Clinical Trials /

A Study of Enhancing Response to MK-3475 in Advanced Colorectal Cancer

NCT02512172

Description:

This study is being done to test the safety and effectiveness of the combination of intravenous (IV) romidepsin and/or oral 5-azacitidine with IV MK-3475 in people with microsatellite stable (MSS) advanced colorectal cancer.

Related Conditions:
  • Colorectal Carcinoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Pilot Study of Enhancing Response to MK-3475 in Advanced Colorectal Cancer
  • Official Title: A Pilot Study of Using Epigenetic Modulators to Enhance Response to MK-3475 in Microsatellite Stable Advanced Colorectal Cancer

Clinical Trial IDs

  • ORG STUDY ID: J1538
  • SECONDARY ID: IRB00060125
  • NCT ID: NCT02512172

Conditions

  • Colorectal Cancer

Interventions

DrugSynonymsArms
Oral CC - 486oral azacitidine, oral azaOral CC - 486 & MK-3475
RomidepsinIstodaxRomidepsin & MK-3475
MK - 3475pembrolizumabOral CC - 486 & MK-3475

Purpose

This study is being done to test the safety and effectiveness of the combination of intravenous (IV) romidepsin and/or oral 5-azacitidine with IV MK-3475 in people with microsatellite stable (MSS) advanced colorectal cancer.

Detailed Description

      This study is being done to test the safety and effectiveness of the combination of
      intravenous (IV) romidepsin and/or oral CC - 486 with IV MK-3475 in people with
      microsatellite stable advanced colorectal cancer.

      The use of CC - 486 in this research study is investigational. The word "investigational"
      means that the oral form of CC - 486 is not approved for marketing by the U.S. Food and Drug
      Administration (FDA). Oral CC - 486 has only been given to a very small number of people so
      far, and this combination has never before been given together to people.

      Romidepsin has been approved by the FDA for the treatment of cutaneous T-cell lymphoma
      (blood cancer). It is not approved by the FDA for use in other cancers.

      MK-3475 is an antibody. Antibodies are proteins that the immune system uses to fight
      infection. Researchers have designed MK-3475 to block PD-1. PD-1 is a molecule that can shut
      down an immune response to infection or a cancer cell. An antibody to PD-1 can stop it from
      turning off an immune response and may be able to boost the immune system against the
      cancer.

      People with advanced colorectal tumors that are microsatellite stable (MSS) may join this
      study. Tumors that are MSS positive are not deficient in repair of DNA.

      This is a pilot study that will look at different ways of making MSS colorectal tumors
      sensitive to MK-3475 by giving 14 or 21 days of an epigenetic agent (oral CC - 486 and/or
      romidepsin).

      Participants will be randomly assigned (by chance, like drawing numbers from a hat) to one
      of three study drug combinations:

      A. Oral CC - 486 taken daily for 21 days (and later shortened to 14 days if there are side
      effects) and IV MK-3475 given every 2 weeks.

      B. IV romidepsin given once weekly for 3 weeks and IV MK-3475 given every 2 weeks C. Oral CC
      - 486 taken daily for 21 days (and later shortened to 14 days if there side effects) and IV
      romidepsin given every 2 weeks and IV MK-3475 given every 2 weeks.

      Each arm is repeated every 28 days and will continue until the point that the study drug are
      no longer working. It will not be possible to cross over onto another arm if a participant's
      disease does not respond to the study drugs.

      In this study investigators are looking for the following information:

        -  What effects, good and/or bad, the combination of oral CC - 486 and/or romidepsin in
           combination with MK-3475 has on participants' cancer; and

        -  If the genetic and chemical make-up of participants' blood and tumor cells play a role
           in a response to oral CC - 486 and/or romidepsin in combination with MK-3475.
    

Trial Arms

NameTypeDescriptionInterventions
Oral CC - 486 & MK-3475ExperimentalOral CC - 486 300 mg days 1-14 or 21 every 28 days + IV MK-3475 200 mg days 1 and 15 every 28 days
  • Oral CC - 486
  • MK - 3475
Romidepsin & MK-3475ExperimentalRomidepsin 14 mg/m2 days 1, 8 and 15 + IV MK-3475 200 mg days 1 and 15 every 28 days
  • Romidepsin
  • MK - 3475
Oral CC - 486 & Romidepsin & MK-3475ExperimentalOral CC - 486 300 mg days 1-14 or 21 + romidepsin 7 mg/m2 (days 1, 8 and 15) + IV MK-3475 200 mg days 1 and 15 every 28 days.
  • Oral CC - 486
  • Romidepsin
  • MK - 3475

Eligibility Criteria

        Inclusion Criteria:

          1. Have histologically confirmed microsatellite stable metastatic colorectal cancer and
             have received at least one line of treatment for metastatic colorectal cancer
             including fluoropyrimidines, oxaliplatin and/or irinotecan

          2. Be willing and able to provide written informed consent/assent for the trial

          3. Be 18 years of age on day of signing informed consent

          4. Have measurable disease

          5. Have biopsiable disease. If biopsy is attempted and unsuccessful (the patient
             undergoes an invasive procedure), the patient may still be treated

          6. Have a performance status of 0 or 1 on the ECOG Performance Scale at study entry

          7. Demonstrate adequate organ function

          8. Female subject of childbearing potential must have a negative urine or serum
             pregnancy test within 72 hours prior to receiving the first dose of study medication

          9. Female subjects of childbearing potential must 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

         10. Male subjects must agree to use an adequate method of contraception starting with the
             first dose of study therapy through 120 days after the last dose of study therapy

         11. In patients with liver metastases, there should be <50% involvement of the liver with
             no tumors greater than 5 cm in size

         12. Patients must have had < 3 prior therapies in the metastatic setting.

        Exclusion Criteria:

          1. Patients whose tumors have progressed at the first restaging during first line
             therapy

          2. Is currently participating in or has participated in a study of an investigational
             agent or using an investigational device within 4 weeks of the first dose of
             treatment

          3. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any
             other form of immunosuppressive therapy within 7 days prior to the first dose of
             trial treatment

          4. Has had a prior monoclonal antibody 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

          5. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy
             within 4 weeks (6 weeks for nitrosureas or mitomycin C) prior to study Day 1 or who
             has not recovered from adverse events due to a previously administered agent

          6. Has a known additional malignancy that is progressing or requires active treatment

          7. Has known central nervous system (CNS) metastases and/or carcinomatous meningitis

          8. 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.

          9. Has evidence of interstitial lung disease or active, non-infectious pneumonitis.

         10. Has an active infection requiring systemic therapy.

         11. Any clinical or radiological ascites or pleural effusions

         12. Has a history or current evidence of any condition, therapy, or laboratory
             abnormality that might confound the results of the trial, interfere with the
             subject's participation for the full duration of the trial, or is not in the best
             interest of the subject to participate, in the opinion of the treating investigator

         13. Has known psychiatric or substance abuse disorders that would interfere with
             cooperation with the requirements of the trial

         14. Is pregnant or breastfeeding, or expecting to conceive or father children within the
             projected duration of the trial

         15. Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137,
             anti-OX-40, anti-CD40, or anti-Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4)
             antibody (including ipilimumab or any other antibody or drug specifically targeting
             T-cell co-stimulation or checkpoint pathways). Prior therapies with other
             immunomodulatory agents must be reviewed by the PI and may be cause for ineligibility

         16. Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies)

         17. Has known active Hepatitis B or Hepatitis C

         18. Has received a live vaccine within 30 days prior to the first dose of trial treatment

         19. Any known cardiac abnormalities
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Degree of change in tumor infiltrating lymphocytes
Time Frame:1 year
Safety Issue:
Description:Change is determined by the number of CD45NO+ cells per high powered field

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Sidney Kimmel Comprehensive Cancer Center

Last Updated

April 20, 2016