Summary
This study is recruiting people with newly diagnosed advanced (Stage IV) non-small cell lung cancer who have not received any prior treatment with systemic therapy. Eligible participants will be randomly allocated to either the Active Comparator Arm or the Experimental Arm.
In the Active Comparator Arm, participants will receive Standard of Care (SoC) systemic therapy. The drugs you will receive will depend on whether you have squamous cell or non-squamous cell non-small cell lung cancer.
For people with squamous cell, permitted SoC chemo-immunotherapy will include single agent immunotherapy (pembrolizumab) or in combination with chemotherapy (carboplatin or paclitaxel). Carbo/Paclitaxel/Pembrolizumab intravenous infusions are given every 3 weeks for cycles 1-4, followed by ongoing maintenance therapy with pembrolizumab alone from cycle 5.
For people with non-squamous cell, SoC chemo-immunotherapy will include single agent immunotherapy (pembrolizumab) or in combination with chemotherapy (Carboplatin or Pemetrexed). Carboplatin/Pemetrexed/Pembrolizumab infusions are given every 3 weeks for four cycles, followed by maintenance therapy with pemetrexed/pembrolizumab from Cycle 5.
In the Experimental Arm, participants will receive stereotactic ablative radiation therapy (SABR) to the lung, delivered before cycle one or cycle two of SoC chemo-immunotherapy. SoC chemo-immunotherapy in this group will be the same as in the Active Comparator group.