CAFs (Combination of Atezolizumab and Pirfenidone in Second-line and Beyond NSCLC): a Phase I/II Study

Inclusion Criteria: * Participant or legal representative is able to provide written informed prior to performing any protocol-related procedures * Is willing and able to comply with scheduled visits, treatment schedule, laboratory testing and other requirements of the study * Men or women at least 18 years of age with histologically or cytologically confirmed non-small cell lung cancer * Previous history of other than lung cancer is allowed if no active treatment for that cancer within 1 year * Life expectancy of at least 6 months * De novo stage IV or recurrent NSCLC without actionable mutation (e.g. EGFR/ ALK/ ROS-1) that was previously treated with either PD-1 / PD-L1 or the combination of PD1/PDL1 and cytotoxic chemotherapy, no more than 2 systemic regimens for metastatic disease with measurable disease \*. Maintenance therapy will be considered part of the 1 regimen * At least 1 measurable lesion * PDL1 TPS score less than 1% or unknown: first-line must be PD1/PDL1 inhibitor in combination with chemotherapy * Early stage (I-III) NSCLC treated with adjuvant or neoadjuvant chemotherapy then PD1/PDL1 inhibitor treatment for recurrent disease * Recurrent Unresectable stage III NSCLC treated with prior chemoradiation followed by maintenance PD1/PDL1 inhibitor with measurable disease * Eastern Cooperative Group (ECOG) Performance Status 0 - 2 * Is able to swallow oral medications * Adequate hematologic function * Adequate organ function Exclusion Criteria: * The presence of any other concurrent severe and/or uncontrolled medical condition that would, in the investigator or treating physician's judgement, cause unacceptable safety risks, contraindicate patient participation in the clinical study or compromise compliance with the protocol * Has received investigational agents within 14 days or 5 half-lives of the compound or active metabolites, whichever is longer, before the first dose of study treatment * Has a known hypersensitivity to atezolizumab or pirfenidone * Has active medical or psychiatric illness that would interfere with the study treatment * Has uncontrolled diabetes * Has any of the following cardiac diagnoses: Unstable angina Myocardial infarction within 6 months Uncontrolled congestive heart failure Left ventricular ejection fraction \< 35% * Has a history of any Grade 3 or 4 toxicities to a prior checkpoint inhibitor treatment * Is pregnant or breast feeding * Uncontrolled HIV * Clinically diagnosed with grade 2 or 3 radiation-induced lung injury within the last 3 months prior to registering for the study * Has a history of idiopathic pneumonitis that required systemic agent including steroid * Has drug-induced pneumonitis * Has evidence of active pneumonitis on screening chest computed tomography (CT) scan * Smoker of more than 1 pack / day * Has active peptic ulcer diagnosed within 4 weeks of enrollment * Active infection requiring systemic treatment * Current use of systemic antibacterial or antifungal agent * Prior monoclonal antibody within 4 weeks before study Day 1 Exception: The use of denosumab * Patient not recovered to ≤ Grade 1 from AEs due to agents administered more than 4 weeks earlier * Concurrent use of other investigational agents * Uncontrolled or symptomatic brain metastasis or leptomeningeal disease that requires use of steroids * Use of strong CYP1A2 inhibitors * Previous history of cancer with active treatment within less than 1 year of enrollment * Active auto-immune diseases