search
Back to results

GR-MD-02 + Pembrolizumab Versus Pembrolizumab Monotherapy in Melanoma and Squamous Cell Head and Neck Cancer Patients

Primary Purpose

Metastatic Melanoma, Head and Neck Squamous Cell Carcinoma

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
GR-MD-02
Placebo
Pembrolizumab
Sponsored by
Providence Health & Services
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Melanoma focused on measuring HNSCC, MM, pembrolizumab, GR-MD-02, Galectin Inhibitor, GRMD-02, GRMD002

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with unresectable or metastatic melanoma including unknown primary, mucosal or uveal melanomas. Histological confirmation of melanoma will be required by previous biopsy or cytology. Patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) with disease progression during or after platinum-containing chemotherapy are eligible. PD-L1 testing is not needed for OHN cancers.
  • Patients who have received anti-PD1 or anti-PD-L1 in the past are eligible if it has been at least 6 months since the last anti-PD-1 or PD-L1 dose, they meet all other eligibility criteria and progression of malignancy has been documented on imaging. Progression for this patient subset is defined as the appearance of one or more new metastatic sites, or a 5% or greater increase in the sum of diameter of target lesions or an unequivocal increase in non-target site. Treatment naïve melanoma patients are eligible.
  • Patients must be ≥ 18 years of age.
  • ECOG performance status of 0-2.
  • Women of childbearing potential must have a serum or urine pregnancy test performed within 72 hours prior to the start of protocol treatment. The results of this test must be negative in order for the patient to be eligible. In addition, women of childbearing potential as well as male patients must agree to take appropriate precautions to avoid pregnancy.
  • No active bleeding.
  • Anticipated lifespan greater than 12 weeks.
  • Patients must sign a study-specific consent document.

Exclusion Criteria:

  • Patients who have previously received a galectin antagonist.
  • Patients with active autoimmune disease except for autoimmune thyroiditis or vitiligo (see Appendix C).
  • Patients with history of autoimmune colitis.
  • Patients with untreated brain metastases. Patients with treated brain metastases who demonstrate control of brain metastases with follow-up imaging 4 or more weeks after initial therapy are eligible.
  • Patients requiring other systemic oncologic therapy, including experimental therapies.
  • Patients with active infection requiring antibiotics.
  • Pregnant or lactating women, as treatment involves unforeseeable risks to the embryo or fetus.
  • Need for steroids at greater than physiologic replacement doses. Inhaled corticosteroids are acceptable.
  • Laboratory exclusions (to be performed within 28 days of enrollment):

    • WBC < 3.0 x 109/L
    • Hgb < 9.0 g/dL
    • AST or ALT > 1.5 times ULN
    • Total bilirubin > 1.9 g/dL, unless due to Gilbert's Syndrome. If Gilbert's Syndrome is present by clinical history, then direct bilirubin must by < 3.0 g/dl.
    • Known history of HIV
    • Known history of Hepatitis B
    • Known history of Hepatitis C
    • INR > 1.5x ULN
  • Inability to give informed consent and comply with the protocol. Patients must be judged able to understand fully the investigational nature of the study and the risks associated with the therapy.
  • Any medical condition that in the opinion of the Principal Investigator would compromise the safety or conduct of the study procedures.
  • Unresolved immune-mediated pneumonitis, diarrhea, elevation of hepatocellular enzymes or other toxicities requiring greater than physiological replacement doses of steroids.

Sites / Locations

  • Portland Providence Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

GR-MD-02 + pembrolizumab

Pembrolizumab Monotherapy

Arm Description

4 mg/kg GR-MD-02 in combination with standard pembrolizumab treatment.

4 mg/kg placebo in combination with standard pembrolizumab treatment.

Outcomes

Primary Outcome Measures

Overall response rate based on disease imaging
Determine the objective response of GR-MD-02 + pembrolizumab versus pembrolizumab monotherapy in patients with advanced MM or HNSCC

Secondary Outcome Measures

Evaluation of GAL-3 expression
Compare GAL-3 expression in paired biopsies after GR-MD-02 + pembrolizumab or pembrolizumab monotherapy.
Evaluation of predictive biomarker
Characterize MDSC expression over time as a predictive biomarker of response after GRMD02 + pembrolizumab or pembrolizumab monotherapy
Frequency of Immune-mediated adverse events
Compare the frequency of immune-mediated adverse events after GR-MD-02 + pembrolizumab versus pembrolizumab + placebo
Evaluation of antiviral immunity
Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring CD4+T cells with a memory phenotype (CD3+CD4+Ki67+CD25+FoxP3-CCR7-CD45RA-CD27+CD28+/-).
Evaluation of antiviral immunity
Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring CD8+ T cells with effector phenotype (CD3+CD8+CD28-CD95+).
Evaluation of antiviral immunity
Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring tumor-specific T cells using autologous and/or HLA-matched tumor when available.

Full Information

First Posted
July 14, 2021
Last Updated
June 2, 2023
Sponsor
Providence Health & Services
Collaborators
Providence Cancer Center, Earle A. Chiles Research Institute
search

1. Study Identification

Unique Protocol Identification Number
NCT04987996
Brief Title
GR-MD-02 + Pembrolizumab Versus Pembrolizumab Monotherapy in Melanoma and Squamous Cell Head and Neck Cancer Patients
Official Title
Randomized Double-Blind Placebo Controlled Phase II Study of a Galectin Inhibitor (GR-MD-02) and Pembrolizumab Versus Pembrolizumab and Placebo in Patients With Metastatic Melanoma and Head and Neck Squamous Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Study withdrawn due to lack of supply of one of the investigational agents.
Study Start Date
July 1, 2023 (Anticipated)
Primary Completion Date
July 1, 2027 (Anticipated)
Study Completion Date
July 1, 2031 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Providence Health & Services
Collaborators
Providence Cancer Center, Earle A. Chiles Research Institute

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
The purpose of this study is to test the safety & efficacy of combination drugs versus placebo to treat metastatic melanoma and head and neck squamous cell carcinoma.
Detailed Description
Eligible patients will be registered, stratified by diagnosis (melanoma versus OHN cancer), and the number of prior systemic therapies, and randomized to receive either GR-MD-02 + pembrolizumab or pembrolizumab + placebo. In addition to monitoring for toxicity and clinical response, blood and tumor samples will be obtained to assess immunologic measures relevant to galectin biology and pembrolizumab T-cell checkpoint inhibition.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Melanoma, Head and Neck Squamous Cell Carcinoma
Keywords
HNSCC, MM, pembrolizumab, GR-MD-02, Galectin Inhibitor, GRMD-02, GRMD002

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
GR-MD-02 + pembrolizumab
Arm Type
Experimental
Arm Description
4 mg/kg GR-MD-02 in combination with standard pembrolizumab treatment.
Arm Title
Pembrolizumab Monotherapy
Arm Type
Placebo Comparator
Arm Description
4 mg/kg placebo in combination with standard pembrolizumab treatment.
Intervention Type
Drug
Intervention Name(s)
GR-MD-02
Other Intervention Name(s)
Galactoarabino-rhamnogalactouronate
Intervention Description
Patients will receive up to seventeen doses of GR-MD-02 intravenously over 85 Days.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Patients will receive up to seventeen doses of placebo intravenously over 85 Days.
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
Keytruda
Intervention Description
Patients will receive 200mg doses of pembrolizumab intravenously over 85 Days.
Primary Outcome Measure Information:
Title
Overall response rate based on disease imaging
Description
Determine the objective response of GR-MD-02 + pembrolizumab versus pembrolizumab monotherapy in patients with advanced MM or HNSCC
Time Frame
From date of randomization until the date of first documented progression, assessed up to 63 weeks.
Secondary Outcome Measure Information:
Title
Evaluation of GAL-3 expression
Description
Compare GAL-3 expression in paired biopsies after GR-MD-02 + pembrolizumab or pembrolizumab monotherapy.
Time Frame
Screening and Day 68
Title
Evaluation of predictive biomarker
Description
Characterize MDSC expression over time as a predictive biomarker of response after GRMD02 + pembrolizumab or pembrolizumab monotherapy
Time Frame
Day 85
Title
Frequency of Immune-mediated adverse events
Description
Compare the frequency of immune-mediated adverse events after GR-MD-02 + pembrolizumab versus pembrolizumab + placebo
Time Frame
From time of informed consent to week 63
Title
Evaluation of antiviral immunity
Description
Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring CD4+T cells with a memory phenotype (CD3+CD4+Ki67+CD25+FoxP3-CCR7-CD45RA-CD27+CD28+/-).
Time Frame
Day 85
Title
Evaluation of antiviral immunity
Description
Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring CD8+ T cells with effector phenotype (CD3+CD8+CD28-CD95+).
Time Frame
Day 85
Title
Evaluation of antiviral immunity
Description
Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring tumor-specific T cells using autologous and/or HLA-matched tumor when available.
Time Frame
Day 85

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with unresectable or metastatic melanoma including unknown primary, mucosal or uveal melanomas. Histological confirmation of melanoma will be required by previous biopsy or cytology. Patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) with disease progression during or after platinum-containing chemotherapy are eligible. PD-L1 testing is not needed for OHN cancers. Patients who have received anti-PD1 or anti-PD-L1 in the past are eligible if it has been at least 6 months since the last anti-PD-1 or PD-L1 dose, they meet all other eligibility criteria and progression of malignancy has been documented on imaging. Progression for this patient subset is defined as the appearance of one or more new metastatic sites, or a 5% or greater increase in the sum of diameter of target lesions or an unequivocal increase in non-target site. Treatment naïve melanoma patients are eligible. Patients must be ≥ 18 years of age. ECOG performance status of 0-2. Women of childbearing potential must have a serum or urine pregnancy test performed within 72 hours prior to the start of protocol treatment. The results of this test must be negative in order for the patient to be eligible. In addition, women of childbearing potential as well as male patients must agree to take appropriate precautions to avoid pregnancy. No active bleeding. Anticipated lifespan greater than 12 weeks. Patients must sign a study-specific consent document. Exclusion Criteria: Patients who have previously received a galectin antagonist. Patients with active autoimmune disease except for autoimmune thyroiditis or vitiligo (see Appendix C). Patients with history of autoimmune colitis. Patients with untreated brain metastases. Patients with treated brain metastases who demonstrate control of brain metastases with follow-up imaging 4 or more weeks after initial therapy are eligible. Patients requiring other systemic oncologic therapy, including experimental therapies. Patients with active infection requiring antibiotics. Pregnant or lactating women, as treatment involves unforeseeable risks to the embryo or fetus. Need for steroids at greater than physiologic replacement doses. Inhaled corticosteroids are acceptable. Laboratory exclusions (to be performed within 28 days of enrollment): WBC < 3.0 x 109/L Hgb < 9.0 g/dL AST or ALT > 1.5 times ULN Total bilirubin > 1.9 g/dL, unless due to Gilbert's Syndrome. If Gilbert's Syndrome is present by clinical history, then direct bilirubin must by < 3.0 g/dl. Known history of HIV Known history of Hepatitis B Known history of Hepatitis C INR > 1.5x ULN Inability to give informed consent and comply with the protocol. Patients must be judged able to understand fully the investigational nature of the study and the risks associated with the therapy. Any medical condition that in the opinion of the Principal Investigator would compromise the safety or conduct of the study procedures. Unresolved immune-mediated pneumonitis, diarrhea, elevation of hepatocellular enzymes or other toxicities requiring greater than physiological replacement doses of steroids.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brendan D. Curti, MD
Organizational Affiliation
Providence Health & Services
Official's Role
Principal Investigator
Facility Information:
Facility Name
Portland Providence Medical Center
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States

12. IPD Sharing Statement

Learn more about this trial

GR-MD-02 + Pembrolizumab Versus Pembrolizumab Monotherapy in Melanoma and Squamous Cell Head and Neck Cancer Patients

We'll reach out to this number within 24 hrs