A Study of mRNA-5671/V941 as Monotherapy and in Combination With Pembrolizumab (V941-001)

Neoplasms Clinical Trial

Official title:

A Phase 1, Open-Label, Multicenter Study to Assess the Safety and Tolerability of mRNA-5671/V941 as a Monotherapy and in Combination With Pembrolizumab in Participants With KRAS Mutant Advanced or Metastatic Non-Small Cell Lung Cancer, Colorectal Cancer or Pancreatic Adenocarcinoma

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03948763
• Other study ID #: V941-001
• Secondary ID: V941-001
• Status: Completed
• Phase: Phase 1
• Start date: June 26, 2019
• Est. completion date: August 25, 2022

Study information

• Verified date: September 2022
• Source: Merck Sharp & Dohme LLC
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study will determine the safety and tolerability and establish a preliminary recommended Phase 2 dose of V941(mRNA-5671/V941) as a monotherapy and in combination with pembrolizumab infusion.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 70
• Est. completion date: August 25, 2022
• Est. primary completion date: August 25, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

Part 2 Only

• Has a histologically confirmed advanced or metastatic non-small cell lung cancer (NSCLC), non-mismatch repair deficient/microsatellite instability-high tumors colorectal cancers (non-MSI-H CRC), or pancreatic adenocarcinoma, and confirmed HLA types HLA-A11:01 and/or HLA C08:02 (and/or potentially other additional HLA types to be specified).

NSCLC: Participants must have been tested for mutations affecting EGFR and/or anaplastic lymphoma kinase (ALK). Participants with ALK or epidermal growth factor receptor (EGFR)-positive NSCLC must have had recurrent or progressive disease (PD) after treatment with the corresponding inhibitor and current standard of care, in any sequence.

Non-MSI-H CRC: Participant tumors must have been locally tested for MSI and have been found to be non-MSI-H.

All

• Has a histologically confirmed advanced or metastatic KRAS 4MUT+ (G12D, G12V, G13D or G12C) (4 prevalent KRAS mutant antigens in solid tumors) solid tumor identified by local laboratory testing, and who have received, or been intolerant to, or ineligible for all treatment known to confer clinical benefit.

• A male participant must agree to use study-approved contraception during the treatment period and for at least 120 days after the last dose of study intervention and refrain from donating sperm during this period.

• A female participant was not be pregnant, not breastfeeding, and at not be a woman of childbearing potential (WOCBP) OR if a WOCBP, agrees to follow study-approved contraceptive guidance during treatment period and for at least 120 days after the last dose of study intervention.

• Have measurable disease per RECIST 1.1 as assessed by the local site investigator/radiology. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.

• For Part 1 only: Cutaneous lesions can be considered in addition to imaging, but measurable disease should be defined by radiologic assessment.

• Have an evaluable archival tumor sample to submit for analysis. Formalin-fixed, paraffin embedded (FFPE) tissue blocks are preferred to slides.

• Have adequate organ function

• Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale.

Exclusion Criteria:

• A WOCBP who has a positive urine pregnancy test within 72 hours prior to randomization or treatment allocation

• Has an active infection requiring therapy.

• Has a history of interstitial lung disease.

• Has an active autoimmune disease that has required systemic treatment in the past 2 years (ie, with use of disease modifying agents, corticosteroids, or immunosuppressive drugs) except vitiligo or resolved childhood asthma/atopy.

• Has not fully recovered from any effects of major surgery or has evidence of detectable infection. Surgeries that required general anesthesia must be completed at least 2 weeks before first study treatment administration. Surgery requiring regional/epidural anesthesia must be completed at least 72 hours before first study treatment administration and participants should be recovered.

• Has had chemotherapy, definitive radiation, or biological cancer therapy within 4 weeks (2 weeks for palliative radiation) prior to the first dose of study therapy, non-cytotoxic small molecule therapeutics within 5 half-lives (or 2 weeks, whichever is longer) prior to the first dose of study treatment, or has not recovered to Common Toxicity Criteria for Adverse Events (CTCAE) Grade 1 or better from any adverse events that were due to cancer therapeutics administered more than 4 weeks earlier (this includes participants with previous immunomodulatory therapy with residual immune-related adverse events).

• Has received a live-virus vaccine within 30 days of planned treatment start. Seasonal flu vaccines that do not contain live virus are permitted.

• Has received hematopoietic colony-stimulating growth factors (eg, granulocyte-colony stimulating factor, granulocyte-macrophage-colony stimulating factor, macrophage colony stimulating factor) within 2 weeks prior to the first dose of study intervention.

• Discontinued from therapy with an anti-programmed cell death protein 1 (anti-PD-1), anti-PD-L1, or anti-PD-L2 agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (TCR; eg, cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), CD137 (4-1BB, Tumor necrosis factor-receptor superfamily 9 [TNFSF9]), and OX 40 (TNFRSF4), due to a Grade 3 or higher immune-related adverse event (irAE).

• Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 28 days prior to the first dose of study intervention.

• Has a 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 the first dose of study drug.

• Has a known additional malignancy that is progressing or has required active treatment within the past 2 years.

• Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.

• Has severe hypersensitivity (=Grade 3) to pembrolizumab and/or any of its excipients.

• Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis.

• Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active Hepatitis C virus (defined as HCV ribonucleic acid (RNA) [qualitative] is detected) infection.

• Has a known history of HIV.

• Has a known psychiatric or substance abuse disorder that would interfere with cooperating with the requirements of the study.

• Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study intervention.

• Has had an allogenic tissue/solid organ transplant.

Related Conditions & MeSH terms

• Carcinoma, Non-Small-Cell Lung
• Colorectal Neoplasms
• Neoplasms
• Pancreatic Neoplasms

Intervention

Biological:
• V941
V941 administered IM, Q3W for 9 3-week cycles
• Pembrolizumab
Pembrolizumab 200 mg, IV for 35 3-week cycles

Locations

Country	Name	City	State
Australia	Southern Oncology Clinical Research Unit SOCRU ( Site 6002)	Bedford Park	South Australia
Australia	Monash Health-Monash Medical Centre ( Site 6001)	Clayton	Victoria
Australia	Kinghorn Cancer Centre ( Site 6000)	Darlinghurst	New South Wales
Hong Kong	Prince of Wales Hospital ( Site 2002)	Hong Kong
Hong Kong	Queen Mary Hospital ( Site 2001)	Hong Kong
Korea, Republic of	Seoul National University Hospital ( Site 0801)	Seoul
Korea, Republic of	Severance Hospital ( Site 0800)	Seoul
Korea, Republic of	Asan Medical Center ( Site 0802)	Songpagu	Seoul
New Zealand	Auckland City Hospital ( Site 6500)	Auckland
New Zealand	New Zealand Clinical Research (Christchurch) ( Site 6501)	Christchurch	Canterbury
Singapore	National Cancer Centre Singapore ( Site 3005)	Singapore	Central Singapore
Singapore	National University Hospital ( Site 3006)	Singapore	Central Singapore
Singapore	Tan Tock Seng Hospital ( Site 3007)	Singapore	Central Singapore
Taiwan	National Cheng Kung University Hospital ( Site 4002)	Tainan
Taiwan	National Taiwan University Hospital ( Site 4000)	Taipei
Taiwan	Taipei Veterans General Hospital ( Site 4001)	Taipei
United States	Dana-Farber Cancer Institute (Boston) ( Site 1007)	Boston	Massachusetts
United States	City of Hope ( Site 1002)	Duarte	California
United States	Banner MD Anderson Cancer Center ( Site 1008)	Gilbert	Arizona
United States	Comprehensive Cancer Centers of Nevada ( Site 1012)	Las Vegas	Nevada
United States	Tennessee Oncology Nashville Drug Development Unit ( Site 7000)	Nashville	Tennessee
United States	Smilow Cancer Hospital at Yale New Haven ( Site 1005)	New Haven	Connecticut
United States	START San Antonio ( Site 1004)	San Antonio	Texas
United States	University of California at San Francisco ( Site 1006)	San Francisco	California
United States	Northwest Medical Specialties, PLLC ( Site 1001)	Tacoma	Washington
United States	Baylor Scott & White Medical Center - Temple ( Site 1009)	Temple	Texas

Sponsors (1)

Lead Sponsor	Collaborator
Merck Sharp & Dohme LLC

Countries where clinical trial is conducted

United States,  Australia,  Hong Kong,  Korea, Republic of,  New Zealand,  Singapore,  Taiwan, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	T-cell receptor (TCR)	T-cell receptor (TCR) clonality and diversity in the periphery and tumor.	Up to approximately 24 months
Primary	Dose-Limiting Toxicities (DLTs)	The following toxicities graded for severity using NCI Common Terminology for Adverse Events (CTCAE), Version 4.0 will be considered a DLT if judged by the investigator to be possibly related to study investigational products: 1) Grade 4 nonhematologic toxicity (ie. not a laboratory finding). 2) Grade 4 hematologic toxicity lasting = 7 days, except thrombocytopenia: 3) Grade 4 thrombocytopenia of any duration 4) Grade 3 thrombocytopenia associated with clinically significant bleeding 5) Any nonhematologic AE = Grade 3 in severity, with some exceptions 6) Any Grade 3 or Grade 4 nonhematologic laboratory value that meets one of the study criteria 7) Febrile neutropenia Grade 3 or Grade 4 8) Prolonged delay (> 2 weeks) in initiating Cycle 2 due to treatment-related toxicity. 9) Any treatment-related toxicity that causes the participant to discontinue treatment during Cycle 1. 10) Grade 5 toxicity 11) Any other clinically significant toxicity judged to be a DLT by the investigator.	Cycle 1 (Up to 21 days)
Primary	Number of Participants Who Experienced an Adverse Event (AE)	An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study. The number of participants who experienced an AE will be reported.	Up to approximately 25 months
Primary	Number of Participants Who Discontinued Study Treatment Due to an AE	An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study. The number of participants who discontinued study treatment due to an AE will be reported.	Up to approximately 24 months
Secondary	Objective Response Rate (ORR)	ORR is assessed by the investigator based on Response Rate Assessed by Modified Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1) and RECIST for immune-based therapeutics (iRECIST) following administration of V941 in combination with pembrolizumab. Objective response is a confirmed complete response (CR) or partial response (PR).	Up to approximately 24 months
Secondary	Mutant KRAS Specific T cells	Presence of and changes in the quantity of mutant KRAS specific T cells in the blood.	Up to approximately 24 months

External Links

•   Merck Oncology Clinical Trials Information