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A Study of Pembrolizumab in Combination With Cisplatin and Pemetrexed in Advanced Malignant Pleural Mesothelioma (MPM) (MK-3475-A17)

Primary Purpose

Mesothelioma

Status
Completed
Phase
Phase 1
Locations
Japan
Study Type
Interventional
Intervention
Pembrolizumab
Pemetrexed
Cisplatin
Sponsored by
Merck Sharp & Dohme LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Mesothelioma focused on measuring Programmed Cell Death-1 (PD1, PD-1), Programmed Death-Ligand 1 (PDL1, PD-L1), Programmed Cell Death 1 Ligand 2 (PDL2, PD-L2)

Eligibility Criteria

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

Inclusion Criteria:

  • Has histologically confirmed diagnosis of advanced/unresectable malignant pleural mesothelioma (MPM)
  • Have at least one measurable disease, which is systemic therapy naïve, radiologically assessed by the local site investigator per modified Response Evaluation Criteria in Solid Tumors (RECIST) using imaging scanned within 28 days prior to the first dose in this study
  • Has a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale
  • Has a life expectancy of at least 3 months
  • Demonstrate adequate organ function
  • Male participants are eligible to participate if they agree to remain abstinent or agree to use contraception unless confirmed to be azoospermic
  • A female participant is eligible to participate if she is not pregnant or breastfeeding, using contraceptives or is not a woman of child bearing potential (WOCBP)

Exclusion Criteria:

  • A WOCBP who has a positive pregnancy test within 72 hours prior to treatment allocation
  • Has received prior therapy with an anti-programmed cell-death 1 (anti PD-1), anti programmed cell-death ligand 1 (anti-PD-L1), or anti programmed cell-death ligand 2 (anti PD-L2) agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor
  • Has previously received systemic anti-cancer therapy (including investigational agents) for MPM
  • Participants who received (neo) adjuvant previously may be eligible, only if the last dose of chemotherapy was completed at least 6 months before registration. Such participants must have recovered from all adverse events (AEs) due to previous (neo) adjuvant therapies to ≤Grade 1 or baseline. Participants with ≤Grade 2 neuropathy may be eligible
  • Received radiation therapy to the lung that is > 30 gray (Gy) within 6 months of the first dose of trial treatment
  • Completed palliative radiotherapy within 7 days of the first dose of trial treatment
  • Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis
  • Had a major surgery within 3 months prior to the first administration in this study
  • Has received a live vaccine within 30 days prior to the first dose of study drug
  • 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 intervention
  • 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 the first dose of study drug
  • Has a known additional malignancy that is progressing or has required active treatment within the past 5 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (eg, breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded
  • Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis
  • Has had a severe hypersensitivity reaction (≥Grade 3) to treatment a monoclonal antibody/components of the study intervention
  • Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease
  • Is being treated for pericardial effusion, or has symptomatic ascites or pleural effusion. A participant who is clinically stable following treatment for these conditions is eligible
  • Has an active infection requiring systemic therapy
  • Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator

Sites / Locations

  • Hyogo College of Medicine Hospital ( Site 0003)
  • Kanagawa Cancer Center ( Site 0004)
  • JOHAS Okayama Rosai Hospital ( Site 0002)
  • National Cancer Center Hospital ( Site 0001)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pembrolizumab + Cisplatin + Pemetrexed

Arm Description

Pembrolizumab 200 mg IV every 3 weeks (Q3W) in combination with Cisplatin 75 mg/m^2 IV, and Pemetrexed 500 mg/m^2 IV for 4-6 cycles followed by monotherapy of Pembrolizumab up to 35 cycles from the first dose of the study in treatment phase (approximately 2 years).

Outcomes

Primary Outcome Measures

Number of Participants Who Experience a Dose-limiting Toxicity (DLT) Per Common Terminology Criteria for Adverse Events (AEs), Version 5.0 (CTCAE)
DLTs will be assessed during the first cycle (21 days) and are defined as Grade (Gr) 4 hematologic toxicities (any period), except neutropenia and febrile neutropenia. Gr 4 neutropenia lasting >7 days despite appropriate supportive treatment. Gr 4 febrile neutropenia (any period) only if the event is considered as clinically significant for the participant deemed by investigator and sponsor. Any Gr 4 non-hematologic toxicity (except laboratory test abnormal including transient electrolyte abnormalities). Any Gr 3 non-hematologic toxicity lasting >72 hours despite appropriate supportive treatment (not laboratory). Clinical test value abnormality is any Gr 4 laboratory test value abnormality. Any Gr 3 laboratory test value abnormality lasting >7 days. The start of the second course is delayed by more than 2 weeks (more than 35 days after the first dose) due to toxicity related to study procedures or any Gr 5.
Number of Participants Who Experience an Adverse Event (AE)
An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention whether or not considered related to the study intervention.
Number of Participants Who Discontinue Study Treatment Due to an AE
An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention whether or not considered related to the study intervention.

Secondary Outcome Measures

Objective Response Rate (ORR) per modified Response Evaluation Criteria In Solid Tumors (RECIST) as Assessed by Investigator
ORR is defined as the percentage of participants who have a Complete Response (CR): Disappearance of all target lesions) or a Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions). The percentage of participants who experience a CR or PR based on modified RECIST will be presented
Disease Control Rate (DCR) per modified RECIST as Assessed by Investigator
DCR is defined as the percentage of participants who have a Complete Response (CR): Disappearance of all target lesions) or Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions) or Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD): At least a 20% increase in the sum of diameters of target lesions and an absolute increase of at least 5 mm. Note: The appearance of one or more new lesions is also considered PD.
Duration of Response (DOR) per modified RECIST as Assessed by Investigator
For participants who demonstrate a confirmed complete response (CR): Disappearance of all target lesions) or confirmed Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions) per RECIST, DOR is defined as the time from first documented evidence of CR or PR until disease progression or death.

Full Information

First Posted
November 4, 2019
Last Updated
September 29, 2022
Sponsor
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04153565
Brief Title
A Study of Pembrolizumab in Combination With Cisplatin and Pemetrexed in Advanced Malignant Pleural Mesothelioma (MPM) (MK-3475-A17)
Official Title
A Phase Ib Clinical Study to Evaluate the Safety and Efficacy of Pembrolizumab (MK-3475) in Combination With Cisplatin and Pemetrexed in Treatment-naive Participants With Advanced Malignant Pleural Mesothelioma (KEYNOTE-A17).
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Completed
Study Start Date
December 9, 2019 (Actual)
Primary Completion Date
September 21, 2022 (Actual)
Study Completion Date
September 21, 2022 (Actual)

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

5. Study Description

Brief Summary
This is a multicenter, open-label, non-randomized, study of pembrolizumab in combination with cisplatin and pemetrexed in treatment of naïve participants with a histologically confirmed diagnosis of advanced/unresectable malignant pleural mesothelioma (MPM) in Japanese participants. This study will evaluate the safety, tolerability, and preliminary efficacy of pembrolizumab in combination with cisplatin and pemetrexed. The primary objective is to evaluate the safety and tolerability of treatment with pembrolizumab in combination with cisplatin and pemetrexed.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Mesothelioma
Keywords
Programmed Cell Death-1 (PD1, PD-1), Programmed Death-Ligand 1 (PDL1, PD-L1), Programmed Cell Death 1 Ligand 2 (PDL2, PD-L2)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pembrolizumab + Cisplatin + Pemetrexed
Arm Type
Experimental
Arm Description
Pembrolizumab 200 mg IV every 3 weeks (Q3W) in combination with Cisplatin 75 mg/m^2 IV, and Pemetrexed 500 mg/m^2 IV for 4-6 cycles followed by monotherapy of Pembrolizumab up to 35 cycles from the first dose of the study in treatment phase (approximately 2 years).
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
Keytruda, MK-3475
Intervention Description
Participants will receive Pembrolizumab 200 mg IV every 3 weeks (Q3W) until disease progression, or until participant has received 35 administrations of Pembrolizumab (approximately 2 years).
Intervention Type
Drug
Intervention Name(s)
Pemetrexed
Other Intervention Name(s)
Alimta
Intervention Description
Participants will receive Pemetrexed 500 mg/m^2 IV on Day 1 of each cycle up to 4-6 cycles where each cycle = 3 weeks
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Other Intervention Name(s)
Platinol-AQ
Intervention Description
Participants will receive Cisplatin 75 mg/m^2 IV on Day 1 of each cycle up to 4-6 cycles where each cycle = 3 weeks
Primary Outcome Measure Information:
Title
Number of Participants Who Experience a Dose-limiting Toxicity (DLT) Per Common Terminology Criteria for Adverse Events (AEs), Version 5.0 (CTCAE)
Description
DLTs will be assessed during the first cycle (21 days) and are defined as Grade (Gr) 4 hematologic toxicities (any period), except neutropenia and febrile neutropenia. Gr 4 neutropenia lasting >7 days despite appropriate supportive treatment. Gr 4 febrile neutropenia (any period) only if the event is considered as clinically significant for the participant deemed by investigator and sponsor. Any Gr 4 non-hematologic toxicity (except laboratory test abnormal including transient electrolyte abnormalities). Any Gr 3 non-hematologic toxicity lasting >72 hours despite appropriate supportive treatment (not laboratory). Clinical test value abnormality is any Gr 4 laboratory test value abnormality. Any Gr 3 laboratory test value abnormality lasting >7 days. The start of the second course is delayed by more than 2 weeks (more than 35 days after the first dose) due to toxicity related to study procedures or any Gr 5.
Time Frame
Up to 3 weeks
Title
Number of Participants Who Experience an Adverse Event (AE)
Description
An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention whether or not considered related to the study intervention.
Time Frame
Up to approximately 33 months
Title
Number of Participants Who Discontinue Study Treatment Due to an AE
Description
An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention whether or not considered related to the study intervention.
Time Frame
Up to approximately 2 years
Secondary Outcome Measure Information:
Title
Objective Response Rate (ORR) per modified Response Evaluation Criteria In Solid Tumors (RECIST) as Assessed by Investigator
Description
ORR is defined as the percentage of participants who have a Complete Response (CR): Disappearance of all target lesions) or a Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions). The percentage of participants who experience a CR or PR based on modified RECIST will be presented
Time Frame
Up to approximately 31 months
Title
Disease Control Rate (DCR) per modified RECIST as Assessed by Investigator
Description
DCR is defined as the percentage of participants who have a Complete Response (CR): Disappearance of all target lesions) or Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions) or Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for progressive disease (PD): At least a 20% increase in the sum of diameters of target lesions and an absolute increase of at least 5 mm. Note: The appearance of one or more new lesions is also considered PD.
Time Frame
Up to approximately 31 months
Title
Duration of Response (DOR) per modified RECIST as Assessed by Investigator
Description
For participants who demonstrate a confirmed complete response (CR): Disappearance of all target lesions) or confirmed Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions) per RECIST, DOR is defined as the time from first documented evidence of CR or PR until disease progression or death.
Time Frame
Up to approximately 31 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has histologically confirmed diagnosis of advanced/unresectable malignant pleural mesothelioma (MPM) Have at least one measurable disease, which is systemic therapy naïve, radiologically assessed by the local site investigator per modified Response Evaluation Criteria in Solid Tumors (RECIST) using imaging scanned within 28 days prior to the first dose in this study Has a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale Has a life expectancy of at least 3 months Demonstrate adequate organ function Male participants are eligible to participate if they agree to remain abstinent or agree to use contraception unless confirmed to be azoospermic A female participant is eligible to participate if she is not pregnant or breastfeeding, using contraceptives or is not a woman of child bearing potential (WOCBP) Exclusion Criteria: A WOCBP who has a positive pregnancy test within 72 hours prior to treatment allocation Has received prior therapy with an anti-programmed cell-death 1 (anti PD-1), anti programmed cell-death ligand 1 (anti-PD-L1), or anti programmed cell-death ligand 2 (anti PD-L2) agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor Has previously received systemic anti-cancer therapy (including investigational agents) for MPM Participants who received (neo) adjuvant previously may be eligible, only if the last dose of chemotherapy was completed at least 6 months before registration. Such participants must have recovered from all adverse events (AEs) due to previous (neo) adjuvant therapies to ≤Grade 1 or baseline. Participants with ≤Grade 2 neuropathy may be eligible Received radiation therapy to the lung that is > 30 gray (Gy) within 6 months of the first dose of trial treatment Completed palliative radiotherapy within 7 days of the first dose of trial treatment Participants must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis Had a major surgery within 3 months prior to the first administration in this study Has received a live vaccine within 30 days prior to the first dose of study drug 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 intervention 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 the first dose of study drug Has a known additional malignancy that is progressing or has required active treatment within the past 5 years. Note: Participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (eg, breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy are not excluded Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis Has had a severe hypersensitivity reaction (≥Grade 3) to treatment a monoclonal antibody/components of the study intervention Has a history of (non-infectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease Is being treated for pericardial effusion, or has symptomatic ascites or pleural effusion. A participant who is clinically stable following treatment for these conditions is eligible Has an active infection requiring systemic therapy Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator
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
Hyogo College of Medicine Hospital ( Site 0003)
City
Nishinomiya
State/Province
Hyogo
ZIP/Postal Code
663-8501
Country
Japan
Facility Name
Kanagawa Cancer Center ( Site 0004)
City
Yokohama
State/Province
Kanagawa
ZIP/Postal Code
241-8515
Country
Japan
Facility Name
JOHAS Okayama Rosai Hospital ( Site 0002)
City
Okayama
ZIP/Postal Code
702-8055
Country
Japan
Facility Name
National Cancer Center Hospital ( Site 0001)
City
Tokyo
ZIP/Postal Code
104-0045
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
IPD Sharing URL
http://engagezone.msd.com/ds_documentation.php
Links:
URL
http://merckoncologyclinicaltrials.com
Description
Merck Oncology Clinical Trials Information

Learn more about this trial

A Study of Pembrolizumab in Combination With Cisplatin and Pemetrexed in Advanced Malignant Pleural Mesothelioma (MPM) (MK-3475-A17)

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