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Safety Lead-In Study of a Repurposed Drug Added to the Combination of Len Plus Pem

Primary Purpose

Advanced Endometrial Cancer

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
EG-007
Pembrolizumab 100 mg/4 mL (25 mg/ml) Injection
Lenvatinib Capsules
Sponsored by
Evergreen Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Advanced Endometrial Cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Female, 18 years and older at the time of informed consent, who has a histologically confirmed diagnosis of endometrial carcinoma, endometroid histology, that is not MSI-H or dMMR ).
  2. Documented evidence of advanced (Stage III or IV), or recurrent EC.
  3. Must have a recurrence or progressed on a platinum containing chemotherapy regimen and are not candidates for curative surgery or radiation
  4. Has historical or fresh tumor biopsy specimen for confirmation of mismatch repair (MMR) status as not MSI-H or dMMR.
  5. Has measurable or evaluable disease according to Response Evaluation Criteria In Solid Tumors (RECIST v1.1).
  6. Is a candidate for initiation of treatment with the combined regimen of Keytruda plus Lenvima (Len+Pem) OR IS CURRENTLY RECEIVING a tolerated regimen of Len+Pem at the doses specified as the Len+Pem Regimen (per Labeling July 2021)
  7. Life expectancy of 12 weeks or more.
  8. Has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 within 7 days of starting study treatment.
  9. Adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP less than or equal to 150/90 mmHg at screening and no change in antihypertensive medications within 1 week prior to the Cycle 1 Day 1.
  10. Adequate renal function defined as creatinine less than or equal to 1.5 × ULN (upper limit of normal) or calculated creatinine clearance greater than or equal to 40 mL/min per the Cockcroft and Gault formula with creatinine levels greater than 1.5 × ULN.

Additional detail upon request.

Exclusion Criteria:

  1. Brain metastasis: Previously treated CNS disease needs to be asymptomatic and does not require steroids. Brain metastases must be asymptomatic, fully treated and stable and not requiring steroids within 4 weeks prior to study treatment initiation.
  2. Has carcinosarcoma (malignant mixed mullerian tumor), serous carcinoma, endometrial leiomyosarcoma and endometrial stromal sarcomas.
  3. Has failed treatment of lenvatinib + pembrolizumab in prior lines of therapy.
  4. Except for the allowance of ongoing use of Len+Pem, the protocol excludes patients having received any other prior anticancer treatment within 28 days (or 5 times the half-life time, whichever is shorter) or any investigational agent within 30 days prior to the first dose of study drugs. All acute toxicities related to prior treatments must be resolved to Grade less than or equal to 1.
  5. Participants must have recovered adequately from any toxicity and/or complications from major surgery prior to starting therapy.
  6. Participants having greater than 1+ proteinuria on urinalysis will undergo 24-h urine collection for quantitative assessment of proteinuria. Participants with urine protein greater than or equal to 1 g/24-hour will be ineligible.
  7. Gastrointestinal malabsorption, gastrointestinal anastomosis, or any other condition that might affect the absorption of the study drugs
  8. Has a pre-existing greater than or equal (>=) Grade 3 gastrointestinal or non-gastrointestinal fistula.
  9. Has radiographic evidence of major blood vessel invasion/infiltration.
  10. Has clinically significant tumor bleeding within 2 weeks prior to the first dose of study treatment.

Additional detail upon request.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    EG-007 1000mg + Len + Pem

    EG-007 1000mg Loading + Len + Pem

    EG-007 1000mg D-4 Loading + Len + Pem

    Arm Description

    3 to 6 patients will receive EG-007 1000 mg once weekly starting on the day of injection of Pembrolizimab starting the next 21-day cycle of treatment.

    6 to 10 patients will receive EG-007 loading dose of 5000 mg given as 1000 mg daily over 5 consecutive days starting 4 days before the first dose of Pembrolizumab under this protocol.

    6 to 12 patients initiating new regimens of Len+Pem will receive EG-007 loading dose of 5000 mg given as 1000 mg daily over 5 consecutive days starting 4 days before the first dose of Pembrolizumab.

    Outcomes

    Primary Outcome Measures

    Adverse Events Assessment using CTCAE v5.0
    Number of Participants With Treatment-Related Adverse Events as Assessed by NCI CTCAE v5.0, toxicities will be characterized in terms including seriousness, causality, toxicity grading, and action taken with regard to trial treatment. Data Monitoring committee review for safety to proceed through dose escalation.
    Tolerability Score measurement using NCI-PRO CTCAE
    Using NCI-PRO CTCAE to record the tolerability score for patients to evaluate symptomatic toxicities.

    Secondary Outcome Measures

    Long-term Safety Monitoring for EG-007 plus Len+Pem
    To conduct long-term monitoring of the safety and clinical outcomes for EG-007 plus Len+Pem. The proportion of Participants With Treatment-Related Adverse Events during long-term monitoring.

    Full Information

    First Posted
    September 22, 2021
    Last Updated
    July 26, 2023
    Sponsor
    Evergreen Therapeutics, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05106127
    Brief Title
    Safety Lead-In Study of a Repurposed Drug Added to the Combination of Len Plus Pem
    Official Title
    A Phase 2, Open-Label, Safety Lead-In With Long Term Safety Study of EG-007, Added to the Combination of Lenvatinib Plus Pembrolizumab
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 2023 (Anticipated)
    Primary Completion Date
    July 2024 (Anticipated)
    Study Completion Date
    July 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Evergreen Therapeutics, Inc.

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    This is a Phase 2 trial Safety Lead-in trial conducted in 3 cohorts of patients. A safety lead-in study of the impact of adding the Repurposed Drugs a third agent will be conducted prior to opening enrollment into the compassionate use study. All patients enrolled in the safety lead-in study may continue long-term treatment under this protocol without interruption of dosing.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Advanced Endometrial Cancer

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Sequential Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    28 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    EG-007 1000mg + Len + Pem
    Arm Type
    Experimental
    Arm Description
    3 to 6 patients will receive EG-007 1000 mg once weekly starting on the day of injection of Pembrolizimab starting the next 21-day cycle of treatment.
    Arm Title
    EG-007 1000mg Loading + Len + Pem
    Arm Type
    Experimental
    Arm Description
    6 to 10 patients will receive EG-007 loading dose of 5000 mg given as 1000 mg daily over 5 consecutive days starting 4 days before the first dose of Pembrolizumab under this protocol.
    Arm Title
    EG-007 1000mg D-4 Loading + Len + Pem
    Arm Type
    Experimental
    Arm Description
    6 to 12 patients initiating new regimens of Len+Pem will receive EG-007 loading dose of 5000 mg given as 1000 mg daily over 5 consecutive days starting 4 days before the first dose of Pembrolizumab.
    Intervention Type
    Drug
    Intervention Name(s)
    EG-007
    Intervention Description
    A Repurposed Drug
    Intervention Type
    Drug
    Intervention Name(s)
    Pembrolizumab 100 mg/4 mL (25 mg/ml) Injection
    Intervention Description
    Pembrolizumab will be provided as a sterile, preservative-free, clear to slightly opalescent, colorless to slightly yellow solution that requires dilution for intravenous infusion. Each vial contains 100 mg of pembrolizumab in 4 mL of solution.
    Intervention Type
    Drug
    Intervention Name(s)
    Lenvatinib Capsules
    Intervention Description
    Lenvatinib will be provided as 4-mg and 10-mg capsules. Lenvatinib is formulated with calcium carbonate, mannitol, microcrystalline cellulose, hydroxypropyl cellulose, low-substituted hydroxypropylcellulose, and talc.
    Primary Outcome Measure Information:
    Title
    Adverse Events Assessment using CTCAE v5.0
    Description
    Number of Participants With Treatment-Related Adverse Events as Assessed by NCI CTCAE v5.0, toxicities will be characterized in terms including seriousness, causality, toxicity grading, and action taken with regard to trial treatment. Data Monitoring committee review for safety to proceed through dose escalation.
    Time Frame
    1 Cycle of 21 days
    Title
    Tolerability Score measurement using NCI-PRO CTCAE
    Description
    Using NCI-PRO CTCAE to record the tolerability score for patients to evaluate symptomatic toxicities.
    Time Frame
    1 Cycle of 21 days
    Secondary Outcome Measure Information:
    Title
    Long-term Safety Monitoring for EG-007 plus Len+Pem
    Description
    To conduct long-term monitoring of the safety and clinical outcomes for EG-007 plus Len+Pem. The proportion of Participants With Treatment-Related Adverse Events during long-term monitoring.
    Time Frame
    At the end of every Cycle (21 days per Cycle), up to 12 Cycles; and upon study exit

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Female, 18 years and older at the time of informed consent, who has a histologically confirmed diagnosis of endometrial carcinoma, endometroid histology, that is not MSI-H or dMMR ). Documented evidence of advanced (Stage III or IV), or recurrent EC. Must have a recurrence or progressed on a platinum containing chemotherapy regimen and are not candidates for curative surgery or radiation Has historical or fresh tumor biopsy specimen for confirmation of mismatch repair (MMR) status as not MSI-H or dMMR. Has measurable or evaluable disease according to Response Evaluation Criteria In Solid Tumors (RECIST v1.1). Is a candidate for initiation of treatment with the combined regimen of Keytruda plus Lenvima (Len+Pem) OR IS CURRENTLY RECEIVING a tolerated regimen of Len+Pem at the doses specified as the Len+Pem Regimen (per Labeling July 2021) Life expectancy of 12 weeks or more. Has an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1 within 7 days of starting study treatment. Adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP less than or equal to 150/90 mmHg at screening and no change in antihypertensive medications within 1 week prior to the Cycle 1 Day 1. Adequate renal function defined as creatinine less than or equal to 1.5 × ULN (upper limit of normal) or calculated creatinine clearance greater than or equal to 40 mL/min per the Cockcroft and Gault formula with creatinine levels greater than 1.5 × ULN. Additional detail upon request. Exclusion Criteria: Brain metastasis: Previously treated CNS disease needs to be asymptomatic and does not require steroids. Brain metastases must be asymptomatic, fully treated and stable and not requiring steroids within 4 weeks prior to study treatment initiation. Has carcinosarcoma (malignant mixed mullerian tumor), serous carcinoma, endometrial leiomyosarcoma and endometrial stromal sarcomas. Has failed treatment of lenvatinib + pembrolizumab in prior lines of therapy. Except for the allowance of ongoing use of Len+Pem, the protocol excludes patients having received any other prior anticancer treatment within 28 days (or 5 times the half-life time, whichever is shorter) or any investigational agent within 30 days prior to the first dose of study drugs. All acute toxicities related to prior treatments must be resolved to Grade less than or equal to 1. Participants must have recovered adequately from any toxicity and/or complications from major surgery prior to starting therapy. Participants having greater than 1+ proteinuria on urinalysis will undergo 24-h urine collection for quantitative assessment of proteinuria. Participants with urine protein greater than or equal to 1 g/24-hour will be ineligible. Gastrointestinal malabsorption, gastrointestinal anastomosis, or any other condition that might affect the absorption of the study drugs 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 tumor bleeding within 2 weeks prior to the first dose of study treatment. Additional detail upon request.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Xin Du, Ph.D.
    Phone
    2404064016
    Email
    david.du@egpharm.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Charles Lee, M.D., Ph.D.
    Phone
    2404064016
    Email
    charles.lee@egpharm.com

    12. IPD Sharing Statement

    Learn more about this trial

    Safety Lead-In Study of a Repurposed Drug Added to the Combination of Len Plus Pem

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