This study is looking at small cell lung cancer that has spread or cannot be removed by surgery and has come back after previous treatment. The study will test a medicine called IDP-121 given together with standard chemotherapy drugs. There are two treatment groups in this study. One group will receive IDP-121 combined with topotecan, which is a chemotherapy drug given on days 1 through 5 every 3 weeks. The other group will receive IDP-121 combined with two chemotherapy drugs called carboplatin and etoposide. In this second group, carboplatin is given on day 1 and etoposide is given on days 1, 2, and 3 every 3 weeks. The choice of which treatment group a patient joins depends on how long it has been since their cancer started growing again after the first treatment they received.
The purpose of this study is to find out the best dose of IDP-121 when it is given with chemotherapy and to see how well this combination works in treating small cell lung cancer that has come back. The study has two parts. In the first part, different doses of IDP-121 will be tested to find the highest dose that can be given safely and the best dose to use in the second part of the study. In the second part, more patients will receive the chosen dose of IDP-121 with chemotherapy to learn more about how well it works in shrinking or controlling the cancer.
During the study, patients will receive IDP-121 as an infusion into a vein along with their chemotherapy treatment. The study will check how patients respond to the treatment by looking at whether the cancer shrinks, stays the same, or grows. Doctors will also monitor patients for any side effects and will perform regular tests including blood tests, heart function tests using echocardiogram, physical examinations, and electrocardiograms to check the electrical activity of the heart. The study will also measure how long the treatment keeps working if the cancer responds and how long patients live.



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