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Safety and Efficacy Study of Pazopanib and MK 3475 in Advanced Renal Cell Carcinoma (RCC; KEYNOTE-018)

Primary Purpose

Carcinoma, Renal Cell

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Pazopanib
MK-3475
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Renal Cell focused on measuring Pazopanib (GW786034), MK 3475, Renal cell carcinoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed written informed consent before performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up
  • Diagnosis of locally advanced or metastatic RCC that is predominantly clear cell histology
  • Must have measurable disease
  • Subject has received no prior systemic therapy
  • A woman is eligible to participate in the study if she is of Non-childbearing potential, has a negative serum pregnancy test within 7 days of the first dose of study treatment, not lactating, and agrees to use adequate contraception during the study until at least 120 days after the last dose of investigational product
  • Eastern Cooperative Oncology Group performance status 0 or 1
  • Adequate organ function as defined in the protocol
  • Left ventricular ejection fraction >= lower limit of normal as assessed by echocardiogram or multigated acquisition scan
  • In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category

Exclusion Criteria:

  • Subject has an active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents
  • Subject is currently participating or has participated in a study of an investigational agent or using an investigational device within 30 days of the first dose of study treatment
  • Subject is expected to require any other form of systemic or localized antineoplastic therapy while on study
  • Subject is on any systemic steroid therapy, within one week before the planned date for first dose of study treatment. Subject is on any other form of immunosuppressive medication
  • Subject has a history of a malignancy (other than the disease under treatment in the study) within 5 years before first study treatment administration
  • Central nervous system metastasis
  • Unable to swallow and retain orally administered medication
  • Subject has interstitial lung disease or a history of pneumonitis
  • Active peptic ulcer disease, inflammatory bowel disease, ulcerative colitis, or other Gastrointestinal conditions with increased risk of perforation; history of abdominal fistula, GI perforation, or intra-abdominal abscess within 4 weeks before beginning study treatment
  • Known history of HIV infection or a known history of or is positive for Hepatitis B or Hepatitis C
  • Presence of active infection requiring systemic therapy
  • Corrected QT interval duration prolongation
  • History of any one or more of the following cardiac conditions within the past 6 months: Cardiac angioplasty or stenting; Myocardial infarction; Unstable angina; History of Class III or IV congestive heart failure according to New York Heart Association classification
  • History of cerebrovascular accident within the past 6 months
  • Poorly controlled hypertension
  • History of untreated deep venous thrombosis
  • Presence of any non-healing wound, fracture, or ulcer, or presence of symptomatic peripheral vascular disease
  • Evidence of bleeding diathesis or coagulopathy
  • Recent hemoptysis
  • Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage
  • Any serious and/or unstable pre-existing medical, psychiatric, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures
  • Previous severe hypersensitivity reaction to another Monoclonal antibody. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the excipients in pazopanib tablets
  • Has taken any prohibited medications that are listed in the protocol within 14 days of the first dose of study treatment. Subject has received or will receive a live vaccine within 30 days before the first administration of study treatment

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Part 1

Part 2

Arm Description

Part 1 is a dose escalation phase in which subjects will receive pazopanib orally and the MK 3475 intravenously. Subjects will be evaluated for a minimum of 8 weeks before the next dose level cohort is enrolled.

Part 2 is a randomized phase in which subjects will be enrolled in each treatment arm: Pazopanib monotherapy Pazopanib+MK-3475 MK-3475 monotherapy

Outcomes

Primary Outcome Measures

Part 1: Incidence and severity of adverse events (AEs) and serious adverse events (SAEs )
Part 1: To determine the dose limiting toxicity (DLT) and maximum tolerated regimen (MTR)
MTR is defined as the highest dose of pazopanib in combination with the highest dose of MK 3475 at which no more than 1 of 6 subjects experiences a DLT after a minimum of 8 weeks of treatment. DLT is defined as a drug-related AE starting in the first 8 weeks of treatment
Part 1: Number of subjects with permanent discontinuation of treatment, dose reductions, interruptions, or delays
Part 1: Change from baseline in laboratory parameters
Laboratory assessments include haematology, clinical chemistry, urine, coagulation and thyroid function test
Part 1: Change from baseline in vital signs
Vital sign measurements will include heart rate, temperature and blood pressure
Part 1: Change from baseline in cardiac parameters
Cardiac assessments will include Electrocardiogram (ECG) and Echocardiograms (ECHOs)
Part 1: Incidence and titer of anti MK 3475 antibodies
Subjects will be monitored for anti-MK 3475 antibodies throughout the study
Part 2: Progression-free survival (PFS)
PFS is defined as the interval between the date of randomization and the earlier date of disease progression (using RECIST v1.1) or death due to any cause.

Secondary Outcome Measures

Part 1: Dose escalation cohorts: pazopanib plasma concentrations and serum MK 3475 concentrations.
For analysis of plasma pazopanib and serum MK 3475 concentrations, blood samples will be collected from all subjects
Part 1: Pharmacokinetic (PK) parameters in Expansion cohort
Area under the plasma concentration-time curve from time 0 to 24 hrs (AUC[0-24], maximum observed concentration (Cmax), tmax, and concentration at 24 hours (C24) of pazopanib; Pre-dose (trough) concentration at the end of the dosing interval (Ctau), and apparent clearance following oral dosing CL/F of pazopanib will be determined if data permit.
Part 1 and Part 2: Overall response rate (ORR)
Overall response rate is defined as the percentage of subjects, who achieved either a confirmed complete response (CR) or partial response (PR) by RECIST v1.1 and modified RECIST
Part 1 and Part 2: Clinical benefit rate
Clinical benefit rate is defined as a confirmed response of CR or PR or at least 6-months stable disease by RECIST v1.1 and modified RECIST.
Part 1 and Part 2: Time to response
Time to response is defined for all subjects with a confirmed CR or PR as per RECIST v1.1as the time from randomization until the first documented evidence of CR or PR (whichever status is recorded first)
Part 1 and Part 2: Duration of response
Duration of response is defined for all subjects with confirmed CR or PR as the time from the first documented evidence of CR or PR until time of first documented disease progression or death due to any causes, whichever is first by RECIST v1.1 and modified RECIST
Part 2: PFS by modified RECIST
Part 1 and Part 2: Progression-free survival rate at 18 months (PFSR18)
PFSR18 will be calculated based on Kaplan-Meier estimates of Progression-free survival (PFS) at 18 months by RECIST v1.1 and modified RECIST
Part 2: Overall survival (OS) at 18 months
Overall survival at 18 months will be summarized based on the Kaplan-Meier method.
Part 2: Overall survival (OS)
Overall survival will be summarized using Kaplan-Meier survival curves
Part 2: Incidence and severity of AEs and SAEs
Part 2: Number of subjects with permanent discontinuation of treatment, dose reductions, interruptions, or delays
Part 2: Change from baseline in laboratory parameters
Laboratory assessments include haematology, clinical chemistry, urine, coagulation and thyroid function test
Part 2: Change from baseline in vital signs
Vital sign measurements will include heart rate, temperature and blood pressure
Part 2: Change from baseline in cardiac parameters
Cardiac assessments will include ECG and ECHOs
Part 2: Incidence and titer of anti MK 3475 antibodies in patients treated with pazopanib + MK 3475 and single-agent MK 3475
Subjects will be monitored for anti-MK 3475 antibodies throughout the study
Part 2: PK parameters in randomized phase
For analysis of plasma pazopanib and serum MK 3475 concentrations, blood samples will be collected from all subjects. AUC[0-24], Cmax, tmax, and C24 of pazopanib alone and in combination with MK 3475; Cmax, Ctau, and apparent clearance following oral dosing CL/F of pazopanib will be determined if data permit.

Full Information

First Posted
December 12, 2013
Last Updated
February 28, 2020
Sponsor
Novartis Pharmaceuticals
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02014636
Brief Title
Safety and Efficacy Study of Pazopanib and MK 3475 in Advanced Renal Cell Carcinoma (RCC; KEYNOTE-018)
Official Title
A Phase I/II Study to Assess the Safety and Efficacy of Pazopanib and MK 3475 in Patients With Advanced Renal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
December 27, 2013 (Actual)
Primary Completion Date
February 27, 2019 (Actual)
Study Completion Date
February 27, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is an open-label, 2 part study of pazopanib and/or MK 3475 in treatment naïve subjects with advanced RCC. Part 1 consists of a Phase I dose escalation of pazopanib + MK 3475 followed by an expansion cohort to determine the maximum tolerated regimen and the recommended Phase II dose. Part 2 is a randomized 3-arm Phase II study to evaluate the clinical efficacy and safety of pazopanib + MK 3475 as compared to single-agent pazopanib and single-agent MK 3475. The objectives of this Phase I/II study are to test the safety and tolerability of pazopanib in combination with MK 3475, and study the clinical efficacy of pazopanib in combination with MK 3475 in subjects with advanced RCC as compared with single-agent pazopanib and single-agent MK 3475. Following the Urgent Safety Measure (USM) released on February 09, 2017, the phase II (Part 2) portion of this study will not commence.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Renal Cell
Keywords
Pazopanib (GW786034), MK 3475, Renal cell carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
42 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1
Arm Type
Experimental
Arm Description
Part 1 is a dose escalation phase in which subjects will receive pazopanib orally and the MK 3475 intravenously. Subjects will be evaluated for a minimum of 8 weeks before the next dose level cohort is enrolled.
Arm Title
Part 2
Arm Type
Experimental
Arm Description
Part 2 is a randomized phase in which subjects will be enrolled in each treatment arm: Pazopanib monotherapy Pazopanib+MK-3475 MK-3475 monotherapy
Intervention Type
Drug
Intervention Name(s)
Pazopanib
Intervention Description
Pazopanib is an orally administered 200 mg tablet available in the dose range of 400 to 800 mg
Intervention Type
Drug
Intervention Name(s)
MK-3475
Intervention Description
MK 3475 is an intravenously administered 100 mg/ 4mL solution available in the potential dose range of 1 to 10 mg/kg.
Primary Outcome Measure Information:
Title
Part 1: Incidence and severity of adverse events (AEs) and serious adverse events (SAEs )
Time Frame
From the start of study treatment (first dose) and, until the post-treatment follow-up visit (at least 30 days after the last dose of investigational product) for AEs, and until 90 days after last dose for SAEs
Title
Part 1: To determine the dose limiting toxicity (DLT) and maximum tolerated regimen (MTR)
Description
MTR is defined as the highest dose of pazopanib in combination with the highest dose of MK 3475 at which no more than 1 of 6 subjects experiences a DLT after a minimum of 8 weeks of treatment. DLT is defined as a drug-related AE starting in the first 8 weeks of treatment
Time Frame
8 weeks
Title
Part 1: Number of subjects with permanent discontinuation of treatment, dose reductions, interruptions, or delays
Time Frame
24 months
Title
Part 1: Change from baseline in laboratory parameters
Description
Laboratory assessments include haematology, clinical chemistry, urine, coagulation and thyroid function test
Time Frame
Average of 4 years
Title
Part 1: Change from baseline in vital signs
Description
Vital sign measurements will include heart rate, temperature and blood pressure
Time Frame
30 days after the last dose of study treatment
Title
Part 1: Change from baseline in cardiac parameters
Description
Cardiac assessments will include Electrocardiogram (ECG) and Echocardiograms (ECHOs)
Time Frame
24 months
Title
Part 1: Incidence and titer of anti MK 3475 antibodies
Description
Subjects will be monitored for anti-MK 3475 antibodies throughout the study
Time Frame
24 months
Title
Part 2: Progression-free survival (PFS)
Description
PFS is defined as the interval between the date of randomization and the earlier date of disease progression (using RECIST v1.1) or death due to any cause.
Time Frame
Average of 4 years
Secondary Outcome Measure Information:
Title
Part 1: Dose escalation cohorts: pazopanib plasma concentrations and serum MK 3475 concentrations.
Description
For analysis of plasma pazopanib and serum MK 3475 concentrations, blood samples will be collected from all subjects
Time Frame
For Pazopanib: before and after the 1st and 2nd dose of MK-3475. For MK-3475: Until 6 months after the last dose of MK-3475
Title
Part 1: Pharmacokinetic (PK) parameters in Expansion cohort
Description
Area under the plasma concentration-time curve from time 0 to 24 hrs (AUC[0-24], maximum observed concentration (Cmax), tmax, and concentration at 24 hours (C24) of pazopanib; Pre-dose (trough) concentration at the end of the dosing interval (Ctau), and apparent clearance following oral dosing CL/F of pazopanib will be determined if data permit.
Time Frame
For Pazopanib: before and after the 1st and 2nd dose of MK-3475. For MK-3475: Until 6 months after the last dose of MK-3475
Title
Part 1 and Part 2: Overall response rate (ORR)
Description
Overall response rate is defined as the percentage of subjects, who achieved either a confirmed complete response (CR) or partial response (PR) by RECIST v1.1 and modified RECIST
Time Frame
Average of 4 years
Title
Part 1 and Part 2: Clinical benefit rate
Description
Clinical benefit rate is defined as a confirmed response of CR or PR or at least 6-months stable disease by RECIST v1.1 and modified RECIST.
Time Frame
Average of 4 years
Title
Part 1 and Part 2: Time to response
Description
Time to response is defined for all subjects with a confirmed CR or PR as per RECIST v1.1as the time from randomization until the first documented evidence of CR or PR (whichever status is recorded first)
Time Frame
Average of 4 years
Title
Part 1 and Part 2: Duration of response
Description
Duration of response is defined for all subjects with confirmed CR or PR as the time from the first documented evidence of CR or PR until time of first documented disease progression or death due to any causes, whichever is first by RECIST v1.1 and modified RECIST
Time Frame
Average of 4 years
Title
Part 2: PFS by modified RECIST
Time Frame
Average of 4 years
Title
Part 1 and Part 2: Progression-free survival rate at 18 months (PFSR18)
Description
PFSR18 will be calculated based on Kaplan-Meier estimates of Progression-free survival (PFS) at 18 months by RECIST v1.1 and modified RECIST
Time Frame
18 months
Title
Part 2: Overall survival (OS) at 18 months
Description
Overall survival at 18 months will be summarized based on the Kaplan-Meier method.
Time Frame
18 months
Title
Part 2: Overall survival (OS)
Description
Overall survival will be summarized using Kaplan-Meier survival curves
Time Frame
Average of 4 years
Title
Part 2: Incidence and severity of AEs and SAEs
Time Frame
From the start of study treatment (first dose) and, until the post-treatment follow-up visit (at least 30 days after the last dose of investigational product) for AEs, and until 90 days after last dose for SAEs
Title
Part 2: Number of subjects with permanent discontinuation of treatment, dose reductions, interruptions, or delays
Time Frame
Average of 4 years
Title
Part 2: Change from baseline in laboratory parameters
Description
Laboratory assessments include haematology, clinical chemistry, urine, coagulation and thyroid function test
Time Frame
Average of 4 years
Title
Part 2: Change from baseline in vital signs
Description
Vital sign measurements will include heart rate, temperature and blood pressure
Time Frame
Average of 4 years
Title
Part 2: Change from baseline in cardiac parameters
Description
Cardiac assessments will include ECG and ECHOs
Time Frame
Average of 4 years
Title
Part 2: Incidence and titer of anti MK 3475 antibodies in patients treated with pazopanib + MK 3475 and single-agent MK 3475
Description
Subjects will be monitored for anti-MK 3475 antibodies throughout the study
Time Frame
Until 6 months after the last dose of MK-3475
Title
Part 2: PK parameters in randomized phase
Description
For analysis of plasma pazopanib and serum MK 3475 concentrations, blood samples will be collected from all subjects. AUC[0-24], Cmax, tmax, and C24 of pazopanib alone and in combination with MK 3475; Cmax, Ctau, and apparent clearance following oral dosing CL/F of pazopanib will be determined if data permit.
Time Frame
For Pazopanib: Until Dose 49 of MK-3475.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed written informed consent before performance of study-specific procedures or assessments and must be willing to comply with treatment and follow up Diagnosis of locally advanced or metastatic RCC that is predominantly clear cell histology Must have measurable disease Subject has received no prior systemic therapy A woman is eligible to participate in the study if she is of Non-childbearing potential, has a negative serum pregnancy test within 7 days of the first dose of study treatment, not lactating, and agrees to use adequate contraception during the study until at least 120 days after the last dose of investigational product Eastern Cooperative Oncology Group performance status 0 or 1 Adequate organ function as defined in the protocol Left ventricular ejection fraction >= lower limit of normal as assessed by echocardiogram or multigated acquisition scan In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category Exclusion Criteria: Subject has an active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents Subject is currently participating or has participated in a study of an investigational agent or using an investigational device within 30 days of the first dose of study treatment Subject is expected to require any other form of systemic or localized antineoplastic therapy while on study Subject is on any systemic steroid therapy, within one week before the planned date for first dose of study treatment. Subject is on any other form of immunosuppressive medication Subject has a history of a malignancy (other than the disease under treatment in the study) within 5 years before first study treatment administration Central nervous system metastasis Unable to swallow and retain orally administered medication Subject has interstitial lung disease or a history of pneumonitis Active peptic ulcer disease, inflammatory bowel disease, ulcerative colitis, or other Gastrointestinal conditions with increased risk of perforation; history of abdominal fistula, GI perforation, or intra-abdominal abscess within 4 weeks before beginning study treatment Known history of HIV infection or a known history of or is positive for Hepatitis B or Hepatitis C Presence of active infection requiring systemic therapy Corrected QT interval duration prolongation History of any one or more of the following cardiac conditions within the past 6 months: Cardiac angioplasty or stenting; Myocardial infarction; Unstable angina; History of Class III or IV congestive heart failure according to New York Heart Association classification History of cerebrovascular accident within the past 6 months Poorly controlled hypertension History of untreated deep venous thrombosis Presence of any non-healing wound, fracture, or ulcer, or presence of symptomatic peripheral vascular disease Evidence of bleeding diathesis or coagulopathy Recent hemoptysis Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage Any serious and/or unstable pre-existing medical, psychiatric, or other conditions that could interfere with subject's safety, obtaining informed consent or compliance to the study procedures Previous severe hypersensitivity reaction to another Monoclonal antibody. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to the excipients in pazopanib tablets Has taken any prohibited medications that are listed in the protocol within 14 days of the first dose of study treatment. Subject has received or will receive a live vaccine within 30 days before the first administration of study treatment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Novartis Pharmaceuticals
Organizational Affiliation
Novartis Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Novartis Investigative Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Novartis Investigative Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Novartis Investigative Site
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Novartis Investigative Site
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Novartis Investigative Site
City
Manchester
State/Province
Lancashire
ZIP/Postal Code
M20 4BX
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
London
ZIP/Postal Code
W1G 6AD
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Learn more about this trial

Safety and Efficacy Study of Pazopanib and MK 3475 in Advanced Renal Cell Carcinoma (RCC; KEYNOTE-018)

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