not Available

  • University of Colorado Anschutz Medical Campus

    Aurora, Colorado 80045
    United States

    Active - Recruiting

  • University of Colorado - Anschutz Medical Campus (University of Colorado Health Sciences Center)

    Aurora 5412347, Colorado 5417618 80045
    United States

    Site Not Available

  • Yale Cancer Center

    New Haven, Connecticut 06511
    United States

    Active - Recruiting

  • Smilow Cancer Center

    North Haven, Connecticut 06473
    United States

    Site Not Available

  • Yale Cancer Center

    New Haven 4839366, Connecticut 4831725 06511
    United States

    Site Not Available

  • MedStar Georgetown University Hospital (Lombardi Comprehensive Cancer Center)

    Washington, District of Columbia 20007
    United States

    Site Not Available

  • MedStar Georgetown University Hospital (Lombardi Comprehensive Cancer Center)

    Washington D.C., District of Columbia 20007
    United States

    Active - Recruiting

  • MedStar Georgetown University Hospital (Lombardi Comprehensive Cancer Center)

    Washington D.C. 4140963, District of Columbia 4138106 20007
    United States

    Site Not Available

  • Sylvester Comprehensive Cancer Center - Deerfield Beach

    Miami, Florida 33136
    United States

    Site Not Available

  • Moffitt Cancer Center

    Tampa, Florida 33612
    United States

    Active - Recruiting

  • Moffitt Cancer Center

    Tampa 4174757, Florida 4155751 33612
    United States

    Site Not Available

  • Northwestern University

    Chicago, Illinois 60611
    United States

    Active - Recruiting

  • Northwestern University; Robert H. Lurie Comp Can Ctr

    Chicago, Illinois 60611
    United States

    Active - Recruiting

  • Northwestern Medicine Cancer Center Kishwaukee

    DeKalb, Illinois 60115
    United States

    Active - Recruiting

  • Northwestern Medicine Cancer Center Delnor

    Geneva, Illinois 60134
    United States

    Active - Recruiting

  • Northwestern Medicine Cancer Center Warrenville

    Warrenville, Illinois 60555
    United States

    Active - Recruiting

  • Northwestern University

    Chicago 4887398, Illinois 4896861 60611
    United States

    Site Not Available

  • Northwestern Medicine Cancer Center Kishwaukee

    DeKalb 4889553, Illinois 4896861 60115
    United States

    Site Not Available

  • Northwestern Medicine Cancer Center Delnor

    Geneva 4893591, Illinois 4896861 60134
    United States

    Site Not Available

  • Northwestern Medicine Cancer Center Warrenville

    Warrenville 4915525, Illinois 4896861 60555
    United States

    Site Not Available

  • Boston Medical Center

    Boston, Massachusetts 02118
    United States

    Site Not Available

  • Dana-Farber Cancer Institute

    Boston, Massachusetts 02215
    United States

    Active - Recruiting

  • Dana-Farber Cancer Institute; Brigham and Women's Cancer Center

    Boston, Massachusetts 02115
    United States

    Active - Recruiting

  • Boston Medical Center

    Boston 4930956, Massachusetts 6254926 02118
    United States

    Site Not Available

  • Dana-Farber Cancer Institute

    Boston 4930956, Massachusetts 6254926 02215
    United States

    Active - Recruiting

  • University of Michigan

    Ann Arbor, Michigan 48109
    United States

    Active - Recruiting

  • Karmanos Cancer Institute - Farmington Hills/Weisberg Cancer Treatment Center

    Farmington Hills, Michigan 48334
    United States

    Site Not Available

  • University of Michigan

    Ann Arbor 4984247, Michigan 5001836 48109
    United States

    Site Not Available

  • Karmanos Cancer Institute - Farmington Hills/Weisberg Cancer Treatment Center

    Farmington Hills 4992523, Michigan 5001836 48334
    United States

    Site Not Available

  • Mayo Clinic

    Rochester, Minnesota 55905
    United States

    Active - Recruiting

  • Mayo Clinic

    Rochester 5043473, Minnesota 5037779 55905
    United States

    Site Not Available

  • Ellis Fischel Cancer Center

    Columbia, Missouri 65201
    United States

    Active - Recruiting

  • University of Missouri Health Care

    Columbia, Missouri 65212
    United States

    Active - Recruiting

  • University of Missouri Health Care; Ellis Fischel Cancer Center

    Columbia, Missouri 65212
    United States

    Active - Recruiting

  • HCA Midwest Health

    Kansas City, Missouri 64132
    United States

    Site Not Available

  • Siteman Cancer Center - Washington University Medical Campus

    Saint Louis, Missouri 63108
    United States

    Site Not Available

  • Washington University School of Medicine; Sitemann Cancer Center

    Saint Louis, Missouri 63110
    United States

    Active - Recruiting

  • Siteman Cancer Center - Washington University Medical Campus

    St Louis, Missouri 63108
    United States

    Active - Recruiting

  • Ellis Fischel Cancer Center

    Columbia 4381982, Missouri 4398678 65201
    United States

    Site Not Available

  • Siteman Cancer Center - Washington University Medical Campus

    St Louis 4407066, Missouri 4398678 63108
    United States

    Site Not Available

  • Dartmouth Hitchcock Medical Center

    Lebanon, New Hampshire 03756
    United States

    Active - Recruiting

  • Dartmouth Hitchcock Medical Center

    Lebanon 5088597, New Hampshire 5090174 03756
    United States

    Site Not Available

  • Columbia University Medical Center

    New York, New York 10032
    United States

    Active - Recruiting

  • Laura and ISAAC Perlmutter Cancer Center at NYU Langone.

    New York, New York 10016
    United States

    Active - Recruiting

  • Memorial Sloan Kettering Cancer Center

    New York, New York 10065
    United States

    Active - Recruiting

  • Memorial Sloan Kettering Cancer Center at Nassau

    Uniondale, New York 11553
    United States

    Site Not Available

  • Columbia University Medical Center

    New York 5128581, New York 5128638 10032
    United States

    Active - Recruiting

  • Laura and ISAAC Perlmutter Cancer Center at NYU Langone.

    New York 5128581, New York 5128638 10016
    United States

    Site Not Available

  • Memorial Sloan Kettering Cancer Center

    New York 5128581, New York 5128638 10065
    United States

    Active - Recruiting

  • University Hospitals Cleveland Medical Center

    Cleveland, Ohio 44016
    United States

    Site Not Available

  • Ohio State University

    Columbus, Ohio 43210
    United States

    Active - Recruiting

  • Ohio State University; Hemat/Onc

    Columbus, Ohio 43210
    United States

    Active - Recruiting

  • University Hospitals Cleveland Medical Center

    Cleveland 5150529, Ohio 5165418 44016
    United States

    Site Not Available

  • Ohio State University

    Columbus 4509177, Ohio 5165418 43210
    United States

    Site Not Available

  • AHN Cancer Institute ? Allegheny General Hospital

    Pittsburgh, Pennsylvania 15212
    United States

    Completed

  • Allegheny General Hospital

    Pittsburgh, Pennsylvania 15212
    United States

    Active - Recruiting

  • AHN Cancer Institute ? Allegheny General Hospital

    Pittsburgh 5206379, Pennsylvania 6254927 15212
    United States

    Site Not Available

  • Tennessee Oncology, PLLC (Hendersonville)

    Hendersonville, Tennessee 37075
    United States

    Site Not Available

  • Baptist Clinical Research Institute

    Memphis, Tennessee 38120
    United States

    Active - Recruiting

  • Tennessee Oncology

    Nashville, Tennessee 37203
    United States

    Site Not Available

  • Tennessee Oncology - Nashville

    Nashville, Tennessee 37203
    United States

    Site Not Available

  • Baptist Clinical Research Institute

    Memphis 4641239, Tennessee 4662168 38120
    United States

    Site Not Available

  • Tennessee Oncology - Nashville

    Nashville 4644585, Tennessee 4662168 37203
    United States

    Site Not Available

  • Baylor College of Medicine

    Houston, Texas 77030
    United States

    Site Not Available

  • Kelsey Seybold Clnic

    Houston, Texas 77025
    United States

    Site Not Available

  • MD Anderson Cancer Center

    Houston, Texas 77030
    United States

    Active - Recruiting

  • University of Texas MD Anderson Cancer Center

    Houston, Texas 77030-4008
    United States

    Active - Recruiting

  • Lumi Research

    Kingwood, Texas 77339
    United States

    Site Not Available

  • Baylor College of Medicine

    Houston 4699066, Texas 4736286 77030
    United States

    Site Not Available

  • Kelsey Seybold Clnic

    Houston 4699066, Texas 4736286 77025
    United States

    Site Not Available

  • University of Texas MD Anderson Cancer Center

    Houston 4699066, Texas 4736286 77030-4008
    United States

    Active - Recruiting

  • Lumi Research

    Kingwood 7534469, Texas 4736286 77339
    United States

    Site Not Available

  • Virginia Cancer Specialists

    Fairfax, Virginia 22031
    United States

    Active - Recruiting

  • Virginia Cancer Specialists (Fairfax) - USOR

    Fairfax, Virginia 22031
    United States

    Active - Recruiting

  • Virginia Cancer Specialists (Fairfax) - USOR

    Fairfax 4758023, Virginia 6254928 22031
    United States

    Site Not Available

  • Seattle Cancer Care Alliance

    Seattle, Washington 98109
    United States

    Site Not Available

  • Seattle Cancer Care Alliance

    Seattle 5809844, Washington 5815135 98109
    United States

    Site Not Available

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