search
Back to results

Azacitidine Combined With Pembrolizumab and Epacadostat in Subjects With Advanced Solid Tumors (ECHO-206)

Primary Purpose

Solid Tumors, Advanced Malignancies, Metastatic Cancer

Status
Terminated
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Azacitidine
Pembrolizumab
Epacadostat
INCB057643
Pembrolizumab
Epacadostat
INCB059872
Sponsored by
Incyte Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumors focused on measuring Solid tumors, NSCLC, CRC

Eligibility Criteria

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

Inclusion Criteria:

  • Willingness to provide written informed consent for the study.
  • Willingness to undergo a pretreatment and on-treatment tumor biopsy to obtain tumor tissue.
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Part 1: Subjects with histologically or cytologically confirmed advanced or metastatic solid tumors that have failed prior standard therapy (disease progression; subject refusal or intolerance is also allowable).
  • Part 2:

    *Note: Subjects must have failed available therapies that are known to confer clinical benefit as indicated below, unless they are ineligible, intolerant, or refused standard treatment.

  • Subjects with histologically or cytologically confirmed NSCLC:

    • Metastatic (Stage IV) or recurrent NSCLC (according to American Joint Committee on Cancer 7th edition guidelines) who have had disease progression after available therapies for advanced or metastatic disease that are known to confer clinical benefit, been intolerant to treatment, or refused standard treatment.
    • Prior systemic regimens must include previously approved therapies, including a platinum-containing chemotherapy regimen; a tyrosine kinase inhibitor for tumors with driver mutations; and checkpoint inhibitors where approved.
    • Must have disease progression on a prior PD-1-pathway targeted agent.
  • Subjects with recurrent (unresectable) or metastatic CRC:

    • Have histologically confirmed microsatellite stable (MSS) CRC.
    • Stage IV MSS CRC (according to American Joint Committee on Cancer 7th edition guidelines) who have had disease progression after available therapies for advanced or metastatic disease that are known to confer clinical benefit, been intolerant to treatment, or refused standard treatment.
    • Prior systemic regimens must include previously approved therapies, including fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy; an anti-VEGF therapy (if no contraindication); and if negative for KRAS, NRAS, and BRAF mutations and no contraindication, an anti-epidermal growth factor receptor (EGFR) therapy; and progressed after the last administration of approved therapy.
  • Subjects with HNSCC:

    • Histologically confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx.
    • Carcinomas of the nasopharynx, salivary gland, or nonsquamous cell histology are excluded.
    • Must have received prior treatment with a platinum-based therapy
    • Must have had documented disease progression while on a prior PD-1 pathway-targeted agent.
  • Subjects with melanoma:

    • Histologically or cytologically confirmed melanoma.
    • Unresectable Stage III or Stage IV melanoma, as per American Joint Committee on Cancer staging system not amenable to local therapy.
  • Subjects with urothelial carcinoma:

    • Histologically or cytologically confirmed urothelial carcinoma of the renal pelvis, ureter, urinary bladder, or urethra that is transitional cell or mixed transitional/nontransitional (predominantly transitional) cell type.
    • Stage IV locally advanced or metastatic urothelial carcinoma (according to American Joint Committee on Cancer 7th edition guidelines) with documented disease progression while on a PD-1 pathway targeted therapy.

Exclusion Criteria:

  • Laboratory parameters not within the protocol-defined range.
  • Receipt of anticancer medications or investigational drugs within a defined interval before the first administration of study drug.
  • Has not recovered from toxic effects of prior therapy to ≤ Grade 1.
  • Active or inactive autoimmune disease or syndrome.
  • Active infection requiring systemic therapy.
  • Known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  • History or presence of an abnormal ECG that, in the investigator's opinion, is clinically meaningful.
  • Has received a live vaccine within 30 days of planned start of study therapy.
  • Prior receipt of an IDO inhibitor.
  • Subjects with uncontrolled type I or type II diabetes mellitus (defined as HgbA1c > 8).
  • Prior receipt of a BET inhibitor (Treatment Group B only).
  • Subjects with a history of bleeding related to cancer under study requiring a medical intervention (eg, embolization procedure, RBC transfusion, or hospitalization) within 30 days of study enrollment (Treatment Groups B and C only).
  • Clinically significant bleeding within 14 days of Cycle 1 Day 1 (Treatment Groups B and C only).
  • Prior receipt of an LSD1 inhibitor including INCB059872 (Treatment Group C only).

Sites / Locations

  • City of Hope National Medical Center
  • University of California San Diego
  • The University of Chicago
  • University of Pennsylvania Health System
  • Sarah Cannon
  • Vanderbilt-Ingram Cancer Center
  • MD Anderson Cancer Center
  • University of Washington
  • Vall D Hebron Univ
  • Univ De Navarra
  • University College London Hospitals (Uclh)
  • Churchill Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Treatment Group A: Azacitidine + Pembrolizumab + Epacadostat

Treatment Group B: INCB057643 + Pembrolizumab + Epacadostat

Treatment Group C: INCB059872 + Pembrolizumab + Epacadostat

Arm Description

Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 21 days. Part 2 will evaluate the recommended dose determined in Part 1.

Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 42 days. Part 1 will also contain dose-expansion cohorts in previously treated NSCLC and MSS CRC. Part 2 will evaluate the recommended dose determined in Part 1.

Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 42 days. Part 1 will also contain dose-expansion cohorts in previously treated NSCLC and MSS CRC. Part 2 will evaluate the recommended dose determined in Part 1.

Outcomes

Primary Outcome Measures

Part 1 and 2 : Number of Participants With Treatment Emergent Adverse Events
A treatment-emergent AE was defined as an event occurring after exposure to at least 1 dose of study drug. A treatment-related AE was defined as an event with a definite, probable, or possible causality to study medication. A serious AE is an event resulting in death, hospitalization, persistent or significant disability/incapacity, or is life threatening, a congenital anomaly/birth defect or requires medical or surgical intervention to prevent 1 of the outcomes above. The intensity of an AE was graded according to the National Cancer Institute common terminology criteria for adverse events (NCI-CTCAE) version 4.03: Grade 1 (Mild); Grade 2 (Moderate); Grade 3 (Severe); Grade 4 (life-threatening).
Part 1 and 2: Objective Response Rate Based on Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
ORR was defined as the percentage of participants having a complete response (CR) or partial response (PR) as determined by investigator assessment of radiographic disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. CR is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. PR is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters. A participant was considered as an objective responder if the participant had a best overall response of CR or PR.

Secondary Outcome Measures

Parts 1 and 2: Percentage of Responders Determined by Immunohistochemistry
Responder is defined as an increase in the number of tumor-infiltrating lymphocytes or the ratio of CD8+ lymphocytes to T regulatory cells infiltrating tumor post-treatment versus pretreatment with pembrolizumab and epacadostat in combination with azacitidine.
Parts 1 and 2: Progression-free Survival Based on RECIST v1.1.
Defined as the time from date of first dose of study drug until the earliest date of disease progression per RECIST v1.1, or death due to any cause, if occurring sooner than progression.
Parts 1 and 2: Duration of Response Based on RECIST v1.1
Defined as the time from earliest date of disease response until the earliest date of disease progression per RECIST v1.1, or death due to any cause, if occurring sooner than progression.

Full Information

First Posted
November 7, 2016
Last Updated
April 13, 2021
Sponsor
Incyte Corporation
search

1. Study Identification

Unique Protocol Identification Number
NCT02959437
Brief Title
Azacitidine Combined With Pembrolizumab and Epacadostat in Subjects With Advanced Solid Tumors (ECHO-206)
Official Title
A Phase 1/2 Study Exploring the Safety, Tolerability, Effect on the Tumor Microenvironment, and Efficacy of Azacitidine in Combination With Pembrolizumab and Epacadostat in Subjects With Advanced Solid Tumors and Previously Treated Stage IIIB or Stage IV Non-Small Cell Lung Cancer and Stage IV Microsatellite-Stable Colorectal Cancer (ECHO-206)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Terminated
Why Stopped
Study terminated by Sponsor
Study Start Date
February 27, 2017 (Actual)
Primary Completion Date
February 15, 2019 (Actual)
Study Completion Date
March 2, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Incyte Corporation

4. Oversight

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

5. Study Description

Brief Summary
This is an open-label, Phase 1/2 study in subjects with advanced or metastatic solid tumors. The study has three separate treatment groups where separate epigenetic agents are evaluated with an immunotherapy combination. Treatment Group A will evaluate the DNA methyltransferase inhibitor azacitidine in combination with the programmed death receptor-1 (PD-1) inhibitor pembrolizumab and the indoleamine 2,3-dioxygenase (IDO-1) inhibitor epacadostat; Treatment Group B will evaluate the bromodomain and extra-terminal (BET) inhibitor INCB057643 with pembrolizumab and epacadostat; and Treatment Group C will evaluate the lysine-specific demethylase 1A (LSD1) inhibitor INCB059872 with pembrolizumab and epacadostat. The study will be divided into 2 parts (Part 1 and 2). Part 1 is a dose-escalation assessment to evaluate the safety and tolerability of the combination therapies. Once the recommended doses have been determined, subjects with previously treated NSCLC, microsatellite-stable colorectal cancer (CRC), head and neck squamous cell carcinoma, urothelial carcinoma, and melanoma will be enrolled into expansion cohorts in Part 2.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumors, Advanced Malignancies, Metastatic Cancer
Keywords
Solid tumors, NSCLC, CRC

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment Group A: Azacitidine + Pembrolizumab + Epacadostat
Arm Type
Experimental
Arm Description
Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 21 days. Part 2 will evaluate the recommended dose determined in Part 1.
Arm Title
Treatment Group B: INCB057643 + Pembrolizumab + Epacadostat
Arm Type
Experimental
Arm Description
Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 42 days. Part 1 will also contain dose-expansion cohorts in previously treated NSCLC and MSS CRC. Part 2 will evaluate the recommended dose determined in Part 1.
Arm Title
Treatment Group C: INCB059872 + Pembrolizumab + Epacadostat
Arm Type
Experimental
Arm Description
Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 42 days. Part 1 will also contain dose-expansion cohorts in previously treated NSCLC and MSS CRC. Part 2 will evaluate the recommended dose determined in Part 1.
Intervention Type
Drug
Intervention Name(s)
Azacitidine
Intervention Description
Five doses of azacitidine will be administered by subcutaneous injection or intravenously (IV) over Days 1 to 7 in Cycles 1 through 6.
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Intervention Description
Pembrolizumab will be administered in a 30-minute IV infusion every 3 weeks on Day 1 of each 21-day cycle.
Intervention Type
Drug
Intervention Name(s)
Epacadostat
Intervention Description
Epacadostat tablets will be administered orally twice daily.
Intervention Type
Drug
Intervention Name(s)
INCB057643
Intervention Description
INCB057643 will be orally self- administered once daily beginning on Cycle 1 Day 1 and continuously thereafter in 21-day cycles.
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Intervention Description
Pembrolizumab will be administered in a 30-minute IV infusion every 3 weeks of each 21-day cycle starting on Cycle 2 Day 1.
Intervention Type
Drug
Intervention Name(s)
Epacadostat
Intervention Description
Epacadostat tablets will be administered orally twice daily starting at Cycle 2 Day 1.
Intervention Type
Drug
Intervention Name(s)
INCB059872
Intervention Description
INCB059872 will be orally self- administered once daily OR every other day beginning on Cycle 1 Day 1 and continuously thereafter in 21-day cycles.
Primary Outcome Measure Information:
Title
Part 1 and 2 : Number of Participants With Treatment Emergent Adverse Events
Description
A treatment-emergent AE was defined as an event occurring after exposure to at least 1 dose of study drug. A treatment-related AE was defined as an event with a definite, probable, or possible causality to study medication. A serious AE is an event resulting in death, hospitalization, persistent or significant disability/incapacity, or is life threatening, a congenital anomaly/birth defect or requires medical or surgical intervention to prevent 1 of the outcomes above. The intensity of an AE was graded according to the National Cancer Institute common terminology criteria for adverse events (NCI-CTCAE) version 4.03: Grade 1 (Mild); Grade 2 (Moderate); Grade 3 (Severe); Grade 4 (life-threatening).
Time Frame
Baseline through 42-49 days after end of treatment, estimated up to 27 months (24 months with 100 day FU period).
Title
Part 1 and 2: Objective Response Rate Based on Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST v1.1)
Description
ORR was defined as the percentage of participants having a complete response (CR) or partial response (PR) as determined by investigator assessment of radiographic disease per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1. CR is disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm. PR is at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum of diameters. A participant was considered as an objective responder if the participant had a best overall response of CR or PR.
Time Frame
Every 9 weeks for the duration of study participation; estimated minimum of 6 months.
Secondary Outcome Measure Information:
Title
Parts 1 and 2: Percentage of Responders Determined by Immunohistochemistry
Description
Responder is defined as an increase in the number of tumor-infiltrating lymphocytes or the ratio of CD8+ lymphocytes to T regulatory cells infiltrating tumor post-treatment versus pretreatment with pembrolizumab and epacadostat in combination with azacitidine.
Time Frame
Baseline to Week 5/6 or week 8/9
Title
Parts 1 and 2: Progression-free Survival Based on RECIST v1.1.
Description
Defined as the time from date of first dose of study drug until the earliest date of disease progression per RECIST v1.1, or death due to any cause, if occurring sooner than progression.
Time Frame
Every 9 weeks from date of randomization until the date of first documented progression or date of death from any cause whichever came first, assessed up to 24 months
Title
Parts 1 and 2: Duration of Response Based on RECIST v1.1
Description
Defined as the time from earliest date of disease response until the earliest date of disease progression per RECIST v1.1, or death due to any cause, if occurring sooner than progression.
Time Frame
Every 9 weeks from date of randomization until the date of first documented progression or date of death from any cause whichever came first, assessed up to 24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willingness to provide written informed consent for the study. Willingness to undergo a pretreatment and on-treatment tumor biopsy to obtain tumor tissue. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Part 1: Subjects with histologically or cytologically confirmed advanced or metastatic solid tumors that have failed prior standard therapy (disease progression; subject refusal or intolerance is also allowable). Part 2: *Note: Subjects must have failed available therapies that are known to confer clinical benefit as indicated below, unless they are ineligible, intolerant, or refused standard treatment. Subjects with histologically or cytologically confirmed NSCLC: Metastatic (Stage IV) or recurrent NSCLC (according to American Joint Committee on Cancer 7th edition guidelines) who have had disease progression after available therapies for advanced or metastatic disease that are known to confer clinical benefit, been intolerant to treatment, or refused standard treatment. Prior systemic regimens must include previously approved therapies, including a platinum-containing chemotherapy regimen; a tyrosine kinase inhibitor for tumors with driver mutations; and checkpoint inhibitors where approved. Must have disease progression on a prior PD-1-pathway targeted agent. Subjects with recurrent (unresectable) or metastatic CRC: Have histologically confirmed microsatellite stable (MSS) CRC. Stage IV MSS CRC (according to American Joint Committee on Cancer 7th edition guidelines) who have had disease progression after available therapies for advanced or metastatic disease that are known to confer clinical benefit, been intolerant to treatment, or refused standard treatment. Prior systemic regimens must include previously approved therapies, including fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy; an anti-VEGF therapy (if no contraindication); and if negative for KRAS, NRAS, and BRAF mutations and no contraindication, an anti-epidermal growth factor receptor (EGFR) therapy; and progressed after the last administration of approved therapy. Subjects with HNSCC: Histologically confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx. Carcinomas of the nasopharynx, salivary gland, or nonsquamous cell histology are excluded. Must have received prior treatment with a platinum-based therapy Must have had documented disease progression while on a prior PD-1 pathway-targeted agent. Subjects with melanoma: Histologically or cytologically confirmed melanoma. Unresectable Stage III or Stage IV melanoma, as per American Joint Committee on Cancer staging system not amenable to local therapy. Subjects with urothelial carcinoma: Histologically or cytologically confirmed urothelial carcinoma of the renal pelvis, ureter, urinary bladder, or urethra that is transitional cell or mixed transitional/nontransitional (predominantly transitional) cell type. Stage IV locally advanced or metastatic urothelial carcinoma (according to American Joint Committee on Cancer 7th edition guidelines) with documented disease progression while on a PD-1 pathway targeted therapy. Exclusion Criteria: Laboratory parameters not within the protocol-defined range. Receipt of anticancer medications or investigational drugs within a defined interval before the first administration of study drug. Has not recovered from toxic effects of prior therapy to ≤ Grade 1. Active or inactive autoimmune disease or syndrome. Active infection requiring systemic therapy. Known active central nervous system (CNS) metastases and/or carcinomatous meningitis. History or presence of an abnormal ECG that, in the investigator's opinion, is clinically meaningful. Has received a live vaccine within 30 days of planned start of study therapy. Prior receipt of an IDO inhibitor. Subjects with uncontrolled type I or type II diabetes mellitus (defined as HgbA1c > 8). Prior receipt of a BET inhibitor (Treatment Group B only). Subjects with a history of bleeding related to cancer under study requiring a medical intervention (eg, embolization procedure, RBC transfusion, or hospitalization) within 30 days of study enrollment (Treatment Groups B and C only). Clinically significant bleeding within 14 days of Cycle 1 Day 1 (Treatment Groups B and C only). Prior receipt of an LSD1 inhibitor including INCB059872 (Treatment Group C only).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kevin O'Hayer, MD
Organizational Affiliation
Incyte Corporation
Official's Role
Study Director
Facility Information:
Facility Name
City of Hope National Medical Center
City
Duarte
State/Province
California
ZIP/Postal Code
91010
Country
United States
Facility Name
University of California San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
The University of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
University of Pennsylvania Health System
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19014
Country
United States
Facility Name
Sarah Cannon
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Vanderbilt-Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Washington
City
Seattle
State/Province
Washington
ZIP/Postal Code
98109
Country
United States
Facility Name
Vall D Hebron Univ
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Univ De Navarra
City
Pamplona
ZIP/Postal Code
31008
Country
Spain
Facility Name
University College London Hospitals (Uclh)
City
London
ZIP/Postal Code
W1t7ha
Country
United Kingdom
Facility Name
Churchill Hospital
City
Oxford
ZIP/Postal Code
Ox37le
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Azacitidine Combined With Pembrolizumab and Epacadostat in Subjects With Advanced Solid Tumors (ECHO-206)

We'll reach out to this number within 24 hrs