Study of Pembrolizumab in Combination With Chemotherapy for Patients With Advanced Colorectal Cancer

NCT02375672 | Completed Phase 2 Results DMC

• 1 other identifier: HCRN GI14-186
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 3

Brief Summary

This is a multi-institutional, single arm, open-label, phase II study, including a safety run-in cohort. No randomization or blinding involved.

Conditions

Colorectal Cancer

Keywords

Pembrolizumab; MK-3475

Outcome Measures

Primary Outcomes (1)

• Median Progression Free Survival (mPFS)

  Determine if pembrolizumab (MK-3475) in combination with chemotherapy improves median progression free survival (mPFS) compared to historical standards. Response Criteria - Evaluation of target lesions Complete Response (CR): Disappearance of all target lesions Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started

  From time of registration to the time of documented progression per RECIST 1.1 or subject death (estimate 14 months)

Secondary Outcomes (4)

• Disease Assessment for Objective Response Rate (ORR)

  Begin C1D1 and every 8 weeks thereafter (up to 24 months)

• Disease Assessment for Disease Control Rate

  Begin C1D1 and every 8 weeks thereafter (up to 24 months) per RECIST 1.1 criteria

• Overall Survival (OS)

  Subject should be followed from time of registration till the time of subject death up to a maximum 35.5 months

• Number of Patients With Grade 3 or Higher Treatment Related Adverse Event

  Begin C1D1 and very 2 weeks (Day 1) for up to 24 months

Study Arms (1)

Pembrolizumab (MK-3475) + mFOLFOX6

EXPERIMENTAL

Following the safety run-in cohort: mFOLFOX6 Treatment D1 and D15 (every 2 weeks); Pembrolizumab (MK-3475) IV over 30 minutes (every 3 weeks)

Drug: Pembrolizumab; Drug: mFOLFOX6

Interventions

Pembrolizumab DRUG

Pembrolizumab (MK-3475) 200mg IV over 30 minutes every 3 weeks

Also known as: MK-3475

Pembrolizumab (MK-3475) + mFOLFOX6

mFOLFOX6 DRUG

mFOLFOX6 Treatment D1 and D15 (Cycle = 28 days) * Oxaliplatin 85 mg/m\^2 IV with * Leucovorin 400 mg/m\^2 IV followed by * 5FU 400 mg/m\^2 bolus and then 2400 mg/m\^2 via continuous infusion

Pembrolizumab (MK-3475) + mFOLFOX6

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Be willing and able to provide written informed consent for the trial and HIPAA authorization for release of personal health information. NOTE: HIPAA authorization may be included in the informed consent or obtained separately.
• Be ≥ 18 years of age on day of signing informed consent.
• Have a performance status of 0 or 1 on the ECOG Performance Scale within 14 days prior to registration.
• Have histological or cytological evidence of colorectal adenocarcinoma with confirmation of metastatic disease either by pathologic or radiologic findings.
• Have identified tissue from an archival tissue sample (preferably from a metastasis, but sample from primary tumor allowable) or newly obtained core or excisional biopsy of a tumor lesion.
• Have had no prior systemic therapy for advanced or metastatic disease. Prior adjuvant therapy should have been completed at least 9 months from documentation of metastatic disease. Prior palliative radiotherapy allowed if toxicities resolved to grade 1 or baseline.
• Have measurable disease according to RECIST v1.1 obtained by imaging within 28 days prior to registration.
• Female subjects of childbearing potential should have a negative urine or serum pregnancy test within 14 days prior to study registration. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required. Subjects of childbearing potential (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) are those who meet the following criteria: has not undergone a hysterectomy or bilateral oophorectomy; OR has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months).
• Female subjects of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication

You may not qualify if:

• Has clearly resectable colon cancer liver metastases (CCLM), for example oligometastatic disease involving only one lobe of the liver. Subjects with suspected resectable CCLM should undergo evaluation by a liver surgeon prior to enrollment to document the incurable nature of their disease.
• Is currently participating in or has participated in a study of an investigational agent or using an investigational device within 4 weeks of registration. Subjects are not permitted to participate in another investigational drug study while being treated on this protocol.
• Is unable to receive a port or peripherally inserted central catheter (PICC).
• Has a diagnosis of immunodeficiency or is receiving chronic steroid therapy of prednisone ≥ 10 mg daily or any equivalent dose of corticosteroids.
• Has previously undergone organ or bone marrow transplantation and is on immunosuppressive therapy
• Has had major surgery or significant traumatic injury within 4 weeks of study registration. Subjects must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy. A diagnostic or research biopsy does not exclude subjects from enrollment. Placement of a vascular access device such as a Port-A-Cath is not considered major surgery
• Has baseline peripheral neuropathy/paresthesia grade ≥ 1.
• Has a known additional malignancy within the past 3 years. Exceptions include treated localized basal cell or squamous cell carcinoma of the skin, in situ cervical or vulvar carcinoma that has undergone potentially curative therapy, superficial bladder tumors (Ta, Tis \& T1), ductal carcinoma in situ (DCIS) of the breast and low grade prostate cancer (Gleason sore 6). Any cancer curatively treated \> 3 years prior to registration with no clinical evidence of recurrence is permitted
• Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to trial registration and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial registration.
• Has an active autoimmune disease requiring systemic treatment within the past 3 months or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents. Exceptions to the rule: subjects with vitiligo; subjects with resolved childhood asthma/atopy; subjects that require intermittent use of bronchodilators or local steroid injections; subjects with hypothyroidism stable on hormone replacement or patients with Sjögren's syndrome
• Has a history of pneumonitis that required steroids or current pneumonitis.
• Has known history of active tuberculosis.
• Has an active infection requiring systemic therapy (≥ grade 2) for more than 3 days within 1 week of enrollment.
• Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of pembrolizumab (MK-3475).
• Has known hypersensitivity to fluorouracil (5FU), oxaliplatin, or other platinum agents.

Sponsors & Collaborators

• Hoosier Cancer Research Network: lead
• Merck Sharp & Dohme LLC: collaborator

Study Sites (3)

Emory University: Winship Cancer Institute

Atlanta, Georgia, 30322, United States

Location

Indiana University Simon Cancer Center

Indianapolis, Indiana, 46202, United States

Location

The Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210, United States

Location

Related Links

• Hoosier Cancer Research Network Website

MeSH Terms

Conditions

Colorectal Neoplasms

Interventions

pembrolizumab

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases

Results Point of Contact

• Title: Fauzia Sharmin
• Organization: Hoosier Cancer Research Network

fsharmin@hoosiercancer.org

(317) 634-5842

Study Officials

• Safi Shahda, M.D.

  Hoosier Cancer Research Network

  STUDY CHAIR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 24, 2015
• First Posted: March 2, 2015
• Study Start: May 28, 2015
• Primary Completion: October 8, 2020
• Study Completion: October 8, 2020
• Last Updated: February 16, 2022
• Results First Posted: October 8, 2021

Record last verified: 2022-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (3)