NCT05662527

Brief Summary

The aim of this study is to evaluate the safety and efficacy of neoadjuvant treatment with pembrolizumab before colonic resection in patients with early-stage (I-III) deficient mismatch repair (dMMR) colon cancer (CC).

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
85

participants targeted

Target at P50-P75 for phase_2

Timeline
Completed

Started Feb 2023

Shorter than P25 for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 24, 2022

Completed
28 days until next milestone

First Posted

Study publicly available on registry

December 22, 2022

Completed
2 months until next milestone

Study Start

First participant enrolled

February 22, 2023

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 6, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 6, 2024

Completed
Last Updated

August 13, 2024

Status Verified

August 1, 2024

Enrollment Period

1.3 years

First QC Date

November 24, 2022

Last Update Submit

August 12, 2024

Conditions

Keywords

Localized colon cancerdMMRImmunotherapyBiomarkers

Outcome Measures

Primary Outcomes (1)

  • Pathological complete response (pCR)

    Number of patients with pCR evaluated according to the Mandard tumour regression grading system

    Tumour specimen evaluated within 2 weeks after surgery.

Secondary Outcomes (5)

  • Safety and tolerability of pembrolizumab administered before surgery

    Up to approximately 9 weeks

  • Postoperative surgical complications

    Before and up to 4 weeks after surgery

  • Immunohistochemistry analysis of markers including CD3, CD8, and PD-L1

    Baseline compared to the surgical specimen at 3-5 weeks

  • Methylated circulating cell-free DNA

    Up to approximately 9 weeks

  • Gene expression by mRNA

    Baseline compared to the surgical specimen at 3-5 weeks

Other Outcomes (3)

  • TCR sequencing

    Baseline compared to 3-5 weeks after pembrolizumab and 2-3 weeks after surgery

  • CT chest/abdomen scans

    1-5 weeks before pembrolizumab and 3-5 weeks after pembrolizumab

  • Endoscopic tumour assessment

    1-5 weeks before pembrolizumab and 3-5 weeks after pembrolizumab

Study Arms (1)

Neoadjuvant pembrolizumab

EXPERIMENTAL

Pembrolizumab

Drug: Pembrolizumab

Interventions

One dosage of 4mg/kg (maximum of 400mg)

Also known as: Keytruda
Neoadjuvant pembrolizumab

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Histologically confirmed localized dMMR stage cT1N0M0 to cT4N2M0 (stage I to III) colon carcinoma.
  • Indication for elective curative intended surgery without neoadjuvant chemotherapy.
  • Age of ≥ 18 years.
  • Written informed consent.
  • Eastern Cooperative Oncology Group performance status of 0 or 1.
  • Adequate bone marrow function defined as:
  • Hemoglobin ≥ 6.2 mmol/L or ≥ 10 g/dL.
  • Absolute neutrophil count ≥ 1.5 × 109/L.
  • Platelet count ≥ 100 × 109/L.
  • Adequate kidney function defined as:
  • o Estimated glomerular filtration rate ≥ 60 mL/min or creatinine ≤1.5 × upper limit of normal (ULN).
  • Adequate liver function defined as:
  • Total bilirubin: ≤ 1.5 × ULN.
  • Alanine aminotransferase: ≤ 2.5 × ULN.
  • Alkaline phosphatase: ≤ 2.5 × ULN.
  • +5 more criteria

You may not qualify if:

  • Any serious or uncontrolled medical disorder that, in the opinion of the investigator or treating physician, may increase the risk associated with study participation, impair the ability of the subject to receive protocol therapy, or interfere with the interpretation of study results.
  • Autoimmune disorders (except thyroiditis with replacement therapy and type I diabetes mellitus).
  • Prior treatment with ICIs or any other antibody/drug specifically targeting the T-cell co-stimulation or checkpoint pathways.
  • A known history of Human Immunodeficiency Virus, active chronic, or acute Hepatitis B or Hepatitis C.
  • A condition requiring systemic treatment with either corticosteroids (\> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses \> 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.
  • Prior participation in another trial with an investigational medicinal product.
  • Received live vaccines within 30 days prior to pembrolizumab trial treatment. Seasonal influenza vaccines for injection are allowed.
  • A history of allergy to study drug components or a history of severe hypersensitivity reaction to any monoclonal antibody.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Zealand University Hospital

Roskilde, Denmark

Location

Related Publications (2)

  • Gogenur I, Justesen TF, Tarpgaard LS, Bulut M, Hansen TF, Jensen LH, Rahr HB, Kirkegaard T, Balsevicius L, Raskov H, Petersen PC, Eriksen JR, Salomon S, Fiehn AK, Brandsborg S, Gotschalck KA, Emmertsen KJ, Born PW, Thorlacius-Ussing O, Lauritzen MB, Olesen RK, Poulsen LO, Lykke J, Schou J, Buskov L, Krarup PM, Andersen CL, Pfeiffer P, Qvortrup C. Neoadjuvant Pembrolizumab in Stage I-III Deficient Mismatch Repair Colon Cancer: A Clinical Trial. Ann Surg. 2024 Dec 18. doi: 10.1097/SLA.0000000000006611. Online ahead of print.

  • Justesen TF, Gogenur I, Tarpgaard LS, Pfeiffer P, Qvortrup C. Evaluating the efficacy and safety of neoadjuvant pembrolizumab in patients with stage I-III MMR-deficient colon cancer: a national, multicentre, prospective, single-arm, phase II study protocol. BMJ Open. 2023 Jun 22;13(6):e073372. doi: 10.1136/bmjopen-2023-073372.

MeSH Terms

Conditions

Colonic Neoplasms

Interventions

pembrolizumab

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal Diseases

Study Officials

  • Camilla Qvortrup, MD, PhD

    Rigshospitalet, Denmark

    STUDY DIRECTOR
  • Ismail Gögenur, Professor

    Zealand University Hospital

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Senior physician oncology

Study Record Dates

First Submitted

November 24, 2022

First Posted

December 22, 2022

Study Start

February 22, 2023

Primary Completion

June 6, 2024

Study Completion

June 6, 2024

Last Updated

August 13, 2024

Record last verified: 2024-08

Data Sharing

IPD Sharing
Will share

In accordance with good academic practice, the study data (health data and genomic data) is planned to be transferred in anonymized form to the secure database European Genome-Phenome Archive (EGA). This will happen after the study has been completed. The purpose is to enable sharing of the data with other research groups for future research, inside and outside of Denmark. In all cases, data access decisions will be made by the study protocol committee. Data sharing will be conducted in accordance with the European data protection regulations, including The Danish Data Protection Act and the General Data Protection Regulation. The EGA is part of the European ELIXIR research infrastructure, which is partly funded by the European Commission.

Shared Documents
STUDY PROTOCOL, ICF
Time Frame
Planned to begin approximately 6 months end ending approximately 5 years after publication of the final article.
Access Criteria
Reasonable request. In all cases, data access decisions will be made by the study protocol committee.

Locations