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Belzutifan/MK-6482 for the Treatment of Advanced Pheochromocytoma/Paraganglioma (PPGL), Pancreatic Neuroendocrine Tumor (pNET), Von Hippel-Lindau (VHL) Disease-Associated Tumors, Advanced Gastrointestinal Stromal Tumor (wt GIST), or Solid Tumors With HIF-2a Related Genetic Alterations (MK-6482-015)

Phase 2
Recruiting
Conditions
Pheochromocytoma/Paraganglioma
Pancreatic Neuroendocrine Tumor
Von Hippel-Lindau Disease
Advanced Gastrointestinal Stromal Tumor
HIF-2a Mutated Cancers
Registration Number
NCT04924075
Lead Sponsor
Merck Sharp & Dohme LLC
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting
Sex
All
Target Recruitment
322
Inclusion Criteria

Inclusion Criteria:<br><br>Cohort A1: Pheochromocytoma/Paraganglioma (PPGL)<br><br> - Has documented histopathological diagnosis (local report) of pheochromocytoma or<br> paraganglioma Note: Participants are allowed to receive therapy in first line where<br> a satisfactory treatment option does not exist and if participants are not<br> candidates for systemic chemotherapy or have refused such therapy. There is no limit<br> on number of prior systemic therapies.<br><br>Locoregional therapies or adjuvant/neoadjuvant therapies are not considered a line of<br>prior systemic therapy<br><br> - Has locally advanced or metastatic disease that is not amenable to surgery or<br> curative intent treatment<br><br> - Has adequately controlled blood pressure defined as blood pressure =150/90 mm Hg<br> (=135/85 mm Hg for adolescents) and with no change in antihypertensive medications<br> (for participants with concomitant hypertension) for at least 2 weeks prior to start<br> of study treatment.<br><br>Cohort A2: Pancreatic Neuroendocrine Tumor (pNET)<br><br> - Has documented histopathological or cytopathological diagnosis (local report) of<br> well-differentiated, low, or intermediate grade (G1 or G2 pNET per 2017 World Health<br> Organization (WHO) classification and grading) pNET.<br><br> - Has locally advanced disease or metastatic disease that is:<br><br> 1. Not amenable for surgery, radiation, locoregional therapies or combination<br> modality of such treatments with curative intent.<br><br> 2. Experienced disease progression on or after at least 1 line of prior systemic<br> therapy that includes an approved targeted agent such as everolimus or<br> sunitinib. Participants who have received >3 prior systemic therapies will be<br> capped to =20% of the cohort.<br><br>Note: Chemoembolization/radiofrequency ablation/locoregional therapies,<br>neoadjuvant/adjuvant treatments, or somatostatin analog monotherapy or interferon<br>monotherapy will not count as 1 line of prior systemic therapy.<br><br>Cohorts A1, A2 and PPGL/pNET participants from Cohort D<br><br> - Has disease progression within the past 12 months from Screening.<br><br> - Has measurable disease per RECIST 1.1 by computed tomography (CT) or magnetic<br> resonance imaging (MRI) as assessed by local site investigator/radiology assessment<br> and verified by BICR.<br><br> 1. Irradiated lesions or lesions treated with locoregional therapies should not be<br> used as target lesions unless they clearly demonstrate growth since completion<br> of radiation.<br><br> 2. Metastatic lesions situated in the brain are not considered measurable and<br> should be considered nontarget lesions.<br><br> 3. Only lesions of the primary indication for the cohort may be evaluated for<br> measurability; other neoplastic lesions will be documented by the investigator<br> and this information provided to the independent reviewers to ensure that such<br> lesions are not included in the RECIST assessment.<br><br> 4. Participants who are adolescents (12-17 years of age) need to have a body<br> weight of 40 kilograms (kg) or more.<br><br>Cohort B1: von Hippel-Lindau (VHL) Disease-Associated Tumors<br><br> - Have a diagnosis of VHL disease as determined by a germline test (documented<br> germline VHL gene alteration) locally and/or clinical diagnosis.<br><br> - Have at least 1 measurable PPGL or pNET per RECIST 1.1 by CT or MRI as assessed by<br> local site investigator/radiology assessment and verified by BICR.<br><br> - Participants from China or Japan defined as participants of Chinese or Japanese<br> origin residing in mainland China or Japan respectively at the time of Screening,<br> must have at least 1 measurable RCC or PPGL or pNET per RECIST 1.1 as assessed by<br> local site investigator/radiology assessment and verified by BICR.<br><br> - Must be =18 years of age.<br><br>For Cohort B1 participants with PPGL<br><br> - Must not have pheochromocytoma >5 cm or paraganglioma >4 cm that requires immediate<br> surgery.<br><br> - Have adequately controlled blood pressure defined as blood pressure =150/90 mm Hg<br> and with no change in antihypertensive medications (for participants with<br> concomitant hypertension) for at least 2 weeks prior to start of study treatment.<br><br> - Must not have Metastatic or locally advanced, unresectable PPGL.<br><br> - Presence of concomitant VHL disease-associated tumors is permitted as long as they<br> do not require immediate surgery or intervention.<br><br>For Cohort B1 participants with pNET:<br><br> - Must not have lesion(s) located in the head of the pancreas must be >2 cm that<br> requires immediate surgery.<br><br> - Must not have lesion(s) located in the body or tail of the pancreas must be >3 cm<br> that requires immediate surgery.<br><br> - Must not have locally advanced, unresectable or metastatic pNET.<br><br> - Presence of concomitant VHL disease-associated tumors is permitted as long as they<br> do not require immediate surgery or intervention.<br><br>For Cohort B1 participants with renal cell carcinoma (RCC):<br><br> - Must not have lesion(s) >3 cm that requires immediate surgery.<br><br> - Must not have metastatic RCC.<br><br> - Presence of concomitant VHL disease-associated tumors is permitted as long as they<br> do not require immediate surgery or intervention.<br><br>For Cohort C participants with GIST (wt):<br><br> - Has documented histopathological diagnosis of GIST.<br><br> - Local test report documenting the absence of sensitizing mutations in both platelet<br> derived growth factor receptor alpha (PDGFRA) and receptor tyrosine kinase (c-KIT).<br><br> - Has locally advanced or metastatic disease that is not amenable to surgery or<br> curative intent treatment.<br><br>For Cohort D participants with advanced solid tumors with HIF-2a related genetic<br>alterations:<br><br> - Local test report documenting germline or somatic mutations in at least one of the<br> HIF-2a related genes.<br><br> - Has locally advanced or metastatic solid tumor that is not amenable to surgery or<br> curative intent treatment.<br><br> - Has progressed on/after standard therapy for advanced/metastatic disease.<br><br> - Male participants are eligible to participate if they agree to the following during<br> the intervention period and for at least 7 days after the last dose of study<br> intervention:<br><br> 1. Be abstinent from heterosexual intercourse as their preferred and usual<br> lifestyle (abstinent on a long-term and persistent basis) and agree to remain<br> abstinent OR<br><br> 2. Must agree to use contraception unless confirmed to be azoospermic<br> (vasectomized or secondary to medical cause as detailed below:<br><br> i. Agree to use a male condom plus partner use of an additional contraceptive method<br> when having penile-vaginal intercourse with a woman/women of childbearing potential<br> (WOCBP) who is not currently pregnant. Note: Men with a pregnant or breastfeeding<br> partner must agree to remain abstinent from penile-vaginal intercourse or use a male<br> condom during each episode of penile-vaginal penetration.<br><br> - A female participant is eligible to participate if she is not pregnant or<br> breastfeeding, and at least one of the following conditions applies:<br><br> 1. Is not a WOCBP OR<br><br> 2. Is a WOCBP and using a contraceptive method that is highly effective (with a<br> failure rate of <1% per year), or be abstinen

Exclusion Criteria

Not provided

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (ORR) as Assessed by Blinded Independent Central Review (BICR)
Secondary Outcome Measures
NameTimeMethod
Duration of Response (DOR) as Assessed by BICR;Time to Response (TTR) as Assessed by BICR;Disease Control Rate (DCR) as Assessed by BICR;Progressive Free Survival (PFS) as Assessed by BICR;Overall Survival (OS);Number of Participants Experiencing Adverse Events (AEs);Number of Participants Discontinuing Study Drug due to an AE;Time to Surgery (TTS)
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