Trial comparing standard treatment (chemotherapy) with pembrolizumab Treatment in patients with advanced pretreated malignant pleural mesothelioma
- Conditions
- Advanced Malignant Pleural MesotheliomaMedDRA version: 20.0Level: LLTClassification code 10035605Term: Pleural mesothelioma malignant advancedSystem Organ Class: 100000015981Therapeutic area: Diseases [C] - Cancer [C04]
- Registration Number
- EUCTR2016-002062-31-ES
- Lead Sponsor
- ETOP (European Thoracic Oncology Platform)
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 144
- Male and female patients aged 18 years and older
- Histologically confirmed malignant pleural mesothelioma (all subtypes are eligible)
- Progressing after or on previous platinum based chemotherapy.
- Availability of tumour tissue for translational research
- ECOG performance status 0-1 (patients who capable of all self-care)
- Life expectancy of at least 3 months
- Measurable or evaluable disease according to RECIST 1.1 criteria
- Adequate haematological function (Haemoglobin =90 g/L or =5.6 mmol/L; White Blood Cells =1.0 × 109/L; Lymphocytes =0.5 g/L; Absolute neutrophils count (ANC) =1.5 × 109/L; Platelet count =100 × 109/L)
- Adequate renal function (Creatinine =1.5 × ULN OR calculated creatinine clearance =40 mL/min)
- Adequate liver function (ALT and AST =2.5 × ULN; if the patient has liver metastases, ALT and AST must be =5 × ULN)
- Women of childbearing potential, including women who had their last menstrual period in the last 2 years, must have a negative serum or urine pregnancy test within 35 days before randomisation (the test has to be repeated 72 hours before pembrolizumab treatment start).
Are the trial subjects under 18? no
Number of subjects for this age range: 0
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 142
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 142
- 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).
- Prior therapy with gemcitabine or vinorelbine.
- Known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Patients with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least 4 weeks prior to randomisation and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to randomisation. This exception does not include carcinomatous meningitis, which is excluded regardless of clinical stability.
- Known or suspected hypersensitivity to pembrolizumab or any of its excipients.
- Known unstable or unresolved surgical or chemotherapy-related toxicity that would compromise the patient’s capacity to participate in the trial.
- Previous allogeneic tissue/solid organ transplant.
- Live vaccines within 30 days prior to first dose of pembrolizumab.
- Regular intake of immune-modulating drugs (such as interferon, methotrexate).
- History of (non-infectious) pneumonitis that required steroids, evidence of interstitial lung disease (ILD) or active, non-infectious pneumonitis.
- Active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (i.e. thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) or topical therapy (e.g., steroids) for psoriasis or eczema is not considered a form of systemic treatment.
- Ongoing clinically serious infections requiring systemic antibiotic or antiviral, antimicrobial, or antifungal therapy.
- HIV infection.
- Known active hepatitis B or hepatitis C.
- Known history of active tuberculosis.
- Patients with diagnosed immunodeficiency or receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to randomisation.
- Patients with other serious diseases or clinical conditions, including but not limited to uncontrolled active infection and any other serious underlying medical condition that could affect the patient’s capacity to participate in the trial.
- Substance abuse, medical, psychological or social conditions that may interfere with the patient’s participation in the trial or evaluation of the trial results.
- Women who are pregnant or in the period of lactation.
- Sexually active men and women of childbearing potential who are not willing to use an effective contraceptive method during the trial and up to 120 days following cessation of trial treatment.
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Main Objective: To investigate whether pre-treated mesothelioma patients treated with pembrolizumab have a better outcome in terms of progression-free survival (PFS), as assessed by independent radiological review, compared to standard, institutional-choice chemotherapy (gemcitabine or vinorelbine).;Secondary Objective: To evaluate secondary measures of clinical efficacy including objective response rate (ORR), investigator assessed progression free survival (PFS), overall survival (OS), and time to treatment failure (TTF). <br><br>To assess the safety and tolerability of the treatment.;Primary end point(s): Progression-free survival according to RECIST 1.1 criteria based on independent radiological review.;Timepoint(s) of evaluation of this end point: Time from the date of randomisation until documented progression or death
- Secondary Outcome Measures
Name Time Method