Pembrolizumab with Lenvatinib versus Docetaxel for Metastatic NSCLC after Platinum Doublet Chemotherapy and Immunotherapy
- Conditions
- SCLC with squamous or nonsquamous histologyMedDRA version: 21.1Level: PTClassification code 10061873Term: Non-small cell lung cancerSystem Organ Class: 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)Therapeutic area: Diseases [C] - Cancer [C04]
- Registration Number
- EUCTR2018-003791-12-HU
- Lead Sponsor
- Merck Sharp & Dohme LLC
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 405
1. Have a histologically or cytologically confirmed diagnosis of metastatic squamous or nonsquamous NSCLC
2. Have PD on treatment with one prior an anti-PD-1/PD-L1 mAb administered either as monotherapy or in combination with other checkpoint inhibitors or other therapies. Anti- PD-1/PD-L1 treatment progression is defined by meeting ALL of the following criteria:
• Treatment with at least 2 doses of an anti-PD-1/PD-L1 mAb
• PD after an anti-PD-1/PD-L1 mAb as defined by RECIST v1.1. Evidence of PD is defined as:
- imaging prior to anti-PD-1/PD-L1 treatment or image showing nadir during anti-PD-1/PD-L1 treatment; AND
- imaging to determine that radiographic progression has occurred per RECIST 1.1 within 12 weeks (84 days) from the last dose of an anti-PD-1/PD-L1 mAb.
3. Have PD during/after platinum doublet chemotherapy for metastatic disease.
4. Have confirmation that EGFR-, ALK-, or ROS1-directed therapy is not indicated as primary therapy (documentation of absence of tumor-activating EGFR mutations [eg, DEL19 or L858R], and absence of ALK and ROS1 gene rearrangements OR presence of a K-ras mutation)
5. Have submitted prestudy imaging that confirmed evidence of PD based on investigator review of at least 2 images per RECIST 1.1, following initiation of an anti-PD-1/PD-L1 mAb
6. Have measurable disease based on RECIST 1.1 as determined by the local site assessment.
• Have at least 1 measurable lesion by CT or MRI per RECIST 1.1
7. Have provided tumor tissue for PD-L1 biomarker analysis from an archival sample (defined as: from initial diagnosis of NSCLC and prior to receiving immunotherapy [antiPD-1/PD-L1], from the primary lesion or a metastatic lesion)
8. Have provided prior to randomization tissue from a newly obtained formalin-fixed sample from a new biopsy (defined as: after completion of immunotherapy [anti-PD-1/PD-L1] and before receiving a randomization number), of a tumor lesion not previously irradiated
9. Be =18 years of age on the day of providing documented informed consent
10. Have ECOG performance status of 0 or 1 within 7 days before the first dose of study intervention but before randomization
11. Have a life expectancy of at least 3 months
12. Male participants receiving pembrolizumab ± lenvatinib or lenvatinib are eligible to participate if they agree to the following during the intervention period or 7 days after the last dose of lenvatinib:
Male participants randomized to docetaxel are eligible to participate if they agree to the following during the intervention period and for at least 180 days after the last dose of docetaxel:
• Refrain from donating sperm
PLUS either:
• Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long-term and persistent basis) and agree to remain abstinent.
OR
• Must agree to use contraception unless confirmed to be azoospermic (vasectomized or secondary to medical cause)
• Agree to use a male condom plus partner use of an additional contraceptive method when having penile-vaginal intercourse with a WOCBP who is not currently pregnant
13. A female participant is eligible to participate if she is not pregnant or breastfeeding and at least 1 of the following conditions applies:
• Is not a 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 is abstinent from heterosexual intercourse as her preferred and usual lifestyle, during the intervention perio
1. Has received docetaxel as monotherapy or in combination with other therapies
2. Has received lenvatinib as monotherapy or in combination with an anti-PD-1/PD-L1 mAb
3. Has received radiotherapy within 2 weeks before the first dose of study intervention or has received lung radiation therapy >30 Gy within 6 months before the first dose of study intervention
4. Has received a live vaccine within 30 days before the first dose of study intervention
5. Has clinically significant hemoptysis (at least 0.5 teaspoon of bright red blood) or tumor bleeding within 2 weeks before the first dose of study intervention
6. Has radiographic evidence of intratumoral cavitation, encasement, or invasion of a major blood vessel. Additionally, the degree of proximity to major blood vessels should be considered 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.
7. Has clinically significant cardiovascular impairment within 12 months of the first dose of study intervention, such as history of congestive heart failure greater than New York Heart Association Class II, unstable angina, myocardial infarction or cerebrovascular accident/transient ischemic attack (TIA)/stroke, cardiac revascularization, or cardiac arrhythmia associated with hemodynamic instability
8. Has a history of a gastrointestinal condition or procedure that, in the opinion of the investigator, may affect oral study intervention absorption
9. Has a pre-existing =Grade 3 gastrointestinal or non-gastrointestinal fistula.
10. Is a WOCBP who has a positive urine pregnancy test within 24 hours or a positive serum pregnancy test within 72 hours before randomization
11. Is currently participating in a clinical trial and receiving study therapy or participated in a study of an investigational agent within 4 weeks of the first dose of study intervention
12. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (exceeding 10 mg of prednisone or equivalent daily) or any other form of immunosuppressive therapy within 7 days before the first dose of study intervention
13. Has a known history of an additional malignancy, except if the participant has undergone potentially curative therapy with no evidence of disease recurrence for 3 years since initiation of that therapy
14. Has known active central nervous system metastases and/or carcinomatous meningitis
15. Has severe hypersensitivity (Grade =3) to pembrolizumab and/or any of its excipients
16. Has a sensitivity to any of the excipients contained in lenvatinib
17. Has a sensitivity to any of the excipients contained in docetaxel
18. Has an active autoimmune disease that has required systemic treatment in the past 2 years (ie, with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs)
19. Has a history of (noninfectious) pneumonitis that required systemic steroids or current pneumonitis/interstitial lung disease
20. Has an active infection requiring systemic therapy
21. Has a known history of human immunodeficiency virus (HIV) infection
22. Has a known history of hepatitis B (defined as hepatitis B surface antigen (HBsAg) reactive or known active hepatitis C virus (HCV) (defined as HCV RNA [qualitative] is detected) infection
23. Has a
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method