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Efficacy and Safety Study of Pembrolizumab (MK-3475) in Combination With Daratumumab in Participants With Relapsed Refractory Multiple Myeloma (MK-3475-668/KEYNOTE-668)

Primary Purpose

Multiple Myeloma

Status
Withdrawn
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Pembrolizumab
Daratumumab
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Multiple Myeloma focused on measuring Programmed cell death 1 receptor (PD1), PD-1, Programmed cell death ligand 1 receptor (PDL1), PD-L1

Eligibility Criteria

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

Inclusion Criteria:

  • Has a confirmed diagnosis of active MM and measurable disease defined as: a.) Serum M-protein levels ≥0.5 g/dL or b.) Urine M-protein levels ≥200 mg/24 hours or c.) For participants without measurable serum and urine M-protein levels, an abnormal serum free light chain ratio (FLC κ/λ) with involved FLC level ≥100 mg/L.
  • Has undergone prior treatment with ≥2 treatment lines of anti-myeloma therapy and must have failed their last line of treatment defined as lack of response or documented disease progression during or within 60 days of completing their last anti-myeloma therapy.
  • Prior anti-myeloma treatments must have included an immunomodulatory drug (IMiD; i.e., lenalidomide, thalidomide, or pomalidomide) AND a proteasome inhibitor (PI; i.e., bortezomib, ixazomib, or carfilzomib) alone or in combination and participant must have failed therapy with an IMiD or PI or both.
  • Has a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale.
  • Has adequate organ function.
  • Male participants must agree to use contraception during the treatment period and for at least 120 days after the last dose of study treatment and refrain from donating sperm during this period.
  • Female participants must not be pregnant, breastfeeding, and must agree to use (or have their partner use) acceptable contraception during heterosexual activity during the treatment period and for at least 120 days after the last dose of study treatment.

Exclusion Criteria:

  • Has oligo-secretory myeloma, smoldering multiple myeloma (SMM), monoclonal gammopathy of undetermined significance (MGUS), Waldenström's macroglobulinemia, or any history of plasma cell leukemia.
  • Has a history of repeated infections, primary amyloidosis, hyperviscosity, or polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome
  • Has a known additional malignancy that is progressing or requires active treatment. Exceptions include early stage cancers (carcinoma in situ or Stage 1) treated with curative intent, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, in situ cervical cancer, or in situ breast cancer that has undergone potentially curative therapy.
  • Has known meningeal involvement of MM.
  • Has severe hypersensitivity (≥ Grade 3) to pembrolizumab and/or daratumumab and any of its excipients.
  • Has known allergies, hypersensitivity, or intolerance to monoclonal antibodies (mAbs) or human proteins, or their excipients, or known sensitivity to mammalian-derived products.
  • Has an active autoimmune disease that has required systemic treatment in past 2 years.
  • Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis.
  • Has either of the following: a.) Known chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in 1 second (FEV1) <50% of predicted normal, or b.) Known moderate or severe persistent asthma within the past 2 years, or uncontrolled asthma of any classification.
  • Has an active infection requiring systemic therapy.
  • Has a known history of human immunodeficiency virus (HIV) infection.
  • Has a known history of hepatitis B or known active hepatitis C.
  • Has a known history of active tuberculosis (TB).
  • Has received prior solid organ transplant.
  • Has clinically significant cardiac disease or electrocardiogram (ECG) abnormalities or any history of clinically significant ventricular arrhythmias.
  • Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment.
  • Has previously received daratumumab or other anti-cluster of differentiation 38 (anti-CD38) therapies.
  • Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor (i.e., cytotoxic T-lymphocyte-associated protein 4 [CTLA-4], OX-40, CD137) or has previously participated in a Merck pembrolizumab (MK-3475) clinical study.
  • Has received prior anti-myeloma therapy including but not limited to dexamethasone, IMiDs, PIs, monoclonal antibody, chemotherapy, or radiation therapy within 4 weeks or 5 half-lives (whichever is longer) before first dose of study treatment or not recovered (≤ Grade 1 or at Baseline) from AEs due to previously administered agents.
  • Has undergone prior allogeneic stem cell transplant (allo-SCT) within the last 5 years.
  • Has received autologous stem cell transplant (auto-SCT) within 12 weeks before the first dose of study treatment or are planning for or are eligible for auto- or allo-SCT.
  • Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior the first dose of study treatment.
  • Has received prior radiotherapy within 2 weeks of start of study treatment. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-central nervous system (CNS) disease.
  • Has received a live vaccine within 30 days prior to the first dose of study treatment.
  • Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study treatment.

Sites / Locations

  • Mayo Clinic Jacksonville ( Site 0003)
  • Emory University School of Medicine ( Site 0002)
  • Karmanos Cancer Institute ( Site 0001)
  • Calgary Lab Services - Foothills Medical Centre ( Site 0105)
  • Cross Cancer Institute ( Site 0104)
  • Capital Health Queen Elizabeth II Health Sciences Centre ( Site 0101)
  • Hopital Maisonneuve-Rosemont [Montreal, Canada] ( Site 0102)
  • McGill University Health Centre ( Site 0100)
  • CHU de Quebec - Hopital de l'Enfant-Jesus ( Site 0106)
  • CHRU Lille Hospital Claude Huriez ( Site 0200)
  • Hopital Saint-Louis ( Site 0202)
  • Centre Hopitalier Lyon Sud ( Site 0201)
  • Rambam Medical Center ( Site 0700)
  • Rabin Medical Center ( Site 0702)
  • Sourasky Medical Center ( Site 0701)
  • Sheba MC ( Site 0703)
  • Hospital Universitari Germans Trias i Pujol ( Site 0302)
  • Instituto Catalan de Oncologia ICO - Hospital Duran i Reynals ( Site 0303)
  • Clinica Universitaria de Navarra ( Site 0301)
  • Hospital Clinico Universitario de Salamanca ( Site 0300)
  • Hospital Clinico Universitario de Valencia ( Site 0304)
  • Skaenes Universitetssjukhus Lund ( Site 0500)
  • Karolinska Universitetssjukhuset ( Site 0501)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pembrolizumab

Arm Description

Participants receive pembrolizumab 200 mg by intravenous (IV) infusion once every 3 weeks (Q3W) for up to 35 administrations (up to approximately 2 years) and receive daratumumab 16 mg/kg by IV infusion on Days 1, 8, 15, and 22 of Cycles 1-2; on Days 1 and 15 of Cycles 3-6, and on Day 1 of Cycle 7 and beyond, for up to 2 years. Each cycle is 28 days long.

Outcomes

Primary Outcome Measures

Objective Response Rate (ORR)
ORR is defined as the percentage of participants who experience a partial response (PR; ≥50% reduction of serum myeloma (M)-protein plus reduction in 24-hour urinary M-protein by ≥90% or to <200 mg per 24 hours) or better per International Myeloma Working Group (IMWG) 2016, based on investigator assessment.

Secondary Outcome Measures

Disease Control Rate (DCR)
DCR is defined as the percentage of participants who experience stable disease (SD; not meeting criteria for complete response, very good partial response, partial response, minimal response or progressive disease) or better prior to any evidence of progression, per IMWG 2016 based on investigator assessment.
Duration of Response (DOR)
DOR is defined as the time from first documented evidence of at least a PR (≥50% reduction of serum M-protein plus reduction in 24-hour urinary M-protein by ≥90% or to <200 mg per 24 hours) until disease progression or death, per IMWG 2016, based on investigator assessment.
Adverse Events (AEs)
An AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants experiencing one or more AEs will be assessed.
Study Treatment Discontinuations Due to AEs
The number of participants discontinuing study treatment due to AEs will be assessed.

Full Information

First Posted
July 17, 2017
Last Updated
March 21, 2019
Sponsor
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03221634
Brief Title
Efficacy and Safety Study of Pembrolizumab (MK-3475) in Combination With Daratumumab in Participants With Relapsed Refractory Multiple Myeloma (MK-3475-668/KEYNOTE-668)
Official Title
A Phase 2 Study of Pembrolizumab in Combination With Daratumumab (Anti CD38) in Participants With Relapsed Refractory Multiple Myeloma (rrMM)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Withdrawn
Why Stopped
Business Reasons
Study Start Date
August 1, 2017 (Anticipated)
Primary Completion Date
March 20, 2019 (Anticipated)
Study Completion Date
June 10, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
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
No

5. Study Description

Brief Summary
The purpose of this study is to assess the efficacy and safety of pembrolizumab (MK-3475) in combination with daratumumab in participants with relapsed refractory multiple myeloma (rrMM). The primary outcome measure for this study is the assessment of Objective Response Rate (ORR) in participants with rrMM.
Detailed Description
Study treatment will continue until the participant has completed 35 infusions (approximately 2 years) of pembrolizumab treatment. All participants who stop study treatment with stable disease (SD) or better may be eligible for up to an additional ~1 year of study treatment if they progress after stopping study treatment from the initial treatment phase.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Myeloma
Keywords
Programmed cell death 1 receptor (PD1), PD-1, Programmed cell death ligand 1 receptor (PDL1), PD-L1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pembrolizumab
Arm Type
Experimental
Arm Description
Participants receive pembrolizumab 200 mg by intravenous (IV) infusion once every 3 weeks (Q3W) for up to 35 administrations (up to approximately 2 years) and receive daratumumab 16 mg/kg by IV infusion on Days 1, 8, 15, and 22 of Cycles 1-2; on Days 1 and 15 of Cycles 3-6, and on Day 1 of Cycle 7 and beyond, for up to 2 years. Each cycle is 28 days long.
Intervention Type
Biological
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
MK-3475
Intervention Description
IV infusion
Intervention Type
Biological
Intervention Name(s)
Daratumumab
Other Intervention Name(s)
DARZALEX®
Intervention Description
IV infusion
Primary Outcome Measure Information:
Title
Objective Response Rate (ORR)
Description
ORR is defined as the percentage of participants who experience a partial response (PR; ≥50% reduction of serum myeloma (M)-protein plus reduction in 24-hour urinary M-protein by ≥90% or to <200 mg per 24 hours) or better per International Myeloma Working Group (IMWG) 2016, based on investigator assessment.
Time Frame
Up to approximately 2 years
Secondary Outcome Measure Information:
Title
Disease Control Rate (DCR)
Description
DCR is defined as the percentage of participants who experience stable disease (SD; not meeting criteria for complete response, very good partial response, partial response, minimal response or progressive disease) or better prior to any evidence of progression, per IMWG 2016 based on investigator assessment.
Time Frame
Up to approximately 2 years
Title
Duration of Response (DOR)
Description
DOR is defined as the time from first documented evidence of at least a PR (≥50% reduction of serum M-protein plus reduction in 24-hour urinary M-protein by ≥90% or to <200 mg per 24 hours) until disease progression or death, per IMWG 2016, based on investigator assessment.
Time Frame
Up to approximately 2 years
Title
Adverse Events (AEs)
Description
An AE is defined as any untoward medical occurrence in a participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. The number of participants experiencing one or more AEs will be assessed.
Time Frame
Up to approximately 27 months
Title
Study Treatment Discontinuations Due to AEs
Description
The number of participants discontinuing study treatment due to AEs will be assessed.
Time Frame
Up to approximately 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has a confirmed diagnosis of active MM and measurable disease defined as: a.) Serum M-protein levels ≥0.5 g/dL or b.) Urine M-protein levels ≥200 mg/24 hours or c.) For participants without measurable serum and urine M-protein levels, an abnormal serum free light chain ratio (FLC κ/λ) with involved FLC level ≥100 mg/L. Has undergone prior treatment with ≥2 treatment lines of anti-myeloma therapy and must have failed their last line of treatment defined as lack of response or documented disease progression during or within 60 days of completing their last anti-myeloma therapy. Prior anti-myeloma treatments must have included an immunomodulatory drug (IMiD; i.e., lenalidomide, thalidomide, or pomalidomide) AND a proteasome inhibitor (PI; i.e., bortezomib, ixazomib, or carfilzomib) alone or in combination and participant must have failed therapy with an IMiD or PI or both. Has a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale. Has adequate organ function. Male participants must agree to use contraception during the treatment period and for at least 120 days after the last dose of study treatment and refrain from donating sperm during this period. Female participants must not be pregnant, breastfeeding, and must agree to use (or have their partner use) acceptable contraception during heterosexual activity during the treatment period and for at least 120 days after the last dose of study treatment. Exclusion Criteria: Has oligo-secretory myeloma, smoldering multiple myeloma (SMM), monoclonal gammopathy of undetermined significance (MGUS), Waldenström's macroglobulinemia, or any history of plasma cell leukemia. Has a history of repeated infections, primary amyloidosis, hyperviscosity, or polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome Has a known additional malignancy that is progressing or requires active treatment. Exceptions include early stage cancers (carcinoma in situ or Stage 1) treated with curative intent, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, in situ cervical cancer, or in situ breast cancer that has undergone potentially curative therapy. Has known meningeal involvement of MM. Has severe hypersensitivity (≥ Grade 3) to pembrolizumab and/or daratumumab and any of its excipients. Has known allergies, hypersensitivity, or intolerance to monoclonal antibodies (mAbs) or human proteins, or their excipients, or known sensitivity to mammalian-derived products. Has an active autoimmune disease that has required systemic treatment in past 2 years. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis. Has either of the following: a.) Known chronic obstructive pulmonary disease (COPD) with a forced expiratory volume in 1 second (FEV1) <50% of predicted normal, or b.) Known moderate or severe persistent asthma within the past 2 years, or uncontrolled asthma of any classification. Has an active infection requiring systemic therapy. Has a known history of human immunodeficiency virus (HIV) infection. Has a known history of hepatitis B or known active hepatitis C. Has a known history of active tuberculosis (TB). Has received prior solid organ transplant. Has clinically significant cardiac disease or electrocardiogram (ECG) abnormalities or any history of clinically significant ventricular arrhythmias. Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment. Has previously received daratumumab or other anti-cluster of differentiation 38 (anti-CD38) therapies. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor (i.e., cytotoxic T-lymphocyte-associated protein 4 [CTLA-4], OX-40, CD137) or has previously participated in a Merck pembrolizumab (MK-3475) clinical study. Has received prior anti-myeloma therapy including but not limited to dexamethasone, IMiDs, PIs, monoclonal antibody, chemotherapy, or radiation therapy within 4 weeks or 5 half-lives (whichever is longer) before first dose of study treatment or not recovered (≤ Grade 1 or at Baseline) from AEs due to previously administered agents. Has undergone prior allogeneic stem cell transplant (allo-SCT) within the last 5 years. Has received autologous stem cell transplant (auto-SCT) within 12 weeks before the first dose of study treatment or are planning for or are eligible for auto- or allo-SCT. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior the first dose of study treatment. Has received prior radiotherapy within 2 weeks of start of study treatment. A 1-week washout is permitted for palliative radiation (≤2 weeks of radiotherapy) to non-central nervous system (CNS) disease. Has received a live vaccine within 30 days prior to the first dose of study treatment. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of study treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Merck Sharp & Dohme LLC
Official's Role
Study Director
Facility Information:
Facility Name
Mayo Clinic Jacksonville ( Site 0003)
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
Emory University School of Medicine ( Site 0002)
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Karmanos Cancer Institute ( Site 0001)
City
Bloomfield Hills
State/Province
Michigan
ZIP/Postal Code
48302
Country
United States
Facility Name
Calgary Lab Services - Foothills Medical Centre ( Site 0105)
City
Calgary
State/Province
Alberta
ZIP/Postal Code
H9H 4M7
Country
Canada
Facility Name
Cross Cancer Institute ( Site 0104)
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
H9H 4M7
Country
Canada
Facility Name
Capital Health Queen Elizabeth II Health Sciences Centre ( Site 0101)
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
H9H 4M7
Country
Canada
Facility Name
Hopital Maisonneuve-Rosemont [Montreal, Canada] ( Site 0102)
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H9H 4M7
Country
Canada
Facility Name
McGill University Health Centre ( Site 0100)
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H9H 4M7
Country
Canada
Facility Name
CHU de Quebec - Hopital de l'Enfant-Jesus ( Site 0106)
City
Quebec
ZIP/Postal Code
H9H 4M7
Country
Canada
Facility Name
CHRU Lille Hospital Claude Huriez ( Site 0200)
City
Lille
Country
France
Facility Name
Hopital Saint-Louis ( Site 0202)
City
Paris
Country
France
Facility Name
Centre Hopitalier Lyon Sud ( Site 0201)
City
Pierre Benite
Country
France
Facility Name
Rambam Medical Center ( Site 0700)
City
Haifa
Country
Israel
Facility Name
Rabin Medical Center ( Site 0702)
City
Petah-Tikva
Country
Israel
Facility Name
Sourasky Medical Center ( Site 0701)
City
Tel Aviv
Country
Israel
Facility Name
Sheba MC ( Site 0703)
City
Tel Hashomer
Country
Israel
Facility Name
Hospital Universitari Germans Trias i Pujol ( Site 0302)
City
Badalona
Country
Spain
Facility Name
Instituto Catalan de Oncologia ICO - Hospital Duran i Reynals ( Site 0303)
City
Hospitalet de Llobregat
Country
Spain
Facility Name
Clinica Universitaria de Navarra ( Site 0301)
City
Pamplona
Country
Spain
Facility Name
Hospital Clinico Universitario de Salamanca ( Site 0300)
City
Salamanca
Country
Spain
Facility Name
Hospital Clinico Universitario de Valencia ( Site 0304)
City
Valencia
Country
Spain
Facility Name
Skaenes Universitetssjukhus Lund ( Site 0500)
City
Lund
Country
Sweden
Facility Name
Karolinska Universitetssjukhuset ( Site 0501)
City
Stockholm
Country
Sweden

12. IPD Sharing Statement

Learn more about this trial

Efficacy and Safety Study of Pembrolizumab (MK-3475) in Combination With Daratumumab in Participants With Relapsed Refractory Multiple Myeloma (MK-3475-668/KEYNOTE-668)

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