Pembro+Chemo in Brain Mets
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|ClinicalTrials.gov Identifier: NCT04964960|
Recruitment Status : Recruiting
First Posted : July 16, 2021
Last Update Posted : January 19, 2022
|Condition or disease||Intervention/treatment||Phase|
|Lung Cancer Lung Cancer Metastatic Brain Cancer Cancer||Drug: Pembrolizumab Drug: Nab paclitaxel Drug: Paclitaxel Drug: Pemetrexed Drug: Carboplatin||Phase 2|
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||45 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Phase II Investigation of Use of CNS Active Pembrolizumab and Chemotherapy for Asymptomatic Brain Metastasis From Non-small Cell Lung Cancer (NSCLC)|
|Actual Study Start Date :||December 7, 2021|
|Estimated Primary Completion Date :||May 2023|
|Estimated Study Completion Date :||May 2033|
Experimental: Pembrolizumab with standard of care chemotherapy treatment
Patients will receive 200mg or 400mg of Pembrolizumab (standard of care dosing at the discretion of treating physician) over thirty minutes on day 1 every three or six weeks with standard of care chemotherapy treatment (carboplatin, pemetrexed, paclitaxel, nab-paclitaxel).
Pembrolizumab is an immunotherapy that can help fight certain cancers.
Other Name: Keytruda
Drug: Nab paclitaxel
Nab-paclitaxel is a taxane derivative that is an albumin-bound paclitaxel nanoparticle formulation that promotes microtubule assembly.
Paclitaxel is a taxane derivative that promotes microtubule assembly by enhancing the action of tubulin dimers, stabilizing existing microtubules, and inhibiting their disassembly, interfering with the late G2 mitotic phase, and inhibiting cell replication.
Pemetrexed is an antifolate agent that disrupts folate-dependent metabolic processes essential for cell replication.
Carboplatin is a platinum compound alkylating agent which covalently binds to DNA and interferes with the function of DNA by producing interstrand DNA cross-links.
- Disease control rate [ Time Frame: 6 months (baseline to 6 months) ]Intracranial benefit defined as stable disease, partial response, and complete response
- Overall survival at 12-month post-enrollment [ Time Frame: 12 months (6 months post-enrollment, 12 months post-enrollment) ]Overall survival at 12-month post-enrollment
- Change in extracranial disease control [ Time Frame: 12 months (6 months post-enrollment, 12 months post-enrollment) ]Kaplan-Meier estimates will be calculated for progression-free survival along with estimates of median survival time and proportion of surviving at specific time points (6 and 12 months).
- Change in patient-reported cognitive functioning - Functional Assessment of Cancer Therapy-Cognitive (FACT-Cog) [ Time Frame: 12 months (Baseline, 3 months post-enrollment, 6 months post-enrollment, 9 months post-enrollment, 12 months post enrollment) ]The FACT-Cog questionnaire was developed to assess perceived cognitive function and impact on quality of life (QOL) in cancer patients. The level of perceived cognitive impairments is measured on a four-point Likert scale (4 = several times a day to 0 = never) FACT-Cog has been widely administered across clinical settings and validated across different cultures and languages. Subjects can complete it in 5 minutes. A higher score indicates a better quality of life/cognitive function.
- Change in quality of life - Functional Assessment of Cancer Therapy-Brain (FACT-Br) [ Time Frame: 12 months (Baseline, 3 months post-enrollment, 6 months post-enrollment, 9 months post-enrollment, 12 months post enrollment) ]The FACT-Br is a commonly used instrument measuring general quality of life (QOL) that reflects symptoms or problems associated with brain malignancies across 5 subscales. The level of well-being is measured on a four-point Likert scale (4 = very much to 0 = not at all). The measure yields information about total quality of life, as well as information about the dimensions of physical well-being, social/family well-being, emotional well-being, functional well-being, and disease-specific concerns. The score range is 0-200 where a higher score indicated a better quality of life. The FACT-Br is written at the 4th grade reading level, and subjects can complete it in 5-10 minutes.
- Change in quality of life - FACIT Fatigue Scale (FACIT-F) [ Time Frame: 12 months (Baseline, 3 months post-enrollment, 6 months post-enrollment, 9 months post-enrollment, 12 months post enrollment) ]FACIT-F is a short, 13-item, easy to administer tool that measures an individual's level of fatigue during their usual daily activities over the past week. The level of fatigue is measured on a four-point Likert scale (4 = not at all fatigued to 0 = very much fatigued) with a score range of 0-52. Subjects can complete the questionnaire in 2-3 minutes and the higher the score, the better the quality of life.
- Change in mild cognitive impairment (MoCA) [ Time Frame: 12 months (Baseline, 3 months post-enrollment, 6 months post-enrollment, 9 months post-enrollment, 12 months post enrollment) ]Neurocognitive functioning will be evaluated utilizing the Montreal Cognitive Assessment (MoCA). MoCA assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking, calculations, and orientation. Participants will complete the MoCA (estimated time 10 minutes). The MoCA is scored to obtain an item total, scores can range from 0 to 30 and score of 26 or above is considered normal.
- Change in performance status [ Time Frame: 12 months (Baseline, 3 months post-enrollment, 6 months post-enrollment, 9 months post-enrollment, 12 months post enrollment) ]Participant performance status will be evaluated utilizing the Eastern Cooperative Oncology Group (ECGO) performance status instrument. Performance status is graded from 0-5 where lower scores indicate better performance/patient daily living abilities.
- Immune based biomarker activity [ Time Frame: 12 weeks (Baseline, 6 weeks after baseline, 6 weeks after prior collection) ]PD-1 and several immune-based markers, such as cytotoxic T cells, will be measured and summarized descriptively. Correlations with PD-1 and between markers will be estimated using Pearson or Spearman's correlation coefficient. Exploratory association of these biological markers with DCR will be performed using two-group comparison tests. Adjustment for multiple testing due to several immune-based markers will be considered using Holm's p-value adjustment method.
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): NCT04964960
|Contact: John Villano, MD, PhDfirstname.lastname@example.org|
|United States, Kentucky|
|University of Kentucky, Markey Cancer Center||Recruiting|
|Lexington, Kentucky, United States, 40536|
|Contact: John Villano, MD, PhD|
|Principal Investigator:||John Villano, MD, PhD||University of Kentucky|