Study to Explore the Safety, Tolerability and Efficacy of MK-3475 in Combination With INCB024360 in Participants With Selected Cancers

Lung Cancer Clinical Trial

Official title:

A Phase 1/2 Study Exploring the Safety, Tolerability, and Efficacy of MK-3475 in Combination With INCB024360 in Subjects With Selected Cancers (ECHO-202/KEYNOTE-037)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02178722
• Other study ID #: INCB 24360-202/ ECHO-202
• Status: Completed
• Phase: Phase 1/Phase 2
• Start date: July 17, 2014
• Est. completion date: November 6, 2020

Study information

• Verified date: February 2022
• Source: Incyte Corporation
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study was to assess the safety, tolerability, and efficacy when combining MK-3475 and INCB024360 in participants with certain cancers. This study was conducted in 2 phases, Phase 1 and Phase 2.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 444
• Est. completion date: November 6, 2020
• Est. primary completion date: November 26, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Subjects with histologically or cytologically non-small cell lung cancer (NSCLC), melanoma, transitional cell carcinoma of the genitourinary (GU) tract, renal cell cancer, triple negative breast cancer, adenocarcinoma of the endometrium or squamous cell carcinoma of the head and neck (Phase 1).
• Subjects with histologically confirmed melanoma, NSCLC, transitional cell carcinoma of the GU tract, TNBC, SCCHN, ovarian cancer, MSI high colorectal cancer (CRC), RCC, gastric cancer, HCC and DLBCL (Phase 2).
• Life expectancy > 12 weeks.
• Eastern Cooperative Oncology Group (ECOG) performance status 0 - 1.
• Presence of measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 or Lugano Classification for subjects with DLBCL.
• Laboratory and medical history parameters within protocol-defined range.
• For Phase 1: Subjects who have advanced or metastatic disease as noted above that have received at least one prior therapy or have advanced or metastatic disease for which no curative treatment is available may be enrolled.
• For Phase 2 expansion cohorts: Subjects with NSCLC, melanoma (checkpoint inhibitor naïve, primary refractory melanoma, relapsed melanoma), transitional cell carcinoma of the GU tract, SCCHN, ovarian cancer, MSI high CRC, RCC, DLBCL, TNBC, gastric cancer, and HCC.
• Phase 2 expansion: NSCLC
• Subjects who have received at least 1 prior platinum-based therapy. Subjects who have a non-platinum-based regimen may be enrolled with medical monitor approval.
• Tumors with epidermal growth factor receptor mutation positive or anaplastic lymphoma kinase fusion oncogene positive treated with a tyrosine kinase inhibitor are permitted; however, subjects should have progressed on or be intolerant to the targeted therapy.
• Subjects must not have received immunotherapy with programmed death receptor-1 (PD-1) or cytotoxic T-lymphocyte antigen (CTLA-4) targeted therapy.
• Phase 2 expansion: Melanoma
• Documentation of V600E-activating BRAF mutation status.
• Prior systemic therapy requirements.
• Melanoma immune checkpoint-naïve: Subjects must not have received immunotherapy with anti-PD-1, anti-PD-L1, or anti-CTLA-4 therapy. Exception: Prior anti-CTLA-4 in the adjuvant setting would be permitted.
• Primary refractory melanoma: Subjects must have received prior treatment with anti-PD-1 or anti-PD-L1 therapy (alone or as part of a combination) in the advanced or metastatic setting and have progressive disease as their best response to treatment that is confirmed 4 weeks later.
• Relapsed melanoma: Subjects must have received prior anti-PD-1 or anti-PD-L1 therapy (alone or as part of a combination) in the advanced or metastatic setting and achieved partial response ore complete response but later have confirmed progressive disease.
• Subjects enrolling in the primary refractory or relapsed melanoma must be willing to undergo mandatory pretreatment and on-treatment biopsies.
• Ocular melanoma is excluded.
• Phase 2 expansion: Transitional cell carcinoma of the GU tract
• Metastatic or locally advanced and not amenable to curative therapy with disease progression on or after platinum-based chemotherapy or alternative therapy if platinum-based therapy is not appropriate.
• Prior PD-1 or CTLA-4 targeted therapies are excluded
• Phase 2 expansion: SCCHN
• Histologically confirmed metastatic or recurrent squamous cell carcinoma not amenable to local therapy with curative intent (surgery or radiation with or without chemotherapy). Carcinoma of the nasopharynx, salivary gland, or * *Subjects must have received at least 1 prior systemic chemotherapy regimen that must have included a platinum-based therapy.
• Prior PD-1 or CTLA-4 targeted therapies are excluded.
• Phase 2 expansion: Ovarian cancer
• Subjects with FIGO Stage Ic, Stage II, Stage III, Stage IV, recurrent, or persistent (unresectable) histologically confirmed epithelial ovarian cancer, primary peritoneal cancer, or fallopian tube carcinoma.
• Subjects must have received a platinum-taxane-based regimen as first-line therapy.
• Prior PD-1 or CTLA-4 targeted therapies are excluded.
• Borderline, low-malignant-potential epithelial carcinoma per histopathology is excluded.
• Phase 2 expansion: Relapsed or refractory DLBCL
• Prior allogeneic stem-cell transplantation is excluded.
• Must have received > or = 1 prior treatment regimen.
• Not a candidate for curative therapy or hematopoietic stem-cell transplantation (either due to disease burden, fitness, or preference).
• Prior PD-1 or CTLA-4 targeted therapies are excluded.
• Phase 2 expansion: TNBC
• Histologically confirmed breast adenocarcinoma that is unresectable loco regional, or metastatic
• Pathologically confirmed as triple negative, source documented, defined as

both of the following:

• Estrogen receptor (ER) and progesterone receptor (PgR) negative.
• Human epidermal growth factor receptor 2 (HER2) negative as per American Society of Clinical Oncology/College of American Pathologists guidelines.
• Subject must have received at least 1 prior systemic regimen for advanced or metastatic disease
• Prior PD-1 or CTLA-4 targeted therapies are excluded.
• Phase 2 expansion: RCC
• Subjects with histological or cytological confirmation of clear cell RCC.
• Not curable by surgery.
• Subjects must have received prior antiangiogenic therapy.
• Subjects must not have received prior immunotherapy with anti-PD-1, anti-PD-L1, or anti-CTLA-4 therapy.
• Phase 2 expansion: MSI high CRC
• Subjects with histological confirmation of locally advanced unresectable or metastatic MSI high CRC.
• MSI status is, respectively, determined by examining CRC tumor.
• Subjects may have received no more than 2 lines of prior therapy for advanced disease.
• Phase 2 expansion: Gastric Cancer
• Must have histologically or cytologically confirmed diagnosis of gastric or gastroesophageal junction adenocarcinoma.
• Must have progression on or after therapy containing platinum/fluoropyrimidine or refused standard therapy.
• Subjects may have received no more than 2 lines of prior therapy for advanced disease.
• Prior PD-1 or CTLA-4 targeted therapies are excluded.
• Phase 2 expansion: HCC
• Must have histologically or cytologically confirmed diagnosis of HCC (fibrolamellar and mixed hepatocellular/cholangiocarcinoma subtypes are not eligible).
• Barcelona Clinic Liver Cancer (BCLC) Stage C disease (Llovet et al 1999), or BCLC Stage B disease.
• Subjects may have received no more than 2 lines of prior therapy for the advanced disease
• Must have progressed on, refused, or were intolerant of sorafenib.
• The following are excluded: Subjects with liver transplants, clear invasion of the bile duct or main portal branch(es), or hepatorenal syndrome, or subjects who have required esophageal variceal ablation within 28 days of starting study treatment.
• Prior PD-1 or CTLA-4 targeted therapies are excluded.
• Tumor biopsies are required. If a subject has inaccessible lesions, such as in ovarian cancer, HCC, or gastric cancer, or highly vascular lesions, such as RCC, enrollment may be considered with medical monitor approval, and archived tissue may be acceptable.
• Females of child-bearing potential and males who use adequate birth control through 120 days post dose.

Exclusion Criteria:

• Subjects who participated in any other study in which receipt of an investigational study drug or device occurred within 2 weeks or 5 half-lives (whichever is longer) prior to first dose.
• Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumab or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways). Exception: Prior anti-CTLA-4 in the adjuvant setting for subjects with melanoma would be permitted.
• Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are stable.
• Has an active autoimmune disease.
• Has evidence of noninfectious pneumonitis that required steroids or current pneumonitis.
• Live vaccine use within 30 days of first dose of study medication.
• Monoamine oxidase inhibitors.

Related Conditions & MeSH terms

• Bladder Cancer
• Carcinoma
• Carcinoma, Renal Cell
• Endometrial Cancer
• Endometrial Neoplasms
• Gastric Cancer
• Head and Neck Cancer
• Hepatocellular Carcinoma (HCC)
• Lung Cancer
• Lymphoma
• Melanoma
• Microsatellite Instability
• Microsatellite-instability (MSI) High Colorectal Cancer (CRC)
• Ovarian Cancer
• Renal Cell Carcinoma (RCC)
• Solid Tumors
• Triple Negative Breast Cancer (TNBC)
• Triple Negative Breast Neoplasms
• UC (Urothelial Cancer)

Intervention

Drug:
• MK-3475
IV infusion
• INCB024360
Oral daily dosing

Locations

Country	Name	City	State
United States	University of Michigan Hospital and Health Systems	Ann Arbor	Michigan
United States	Virginia Cancer Specialists	Arlington	Virginia
United States	Georgia Cancer Specialists affiliated with Northside Hospital Cancer Institute	Atlanta	Georgia
United States	University Of Colorado Cancer Center	Aurora	Colorado
United States	Greater Baltimore Cancer Center	Baltimore	Maryland
United States	St. Agnes Hospital Cancer Institute	Baltimore	Maryland
United States	The Center for Cancer and Blood Disorders (RCCA MD LLC- Maryland Division)	Bethesda	Maryland
United States	The University of Chicago Medicine	Chicago	Illinois
United States	The Christ Hospital Hematology Oncology, Lindner Research Center	Cincinnati	Ohio
United States	University Of Texas Southwestern Medical Center At Dallas	Dallas	Texas
United States	University of Connecticut Health Center Carole And Ray Neag Comprehensive Cancer Center	Farmington	Connecticut
United States	West Cancer Center	Germantown	Tennessee
United States	Greenville Health System Cancer Institute	Greenville	South Carolina
United States	Hackensack University Medical Center - John Theurer Cancer Center	Hackensack	New Jersey
United States	UC San Diego Moores Cancer Center	La Jolla	California
United States	The Angeles Clinic and Research Institute	Los Angeles	California
United States	Miami Cancer Institute at Baptist Health, Inc	Miami	Florida
United States	Sarah Cannon Research Institute at Tennessee Oncology	Nashville	Tennessee
United States	Fox Chase Cancer Center	Philadelphia	Pennsylvania
United States	University of Pennsylvania Hospital	Philadelphia	Pennsylvania
United States	University of Pittsburgh Medical Center Hillman Cancer Center	Pittsburgh	Pennsylvania
United States	US Davis Cancer Center	Sacramento	California
United States	Health Partners Institute	Saint Louis Park	Minnesota
United States	St. Francis Cancer Center	Topeka	Kansas

Sponsors (2)

Lead Sponsor	Collaborator
Incyte Corporation	Merck Sharp & Dohme Corp.

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Phase 1: Percentage of Participants With Treatment-Emergent Adverse Events (TEAE) and Serious Treatment-Emergent Adverse Events	An adverse event is defined as the appearance of (or worsening of any pre-existing) undesirable sign(s), symptom(s), or medical condition(s) that occur after a participant provides informed consent. A TEAE is any adverse event either reported for the first time or worsening of a pre-existing event after first dose of study drug. Serious adverse event (SAE) is defined as an event that meets 1 of the following criteria: is fatal or life threatening, results in persistent or significant disability or incapacity, constitutes a congenital anomaly or birth defect, is clinically meaningful (i.e. defined as an event that jeopardizes the participant or requires potential medical or surgical intervention to prevent 1 of the outcomes listed above) or requires inpatient hospitalization or prolongation of existing hospitalization.	Approximately 54 months
Primary	Phase 2: Objective Response Rate (ORR)	ORR was percentage of participants with best overall response [complete response (CR) or partial response (PR)], per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.	Approximately 54 months
Secondary	Phase 2: Duration of Response (DOR)	Duration of response is the time from the first overall response contributing to an objective response (complete or partial response) for DLBCL to the date of death or the date of first overall response of progressive diseasemeasured (by irRECIST for solid tumors or the Lugano Classification, whichever is earliest.	Up to 54 months
Secondary	Phase 2: Progression Free Survival (PFS)	Progression-free survival is defined as number of days from the first day of taking study drug to the earlier of death or disease progression by irRECIST v1.1 for select solid tumors and modified Lugano Classification for DLBCL.	Up to 54 months
Secondary	Phase 2: Duration of Disease Control	The duration of disease control is the time from the treatment start date to the first objective response of PD (by irRECIST v1.1 or Lugano Classification), death, or last tumor assessment date (if PD/death not present), for subjects with best overall response of SD or better.	Up to 54 months
Secondary	Phase 2: Overall Survival (OS)	Overall survival is determined from the date of first dose until death due to any cause.	Up to 54 months
Secondary	Phase 2: Ordinal Categorical Response Score	Ordinal categorical response score, determined by radiographic disease assessments per irRECIST v1.1. The 5-category ordinal response endpoint is determined at a given timepoint by classifying response into one of the following groups: 1 = Complete response per irRECIST v1.1 2 = Very good response, defined as > 60% tumor reduction 3 = Minor response, defined as > 30% to = 60% tumor reduction 4 = Stable disease per irRECIST v1.1 5 = Progressive disease per irRECIST v1.1	Up to 54 months
Secondary	Phase 2: Percentage of Participants With Treatment-Emergent Adverse Events (TEAE) and Serious Treatment-Emergent Adverse Events		Up to 54 months