A Study of Duvelisib in Combination With Pembrolizumab in Head and Neck Cancer
Primary Purpose
Head and Neck Squamous Cell Carcinoma
Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Duvelisib
Pembrolizumab
Sponsored by
About this trial
This is an interventional treatment trial for Head and Neck Squamous Cell Carcinoma focused on measuring Squamous Cell Carcinoma of the Head and Neck, Head and Neck Cancer, PI3K-δ,γ, PI3K Inhibitor
Eligibility Criteria
Inclusion Criteria
- Age ≥ 18 years, ECOG performance status ≤ 1
- Histologically or cytologically-confirmed diagnosis of recurrent or metastatic head and neck squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx that is considered incurable by local therapies
- Eligible for pembrolizumab monotherapy based on the current prescribing information for pembrolizumab (Keytruda 2019)
- Must have had 0 to 2 prior therapies for R/M HNSCC.
- At least 1 measurable lesion (which has not been previously irradiated) according to RECIST v 1.1
- For stage 1 only: Must have at least 1 other lesion that can be biopsied and willing to undergo a pretreatment and on-treatment biopsy of the available tumor lesion
- For stage 1 only: Must be willing to undergo a pretreatment and on-treatment biopsy of the available tumor lesion
- Adequate organ function defined by the following laboratory parameters:
- Absolute neutrophil count (ANC) ≥ 1.5 × 109/L
- Platelet count ≥ 100 × 109/L
- Hemoglobin level ≥ 9.0 g/dL
- A serum creatinine level < 1.5 mg/dL, or
- Estimated creatinine clearance value ≥ 60 mL/min (as determined by the Cockcroft-Gault method) for subjects with creatinine levels > 1.5 × institutional upper limit of normal (ULN)
- Total bilirubin level ≤ 1.5 × ULN (exception: subjects with Gilbert's Syndrome may have a bilirubin level > 1.5 × ULN)
- Aspartate aminotransaminase (AST)/serum glutamic-oxaloacetic transaminase (SGOT) and alanine aminotransferase (ALT)/serum pyruvic transaminase (SGPT) levels ≤ 2.5 × ULN or ≤ 5 × ULN in subjects with liver metastases
- International normalized ratio (INR) or prothrombin time (PT) and activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN, unless subject is receiving anticoagulant therapy in which case PT or aPTT must be within therapeutic range of intended use of anticoagulants
Exclusion Criteria
- Previously treated with 3 or more systemic regimens given for recurrent and/or metastatic disease
- Received anticancer treatment, major surgery, or any investigational drug within 30 days or 5 half-lives, whichever is shorter, before the start of study intervention
- Received radiation therapy within 14 days before the start of study intervention, including, in addition (if necessary), the timeframe for resolution of any actual or anticipated toxicities from such radiation; Palliative radiation is allowed if > 7 days and any toxicity is ≤ Grade 1
- Previous treatment with a PI3K, PD-1 or PD-L1 inhibitor
- Have received organ or allogenic bone marrow or peripheral blood stem cell transplant
- History of drug-induced colitis or drug-induced pneumonitis; history or concurrent condition of interstitial lung disease of any severity and/or severely impaired lung function; tuberculosis treatment within 2 years prior to the start of study intervention; chronic liver disease or veno-occlusive disease/sinusoidal obstruction syndrome
- Active cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection; history of or known human immunodeficiency virus (HIV) infection
- Ongoing treatment with chronic immunosuppressants or systemic steroids or treatment for systemic bacterial, fungal, or viral infection
- Unable to receive prophylactic treatment for pneumocystis, herpes simplex virus (HSV), or herpes zoster (VZV) at screening
- Concurrent administration of medications or foods that are strong inhibitors or inducers of cytochrome P450 3A (CYP3A). No prior use within 2 weeks before the start of study intervention Received a live or live attenuated vaccine within 6 weeks of first dose of duvelisib
- Unable to receive prophylactic treatment for pneumocystis, herpes simplex virus (HSV), or herpes zoster (VZV) at screening
- Any active gastrointestinal dysfunction interfering with the subject's ability to be administered oral medications
- Known active central nervous system metastases and/or carcinomatous meningitis
- QT interval > 500 ms (except for subjects with a right or left bundle branch block)
- New York Heart Association Class III or IV congestive heart failure
Sites / Locations
- UPMC Hillman Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Duvelisib + Pembrolizumab
Arm Description
Stage 1: Duvelisib twice daily (BID) for 1 week followed by combination therapy with duvelisib BID + pembrolizumab every 3 weeks (q3w) (Cycle 1 was 4 weeks consisting of the 1-week duvelisib monotherapy lead-in period followed by 1 dose of pembrolizumab in combination with 3 additional weeks of continuous dosing of duvelisib; subsequent cycles were 3 weeks). Stage 2: Duvelisib BID + pembrolizumab q3w in 3-week cycles.
Outcomes
Primary Outcome Measures
Stage 1: Number of Participants With Dose-limiting Toxicities
Stage 1: Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Number of participants with TEAEs as assessed by the Common Terminology Criteria for Adverse Events version 5 (CTCAE v5) as a measure of safety and tolerability of duvelisib in combination with pembrolizumab.
Stage 1 and 2: Overall Response Rate (ORR)
Proportion of participants achieving complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v 1.1).
Secondary Outcome Measures
Stage 1: ORR
Proportion of participants achieving complete CR or PR according to RECIST v 1.1.
Stage 1 and 2: Duration of Response (DOR)
Time from response ≥ PR to documented disease progression according to RECIST v 1.1.
Stage 1 and 2: Progression-free Survival (PFS)
Time from start of treatment to documented disease progression according to RECIST v 1.1, or death due to any cause.
Stage 1 and 2: Overall Survival
Time from start of treatment to death.
Stage 1 and 2: Maximum Observed Concentration [Cmax]
Pharmacokinetics (PK) parameters for duvelisib (and metabolite IPI-656) determined using bioanalytical data and Population PK (POPPK) modeling.
Stage 1 and 2: Area Under the Curve [AUC]
PK parameters for duvelisib (and metabolite IPI-656) determined using bioanalytical data and POPPK modeling.
Stage 1 and 2: Number of Participants With TEAEs
Number of participants with TEAEs as assessed by CTCAE v5.0.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04193293
Brief Title
A Study of Duvelisib in Combination With Pembrolizumab in Head and Neck Cancer
Official Title
A Phase 1b/2 Study of Duvelisib in Combination With Pembrolizumab in Subjects With Recurrent or Metastatic Head and Neck Squamous Cell Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Terminated
Why Stopped
The study was terminated due to low enrollment.
Study Start Date
June 1, 2020 (Actual)
Primary Completion Date
December 10, 2020 (Actual)
Study Completion Date
December 10, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SecuraBio
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 study was designed to assess the safety and preliminary efficacy of duvelisib in combination with pembrolizumab in participants with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC).
Detailed Description
This was a non-randomized, open-label Phase 1b/2 study designed to evaluate safety, tolerability, and preliminary efficacy of duvelisib in combination with pembrolizumab in participants with R/M HNSCC who were eligible for pembrolizumab monotherapy based on the current pembrolizumab prescribing information.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Head and Neck Squamous Cell Carcinoma
Keywords
Squamous Cell Carcinoma of the Head and Neck, Head and Neck Cancer, PI3K-δ,γ, PI3K Inhibitor
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Duvelisib + Pembrolizumab
Arm Type
Experimental
Arm Description
Stage 1: Duvelisib twice daily (BID) for 1 week followed by combination therapy with duvelisib BID + pembrolizumab every 3 weeks (q3w) (Cycle 1 was 4 weeks consisting of the 1-week duvelisib monotherapy lead-in period followed by 1 dose of pembrolizumab in combination with 3 additional weeks of continuous dosing of duvelisib; subsequent cycles were 3 weeks).
Stage 2: Duvelisib BID + pembrolizumab q3w in 3-week cycles.
Intervention Type
Drug
Intervention Name(s)
Duvelisib
Other Intervention Name(s)
VS-0145, Copiktra
Intervention Description
Phosphoinositide 3-kinase (PI3K) Inhibitor
Intervention Type
Biological
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
PD-1 inhibitor, anti-PD-1, Keytruda
Intervention Description
Immunotherapy (programmed cell death protein 1 [PD-1] inhibitor)
Primary Outcome Measure Information:
Title
Stage 1: Number of Participants With Dose-limiting Toxicities
Time Frame
4 weeks or 28 days
Title
Stage 1: Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Description
Number of participants with TEAEs as assessed by the Common Terminology Criteria for Adverse Events version 5 (CTCAE v5) as a measure of safety and tolerability of duvelisib in combination with pembrolizumab.
Time Frame
6 months
Title
Stage 1 and 2: Overall Response Rate (ORR)
Description
Proportion of participants achieving complete response (CR) or partial response (PR) according to Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v 1.1).
Time Frame
Up to 2 years
Secondary Outcome Measure Information:
Title
Stage 1: ORR
Description
Proportion of participants achieving complete CR or PR according to RECIST v 1.1.
Time Frame
Until documented progressive disease (PD), unacceptable toxicity, discontinuation criteria are met, withdrawal, or death (up to 2 years)
Title
Stage 1 and 2: Duration of Response (DOR)
Description
Time from response ≥ PR to documented disease progression according to RECIST v 1.1.
Time Frame
From first response until documented PD (up to 2 years)
Title
Stage 1 and 2: Progression-free Survival (PFS)
Description
Time from start of treatment to documented disease progression according to RECIST v 1.1, or death due to any cause.
Time Frame
From start of treatment until documented PD or death (up to 2.5 years)
Title
Stage 1 and 2: Overall Survival
Description
Time from start of treatment to death.
Time Frame
From start of treatment until death (up to 2.5 years)
Title
Stage 1 and 2: Maximum Observed Concentration [Cmax]
Description
Pharmacokinetics (PK) parameters for duvelisib (and metabolite IPI-656) determined using bioanalytical data and Population PK (POPPK) modeling.
Time Frame
Up to 5 cycles (46 weeks)
Title
Stage 1 and 2: Area Under the Curve [AUC]
Description
PK parameters for duvelisib (and metabolite IPI-656) determined using bioanalytical data and POPPK modeling.
Time Frame
Up to 5 cycles (46 weeks)
Title
Stage 1 and 2: Number of Participants With TEAEs
Description
Number of participants with TEAEs as assessed by CTCAE v5.0.
Time Frame
24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria
Eastern Cooperative Oncology Group performance status ≤ 1
Histologically or cytologically confirmed diagnosis of recurrent or metastatic head and neck squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx that was considered incurable by local therapies
Eligible for pembrolizumab monotherapy based on the current prescribing information for pembrolizumab (Keytruda 2019)
Must have had 0 to 2 prior therapies for R/M HNSCC
At least 1 measurable lesion (which has not been previously irradiated) according to Response Evaluation Criteria in Solid Tumors version 1.1
For stage 1 only: Must have had at least 1 other lesion that could be biopsied and willing to undergo a pretreatment and on-treatment biopsy of the available tumor lesion
For stage 1 only: Must have been willing to undergo a pretreatment and on-treatment biopsy of the available tumor lesion
Adequate organ function defined by the following laboratory parameters:
Absolute neutrophil count ≥ 1.5 × 10^9/liter (L)
Platelet count ≥ 100 × 10^9/L
Hemoglobin level ≥ 9.0 grams/deciliter (dL)
A serum creatinine level < 1.5 milligrams/dL, or
Estimated creatinine clearance value ≥ 60 milliliters/minute (as determined by the Cockcroft-Gault method) for participants with creatinine levels > 1.5 × institutional upper limit of normal (ULN)
Total bilirubin level ≤ 1.5 × ULN (exception: participants with Gilbert's Syndrome may have a bilirubin level > 1.5 × ULN)
Aspartate aminotransaminase/serum glutamic-oxaloacetic transaminase and alanine aminotransferase/serum pyruvic transaminase levels ≤ 2.5 × ULN or ≤ 5 × ULN in participants with liver metastases
International normalized ratio or prothrombin time (PT) and activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN, unless participant was receiving anticoagulant therapy in which case PT or aPTT must have been within therapeutic range of intended use of anticoagulants
Exclusion Criteria
Previously treated with 3 or more systemic regimens given for recurrent and/or metastatic disease
Received anticancer treatment, major surgery, or any investigational drug within 30 days or 5 half-lives, whichever is shorter, before the start of study intervention
Received radiation therapy within 14 days before the start of study intervention, including, in addition (if necessary), the timeframe for resolution of any actual or anticipated toxicities from such radiation; Palliative radiation is allowed if > 7 days and any toxicity is ≤ Grade 1
Previous treatment with a PI3K, PD-1 or programmed cell death ligand 1 inhibitor
Have received organ or allogenic bone marrow or peripheral blood stem cell transplant
History of drug-induced colitis or drug-induced pneumonitis; history or concurrent condition of interstitial lung disease of any severity and/or severely impaired lung function; tuberculosis treatment within 2 years prior to the start of study intervention; chronic liver disease or veno-occlusive disease/sinusoidal obstruction syndrome
Active cytomegalovirus or Epstein-Barr virus infection; history of or known human immunodeficiency virus infection
Ongoing treatment with chronic immunosuppressants or systemic steroids or treatment for systemic bacterial, fungal, or viral infection
Unable to receive prophylactic treatment for pneumocystis, herpes simplex virus (HSV), or herpes zoster (VZV) at screening
Concurrent administration of medications or foods that are strong inhibitors or inducers of cytochrome P450 3A. No prior use within 2 weeks before the start of study intervention Received a live or live attenuated vaccine within 6 weeks of first dose of duvelisib
Unable to receive prophylactic treatment for pneumocystis, HSV, or VZV at screening
Any active gastrointestinal dysfunction interfering with the participant's ability to be administered oral medications
Known active central nervous system metastases and/or carcinomatous meningitis
QT interval > 500 milliseconds (except for participants with a right or left bundle branch block)
New York Heart Association Class III or IV congestive heart failure
Facility Information:
Facility Name
UPMC Hillman Cancer Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15232
Country
United States
12. IPD Sharing Statement
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A Study of Duvelisib in Combination With Pembrolizumab in Head and Neck Cancer
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