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A phase II study of lenvatinib (E7080/MK-7902) in combination with carboplatin pemetrexed and pembrolizumab (MK-3475) for patients with pretreated advanced non-squamous non-small cell lung cancer harboring EGFR mutations

Phase 2
Conditions
Advanced non-squamous non-small cell lung cancer harboring EGFR mutations
Registration Number
JPRN-jRCT2031220147
Lead Sponsor
Takahashi Kazuhisa
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
30
Inclusion Criteria

1.Have a histologically or cytologically confirmed diagnosis of incurable Stage IIIB, IIIC, IVA, IVB (American Joint Committee on Cancer [AJCC], version 8) non-squamous NSCLC. Postoperative recurrence is acceptable if the disease is not curable.
2.Have documentation of tumor activating EGFR mutation, specifically either exon 19 deletion or exon 21 L858R.
3.Have investigator determined radiographic disease progression per RECIST 1.1 after treatment with EGFR-TKI therapy.
4.Have measurable disease per RECIST 1.1.
5.Be male or female >=20 years of age inclusive, at the time of signing the informed consent form (ICF).
6.Have a life expectancy of at least 3 months.
7.Have an ECOG performance status of 0 or 1 within 7 days prior to the first dose of study intervention but before registration.
8.A male participant must agree to use a contraception during the treatment period.
9.A female participant is eligible to participate if she is not pregnant , not breastfeeding.
10.The participant provides written informed consent for the study.
11.Have adequate organ function.
12.Have adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP<=150/90 mmHg and no change in antihypertensive medications within 1 week prior to registration.

Exclusion Criteria

1.Has known untreated central nervous system (CNS) metastases and/or carcinomatous meningitis. Participants with previously treated brain metastases may participate provided they are radiologically stable, clinically stable, and have not required steroids for at least 14 days prior to the first dose of study intervention.
2.Has history of (noninfectious) pneumonitis that required systemic steroids or current pneumonitis/interstitial lung disease.
3.Radiographic evidence of intratumoral caviations, encasement, or invasion of a major blood vessel. Additionally, the degree of proximity to major blood vessels should be considered because for exclusion because of the potential risk of severe hemorrhage associated with tumor shrinkage/necrosis after lenvatinib therapy (in the chest, major blood vessels include the main pulmonary artery, the left and right pulmonary arteries, the 4 major pulmonary veins, the superior or inferior vena cava, and the aorta).
4.Has a known history of an additional malignancy, except if the participant has undergone potentially curative therapy with no evidence of that disease of that disease recurrence for at least 3 year since initiation of that therapy.
5.Has an autoimmune disease that has required systemic treatment in the past 2 years (ie, with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is allowed.
6.Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (doses exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior the first dose of study intervention.
7.Has had an allogeneic tissue/solid organ transplant.
8.Has a known history of human immunodeficiency virus (HIV) infection. HIV testing is not required unless mandated by the local health authority.
9.Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg] reactive or HBV-DNA detected) or known active Hepatitis C virus (HCV antibody reactive).
10.Has a history of a gastrointestinal condition or procedure that in the opinion of the investigator may affect oral drug absorption.
11.Has active hemoptysis (at least 0.5 tsp of bright red blood) within 2 weeks prior to the first dose of study intervention.
12.Has significant cardiovascular impairment within 12 months prior to the first dose of study intervention, including history of congestive heart failure greater than New York Heart Association (NYHA) Class II, unstable angina, myocardial infarction, cerebrovascular accident (CVA)/stroke, or cardiac arrhythmia associated with hemodynamic instability.
13.Has a known history of active tuberculosis.
14.Has an active infection requiring systemic therapy.
15.Has had major surgery within 3 weeks prior to first dose of study interventions.
16.Has known psychiatric or substance abuse disorders that would interfere with the participant's cooperation to meet with the requirements of the study.
17.Previously had a severe hypersensitivity reaction to treatment with a monoclonal antibody or has s known sensitivity to any component of lenvatinib or pembrolizumab, or as applicable, carboplatin, or pemetrexed.
18.A women of childbearing potential (WOCBP) who has a positive urine pregnancy test within 72 hours prior to registration. If the urine test is positive or cannot be confirmed as neg

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Objective Response Rate (by central imaging review committee)
Secondary Outcome Measures
NameTimeMethod
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