Clinical Trials /

Study of Pembrolizumab (MK-3475) in Participants With Advanced Urothelial Cancer (MK-3475-052/KEYNOTE-052)

NCT02335424

Description:

This is a study using pembrolizumab (MK-3475, KEYTRUDA®) for first-line treatment of participants with advanced/unresectable (inoperable) or metastatic urothelial cancer who are ineligible for cisplatin-based therapy. The primary study objective is to determine the objective response rate (ORR) in all participants and by programmed cell death ligand 1 (PD-L1) status. With Amendment 4, once a participant has achieved the study objective or the study has ended, the participant will be discontinued from this study and will be enrolled in an extension study to continue protocol-defined assessments and treatment.

Related Conditions:
  • Bladder Carcinoma
  • Urothelial Carcinoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Study of Pembrolizumab (MK-3475) in Participants With Advanced Urothelial Cancer (MK-3475-052/KEYNOTE-052)
  • Official Title: A Phase II Clinical Trial of Pembrolizumab (MK-3475) in Subjects With Advanced/Unresectable or Metastatic Urothelial Cancer

Clinical Trial IDs

  • ORG STUDY ID: 3475-052
  • SECONDARY ID: 2014-002206-20
  • SECONDARY ID: MK-3475-052
  • SECONDARY ID: KEYNOTE-052
  • NCT ID: NCT02335424

Conditions

  • Urothelial Cancer

Interventions

DrugSynonymsArms
pembrolizumabMK-3475, KEYTRUDA®Pembrolizumab

Purpose

This is a study using pembrolizumab (MK-3475, KEYTRUDA®) for first-line treatment of participants with advanced/unresectable (inoperable) or metastatic urothelial cancer who are ineligible for cisplatin-based therapy. The primary study objective is to determine the objective response rate (ORR) in all participants and by programmed cell death ligand 1 (PD-L1) status. With Amendment 4, once a participant has achieved the study objective or the study has ended, the participant will be discontinued from this study and will be enrolled in an extension study to continue protocol-defined assessments and treatment.

Detailed Description

      Participants receiving pembrolizumab who attain a complete response (CR) may consider
      stopping trial treatment if they meet criteria for holding therapy. Participants who stop
      trial treatment after receiving 24 months of trial treatment for reasons other than
      progressive disease (PD) or intolerability, or participants who attain a CR and stop trial
      treatment may be eligible for up to one year of retreatment upon experiencing PD.
    

Trial Arms

NameTypeDescriptionInterventions
PembrolizumabExperimentalParticipants receive pembrolizumab, 200 mg intravenous (IV) on Day 1 of each 3-week cycle for up to 24 months.
  • pembrolizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Histologically- or cytologically-confirmed diagnosis of advanced/unresectable
             (inoperable) or metastatic urothelial cancer of the renal pelvis, ureter, bladder, or
             urethra (transitional cell and mixed transitional/non-transitional cell histologies)

          -  Ineligible for cisplatin therapy

          -  No prior systemic chemotherapy for metastatic disease (adjuvant or neoadjuvant
             platinum-based chemotherapy with recurrence >12 months since completion of therapy is
             allowed)

          -  Available tissue from a newly obtained core or excisional biopsy of a tumor lesion not
             previously irradiated

          -  Measureable disease

          -  Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2

          -  Adequate organ function

          -  Female participants of childbearing potential have a negative urine or serum pregnancy
             test; surgically sterile, or willing to use 2 acceptable methods of birth control, or
             abstain from heterosexual activity for the course of the study through 120 days after
             the last dose of study treatment

          -  Male participants must be willing to use an adequate method of contraception starting
             with the first dose of study medication through 120 days after the last dose of study
             treatment

        Exclusion Criteria:

          -  Disease that is suitable for local therapy administered with curative intent

          -  Currently participating or has participated in a study of an investigational agent and
             received study therapy or used an investigational device within 4 weeks prior to the
             first dose of study treatment

          -  Prior anti-cancer monoclonal antibody (mAb) for direct anti-neoplastic treatment
             within 4 weeks prior to study Day 1 or who has not recovered from adverse events due
             to agents administered more than 4 weeks earlier

          -  Prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2
             weeks prior to study Day 1 or not recovered from AEs due to a previously administered
             agent

          -  Known additional malignancy that is progressing or requires active treatment excepting
             basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has
             undergone potentially curative therapy, or in situ cancer

          -  Known active central nervous system (CNS) metastases and/or carcinomatous meningitis

          -  Active autoimmune disease that has required systemic treatment in past 2 years

          -  Evidence of interstitial lung disease or active non-infectious pneumonitis

          -  Active infection requiring systemic therapy

          -  Pregnant or breastfeeding, or expecting to conceive or father children within the
             projected duration of the trial, starting with the screening visit through 120 days
             after the last dose of study treatment

          -  Prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent, or with an agent
             directed to another co-inhibitory T-cell receptor

          -  Known human immunodeficiency virus (HIV)

          -  Known active Hepatitis B or C

          -  Received a live virus vaccine within 30 days of planned start of study treatment
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in All Participants
Time Frame:Through Database Cutoff Date of 26-Sep-2018 (up to approximately 41 months)
Safety Issue:
Description:ORR was determined in all participants and was defined as the percentage of participants who had a confirmed Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). Participants with missing data were considered non-responders. The percentage of participants who experienced a CR or PR per RECIST 1.1 is presented.

Secondary Outcome Measures

Measure:Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in All Participants
Time Frame:From time of first documented evidence of CR or PR through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:DOR was determined in participants who demonstrated a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). DOR was defined as the time from first documented evidence of a CR or PR until progressive disease (PD) or death. Participants who had not progressed or died at the time of analysis were censored at the date of their last tumor assessment. Per RECIST 1.1, PD was defined as ≥20% relative increase in the sum of diameters of target lesions. In addition, the sum must also have an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. The DOR per RECIST 1.1 for all participants who had a confirmed CR or PR is presented.
Measure:Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
Time Frame:From time of first documented evidence of CR or PR through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:DOR was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, and had a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). DOR was defined as the time from first documented evidence of a CR or PR until progressive disease (PD) or death. Participants who had not progressed or died at the time of analysis were censored at the date of their last tumor assessment. Per RECIST 1.1, PD was defined as ≥20% relative increase in the sum of diameters of target lesions. In addition, the sum must also have an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. The DOR per RECIST 1.1 for all participants who had a PD-L1 positive expression of ≥1% CPS and who had a confirmed CR or PR is presented.
Measure:Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
Time Frame:From time of first documented evidence of CR or PR through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:DOR was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, and had a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: ≥30% decrease in the sum of diameters of target lesions) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). DOR was defined as the time from first documented evidence of a CR or PR until progressive disease (PD) or death. Participants who had not progressed or died at the time of analysis were censored at the date of their last tumor assessment. Per RECIST 1.1, PD was defined as ≥20% relative increase in the sum of diameters of target lesions. In addition, the sum must also have an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. The DOR per RECIST 1.1 for all participants who had a PD-L1 strong positive expression of ≥10% CPS and who had a confirmed CR or PR is presented.
Measure:Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in All Participants
Time Frame:Through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:PFS was determined in all participants. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). PD was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS per RECIST 1.1 for all participants is presented.
Measure:Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
Time Frame:Through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:PFS was determined in participants who had a PD-L1 CPS of ≥1% as measured by immunohistochemistry assay. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). PD was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS per RECIST 1.1 for all participants who had a PD-L1 positive expression of ≥1% CPS is presented.
Measure:Progression Free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
Time Frame:Through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:PFS was determined in participants who had a PD-L1 CPS of ≥10% as measured by immunohistochemistry assay. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). PD was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS per RECIST 1.1 for all participants who had a PD-L1 strong positive expression of ≥10% CPS is presented.
Measure:Overall Survival (OS) in All Participants
Time Frame:Through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:OS was determined for all participants and was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS for all participants is presented.
Measure:Overall Survival (OS) in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
Time Frame:Through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:OS was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay. OS was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS for all participants who had a PD-L1 positive expression of ≥1% CPS is presented.
Measure:Overall Survival (OS) in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
Time Frame:Through database cutoff date of 26-Sep-2018 (Up to approximately 41 months)
Safety Issue:
Description:OS was determined in participants who had a PD-L1 CPS of ≥10% as measured by immunohistochemistry assay. OS was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS for all participants who had a PD-L1 strong positive expression of ≥10% CPS is presented.
Measure:Progression Free Survival Rate (PFS Rate) at Month 6 in All Participants
Time Frame:Month 6
Safety Issue:
Description:The PFS rate was determined in all participants at Month 6. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR). Progressive Disease (PD) was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS rate at Month 6 was calculated.
Measure:Progression Free Survival Rate (PFS Rate) at Month 6 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
Time Frame:Month 6
Safety Issue:
Description:The PFS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 6. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR). Progressive Disease (PD) was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS rate at Month 6 was calculated.
Measure:Progression Free Survival Rate (PFS Rate) at Month 6 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
Time Frame:Month 6
Safety Issue:
Description:The PFS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 6. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR). Progressive Disease (PD) was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS rate at Month 6 was calculated.
Measure:Progression Free Survival Rate (PFS Rate) at Month 12 in All Participants
Time Frame:Month 12
Safety Issue:
Description:The PFS rate was determined in all participants at Month 12. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR). Progressive Disease (PD) was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS rate at Month 12 was calculated.
Measure:Progression Free Survival Rate (PFS Rate) at Month 12 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
Time Frame:Month 12
Safety Issue:
Description:The PFS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 12. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR). Progressive Disease (PD) was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS rate at Month 12 was calculated.
Measure:Progression Free Survival Rate (PFS Rate) at Month 12 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
Time Frame:Month 12
Safety Issue:
Description:The PFS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 12. PFS was defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurred first, per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) as assessed by Blinded Independent Central Review (BICR). Progressive Disease (PD) was defined as ≥20% increase in the sum of diameters of target lesions and an absolute increase of ≥5 mm. The appearance of ≥1 new lesions was also considered PD. Time to scheduled tumor assessment visit rather than the actual tumor assessment visit was used in the analysis. Participants were censored at the date of their last assessment. The PFS rate at Month 12 was calculated.
Measure:Overall Survival Rate (OS Rate) at Month 6 in All Participants
Time Frame:Month 6
Safety Issue:
Description:The OS rate was determined for all participants at Month 6 and was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS rate at Month 6 was calculated.
Measure:Overall Survival Rate (OS Rate) at Month 6 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
Time Frame:Month 6
Safety Issue:
Description:The OS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 6. OS was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS rate at Month 6 was calculated.
Measure:Overall Survival Rate (OS Rate) at Month 6 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
Time Frame:Month 6
Safety Issue:
Description:The OS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 6. OS was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS rate at Month 6 was calculated.
Measure:Overall Survival Rate (OS Rate) at Month 12 in All Participants
Time Frame:Month 12
Safety Issue:
Description:The OS rate was determined for all participants at Month 12 and was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS rate at Month 12 was calculated.
Measure:Overall Survival Rate (OS Rate) at Month 12 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥1%
Time Frame:Month 12
Safety Issue:
Description:The OS rate was determined in participants who had a PD-L1 CPS of ≥1%, as measured by immunohistochemistry assay, at Month 12. OS was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS rate at Month 12 was calculated.
Measure:Overall Survival Rate (OS Rate) at Month 12 in Participants With a Programmed Cell Death Ligand 1 (PD-L1) Combined Positive Score (CPS) of ≥10%
Time Frame:Month 12
Safety Issue:
Description:The OS rate was determined in participants who had a PD-L1 CPS of ≥10%, as measured by immunohistochemistry assay, at Month 12. OS was defined as the time from randomization to death due to any cause. Participants were censored at the date of their last assessment. The OS rate at Month 12 was calculated.
Measure:Programmed Cell Death Ligand 1 (PD-L1) Expression Status
Time Frame:Day 1
Safety Issue:
Description:PD-L1 expression status was determined as the percent of disease tumor cells, from newly obtained tumor biopsies, demonstrating plasma membrane PD-L1 staining of any intensity using an immunohistochemistry (IHC) assay. The assay uses a Combined Positive Score (CPS) as a measure of PD-L1 positivity. The CPS is calculated as the number of PD-L1-positive cells divided by the number of viable tumor cells analyzed multiplied by 100. A CPS of <1% = negative; ≥1% = positive; and ≥10% = strongly positive. The number of participants categorized by PD-L1 CPS score is presented.
Measure:Number of Participants Who Experienced At Least One Adverse Event (AE)
Time Frame:Through Database Cutoff Date of 26-Sep-2018 (up to approximately 41 months)
Safety Issue:
Description:An AE was defined as any untoward medical occurrence in a participant administered a study treatment and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the study treatment or protocol-specified procedure. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that was temporally associated with the use of study treatment, was also an AE. The number of participants who experienced at least one AE is presented. These safety results are based on a 26-September-2018 data cutoff date.
Measure:Number of Participants Who Discontinued Study Treatment Due to an Adverse Event (AE)
Time Frame:Through Database Cutoff Date of 26-Sep-2018 (up to approximately 41 months)
Safety Issue:
Description:An AE was defined as any untoward medical occurrence in a participant administered a study treatment and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the study treatment or protocol-specified procedure. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that was temporally associated with the use of study treatment, was also an AE. The number of participants who discontinued study treatment due to an AE is presented. These results are based on a 26-September-2018 data cutoff date.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Active, not recruiting
Lead Sponsor:Merck Sharp & Dohme Corp.

Trial Keywords

  • P-D1
  • PD-1
  • PD1
  • P-DL1
  • PD-L1
  • PDL-1
  • PDL1
  • Bladder cancer

Last Updated

January 26, 2021