A Study of Combination Therapies With or Without Pembrolizumab (MK-3475) and/or Chemotherapy in Participants With Advanced Esophageal Cancer (MK-3475-06A)
- Conditions
- Esophageal Squamous Cell Carcinoma (ESCC)
- Interventions
- Registration Number
- NCT05342636
- Lead Sponsor
- Merck Sharp & Dohme LLC
- Brief Summary
This is a phase I/II multicenter, open-label umbrella platform study that will evaluate the safety and efficacy of investigational agents with pembrolizumab, plus chemotherapy or lenvatinib, for the treatment of participants with advanced esophageal cancer who have failed 1 prior line of therapy and have not been previously exposed to programmed cell death 1 protein (PD-1)/ programmed cell death ligand 1 (PD-L1) based treatment.
With protocol amendment 5 (effective: 17-November-2023), enrollment in study arms "Pembrolizumab plus MK-4830 plus Chemotherapy" and "Pembrolizumab plus MK-4830 plus lenvatinib" is discontinued.
- Detailed Description
The master protocol is MK-3475-U06.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 120
- Histologically or cytologically confirmed diagnosis of metastatic or locally advanced unresectable ESCC
- Has experienced investigator documented radiographic or clinical disease progression on one prior line of standard therapy.
- Has an evaluable baseline tumor sample (newly obtained or archival) for analysis
- Has adequately controlled blood pressure (BP) with or without antihypertensive medications
- Participants who have adverse events (AEs) due to previous anticancer therapies must have recovered to ≤Grade 1 or baseline. Participants with endocrine-related AEs who are adequately treated with hormone replacement or participants who have ≤Grade 2 neuropathy are eligible
- Direct invasion into adjacent organs such as the aorta or trachea
- Has experienced weight loss >10% over approximately 2 months prior to first dose of study therapy
- Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration
- Diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study medication
- Known additional malignancy that is progressing or has required active treatment within the past 3 years, except basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ that has undergone potentially curative therapy
- Known active central nervous system (CNS) metastases and/or carcinomatous meningitis
- Active autoimmune disease that has required systemic treatment in past 2 years
- History of human immunodeficiency virus (HIV) infection
- History of Hepatitis B or known active Hepatitis C virus infection
- History of allogenic tissue/solid organ transplant
- Clinically significant cardiovascular disease within 12 months from first dose of study intervention
- Participants with known gastrointestinal (GI) malabsorption or any other condition that may affect the absorption of lenvatinib
- Has risk for significant GI bleeding, such as:
- Has had a serious nonhealing wound, peptic ulcer, or bone fracture within 28 days prior to allocation/randomization
- Has significant bleeding disorders, vasculitis, or has had a significant bleeding episode from the GI tract within 12 weeks prior to allocation/randomization
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Pembrolizumab plus MK-4830 plus Chemotherapy MK-4830 Participants will receive pembrolizumab intravenously plus MK-4830 plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus MK-4830 plus lenvatinib Pembrolizumab Participants will receive pembrolizumab intravenously plus MK-4830 plus lenvatinib orally at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus chemotherapy Irinotecan Participants will receive pembrolizumab intravenously plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Coformulation Favezelimab/Pembrolizumab plus Chemotherapy Coformulation favezelimab/pembrolizumab Participants will receive coformulation of favezelimab/pembrolizumab administered intravenously plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus MK-4830 plus lenvatinib MK-4830 Participants will receive pembrolizumab intravenously plus MK-4830 plus lenvatinib orally at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus chemotherapy Paclitaxel Participants will receive pembrolizumab intravenously plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Coformulation Favezelimab/Pembrolizumab plus Chemotherapy Irinotecan Participants will receive coformulation of favezelimab/pembrolizumab administered intravenously plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Coformulation Favezelimab/Pembrolizumab plus Chemotherapy Paclitaxel Participants will receive coformulation of favezelimab/pembrolizumab administered intravenously plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus MK-4830 plus Chemotherapy Irinotecan Participants will receive pembrolizumab intravenously plus MK-4830 plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus MK-4830 plus Chemotherapy Paclitaxel Participants will receive pembrolizumab intravenously plus MK-4830 plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus MK-4830 plus lenvatinib Lenvatinib Participants will receive pembrolizumab intravenously plus MK-4830 plus lenvatinib orally at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus chemotherapy Pembrolizumab Participants will receive pembrolizumab intravenously plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years. Pembrolizumab plus MK-4830 plus Chemotherapy Pembrolizumab Participants will receive pembrolizumab intravenously plus MK-4830 plus chemotherapy (investigator's choice of irinotecan or paclitaxel) at specified doses on specified days for a total treatment duration of up to approximately 2 years.
- Primary Outcome Measures
Name Time Method Number of Participants Who Discontinue Study Treatment Due to an AE During Safety Lead-in Phase Up to approximately 3 weeks An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Number of Participants Experiencing a Dose-limiting Toxicity (DLT) During Safety Lead-in Phase Up to approximately 3 weeks A DLT is defined as any drug-related adverse event (AE) according to the National Cancer Institute Common Terminology for Adverse Events (NCI CTCAE) Version 5.0, observed during the DLT evaluation period that results in a change to a given dose or a delay in initiating the next cycle.
Number of Participants Experiencing an Adverse Event (AE) During Safety Lead-in Phase Up to approximately 3 Weeks An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Objective Response Rate (ORR) Up to approximately 40 months ORR is defined as the percentage of participants with Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1). The percentage of participants who experience CR or PR as assessed by Blinded Independent Central Review (BICR) will be presented.
- Secondary Outcome Measures
Name Time Method Duration of Response (DOR) Up to approximately 40 months For participants who demonstrate a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until progressive disease (PD) or death. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. DOR as assessed by BICR will be presented.
Number of Participants Experiencing at Least One Adverse Event (AE) During the Efficacy Phase Up to approximately 40 months An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Number of Participants Who Discontinue Study Treatment Due to An AE During the Efficacy Phase Up to approximately 104 weeks An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Progression-Free Survival (PFS) Up to approximately 40 months PFS is defined as the time from allocation to the first documented progressive disease (PD) as assessed by RECIST 1.1 or death due to any cause, whichever occurs first. PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. PFS as assessed by BICR will be presented.
Overall Survival (OS) Up to approximately 40 months OS is defined as the time from the date of allocation to death from any cause.
Trial Locations
- Locations (46)
Liga Norte Riograndense Contra o Câncer ( Site 2303)
🇧🇷Natal, Rio Grande Do Norte, Brazil
Hospital Nossa Senhora da Conceição ( Site 2301)
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
ICESP - INSTITUTO DO CÂNCER DO ESTADO DE SÃO PAULO ( Site 2300)
🇧🇷São Paulo, Sao Paulo, Brazil
FALP-UIDO ( Site 2400)
🇨🇱Santiago, Region M. De Santiago, Chile
Clínica las Condes ( Site 2403)
🇨🇱Santiago, Region M. De Santiago, Chile
Centre Hospitalier Régional Universitaire de Brest - Hôpital Morvan ( Site 1104)
🇫🇷Brest, Finistere, France
Hopital Claude Huriez - CHU de Lille ( Site 1100)
🇫🇷Lille, Nord, France
Pitie Salpetriere University Hospital ( Site 1102)
🇫🇷Paris, Orne, France
Institut für Klinisch Onkologische Forschung-Klink für Onkologie und Hämatologie ( Site 2801)
🇩🇪Frankfurt, Hessen, Germany
Universitaetsklinikum Duesseldorf ( Site 2802)
🇩🇪Düsseldorf, Nordrhein-Westfalen, Germany
Scroll for more (36 remaining)Liga Norte Riograndense Contra o Câncer ( Site 2303)🇧🇷Natal, Rio Grande Do Norte, Brazil