Lenvatinib (E7080/MK-7902) in Combination With Pembrolizumab (MK-3475) vs. Standard Chemotherapy and Lenvatinib Monotherapy in Participants With Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma That Progressed After Platinum Therapy and Immunotherapy (MK-7902-009/E7080-G000-228/LEAP-009)
Squamous Cell Carcinoma of Head and Neck
About this trial
This is an interventional treatment trial for Squamous Cell Carcinoma of Head and Neck focused on measuring Programmed Cell Death-1 (PD1, PD-1), Programmed Death-Ligand 1 (PDL1, PD-L1)
Eligibility Criteria
Inclusion Criteria:
- Pathologically confirmed recurrent (not amenable to curative treatment with local and/or systemic therapies) or metastatic (disseminated) HNSCC of the oral cavity, oropharynx, hypopharynx, and/or larynx that is considered incurable by local therapies
- Disease progression at any time during or after treatment with a platinum-containing (e.g., carboplatin or cisplatin) regimen
- Disease progression on or after treatment with an anti-PD-1/PD-L1 mAb (programmed cell death protein 1/programmed death-ligand 1 monoclonal antibody)
- Pre-study imaging that demonstrates evidence of disease progression based on investigator review of at least 2 pre-study images per RECIST 1.1, following initiation of treatment with a PD-1/PD-L1 inhibitor
- Measurable disease by CT or MRI based on Response Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as verified by blinded independent central review (BICR). Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions
- ECOG performance status of 0 or 1 assessed within 7 days of the first dose of study intervention
Male participants are eligible to participate if they agree to the following during the intervention period and for at least 1 week after the last dose of lenvatinib, 3 months after the last dose of capecitabine and paclitaxel, and and 6 months after the last dose of docetaxel:
- Refrain from donating sperm
- Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent; or must agree to use contraception unless confirmed to be azoospermic
- Contraceptive use by men should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies
A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
- Is not a woman of childbearing potential (WOCBP)
- Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), with low user dependency or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis), during the intervention period and for at least 120 days post pembrolizumab or 1 month post lenvatinib, whichever occurs last (Arms 1 and 3), or during the intervention period and for at least 6 months after the last dose of capecitabine, docetaxel, paclitaxel; and 2 months after the last dose of cetuximab (Arm 2)
- Female participants who randomize to Arm 2 must also agree not to donate or freeze/store eggs during the intervention period and for at least 6 months after the last dose of capecitabine, docetaxel, paclitaxel; and 2 months after the last dose of cetuximab
- Adequately controlled blood pressure (BP) with or without antihypertensive medications
- Participants who are hepatitis B surface antigen (HBsAg) positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load prior to randomization
- Participants with history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at screening
- Adequate organ function
Exclusion Criteria:
- Disease that is suitable for local therapy administered with curative intent
- Life expectancy of less than 3 months and/or has rapidly progressing disease in the opinion of the treating investigator
- History of (noninfectious) pneumonitis/interstitial lung disease that required steroids, or has current pneumonitis/interstitial lung disease
- Active infection requiring systemic therapy
- 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 the first dose of study drug
- Known active central nervous system (CNS) metastases and/or carcinomatous meningitis
- Known additional malignancy that is progressing or has required active systemic treatment within the past 3 years, except basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer, or carcinoma in situ that have undergone potentially curative therapy
- Active autoimmune disease that has required systemic treatment in the past 2 years
- Had an allogeneic tissue/solid organ transplant
- Known history of human immunodeficiency virus (HIV) infection
- History of any contraindication or has a severe hypersensitivity to any components of pembrolizumab, lenvatinib or SOC chemotherapy.
- Pre-existing ≥Grade 3 gastrointestinal or non-gastrointestinal fistula
- History of a gastrointestinal malabsorption or any other condition or procedure that may affect oral study drug absorption
- Had major surgery within 3 weeks prior to first dose of study interventions
- Clinically significant cardiovascular impairment within 12 months of the first dose of study drug
- Active tuberculosis
- Has difficulty swallowing capsules or ingesting a suspension orally, or by a feeding tube
- Prior treatment with lenvatinib
- Prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to Study Day 1 or has not recovered from adverse events (AEs) due to a previously administered agent. Participants with endocrine-related AEs Grade ≤2 requiring treatment or hormone replacement may be eligible
- Has received a live or live attenuated vaccine within 30 days prior to the first dose of study intervention. Note: Administration of killed vaccines is allowed
- Previously treated with 4 or more systemic regimens given for recurrent/metastatic disease
- Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration
- Known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study
Sites / Locations
- City of Hope ( Site 1519)Recruiting
- UCLA Hematology/Oncology - Westwood (Building 100) ( Site 1568)Recruiting
- Yale-New Haven Hospital-Yale Cancer Center ( Site 1505)Recruiting
- UF Health ( Site 1554)Recruiting
- Mid Florida Hematology and Oncology Center ( Site 1606)Recruiting
- Cleveland Clinic Florida ( Site 1596)Recruiting
- Georgia Cancer Center at Augusta University ( Site 1575)
- Northwest Georgia Oncology Centers, a Service of Wellstar Cobb Hospital-Research ( Site 1521)Recruiting
- Beacon Cancer Care ( Site 1599)Recruiting
- Rush University Medical Center ( Site 1560)Recruiting
- NorthShore University HealthSystem - Evanston Hospital ( Site 1614)Recruiting
- IU Health Ball Memorial Hospital, Inc.-IU Health Ball Memorial Cancer Center ( Site 1612)Recruiting
- University of Iowa ( Site 1572)Recruiting
- University of Kansas Cancer Center ( Site 1538)Recruiting
- Norton Hospital-Norton Cancer Institute - Downtown ( Site 1601)Recruiting
- Mercy Health-Paducah Medical Oncology and Hematology ( Site 1623)Recruiting
- Our Lady of the Lake RMC-Clinical Research ( Site 1624)Recruiting
- Mary Bird Perkins Cancer Center Baton Rouge ( Site 1622)Recruiting
- University of Maryland Greenebaum Cancer Center ( Site 1522)Recruiting
- Boston Medical Center ( Site 1605)Recruiting
- University of Massachusetts Chan Medical School ( Site 1616)Recruiting
- VA Ann Arbor Healthcare System ( Site 1584)Recruiting
- Barbara Ann Karmanos Cancer Institute ( Site 1566)Recruiting
- Henry Ford Health System ( Site 1544)Recruiting
- Hattiesburg Clinic ( Site 1515)
- Jackson Oncology Associates, PLLC-Clinical Trials ( Site 1625)Recruiting
- Washington University School of Medicine ( Site 1500)
- St. Vincent Frontier Cancer Center ( Site 1507)Recruiting
- University Of Nebraska Medical Center ( Site 1570)
- John Theurer Cancer Center at Hackensack University Medical Center ( Site 1555)
- Rutgers Cancer Institute of New Jersey ( Site 1523)Recruiting
- Perlmutter Cancer Center at Winthrop Oncology Hematology Associates NYU Langone Health ( Site 1597)
- Laura and Isaac Perlmutter Cancer Center ( Site 1582)
- Levine Cancer Institute ( Site 1590)
- Duke Cancer Institute ( Site 1541)Recruiting
- University of Cincinnati ( Site 1567)Recruiting
- University Hospital Cleveland ( Site 1578)Recruiting
- Cleveland Clinic ( Site 1598)Recruiting
- The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive C
- Oklahoma Cancer Specialists and Research Institute, LLC ( Site 1508)
- Gettysburg Cancer Center ( Site 1594)
- Penn State Hershey Medical Center ( Site 1561)Recruiting
- Fox Chase Cancer Center ( Site 1502)Recruiting
- Medical University of South Carolina ( Site 1579)Recruiting
- St Francis Cancer Center-Research Office ( Site 1607)Recruiting
- The Center For Cancer And Blood Disorders ( Site 1569)
- Utah Cancer Specialists ( Site 1621)Recruiting
- Huntsman Cancer Institute ( Site 1532)Recruiting
- Inova Schar Cancer Institute ( Site 1550)Recruiting
- Hematology Oncology Associates of Fredericksburg ( Site 1537)Recruiting
- MultiCare Health System-MultiCare Oncology - Puget Sound ( Site 1609)Recruiting
- Medical College of Wisconsin Clinical Cancer Center ( Site 1574)Recruiting
- Blacktown Hospital ( Site 0101)Recruiting
- Mid North Coast Cancer Institute ( Site 0109)
- Gallipoli Medical Research Foundation-GMRF CTU ( Site 0105)Recruiting
- The Townsville Hospital ( Site 0107)Recruiting
- Royal Adelaide Hospital ( Site 0110)Recruiting
- Monash Health ( Site 0102)Recruiting
- Tom Baker Cancer Centre ( Site 0304)Recruiting
- BC Cancer-Vancouver Center ( Site 0306)
- Hamilton Health Sciences-Juravinski Cancer Centre ( Site 0307)Recruiting
- Instituto de Cancerología ( Site 0408)Recruiting
- Sociedad De Oncologia Y Hematologia Del Cesar ( Site 0404)Recruiting
- Oncomédica S.A.S ( Site 0409)Recruiting
- Administradora Country S.A.S - Clínica del Country ( Site 0407)Recruiting
- Rigshospitalet University Hospital Copenhagen ( Site 1000)Recruiting
- Hopital La Timone ( Site 0503)Recruiting
- Centre de Cancerologie du Grand Montpellier ( Site 0508)Recruiting
- Centre Jean Perrin - Centre Régional de Lutte contre le Cancer d'Auvergne-ONCOLOGY ( Site 0510)Recruiting
- Centre de Lutte Contre le Cancer - Centre Henri Becquerel Normandie Rouen ( Site 0509)Recruiting
- Institut Gustave Roussy ( Site 0505)Recruiting
- Institut Curie ( Site 0500)Recruiting
- Soroka Medical Center-Oncology ( Site 0604)Recruiting
- Rambam Health Care Campus-Oncology Division ( Site 0602)Recruiting
- Hadassah Medical Center. Ein Kerem ( Site 0601)Recruiting
- Chaim Sheba Medical Center ( Site 0600)
- Seoul National University Bundang Hospital ( Site 1801)Recruiting
- Ajou University Hospital ( Site 1802)
- Severance Hospital Yonsei University Health System ( Site 1800)Recruiting
- Samsung Medical Center ( Site 1803)Recruiting
- Oslo universitetssykehus, Radiumhospitalet ( Site 1102)Recruiting
- Centro Hospitalar Vila Nova de Gaia. Espinho EPE ( Site 1401)Recruiting
- Inst. Portugues de Oncologia de Porto Francisco Gentil EPE ( Site 1400)Recruiting
- Spitalul Clinic Colțea ( Site 1708)Recruiting
- Cardiomed SRL Cluj-Napoca ( Site 1701)Recruiting
- Institutul Oncologic Prof.Dr. Ion Chiricuta Cluj-Napoca ( Site 1702)Recruiting
- S.C. Radiotherapy Center Cluj S.R.L ( Site 1706)Recruiting
- S.C. Centrul de Oncologie Sf. Nectarie SRL ( Site 1704)Recruiting
- Cabinet Medical Oncomed ( Site 1707)Recruiting
- S.C.Focus Lab Plus S.R.L ( Site 1703)Recruiting
- Instituto Catalan de Oncologia ICO - Hospital Duran i Reynals ( Site 0700)Recruiting
- HOSPITAL CLÍNIC DE BARCELONA ( Site 0707)Recruiting
- Centro Oncologico de Galicia ( Site 0706)Recruiting
- Hospital General de Valencia ( Site 0703)Recruiting
- Hospital Universitari Vall d Hebron ( Site 0701)
- Hospital Ramon y Cajal ( Site 0705)Recruiting
- Hospital Virgen de la Victoria ( Site 0702)Recruiting
- Chang Gung Memorial Hospital - Linkou Branch ( Site 1203)Recruiting
- Chang Gung Medical Foundation - Kaohsiung ( Site 1204)Recruiting
- China Medical University Hospital ( Site 1205)Recruiting
- Taichung Veterans General Hospital ( Site 1206)Recruiting
- National Cheng Kung University Hospital ( Site 1202)Recruiting
- National Taiwan University Hospital ( Site 1200)Recruiting
- Taipei Veterans General Hospital ( Site 1201)Recruiting
- Aberdeen Royal Infirmary ( Site 0911)Recruiting
- Castle Hill Hospital ( Site 0910)
- The Beatson West of Scotland Cancer Centre ( Site 0909)Recruiting
- Guy s and St Thomas Hospital NHS Foundation Trust ( Site 0903)Recruiting
- University Hospital Southampton NHS Foundation Trust ( Site 0905)Recruiting
- Royal Marsden Hospital ( Site 0902)Recruiting
- Charing Cross Hospital ( Site 0908)
- Musgrove Park Hospital ( Site 0904)Recruiting
- Royal Marsden Hospital. ( Site 0901)Recruiting
- The Christie NHS Foundation Trust ( Site 0907)Recruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Active Comparator
Lenvatinib + Pembrolizumab
SOC Chemotherapy
Lenvatinib Monotherapy
Participants will be treated with the combination of lenvatinib (once daily 20 mg oral dose) plus pembrolizumab (200 mg 30-minute intravenous (IV) infusion on Day 1 of each 21-day cycle for 35 cycles), until centrally verified disease progression, or until a protocol-specified discontinuation criterion is met. Participants may receive up to an additional 17 cycles of pembrolizumab as Second Course treatment, with or without lenvatinib.
Participants will be treated with investigator's choice of standard of care (SOC) chemotherapy (docetaxel, paclitaxel, cetuximab, or capecitabine) until centrally verified disease progression, or until a protocol-specified discontinuation criterion is met.
Participants will be treated with lenvatinib monotherapy (once daily 24 mg oral dose) until centrally verified disease progression, or until a protocol-specified discontinuation criterion is met.