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Immunologic Determinants of Response to Pembrolizumab (MK-3475) in Advanced Melanoma (MK-3475-161/KEYNOTE-161)

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ClinicalTrials.gov Identifier: NCT03407170
Recruitment Status : Recruiting
First Posted : January 23, 2018
Last Update Posted : July 18, 2018
Sponsor:
Information provided by (Responsible Party):
Merck Sharp & Dohme Corp.

Brief Summary:
In this study, participants with advanced melanoma will be treated with pembrolizumab (MK-3475) and their tumors and blood will be analyzed for changes related to pembrolizumab therapy.

Condition or disease Intervention/treatment Phase
Advanced Melanoma Biological: pembrolizumab Phase 2

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 60 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-Label, Phase II Study to Determine the Immunologic Correlates of Pembrolizumab-Mediated Tumor Regression in Subjects With Advanced Melanoma (KEYNOTE-161)
Actual Study Start Date : June 28, 2018
Estimated Primary Completion Date : December 13, 2021
Estimated Study Completion Date : December 13, 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Melanoma

Arm Intervention/treatment
Experimental: Pembrolizumab
Participants receive pembrolizumab 200 mg by intravenous (IV) infusion every 3 weeks (Q3W) for up to 24 months
Biological: pembrolizumab
200 mg by IV infusion Q3W for up to 24 months
Other Names:
  • KEYTRUDA®
  • MK-3475




Primary Outcome Measures :
  1. Mean Fraction of Cytotoxic T-lymphocytes (FCT) for Participants with Response versus Participants with Progression [ Time Frame: Up to 24 months ]
    FCT is defined as the fraction of CD8+ T-cells expressing a predefined single-cell RNA gene signature to the total tumor infiltrating CD8+T-cells isolated from tumor biopsies.

  2. Average Specific Cytotoxic T-lymphocyte Frequency Ratio (ASCTFR) for Participants with Response vs Participants with Progression [ Time Frame: Up to 24 months ]
    ASCTFR is defined as the arithmetic average of the log^10 ratio of the frequency of individual specific cytotoxic T-Cell Receptor (TCR) clones of on-treatment to pre-treatment.

  3. Change in Baseline of FCT for Participants With Response Versus Participants With Progression [ Time Frame: Baseline and Month 24 ]
    The fold change from baseline in FCT. FCT is defined as the fraction of CD8+ T-cells expressing a predefined single-cell RNA gene signature to the total tumor infiltrating CD8+T-cells isolated from tumor biopsies.


Secondary Outcome Measures :
  1. Adverse Events (AEs) [ Time Frame: Up to 27 months ]
    Number of participants experiencing an AE defined as any untoward medical occurrence in a participant administered a pharmaceutical product temporally associated with the use of study treatment, whether or not considered related to the study treatment.

  2. Treatment Discontinuations due to AEs [ Time Frame: Up to 24 months ]
    Number of participants discontinuing study drug due to an AE.

  3. Overall Response Rate (ORR) per Immune-related Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 [ Time Frame: Up to 24 months ]
    ORR is defined as the percentage of participants in the analysis population who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST Version 1.1 as assessed by the investigator.

  4. Progression-free Survival (PFS) per RECIST Version 1.1 [ Time Frame: Up to 24 months ]
    PFS is defined as the time from start of treatment to the first documented progressive disease (PD) or death due to any cause, whichever occurs first, per RECIST Version 1.1 as assessed by the investigator..

  5. Overall Survival (OS) [ Time Frame: Up to 24 months ]
    OS is defined as the time from the start of treatment to death due to any cause.

  6. Neoepitope Burden [ Time Frame: Up to 24 months ]
    Neoepitope sequencing will be generated based on single cell RNA sequencing (scRNAseq), whole exome sequencing, and an epitope prediction algorithm to obtain neoepitope burden.

  7. Antigenic Determinants of Highly-functional CD8 + T-cell Clones [ Time Frame: Up to 24 months ]
    TCRs from CD8+ T-cell clones will be identified by scRNAseq and their killing function will be confirmed by TCR-transduced T-cells recognizing autologous tumor-derived cell lines.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Has a histologically confirmed diagnosis of unresectable stage III or metastatic melanoma not amenable to local therapy
  • Has testing for a BRAF mutation prior to study entry
  • Has measurable disease per RECIST 1.1 as assessed by the investigator/radiology
  • Has resolution of toxic effect(s) of the most recent prior chemotherapy to Grade 1 or less (except alopecia). If the participant received major surgery or radiation therapy of >30 Gray units, they must have recovered from the toxicity and/or complications from the intervention
  • Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 10 days of study start
  • Is not pregnant or breastfeeding
  • Female participants of child-bearing potential must be willing to use effective contraception starting with the screening visit through 120 days after the last dose of study therapy

Exclusion Criteria:

  • Has disease that is suitable for local therapy administered with curative intent
  • Has a history of interstitial lung disease
  • Has a positive pregnancy test within 72 hours before the first dose of study therapy
  • Has received prior therapy with an anti-Programmed Cell Death Protein 1 (PD-1), anti-Programmed Cell Death-Ligand 1 (PD-L1), anti-Programmed Cell Death-Ligand 2 (PD-L2) agent or with an agent directed to another stimulatory or co-inhibitory T-cell receptor (eg, CTLA-4, OX-40, CD137)
  • Has received prior systemic anti-cancer therapy including investigational agents within 4 weeks prior to study start
  • Has received prior radiotherapy within 2 weeks of start of study therapy
  • Has received a live vaccine within 30 days prior to the first dose of study therapy
  • Has received transfusion of blood products (including platelets or red blood cells) or administration of colony stimulating factors (including granulocyte colony stimulating factor [G-CSF], granulocyte macrophage colony stimulating factor [GMCSF] or recombinant erythropoietin) within 4 weeks prior to study start
  • 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 the first dose of study therapy
  • Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior the first dose of study therapy
  • Has a known additional malignancy that is progressing or has required active treatment within the past 3 years with the exception of basal cell and squamous cell carcinoma of the skin, transitional cell carcinoma of urothelial cancer, or carcinoma in situ (eg, breast carcinoma, cervical cancer in situ) that have undergone potentially curative therapy
  • Has known active CNS metastases and/or carcinomatous meningitis
  • Has severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its excipients
  • Has an active autoimmune disease that has required systemic treatment in past 2 years
  • Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
  • Has an active infection requiring systemic therapy
  • Has a known history of human immunodeficiency virus (HIV) infection
  • 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
  • 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
  • Has known psychiatric or substance abuse disorders that would interfere with cooperating with the requirements of the study
  • Is pregnant or breastfeeding or expecting to conceive or father children starting with the screening visit through 120 days after the last dose of study therapy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03407170


Contacts
Contact: Toll Free Number 1-888-577-8839 Trialsites@merck.com

Locations
United States, Massachusetts
Massachusetts General Hospital ( Site 0102) Recruiting
Boston, Massachusetts, United States, 02114
Contact: Study Coordinator    617-724-4800      
Dana Farber Cancer Institute ( Site 0101) Recruiting
Boston, Massachusetts, United States, 02215
Contact: Study Coordinator    617-582-9992      
Sponsors and Collaborators
Merck Sharp & Dohme Corp.
Investigators
Study Director: Medical Director Merck Sharp & Dohme Corp.

Responsible Party: Merck Sharp & Dohme Corp.
ClinicalTrials.gov Identifier: NCT03407170     History of Changes
Other Study ID Numbers: 3475-161
MK-3475-161 ( Other Identifier: Merck Protocol Number )
First Posted: January 23, 2018    Key Record Dates
Last Update Posted: July 18, 2018
Last Verified: July 2018

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Merck Sharp & Dohme Corp.:
Programmed Cell Death-1 (PD-1)
PD1
Programmed Cell Death-Ligand 1 (PD-L1)
Programmed Cell Death-Ligand 2 (PD-L2)
PDL1
PDL2

Additional relevant MeSH terms:
Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas
Pembrolizumab
Antineoplastic Agents