Clinical Trials /

Trial to Evaluate the Safety of Talimogene Laherparepvec Injected Into Tumors Alone and in Combination With Systemic Pembrolizumab MK-3475-611/Keynote-611

NCT02509507

Description:

This is a phase 1b/2, multicenter, open-label, basket trial to evaluate the safety of talimogene laherparepvec injected intrahepatically into liver tumors alone and in combination with systemic IV administration of pembrolizumab, in subjects with non-HCC liver metastases from BC, CRC, gastroesophageal cancer (GEC), melanoma, NSCLC, RCC in Part 1 Group A, and subjects with HCC with and without viral hepatitis in Part 1 Group B (viral hepatitis is only applicable in combination setting), and to evaluate the efficacy and safety of intratumoral talimogene laherparepvec in combination with systemic pembrolizumab in subjects with advanced TNBC, hormone receptor positive breast cancer, CRC, CSCC, and BCC in Part 2 Group A and subjects with HCC with and without viral hepatitis in Part 2 Group B. The objective of Part 1 is to evaluate the safety of intrahepatic injection of talimogene laherparepvec into liver tumors alone and in combination with systemically administered pembrolizumab for the non-HCC (Group A) and HCC (Group B) cohorts separately. Part 2 consists of 2-stage design to evaluate the efficacy and safety of talimogene laherparepvec in combination with systemic pembrolizumab. Efficacy and safety will be evaluated in each of the five non-HCC tumor types from Group A separately. Similarly, the efficacy and safety of the combination treatment will be determined for Group B HCC subjects.

Related Conditions:
  • Adenocarcinoma of the Gastroesophageal Junction
  • Basal Cell Carcinoma
  • Breast Carcinoma
  • Colorectal Carcinoma
  • Esophagogastric Carcinoma
  • Hepatocellular Carcinoma
  • Melanoma
  • Non-Small Cell Lung Carcinoma
  • Renal Cell Carcinoma
  • Skin Squamous Cell Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Trial to Evaluate the Safety of Talimogene Laherparepvec Injected Into Tumors Alone and in Combination With Systemic Pembrolizumab MK-3475-611/Keynote-611
  • Official Title: A Phase 1b/2, Multicenter, Open-label, Basket Trial to Evaluate the Safety of Talimogene Laherparepvec Injected Into Liver Tumors Alone and in Combination With Systemic Pembrolizumab in Phase 1b and to Evaluate the Efficacy and Safety of Intratumoral Talimogene Laherparepvec in Combination With Systemic Pembrolizumab to Treat Subjects With Advanced Solid Tumors in Phase 2 (MASTERKEY-318)

Clinical Trial IDs

  • ORG STUDY ID: 20140318
  • SECONDARY ID: 2014-005386-67
  • NCT ID: NCT02509507

Conditions

  • Hepatocellular Carcinoma
  • Liver Metastases
  • Cutaneous or Subcutaneous Lymph Node
  • Liver Tumors

Interventions

DrugSynonymsArms
Talimogene LaherparepvecPhase Ib/II Talimogene Laherparepvec
PembrolizumabPhase Ib/II Talimogene Laherparepvec + Pembrolizumab

Purpose

This is a phase 1b/2, multicenter, open-label, basket trial to evaluate the safety of talimogene laherparepvec injected intrahepatically into liver tumors alone and in combination with systemic IV administration of pembrolizumab, in subjects with non-HCC liver metastases from BC, CRC, gastroesophageal cancer (GEC), melanoma, NSCLC, RCC in Part 1 Group A, and subjects with HCC with and without viral hepatitis in Part 1 Group B (viral hepatitis is only applicable in combination setting), and to evaluate the efficacy and safety of intratumoral talimogene laherparepvec in combination with systemic pembrolizumab in subjects with advanced TNBC, hormone receptor positive breast cancer, CRC, CSCC, and BCC in Part 2 Group A and subjects with HCC with and without viral hepatitis in Part 2 Group B. The objective of Part 1 is to evaluate the safety of intrahepatic injection of talimogene laherparepvec into liver tumors alone and in combination with systemically administered pembrolizumab for the non-HCC (Group A) and HCC (Group B) cohorts separately. Part 2 consists of 2-stage design to evaluate the efficacy and safety of talimogene laherparepvec in combination with systemic pembrolizumab. Efficacy and safety will be evaluated in each of the five non-HCC tumor types from Group A separately. Similarly, the efficacy and safety of the combination treatment will be determined for Group B HCC subjects.

Trial Arms

NameTypeDescriptionInterventions
Phase Ib/II Talimogene LaherparepvecExperimentalTalimogene Laherparepvec
  • Talimogene Laherparepvec
Phase Ib/II Talimogene Laherparepvec + PembrolizumabExperimentalCombination treatment of Talimogene Laherparepvec and Pembrolizumab
  • Pembrolizumab

Eligibility Criteria

        Summary of Subject Eligibility Criteria:

        Key Inclusion Criteria:

        Subjects must be age ≥ 18 years at the time of informed consent. Subjects must have
        histologically or cytologically confirmed disease.

        Part 1 is restricted to BC, CRC, GEC, melanoma, NSCLC, or RCC with liver metastases or HCC.

        Part 2 Group A is restricted to advanced hormone receptor positive BC, CRC, TNBC, CSCC, and
        BCC with or without liver metastases.

          -  Part 2 Hormone receptor positive Breast Cancer Arm only: Histologically and/or
             cytologically confirmed diagnosis of estrogen receptor (ER) positive and/or
             progesterone receptor (PrR) positive breast cancer.

          -  Triple negative breast cancer: Histologically and/or cytologically confirmed diagnosis
             of ER negative, PrR negative, human epidermal growth factor receptor 2 (HER2)-Neu
             negative.

        Part 2 Group B is restricted to HCC (fibrolamellar and mixed
        hepatocellular/cholangiocarcinoma subtypes are not eligible).

        For HCC subjects with a diagnosis of hepatitis B, they must be on antiviral therapy for at
        least 4 weeks prior to enrollment and HBV viral load by real-time polymerase chain reaction
        (qPCR) must be < 100 IU/mL. HCC subjects with past or ongoing hepatitis C infection must
        have completed treatment for hepatitis C at least 1 month prior to study enrollment and
        hepatitis C viral load must be undetectable; subjects with hepatitis B and C must fulfill
        the eligibility criteria for hepatitis B and hepatitis C. Subjects with unresectable
        locally recurrent TNBC are eligible.

        Non-HCC subjects must have received at least 1 prior standard of care systemic anti-cancer
        therapy for their locally advanced or metastatic disease. For the combination cohorts
        (Cohorts 5 and 6 in Part 1) and Part 2, subjects with melanoma CSCC or NSCLC do not need to
        have received prior therapy. In Part 1, subjects must have measurable liver tumors and
        liver tumors that are suitable for injection. In Part 2, subjects must have measurable
        disease and cutaneous, subcutaneous, lymph node, or liver tumors suitable for injection.
        Eastern Cooperative Oncology Group (ECOG) performance status must be 0 or 1, and life
        expectancy should be approximately 5 months or more. Adequate hematological, renal,
        hepatic, and coagulation function is required. Liver function tests may be mildly abnormal
        but within the parameters. Child-Pugh score must be A.

        Key Exclusion Criteria:

        Subjects must not be candidates for surgery or locoregional therapy with curative intent or
        planned systemic anti-cancer therapy, with the exception of immunotherapy in the
        combination cohorts (Cohorts 5 and 6 in Part 1 and all subjects in Part 2). Liver tumors
        must not be estimated to invade approximately more than one-third of the liver. Liver
        tumor-directed therapy, hepatic surgery or major surgery, antibody-based therapy, or
        immunotherapy must not have been performed < 28 days, chemotherapy < 21 days, and targeted
        small molecule therapy or hormonal therapy < 14 days prior to enrollment. Subjects must
        either (1) have no central nervous system (CNS) metastasis, or carcinomatous meningitis, or
        (2) if CNS metastasis is present, must have stable treated cerebral metastases. Subjects
        must not have symptomatic auto-immune disease or be symptomatically immunosuppressed. They
        must not have a history of solid organ transplantation. For non-HCC, there must not be
        acute or chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. For HCC with
        prior hepatitis B and/or C infection, HBV and/or HCV viral load by qPCR must be
        undetectable, and they must not have had recent treatment within 12 weeks for HBV or HCV
        with certain antiviral medications in Part 1 Group B cohorts 1-5 and 6a, and Part 2 Group B
        HCC without viral hepatitis. For all patients in Part 1 and for patients in Part 2 where
        intrahepatic liver injection is planned, there should be no macroscopic intravascular
        invasion of tumors into the main portal vein, hepatic vein, or vena cava. Subjects must
        not: have active herpetic skin lesions or prior complications of herpetic infection (eg,
        herpetic keratitis or encephalitis); require treatment with an antiherpetic drug; have
        received live-virus vaccination within 30 days of planned treatment start; have previous
        therapy with talimogene laherparepvec, oncolytic viruses, or tumor vaccine. Subjects in the
        combination treatment cohort must not have: a history or evidence of psychiatric, substance
        abuse, or any other clinically significant disorder; toxic effects of the most recent prior
        chemotherapy not resolved to grade 1 or less (except alopecia); or expected other cancer
        therapy while on study with the exception of local radiation to the site of bone or other
        metastasis for palliative treatment. Male subjects of reproductive potential in the
        combination treatment must be willing to use acceptable methods of effective contraception
        during treatment and through 4 months after the last dose of pembrolizumab.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Subject incidence DLTs separately in Group A and B observed in monotherapy and combination cohorts and in each tumor type seperately in Part 2
Time Frame:3 year
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Safety: Subject incidence of treatment-related and treatment-emergent adverse events in monotherapy and combination of Part 1 and each separate tumour type in Part 2
Time Frame:5 years
Safety Issue:
Description:
Measure:Safety: To estimate the incidence of detectable talimogene laherparepvec DNA in blood and urine
Time Frame:5 years
Safety Issue:
Description:
Measure:Safety: To estimate the incidence of clearance of talimogene laherparepvec DNA from blood and urine
Time Frame:5 years
Safety Issue:
Description:
Measure:Safety: To estimate the rate of detection and incidence of talimogene laherparepvec DNA and virus at the surface of talimogene laherparepvec injection site, the exterior of the occlusive dressing, and the oral mucosa
Time Frame:5 years
Safety Issue:
Description:
Measure:Safety: To estimate the incidence of talimogene laherparepvec DNA detection in lesions suspected to be herpetic in origin
Time Frame:5 years
Safety Issue:
Description:
Measure:Efficacy: Objective response rate (ORR)
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)
Measure:Efficacy: Best overall response (BOR)
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)
Measure:Efficacy: Durable response rate (DRR)
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)
Measure:Efficacy: Duration of response (DOR)
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)
Measure:Efficacy: Response in injected and uninjected lesions
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)
Measure:Efficacy: Disease control rate (DCR)
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)
Measure:Efficacy Progression-free survival (PFS)
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)
Measure:Efficacy: Overall survival (OS)
Time Frame:5 years
Safety Issue:
Description:To evaluate the efficacy of intrahepatic injection of talimogene laherparepvec in the overall population and by tumor type (non-hepatocellular carcinoma and hepatocellular carcinoma)

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Amgen

Trial Keywords

  • Liver tumours

Last Updated

June 3, 2021