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Lenvatinib and Pembrolizumab Simultaneous Combination Study (Lenva+Pembro)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT03609359
Recruitment Status : Completed
First Posted : August 1, 2018
Last Update Posted : April 26, 2021
Merck Sharp & Dohme LLC
Eisai Co., Ltd.
Information provided by (Responsible Party):
Kohei Shitara, National Cancer Center Hospital East

Brief Summary:
The efficacy and safety of the use of pembrolizumab in combination with lenvatinib.

Condition or disease Intervention/treatment Phase
Advanced Gastric Cancer Drug: Lenvatinib Drug: Pembrolizumab Phase 2

Detailed Description:

In this study, if combination therapy with lenvatinib and pembrolizumab in patients with gastric cancer is judged to be effective, a prospective treatment regimen can be expected for a larger number of participating subjects.

The anticipated disadvantages include any adverse events associated with lenvatinib and pembrolizumab. To minimize the risk and disadvantages of adverse events, the data center together with the Data and Safety Monitoring Committee will monitor any adverse events in the present trial to determine whether or not they are within the expected range. These bodies will also conduct a thorough examination in the event that serious or unexpected adverse events occur, and adopt an appropriate system to take any necessary actions.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 29 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open Label Phase 2 Study to Evaluate the Safety and Efficacy of Lenvatinib With Pembrolizumab in Patients With Advanced Gastric Cancer
Actual Study Start Date : October 15, 2018
Actual Primary Completion Date : March 25, 2019
Actual Study Completion Date : April 1, 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Stomach Cancer

Arm Intervention/treatment
Experimental: Lenvatinib + Pembrolizumab
Lenvatinib and Pembrolizumab will be administrated simultaneously for advanced gastric cancer patients.
Drug: Lenvatinib
Lenvatinib will be administered with water orally once a day (with or without food) in 21-day cycles at approximately the same time each day. On Day 1 of each cycle, in case concomitantly administered, it will be administered approximately within 1 hour after completion of pembrolizumab administration.
Other Name: E7080

Drug: Pembrolizumab
Pembrolizumab will be administered as a dose of 200 mg as a 30-minute IV infusion, Q3W (25 minutes to 40 minutes are acceptable).
Other Name: MK3475

Primary Outcome Measures :
  1. Objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumours (RECIST) version. 1.1, and immune-related (ir) RECIST [ Time Frame: 1 year 9months ]
    Objective response rate (ORR) according to Response Evaluation Criteria in Solid Tumours (RECIST) version. 1.1, and immune-related (ir) RECIST

Secondary Outcome Measures :
  1. The incidences and types of adverse events [ Time Frame: 1 year 9months ]
    The incidences and types of adverse events that occur during treatment will be evaluated according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.

  2. Objective response rate according to immune-related (ir) RECIST [ Time Frame: 1 year 9months ]
    Objective response rate according to immune-related (ir) RECIST

  3. Progression-free survival (PFS) [ Time Frame: 1 year 9months ]
    Progression-free survival (PFS)

  4. Overall survival (OS) [ Time Frame: 1 year 9months ]
    Overall survival (OS)

  5. Disease control rate (DCR) [ Time Frame: 1 year 9months ]
    Disease control rate (DCR)

Other Outcome Measures:
  1. Tests of various biomarkers [ Time Frame: 1 year 9months ]
    Tests of various biomarkers

Information from the National Library of Medicine

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Ages Eligible for Study:   20 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Patients have histologically or cytologically confirmed advanced or recurrent gastric cancer.
  2. Patients at least 20 years of age on the day of providing consent.
  3. Patients have measurable disease as defined by RECIST 1.1 as determined by investigator.
  4. Patients with a performance status of 0 or 1 on the Eastern Cooperative Oncology Group.
  5. Patients with adequate organ function at the time of enrollment as defined below:

    • Neutrophil count ≥1200mm3
    • Platelet count ≥7.5 × 104/mm3
    • Hemoglobin (Hb) ≥ 8.0 g/dL,
    • Total bilirubin ≤1.5 mg/dL
    • Asparate aminotransferase (AST) and Alanine aminotransferase (ALT) ≤ 100 IU/L for subjects with liver metastases ≤ 200 IU/L
    • Creatinine ≤1.5-times the upper limit of normal
    • International normalized ratio (INR) ≤ 1.5
    • Urinary protein : It satisfies one of the following (if any of the inspection criteria are satisfied, other examination may not be carried out) (i) Urinary protein (test paper method) is 2+ or less (ii) Urine Protein Creatinine (UPC) ratio <3.5 (iii) 24-hour urine protein was measured, urinary protein ≦ 3500 mg
  6. Patients who not received a blood transfusion within 7 days of registration.
  7. Patients have recovered adverse events associated with chemotherapy, radiation and surgical operation as pretreatment to Grade 1 or lower with CTCAE v4.0 excluding stable symptoms (eg alopecia, peripheral sensory neuropathy, skin hyperpigmentation, dysgeusia etc.).
  8. Female of childbearing potential who are negative in a pregnancy test within 14 days before enrollment. Both male and female patients should agree to use an adequate method of contraception (total abstinence, an intrauterine device or hormone releasing system, an contraceptive implant and an oral contraceptive) starting with the first dose of study therapy through 120 days after the last dose of study therapy. Duration will be determined when the subject is assigned to treatment.
  9. Patients capable of taking oral medication
  10. Patients who provided written informed consent to be subjects in this trial

Exclusion Criteria:

  1. Patients who received prior anticancer treatment within 14 days (or 5 times the half-life time, whichever is shorter) or any investigational agent within 28 days prior to the first dose of study drugs.
  2. Patients who have undergone surgical treatment and radiotherapy with in 2 weeks before enrollment.
  3. Patients with a history of prior treatment with Lenvatinib or any anti-programmed death 1 (anti-PD-1), anti-programmed ligand death 1 (anti-PD-L1), or anti-programmed ligand death 2 (anti-PD-L2 agent).
  4. Patients with hypertension that is difficult to control (systolic blood pressure ≥160 mmHg and diastolic blood pressure ≥90 mmHg) despite treatment with several hypotensive agents.
  5. Patients with acute coronary syndrome (including myocardial infarction and unstable angina), and with a history of coronary angioplasty or stent placement performed within 6 months before enrollment.
  6. Patients with symptomatic brain metastasis.
  7. Patients with a history of New York Heart Association congestive heart failure of grade II or above, unstable angina, myocardial infarction within the past 6 months, or serious cardiac arrhythmia associated with significant cardiovascular impairment within the past 6 months
  8. Patients have an active malignancy (except for definitively treated melanoma in-situ, basal or squamous cell carcinoma of the skin, or carcinoma in-situ of the cervix) within the past 24 months
  9. Patients have severe (hospitalization required) complications (intestinal palsy, intestinal obstruction, pulmonary fibrosis, diabetes difficult to control, heart failure, myocardial infarction, unstable angina, renal failure, liver failure, mental disease, cerebrovascular disease etc).
  10. Patients with a history of a gastrointestinal perforation and /or gastrointestinal fistula within 6 months before enrollment.
  11. Patients with active hepatitis.
  12. Patients with a history of human immunodeficiency virus (HIV).
  13. Patients with active symptoms or signs of interstitial lung disease.
  14. Patients with concurrent autoimmune disease, or a history of chronic or recurrent autoimmune disease
  15. Patients who require systemic corticosteroids (excluding temporary usage for tests, prophylactic administration for allergic reactions, or to alleviate swelling associated with radiotherapy) or immunosuppressants, or who have received such a therapy <14 days before enrollment.
  16. Patients have a history of (non-infectious) pneumonitis that required steroids or have current pneumonitis
  17. Patients who are administered live vaccines <30 days before the initiation of treatment with the investigational drug.
  18. Patients have serious non-healing wound, ulcer, or bone fracture.
  19. Females who are pregnant or breastfeeding
  20. Patients have no intention to comply with the protocol or cannot comply.
  21. Patients were judged unsuitable as subject of this trial by investigator.

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): NCT03609359

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Kashiwa, Tokyo, Japan, 2778577
Sponsors and Collaborators
National Cancer Center Hospital East
Merck Sharp & Dohme LLC
Eisai Co., Ltd.
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Principal Investigator: Kohei Shitara, Dr National Cancer Center Hospital East
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Kohei Shitara, Assistant chief physician of Gastrointestinal Oncology Division, National Cancer Center Hospital East
ClinicalTrials.gov Identifier: NCT03609359    
Other Study ID Numbers: EPOC 1706 study
First Posted: August 1, 2018    Key Record Dates
Last Update Posted: April 26, 2021
Last Verified: April 2021

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Kohei Shitara, National Cancer Center Hospital East:
lenvatinib, pembrolizumab, phase II, gastric cancer
Additional relevant MeSH terms:
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Stomach Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Stomach Diseases
Antineoplastic Agents, Immunological
Antineoplastic Agents
Protein Kinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action