Lenvatinib in Combination With Pembrolizumab Versus Treatment of Physician's Choice in Participants With Advanced Endometrial Cancer (MK-3475-775/E7080-G000-309 Per Merck Standard Convention [KEYNOTE-775])
Endometrial Neoplasms
About this trial
This is an interventional treatment trial for Endometrial Neoplasms focused on measuring programmed cell death 1 (PD-1, PD1), programmed cell death ligand 1 (PD-L1, PDL1), programmed cell death ligand 2 (PD-L2, PDL2), vascular endothelial growth factor (VEGF) receptors, lenvatinib, pembrolizumab, doxorubicin, paclitaxel, phase 3 endometrial cancer
Eligibility Criteria
Inclusion Criteria:
- Has a histologically confirmed diagnosis of endometrial carcinoma (EC)
- Documented evidence of advanced, recurrent or metastatic EC.
Has radiographic evidence of disease progression after 1 prior systemic, platinum-based chemotherapy regimen for EC. Participants may have received up to 1 additional line of platinum-based chemotherapy if given in the neoadjuvant or adjuvant treatment setting.
Note: There is no restriction regarding prior hormonal therapy.
- Has historical or fresh tumor biopsy specimen for determination of mismatch repair (MMR) status.
- Has at least 1 measurable target lesion according to Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 and confirmed by Blinded Independent Central Review BICR.
- Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 7 days of starting study treatment.
- Is not pregnant, breastfeeding, and agrees to use a highly effective method of contraception during the treatment period and for at least 120 days (for participants treated with lenvatinib plus pembrolizumab) or at least 180 days (for participants treated with treatment of physician's choice [TPC]) after the last dose of study treatment.
Exclusion Criteria:
- Has carcinosarcoma (malignant mixed mullerian tumor), endometrial leiomyosarcoma and endometrial stromal sarcomas.
- Has unstable central nervous system (CNS) metastases.
- Has active malignancy (except for endometrial cancer, definitively treated in-situ carcinomas [e.g. breast, cervix, bladder], or basal or squamous cell carcinoma of the skin) within 24 months of study start.
- Has gastrointestinal malabsorption, gastrointestinal anastomosis, or any other condition that might affect the absorption of lenvatinib.
- Has a pre-existing greater than or equal (>=) Grade 3 gastrointestinal or non-gastrointestinal fistula.
- Has radiographic evidence of major blood vessel invasion/infiltration.
- Has clinically significant hemoptysis or tumor bleeding within 2 weeks prior to the first dose of study treatment.
- Has a history of congestive heart failure greater than New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction, cerebrovascular accident (CVA) stroke, or cardiac arrhythmia associated with hemodynamic instability within 12 months of the first dose of study treatment.
- Has an active infection requiring systemic treatment.
- Has not recovered adequately from any toxicity and/or complications from major surgery prior to starting therapy.
- Is positive for Human Immunodeficiency Virus (HIV).
- Has active Hepatitis B or C.
- Has a history of (non-infectious) pneumonitis that required treatment with steroids, or has current pneumonitis.
- Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the study.
- Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to study start -Has an active autoimmune disease (with the exception of psoriasis) that has required systemic treatment in the past 2 years.
- Is pregnant or breastfeeding.
- Has had an allogenic tissue/solid organ transplant.
- Has received >1 prior systemic chemotherapy regimen (other than adjuvant or neoadjuvant) for Endometrial Cancer. Participants may receive up to 2 regimens of platinum-based chemotherapy in total, as long as one is given in the neoadjuvant or adjuvant treatment setting.
- Has received prior anticancer treatment within 28 days of study start. All acute toxicities related to prior treatments must be resolved to Grade ≤1, except for alopecia and Grade ≤2 peripheral neuropathy.
- Has received prior treatment with any treatment targeting VEGF-directed angiogenesis, any anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
- Has received prior treatment with an agent directed to a stimulatory or co-inhibitory T-cell receptor other than an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent, and who has discontinued from that treatment due to a Grade 3 or higher immune-related adverse event.
- Has received prior radiation therapy within 21 days of study start with the exception of palliative radiotherapy to bone lesions, which is allowed if completed 2 weeks of study start. Participants must have recovered from all radiation-related toxicities and/or complications prior to randomization.
- Has received a live vaccine within 30 days of study start.
- Has a known intolerance to study treatment (or any of the excipients).
- Prior enrollment on a clinical study evaluating pembrolizumab and lenvatinib for endometrial carcinoma, regardless of treatment received.
- Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks of study start.
- Participants with urine protein ≥1 gram (g)/24 hour.
- Prolongation of corrected QT (QTc) interval to >480 milliseconds (ms).
- Left ventricular ejection fraction (LVEF) below the institutional normal range as determined by multigated acquisition scan (MUGA) or echocardiogram (ECHO).
Sites / Locations
- Arizona Oncology Associates, PC- HAL
- University of California San Francisco
- University of California Los Angeles
- Smilow Cancer Hospital at Yale New Haven
- University of Miami Health System
- Florida Hospital Cancer Institute
- Georgia Cancer Center at Augusta University
- North Shore University Health System
- University Medical Center New Orleans
- Greater Baltimore Medical Center
- Maryland Oncology Hematology, P.A.
- John Theurer Cancer Center at Hackensack University Med Ctr
- Holy Name Medical Center
- Memorial Sloan Kettering Cancer Center
- University of Rochester
- Duke University Medical Center
- Stephenson Cancer Center
- Willamette Valley Cancer Institute and Research Center
- Sanford Gynecology Oncology
- UT West Cancer Center
- Texas Oncology-South Austin
- University of Texas Southwestern Medical Center at Dallas
- The University of Texas MD Anderson Cancer Center
- Texas Oncology-San Antonio Medical Center
- Utah Cancer Specialists
- Centro de Oncologia e Investigacion Buenos Aires COIBA
- Hospital Privado de la Comunidad
- Instituto de Investigaciones Metabolicas
- Hospital Aleman
- Instituto de Oncologia Angel H. Roffo
- Instituto Medico Especializado Alexander Fleming
- Centro Oncologico Riojano Integral
- Royal North Shore Hospital
- Royal Brisbane and Women s Hospital
- Peter MacCallum Cancer Centre
- St John of God
- Hospital Araujo Jorge
- Instituto Nacional do Cancer II
- Hospital de Clinicas de Porto Alegre
- Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da Pucrs
- Fundacao Dr Amaral Carvalho
- Instituto do Cancer de Sao Paulo - ICESP
- Clinica de Pesquisas e Ctro de Estudos Onc. Ginecol. e Mamaria Ltda
- Faculdade de Medicina da Universidade Federal de Minas Gerais
- Tom Baker Cancer Centre
- Cancer Care Manitoba
- London Health Sciences Centre
- Ottawa General Hospital
- Sunnybrook Health Science Centre
- Princess Margaret Cancer Centre
- CIUSSS de l Est de L Ile de Montreal - Hopital Maisonneuve-Rosemont
- Centre Hospitalier de l Universite de Montreal - CHUM
- Jewish General Hospital
- CIUSSS de l'Estrie-CHUS
- CHU de Quebec-Universite Laval-Hotel Dieu de Quebec
- Clinica del Country
- Fundacion Valle del Lili
- Biomelab S A S
- Clinica Colsanitas S.A. - Sede Clinica Universitaria Colombia
- Rodrigo Botero SAS
- Fundacion Colombiana de Cancerologia Clinica Vida
- Oncomedica S.A.
- Institut Bergonie
- Centre de Lutte Contre le Cancer Francois Baclesse
- Centre Oscar Lambret
- Centre Leon Berard
- Institut Regional du Cancer de Montpellier - ICM
- Hopital prive du Confluent
- Groupe Hospitalier Broca Cochin Hotel Dieu
- Hopital Diaconesses Croix Saint Simon
- Centre Hospitalier Lyon Sud
- Centre Armoricain de Radiotherapie Imagerie medicale et Oncologie
- Centre Eugene Marquis
- Institut Gustave Roussy
- EISAI Trial Site 4
- EISAI Trial Site 2
- EISAI Trial Site 1
- EISAI Trial Site 6
- EISAI Trial Site 3
- EISAI Trial Site 5
- Mater Misericordiae University Hospital
- Soroka Medical Center
- Rambam Medical Center
- Edith Wolfson Medical Center
- Hadassah Medical Center. Ein Kerem
- Rabin Medical Center
- Chaim Sheba Medical Center
- Azienda Ospedaliera per l Emergenza Cannizzaro
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori
- Ospedale San Raffaele
- Istituto Europeo di Oncologia
- Fondazione IRCCS Istituto Nazionale dei Tumori
- Istituto Nazionale Tumori IRCCS Fondazione Pascale
- Policlinico Universitario Agostino Gemelli
- EISAI Trial Site 9
- EISAI Trial Site 18
- EISAI Trial Site 7
- EISAI Trial Site 15
- EISAI Trial Site 5
- EISAI Trial Site 11
- EISAI Trial Site 8
- EISAI Trial Site 17
- EISAI Trial Site 4
- EISAI Trial Site 19
- EISAI Trial Site 14
- EISAI Trial Site 1
- EISAI Trial Site 2
- EISAI Trial Site 16
- EISAI Trial Site 3
- EISAI Trial Site 10
- EISAI Trial Site 12
- EISAI Trial Site 13
- EISAI Trial Site 6
- National Cancer Center
- Seoul National University Hospital
- Asan Medical Center
- Samsung Medical Center
- Investigacion Onco Farmaceutica S de RL de CV
- Alivia Clinica de Alta Especialidad S.A. de C.V.
- Grupo Medico Camino SC
- Centro Hemato Oncologico Privado
- Faicic S de RL de CV
- Auckland City Hospital
- Centrum Onkologii Instytut im. Marii Sklodowskiej Curie
- Centrum Onkologii. Instytut im. Marii Sklodowskiej-Curie
- Beskidzkie Centrum Onkologii im. Jana Pawla II
- Szpital Morski im. PCK Szpitale Wojewodzkie w Gdyni Sp. z o.o.
- Centrum Onkologii Instytut im. Marii Sklodowskiej Curie
- Instytut Centrum Zdrowia Matki Polki
- Pomorski Uniwersytet Medyczny w Szczecinie
- Szpital Kliniczny im Ks Anny Mazowieckiej
- Altay Regional Oncology Dispensary
- Republican Clinical Oncology Dispensary of Tatarstan MoH
- FSBI National Medical Oncology Research Center n.a. N.N. Blokhina
- FSBI-FRCC of Special Types Med. Care & Technologies FMBA of Russia
- SPb SBHI City Clinical Oncological Dispensary
- Leningrad Regional Oncology Center
- Mordovia Republican Oncological Dispensary
- Tomsk National Research Medical Center of Russian Academy of Sciences
- Republican Clinical Oncology Dispensary of Republic of Bashkortostan
- Instituto Catalan de Oncologia ICO - Hospital Duran i Reynals
- Hospital General Universitari Vall d Hebron
- Hospital Universitario Gregorio Maranon
- Clinica Universitaria Navarra - Madrid
- Hospital Ramon y Cajal
- Hospital Clinico San Carlos
- Hospital Universitario y Politecnico La Fe de Valencia
- Taipei Veterans General Hospital
- Kaohsiung Veterans General Hospital
- Kaohsiung Chang Gung Memorial Hospital of the C.G.M.F.
- Taichung Veterans General Hospital
- National Taiwan University Hospital
- Chang Gung Medical Foundation. Linkou Branch
- Basken Adana Dr.Turgut Noyan Uygulama ve Arastirma Merkezi
- Hacettepe University Medical Faculty
- Baskent Universitesi Ankara Hastanesi
- Acibadem Bursa Hastanesi
- Acibadem Universitesi Atakent Hastanesi
- Florence Nightingale Gayrettepe Hastanesi
- Ege Universitesi Tip Fakultesi
- Royal Sussex County Hospital
- Addenbrookes Hospital
- Barts Health NHS Trust - St Bartholomew s Hospital
- Guy s & St Thomas NHS Foundation Trust
- The Royal Marsden Foundation Trust
- The Royal Marsden NHS Foundation Trust
- Imperial College Healthcare NHS Trust
- University College Hospital
- University Hospital Southampton NHS Foundation Trust
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Lenvatinib 20 mg + Pembrolizumab 200 mg
Treatment of Physician's Choice
Participants will receive pembrolizumab 200 milligram (mg) administered by intravenous (IV) infusion on Day 1 of each 21-day cycle plus lenvatinib 20 mg administered orally (PO) once daily (QD) during each 21-day cycle for up to 35 cycles.
Participants will receive either of the following treatments: doxorubicin 60 milligram per square meter (mg/m^2) administered by IV on Day 1 of each 21-day cycle for up to a maximum cumulative dose of 500 mg/m^2 OR paclitaxel 80 mg/m^2 administered by IV on a 28-day cycle: 3 weeks receiving paclitaxel once a week and 1 week not receiving paclitaxel.