Description:
This is a single arm, open-label, Phase 1b study of pembrolizumab for patients with
myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), and acute lymphoblastic
leukemia (ALL) whose disease has relapsed after receiving allogeneic hematopoetic stem cell
transplant.
Title
- Brief Title: Augmentation of the Graft vs. Leukemia Effect Via Checkpoint Blockade With Pembrolizumab
- Official Title: Augmentation of the Graft vs. Leukemia Effect Via Checkpoint Blockade With Pembrolizumab for Relapse of Primary Malignancy After Allogeneic Hematopoietic Stem Cell Transplant: A Feasibility Study
Clinical Trial IDs
- ORG STUDY ID:
UMCC 2017.056
- SECONDARY ID:
HUM00129255
- NCT ID:
NCT03286114
Conditions
- Myelodysplastic Syndromes
- Acute Myeloid Leukemia
- Acute Lymphoblastic Leukemia
Interventions
Drug | Synonyms | Arms |
---|
Pembrolizumab | KEYTRUDA | Pembrolizumab |
Purpose
This is a single arm, open-label, Phase 1b study of pembrolizumab for patients with
myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), and acute lymphoblastic
leukemia (ALL) whose disease has relapsed after receiving allogeneic hematopoetic stem cell
transplant.
Trial Arms
Name | Type | Description | Interventions |
---|
Pembrolizumab | Experimental | | |
Eligibility Criteria
Inclusion Criteria:
- Acute Myeloid Leukemia (AML), Acute Lymphoblastic Leukemia (ALL) or Myelodysplastic
Syndrome (MDS) in confirmed relapse
- Confirmation of 'measurable disease'
- Patient may not have received definitive salvage chemotherapy for their
post-transplant relapse within the past 21 days.
- Be willing and able to provide written informed consent/assent for the trial
- Be ≥ 18 years of age on day of signing informed consent
- Be willing to provide tissue from bone marrow biopsies
- Have a performance status of 0, to 1 on the ECOG Performance Scale. Eastern
Cooperative Oncology Group Performance Status: an attempt to quantify cancer patients'
general well-being and activities of daily life. The score ranges from 0 to 5 where 0
is asymptomatic and 5 is death.
- Demonstrate adequate organ function
- Female subject of childbearing potential should have a negative urine or serum
pregnancy within 72 hours prior to receiving the first dose of study medication.
- Female subjects of childbearing potential must be willing to use an adequate method of
contraception
- Male subjects of childbearing potential must agree to use an adequate method of
contraception
Exclusion Criteria:
- Has had relapse prior to primary neutrophil engraftment or ≤21 days post HCT.
- Has received >1 line of chemotherapy or other treatment directed towards
post-transplant relapse prior to study entry
- Rapidly progressive relapse requiring urgent chemotherapy as determined by treating
physician
- Is currently participating and receiving study therapy of an investigational agent and
received study therapy within 2 weeks of the first dose of treatment.
- Has a diagnosis of active GvHD (≥ Grade I)
- Receiving systemic steroid therapy of > 10mg prednisone daily or equivalent*
- Has received GM-CSF within 14 days of first dose of pembrolizumab
- Has a known history of active TB (Bacillus Tuberculosis)Hypersensitivity to
pembrolizumab or any of its excipients
- Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study
Day 1 or who has not recovered from adverse events
- Has had prior chemotherapy within 21 days or radiation therapy within 14 days prior to
study Day 1 or who has not recovered from adverse events
- Has a known additional (secondary) malignancy that is progressing or requires active
treatment
- Has known or suspected active central nervous system (CNS) metastases and/or
carcinomatous meningitis
- Has a history of (non-infectious) pneumonitis that required steroids, or current
pneumonitis
- 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.
- Has known psychiatric or substance abuse disorders that would interfere with
cooperation with the requirements of the trial
- Is pregnant or breastfeeding, or expecting to conceive or father children within the
projected duration of the trial
- Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent
- Has a known history of Human Immunodeficiency Virus (HIV)
- Has known active Hepatitis B or Hepatitis C
- Has received a live vaccine within 30 days of planned start of study therapy
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | The number of patients that demonstrate clinical benefit from treatment |
Time Frame: | Day 77 |
Safety Issue: | |
Description: | This study will assess if the study drug is promising for further study. The study drug will be considered promising if at least 4 patients receive a clinical benefit or if any complete response is seen. Clinical benefit is defined as either stable disease, partial remission or complete remission to treatment.
Complete remission (CR) will be defined as achieving a morphologic leukemia free state by achieving all of the following criteria: bone marrow myeloblasts < 5% by morphologic assessment; AND absence of circulating blasts with phenotypic or morphologic features of leukemia (e.g. Auer rods) AND no evidence of extramedulary disease.
Partial remission (PR) will be defined as a ≥ 50% reduction in bone marrow blast percentage to 5-25% or marrow blasts < 5% with persistent Auer rods, flow cytometric or cytogenetic disease.
SD will be defined as ≤ 5% increase in blasts or decreased blast percentage in the bone marrow that does not meet the criteria for PR. |
Secondary Outcome Measures
Measure: | The number of patients alive at 1 year |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | |
Measure: | The number of patients alive at 1 year without disease |
Time Frame: | 1 Year |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | University of Michigan Rogel Cancer Center |
Last Updated
May 27, 2021