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Pembrolizumab (MK-3475) as First-Line Therapy for Advanced Merkel Cell Carcinoma

Phase 1
Conditions
nresectable Stage III and Stage IV Merkel Cell Carcinoma (MCC)
MedDRA version: 20.0 Level: LLT Classification code 10064025 Term: Merkel cell carcinoma System Organ Class: 100000004864
Therapeutic area: Diseases [C] - Cancer [C04]
Registration Number
EUCTR2018-002601-57-ES
Lead Sponsor
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
Not specified
Target Recruitment
50
Inclusion Criteria

1. Have histologically confirmed diagnosis of locoregional MCC that has recurred following standard locoregional therapy with surgery and/or radiation therapy and is not amenable to local therapy or metastatic MCC (Stage IV) as per American Joint Committee on Cancer (AJCC) 8th edition guidelines
2. Have been untreated for advanced or metastatic disease except as follows:
a. Prior intratumoral therapy will be permitted
b. Prior adjuvant or neoadjuvant therapy containing systemic chemotherapy will be permitted if treatment concluded at least 3 months prior to C1D1
c. Prior adjuvant or neoadjuvant therapy containing anti-PD-1/L1 or anti-CTLA-4 therapy will not be permitted
3. Have at least 1 measurable lesion by computed tomography (CT) or magnetic resonance imaging (MRI) per RECIST 1.1 criteria as determined by the local site investigator/radiology assessment. Measurable disease will be verified by BICR prior to treatment allocation. Lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions
4. Toxic effect(s) of the most recent prior therapy have resolved to Grade 1 or less (except alopecia). If participant received major surgery or radiation therapy of >30 Gy, they must have recovered from the toxicity and/or complications from the intervention
5. Be male or female and at least 12 years of age, at the time of signing the informed consent/assent
6. Contraceptive use by men should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies
7. Contraceptive use by women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
• A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
- Is not a woman of childbearing potential (WOCBP)
OR
- Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), with low user dependency, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis), during the intervention period and for at least 120 days (corresponding to the time needed to eliminate any study intervention) after the last dose of study intervention
- A WOCBP must have a negative highly sensitive pregnancy test (urine or serum as required by local regulations) within 72 hours before the first dose of study intervention
- If a urine test cannot be confirmed as negative (eg, an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive
8. Participant (or legally acceptable representative if applicable) provides written informed consent/assent for the study and agrees to OS data collection until the study endpoints are reached. The participant may also provide consent/assent for future biomedical research; however, the participant may participate in the main study without participating in future biomedical research
9. Have an Eastern Cooperative Oncology G

Exclusion Criteria

1. Has a known additional malignancy that is progressing or has required active treatment within the past 2 years
2. Has known active CNS metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable (ie, without evidence of progression) for at least 4 weeks by repeat imaging (note that the repeat imaging should be performed during study screening), clinically stable and without requirement of steroid treatment for at least 14 days prior to first dose of study intervention
3. 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 to C1D1
4. Has severe hypersensitivity (=Grade 3) to pembrolizumab and/or any of its excipients
5. Has an active autoimmune disease that has required systemic treatment in past 2 years
6. Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
7. Has an active infection requiring systemic therapy
8. Has a known history of human immunodeficiency virus (HIV) infection. No HIV testing is required unless mandated by local health authority
9. Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is detected) infection
10. Has a known history of active tuberculosis (TB; Bacillus tuberculosis)
11. Has clinically significant cardiac disease within 6 months of C1D1, including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability
12. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator
13. Has a known psychiatric or substance abuse disorder that would interfere with the participant’s ability to cooperate with the requirements of the study
14. Has not received standard locoregional therapy with surgery and/or radiation therapy for the treatment of local or locoregional disease
15. Has received prior therapy with an 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 (eg, CTLA-4, OX-40, CD137)
16. Has received prior systemic anticancer therapy including investigational agents within 12 weeks prior to C1D1
17. Has received radiotherapy within 2 weeks prior to start of study intervention. Participants must have recovered from all radiation-related toxicities and not require corticosteroids
18. Has received a live vaccine within 30 days prior to C1D1
19. Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks prior to C1D1
20. Is pregnant or breastfeeding or

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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