Safety and Efficacy of Pembrolizumab (MK-3475) Plus Binimetinib Alone or Pembrolizumab Plus Chemotherapy With or Without Binimetinib in Metastatic Colorectal Cancer (mCRC) Participants (MK-3475-651)
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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: NCT03374254 |
Recruitment Status :
Active, not recruiting
First Posted : December 15, 2017
Last Update Posted : June 21, 2022
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Metastatic Colorectal Cancer | Biological: Pembrolizumab Drug: Binimetinib Drug: Oxaliplatin Drug: Leucovorin Drug: 5-Fluorouracil [5-FU] Drug: Irinotecan | Phase 1 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 220 participants |
Allocation: | Non-Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase 1b Multi-cohort Study of the Combination of Pembrolizumab (MK-3475) Plus Binimetinib Alone or the Combination of Pembrolizumab Plus Chemotherapy With or Without Binimetinib in Participants With Metastatic Colorectal Cancer (KEYNOTE-651) |
Actual Study Start Date : | February 16, 2018 |
Estimated Primary Completion Date : | November 16, 2023 |
Estimated Study Completion Date : | November 16, 2023 |

Arm | Intervention/treatment |
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Experimental: Pembrolizumab + Binimetinib (Cohort A)
During Part 1, participants in Cohort A will receive a standard dose (DL1) of pembrolizumab (200 mg) intravenous (IV) every 3 weeks (Q3W) plus binimetinib orally at a starting dose of 30 mg twice a day (BID). Based on dose-limiting toxicities (DLT) assessed during the initial 21 days of Cycle 1, the dose of binimetinib may be escalated to 45 mg orally BID (Dose Level 2 [DL2]). Once a preliminary RP2D for binimetinib is identified in Part 1 for Cohort A, participants will receive pembrolizumab 200 mg IV Q3W plus binimetinib orally at the preliminary RP2D during Part 2.
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Biological: Pembrolizumab
200 mg Pembrolizumab solution for IV infusion Q3W
Other Name: MK-3475 Drug: Binimetinib tablet orally BID at 30 or 45 mg depending upon DLT profile
Other Name: MEK162, ARRY-162, ARRY-438162 |
Experimental: Pembrolizumab + mFOLFOX7 (Cohort B)
During Part 1, participants in Cohort B will receive a standard dose (DL1) of pembrolizumab 200 mg IV Q3W plus mFOLFOX7 (oxaliplatin 85 mg/m^2; leucovorin [calcium folinate] 400 mg/m^2; fluorouracil [5-FU] 2400 mg/m^2 over 46-48 hours) IV every 2 weeks (Q2W). Based on DLTs assessed during the initial 28 days of Cycle 1, the dose of mFOLFOX7 may be de-escalated to oxaliplatin 70 mg/m^2; leucovorin (calcium folinate) 400 mg/m^2; 5-FU 2000 mg/m^2 over 46-48 hours] IV Q2W. Once a preliminary RP2D for mFOLFOX7 is identified in Part 1 for Cohort B, participants will receive pembrolizumab 200 mg IV Q3W plus mFOLFOX7 at the preliminary RP2D during Part 2.
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Biological: Pembrolizumab
200 mg Pembrolizumab solution for IV infusion Q3W
Other Name: MK-3475 Drug: Oxaliplatin 85 mg/m^2 as IV infusion. Administered Q2W as part of mFOLFOX7 cocktail. Dose may be de-escalated to 70 mg/m^2 if the standard dose of mFOLFOX7 is deemed too toxic per mTPI, based upon occurrence of DLTs. Drug: Leucovorin 400 mg/m^2 as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation.
Other Name: calcium folinate Drug: 5-Fluorouracil [5-FU] 2400 mg/m^2 over 46-48 hours as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation. Dose may be de-escalated to 2000 mg/m^2 if the standard dose of mFOLFOX7 or FOLFIRI is deemed too toxic per mTPI, based upon occurrence of DLTs. |
Experimental: Pembrolizumab + mFOLFOX7 + Binimetinib (Cohort C)
After an RP2D for mFOLFOX7 is identified in Part 1 for Cohort B, participants may enroll in Cohort C and receive pembrolizumab 200 mg IV Q3W plus mFOLFOX7 at the preliminary RP2D Q2W in combination with binimetinib orally at a starting dose of 30 mg BID during Part 1. Based on DLTs assessed during the initial 28 days of Cycle 1, the dose of binimetinib may be escalated to 45 mg orally BID (DL2). Once a preliminary RP2D for binimetinib is identified in Part 1 for this cohort, participants in Part 2 will receive pembrolizumab 200 mg IV Q3W plus mFOLFOX7 at the RP2D determined for Cohort B Q2W plus binimetinib orally at the RP2D determined for Cohort C in Part 1.
|
Biological: Pembrolizumab
200 mg Pembrolizumab solution for IV infusion Q3W
Other Name: MK-3475 Drug: Binimetinib tablet orally BID at 30 or 45 mg depending upon DLT profile
Other Name: MEK162, ARRY-162, ARRY-438162 Drug: Oxaliplatin 85 mg/m^2 as IV infusion. Administered Q2W as part of mFOLFOX7 cocktail. Dose may be de-escalated to 70 mg/m^2 if the standard dose of mFOLFOX7 is deemed too toxic per mTPI, based upon occurrence of DLTs. Drug: Leucovorin 400 mg/m^2 as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation.
Other Name: calcium folinate Drug: 5-Fluorouracil [5-FU] 2400 mg/m^2 over 46-48 hours as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation. Dose may be de-escalated to 2000 mg/m^2 if the standard dose of mFOLFOX7 or FOLFIRI is deemed too toxic per mTPI, based upon occurrence of DLTs. |
Experimental: Pembrolizumab + FOLFIRI (Cohort D)
During Part 1, participants in Cohort D will receive a standard dose (DL1) of pembrolizumab 200 mg IV Q3W plus FOLFIRI (irinotecan 180 mg/m^2; leucovorin [calcium folinate] 400 mg/m^2; 5-FU 2400 mg/m^2 over 46-48 hours) IV Q2W. Based on DLTs assessed during the initial 28 days of Cycle 1, the dose of FOLFIRI may be de-escalated to irinotecan 150 mg/m^2; leucovorin (calcium folinate) 400 mg/m^2; 5-FU 2000 mg/m^2 over 46-48 hours) IV Q2W. Once a preliminary RP2D for FOLFIRI is identified in Part 1 for Cohort D, participants will receive pembrolizumab 200 mg IV Q3W plus FOLFIRI at the preliminary RP2D during Part 2.
|
Biological: Pembrolizumab
200 mg Pembrolizumab solution for IV infusion Q3W
Other Name: MK-3475 Drug: Leucovorin 400 mg/m^2 as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation.
Other Name: calcium folinate Drug: 5-Fluorouracil [5-FU] 2400 mg/m^2 over 46-48 hours as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation. Dose may be de-escalated to 2000 mg/m^2 if the standard dose of mFOLFOX7 or FOLFIRI is deemed too toxic per mTPI, based upon occurrence of DLTs. Drug: Irinotecan 180 mg/m^2 as IV infusion. Administered Q2W as part of FOLFIRI cocktail. Dose may be de-escalated to 150 mg/m^2 if the standard dose of FOLFIRI is deemed too toxic per mTPI, based upon occurrence of DLTs. |
Experimental: Pembrolizumab + FOLFIRI + Binimetinib (Cohort E)
After an RP2D for FOLFIRI is identified in Part 1 for Cohort D, participants may enroll in Cohort E and receive pembrolizumab 200 mg IV Q3W plus FOLFIRI at the preliminary RP2D Q2W in combination with binimetinib orally at a starting dose of 30 mg BID during Part 1. Based on DLTs assessed during the initial 28 days of Cycle 1, the dose of binimetinib may be escalated to 45 mg orally BID (DL2). Once a preliminary RP2D for binimetinib is identified in Part 1 for this cohort, participants in Part 2 will receive pembrolizumab 200 mg IV Q3W plus FOLFIRI at the RP2D determined for Cohort D Q2W plus binimetinib orally at the RP2D determined for Cohort E in Part 1.
|
Biological: Pembrolizumab
200 mg Pembrolizumab solution for IV infusion Q3W
Other Name: MK-3475 Drug: Binimetinib tablet orally BID at 30 or 45 mg depending upon DLT profile
Other Name: MEK162, ARRY-162, ARRY-438162 Drug: Leucovorin 400 mg/m^2 as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation.
Other Name: calcium folinate Drug: 5-Fluorouracil [5-FU] 2400 mg/m^2 over 46-48 hours as IV infusion. Administered Q2W as part of mFOLFOX7 or FOLFIRI cocktail, depending upon allocation. Dose may be de-escalated to 2000 mg/m^2 if the standard dose of mFOLFOX7 or FOLFIRI is deemed too toxic per mTPI, based upon occurrence of DLTs. Drug: Irinotecan 180 mg/m^2 as IV infusion. Administered Q2W as part of FOLFIRI cocktail. Dose may be de-escalated to 150 mg/m^2 if the standard dose of FOLFIRI is deemed too toxic per mTPI, based upon occurrence of DLTs. |
- Percentage of participants with a dose limiting toxicity (DLT) [ Time Frame: Up to first 28 days of treatment ]Number of participants experiencing toxicities that are possibly, probably, or definitely related to study therapy; that meet pre-defined severity criteria; and result in a change in the given dose.
- Objective Response Rate (ORR) per Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST 1.1) [ Time Frame: Up to 2 years ]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 1.1.

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- At least 18 years of age
- Has a histologically-confirmed, unresectable or metastatic (Stage IV American Joint Committee on Cancer [AJCC seventh edition]) colorectal cancer (CRC)
- Has a locally determined non microsatellite instability high/ proficient mismatch repair (non-MSI-H/pMMR) tumor status
- Has at least 1 radiologically measurable lesion as defined by RECIST 1.1
- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Has a life expectancy of at least 3 months
- Has the ability to swallow and retain oral medication and not have any clinically significant gastrointestinal abnormalities that might alter absorption.
- Has adequate organ function
- Male participants must agree to use contraception during the treatment period and for ≥180 days, after the last dose of study treatment and refrain from donating sperm during this period. Male participants with pregnant partners must agree to use a condom
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Female participants eligible to participate if not pregnant, not breastfeeding, and is not a woman of childbearing potential (WOCBP) or is a WOCBP who agrees to follow contraceptive guidance during the treatment period and for ≥180 days after the last dose of study treatment
- Participants for Cohort A:
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Has been previously treated with fluoropyrimidine, irinotecan, and oxaliplatin
- Participants for Cohorts B and C:
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Must not have received prior systemic chemotherapy for Stage IV CRC
- Participants for Cohorts D and E:
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Must have been previously treated with 1 line of therapy including a fluoropyrimidine plus an oxaliplatin-based regimen
- Participants for Cohorts A, C, and E:
- Have a 12-lead electrocardiogram (ECG) and echocardiogram (ECHO) or multigated acquisition (MUGA) scan performed by the investigator or other qualified person to evaluate cardiac function prior to enrollment in the study
Exclusion Criteria:
- Is currently participating and receiving study therapy in a study of an investigational agent or has participated and received study therapy in a study of an investigational agent or has used an investigational device within 28 days of administration of MK-3475
- Has had chemotherapy, definitive radiation, or biological cancer therapy within 4 weeks (prior to the first dose of study therapy, or has not recovered to Common Terminology Criteria for Adverse Events (CTCAE) Gr 1 or better from any AEs that were due to cancer therapeutics administered more than 4 weeks earlier
- Has history of a second malignancy, unless potentially curative treatment has been completed with no evidence of malignancy for 2 years
- Has clinically active central nervous system (CNS) metastases and/or carcinomatous meningitis
- Has a known hypersensitivity, intolerability or contraindication to any component of study treatment, including premedication
- Has any active infection requiring systemic therapy
- Has a history of (non-infectious) pneumonitis that required steroids or has current pneumonitis
- Has received prior therapy with compounds targeting programmed death (PD)-1, PD-L1, PD-L2, or a mitogen-activated protein kinase (MAPK) pathway inhibitor
- Has an autoimmune disease that has required systemic treatment in the past 2 years with use of disease modifying agents, corticosteroids, or immunosuppressive drugs
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to randomization
- Has known history of human immunodeficiency virus (HIV) infection
- Has a known history of Hepatitis B
- Has received live vaccine within 30 days of the planned start of study therapy
- Has undergone major surgery and has not recovered adequately from any toxicity and/or complications from the intervention prior to starting study therapy
- Has baseline peripheral neuropathy/paresthesia
- Has any medical, psychiatric, cognitive, or other conditions that may compromise the participant's ability to understand the participant information, give informed consent, comply with the study protocol, or complete the study.
- Has symptomatic congestive heart failure (CHF)
- Has a history of acute or chronic pancreatitis
- Has existing uncontrolled arterial hypertension (systolic blood pressure [SBP] ≥150 mmHg or diastolic blood pressure [DBP] ≥100 mmHg) despite appropriate medical therapy
- Has a history of thromboembolic or cerebrovascular events within 6 months prior to registration
- Has neuromuscular disorders associated with an elevated creatine kinase
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A WOCBP who has a positive urine pregnancy test within 24 hours before the first dose of study treatment
- Potential Participants for Cohorts A, C or E who are to Receive Binimetinib:
- Has a history of, or current, retinal vein occlusion (RVO) or current risk factors for RVO
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Has retinal degenerative disease
- Potential Participants for Cohorts A, C, D or E:
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Has a known history of Gilbert's Syndrome
- Potential Participants for Cohorts D or E:
- Has a previous treatment with irinotecan
- Has plans to use, or is using, any herbal medications/supplements or any medications or foods that are strong inhibitors or inducers of cytochrome P450 3A 4/5 ≤1 week prior to the start of study treatment

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): NCT03374254
United States, California | |
City of Hope National Medical Center ( Site 0102) | |
Duarte, California, United States, 91010 | |
United States, Colorado | |
Anschutz Medical Campus, Anschutz Cancer Pavilion ( Site 0106) | |
Aurora, Colorado, United States, 80045 | |
United States, Connecticut | |
Yale Cancer Center ( Site 0108) | |
New Haven, Connecticut, United States, 06520 | |
United States, Florida | |
Moffitt Cancer Center ( Site 0111) | |
Tampa, Florida, United States, 33612 | |
United States, Illinois | |
University of Chicago ( Site 0105) | |
Chicago, Illinois, United States, 60637 | |
United States, New Jersey | |
Rutgers Cancer Institute of New Jersey ( Site 0107) | |
New Brunswick, New Jersey, United States, 08903-2681 | |
United States, Pennsylvania | |
UPMC Cancer Center/Hillman Cancer Center ( Site 0113) | |
Pittsburgh, Pennsylvania, United States, 15232 | |
United States, Texas | |
Baylor Scott and White ( Site 0110) | |
Temple, Texas, United States, 76508 | |
United States, Washington | |
Seattle Cancer Care Alliance ( Site 0104) | |
Seattle, Washington, United States, 98109 | |
Northwest Medical Specialties, PLLC ( Site 0101) | |
Tacoma, Washington, United States, 98405 | |
Canada, Alberta | |
Cross Cancer Institute ( Site 0123) | |
Edmonton, Alberta, Canada, T6G 1Z2 | |
Canada, Ontario | |
Princess Margaret Cancer Centre ( Site 0122) | |
Toronto, Ontario, Canada, M5G 2M9 | |
Canada, Quebec | |
Centre Hospitalier de l Universite de Montreal - CHUM ( Site 0124) | |
Montreal, Quebec, Canada, H2X 3E4 | |
Jewish General Hospital ( Site 0121) | |
Montreal, Quebec, Canada, H3T 1E2 |
Study Director: | Medical Director | Merck Sharp & Dohme LLC |
Responsible Party: | Merck Sharp & Dohme LLC |
ClinicalTrials.gov Identifier: | NCT03374254 |
Other Study ID Numbers: |
3475-651 MK-3475-651 ( Other Identifier: Merck Protocol Number ) 2017-000356-26 ( EudraCT Number ) |
First Posted: | December 15, 2017 Key Record Dates |
Last Update Posted: | June 21, 2022 |
Last Verified: | June 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf |
URL: | http://engagezone.msd.com/ds_documentation.php |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
CRC, MSS, non-MSI-H, PD-1, anti-PD-1, anti PD-1, MEK, MEK inhibitor |
Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases Leucovorin Pembrolizumab Fluorouracil Oxaliplatin |
Irinotecan Antineoplastic Agents, Immunological Antineoplastic Agents Immune Checkpoint Inhibitors Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Antimetabolites Antimetabolites, Antineoplastic Immunosuppressive Agents Immunologic Factors Topoisomerase I Inhibitors Topoisomerase Inhibitors Enzyme Inhibitors Antidotes Protective Agents |