Nivolumab in Combination With Plinabulin in Patients With Metastatic Non-Small Cell Lung Cancer (NSCLC)

Prior treatment

• Prior therapy with microtubule destabilizing agents for NSCLC (ie. Vinorelbine)
• Prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-CTLA-4 antibody (or any other antibody targeting T cell co-stimulation pathways);
• Concurrent medical condition requiring the use of immunosuppressive medications, or systemic steroids.
• Use of other investigational drugs within 28 days or at least 5 half-lives before study drug administration

Other illness

• History of grade 3 or above hypersensitivity reactions to other monoclonal antibodies
• Subjects with a history of a cardiovascular illness.
• Uncontrolled hypertension, SBP\> 160 or DBP\>100
• Presence of leptomeningeal disease
• Pulmonary conditions, which in the PI's opinion would increase the risk of immunotherapy-related pulmonary toxicity.
• Has active, non-infectious pneumonitis
• Presence of a second malignancy, excluding non-melanomatous skin cancer unless in remission for 3 years
• Subjects with any active, known, or suspected autoimmune disease.
• History of ileus or other significant gastrointestinal disorder known to predispose to ileus or chronic bowel hypomotility.
• Known history of Human Immunodeficiency Virus;
• Active infection requiring therapy, positive tests for Hepatitis B surface antigen or Hepatitis C ribonucleic acid (RNA)
• Underlying medical conditions that, in the Investigator's opinion, will make the administration of study drug hazardous or obscure the interpretation of toxicity determination or adverse events

Other

• Symptomatic or untreated brain metastases
• Pregnant or nursing

• Subjects with histologically or cytologically-confirmed metastatic NSCLC whose disease progressed during/after treatment with at least one platinum-containing chemotherapy regimen.
• At least 1 prior systemic therapy for metastatic disease. Adjuvant chemotherapy or concurrent chemoradiation for early stage disease does not count as prior therapy unless patients progressed within 6 months of completion of chemotherapy
• Eastern Cooperative Oncology Group (ECOG) Performance Status ≤1
• Life expectancy ≥ 12 weeks
• Must have at least 1 measurable lesion per Response Evaluation Criteria in Solid Tumors (RECIST).
• Adequate hematopoietic, electrolyte, hepatic, and renal laboratory findings.
• Prior chemotherapy must have been completed at least 4 weeks or at least 5 half-lives (whichever is longer) before study drug administration, and all adverse events have either returned to baseline or stabilized
• Prior treated brain metastases are allowed. However, prior treated brain metastases must be without MRI evidence of progression for at least 4 weeks and off systemic steroids for at least 2 weeks before study drug administration
• Prior definitive radiation therapy must have been completed at least 4 weeks before study drug administration. Prior palliative radiotherapy should be completed at least 2 weeks before study drug administration. Whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS) and focal radiation to the sites of pain or bronchial obstruction will be considered palliative. No radiopharmaceuticals (strontium, samarium) within 8 weeks before study drug administration
• Prior major surgery must be completed at least 4 weeks before study drug administration. Prior minor surgery must be completed at least 1 week before study drug administration and subjects should be recovered. Percutaneous biopsies should be completed at least 10 days prior to study drug administration;
• A negative serum pregnancy test at screening for women of childbearing potential.