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Study of Pembrolizumab With Maintenance Olaparib or Maintenance Pemetrexed in First-line (1L) Metastatic Nonsquamous Non-Small-Cell Lung Cancer (NSCLC) (MK-7339-006, KEYLYNK-006)

NCT03976323

Description:

The current study will compare pembrolizumab (MK-3475) plus maintenance olaparib, v.s. pembrolizumab plus maintenance pemetrexed for the treatment of nonsquamous NSCLC. The study's 2 primary hypotheses are: 1. Pembrolizumab plus maintenance olaparib is superior to pembrolizumab plus maintenance pemetrexed with respect to progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) by blinded independent clinical review (BICR) and 2. Pembrolizumab plus maintenance olaparib is superior to pembrolizumab plus maintenance pemetrexed with respect to overall survival (OS).

Related Conditions:
  • Non-Small Cell Lung Carcinoma
Recruiting Status:

Recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: Study of Pembrolizumab With Maintenance Olaparib or Maintenance Pemetrexed in First-line (1L) Metastatic Nonsquamous Non-Small-Cell Lung Cancer (NSCLC) (MK-7339-006, KEYLYNK-006)
  • Official Title: A Phase 3 Study of Pembrolizumab in Combination With Pemetrexed/Platinum (Carboplatin or Cisplatin) Followed by Pembrolizumab and Maintenance Olaparib vs Maintenance Pemetrexed in the First-Line Treatment of Participants With Metastatic Nonsquamous Non-Small-Cell Lung Cancer

Clinical Trial IDs

  • ORG STUDY ID: 7339-006
  • SECONDARY ID: MK-7339-006
  • SECONDARY ID: 2018-004720-11
  • SECONDARY ID: KEYLYNK-006
  • SECONDARY ID: 194895
  • NCT ID: NCT03976323

Conditions

  • Carcinoma, Non-squamous Non-small-cell Lung

Interventions

DrugSynonymsArms
PembrolizumabMK-3475, KEYTRUDA®Pembrolizumab + Pemetrexed + Platinum Therapy + Olaparib
PemetrexedALIMTA®Pembrolizumab + Pemetrexed + Platinum Therapy + Olaparib
CarboplatinPARAPLATIN®Pembrolizumab + Pemetrexed + Platinum Therapy + Olaparib
CisplatinPLATINOL®, PLATINOL®-AQPembrolizumab + Pemetrexed + Platinum Therapy + Olaparib
OlaparibLYNPARZA®Pembrolizumab + Pemetrexed + Platinum Therapy + Olaparib

Purpose

The current study will compare pembrolizumab (MK-3475) plus maintenance olaparib, v.s. pembrolizumab plus maintenance pemetrexed for the treatment of nonsquamous NSCLC. The study's 2 primary hypotheses are: 1. Pembrolizumab plus maintenance olaparib is superior to pembrolizumab plus maintenance pemetrexed with respect to progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST 1.1) by blinded independent clinical review (BICR) and 2. Pembrolizumab plus maintenance olaparib is superior to pembrolizumab plus maintenance pemetrexed with respect to overall survival (OS).

Detailed Description

      This study has 2 phases: an Induction Phase (4 Cycles) and a Maintenance Phase (Up to 31
      cycles of pembrolizumab). In the Induction Phase, participants receive pembrolizumab plus
      pemetrexed plus platinum (carboplatin or cisplatin). In the Maintenance Phase, participants
      with a partial or complete disease response or with stable disease after completing four
      cycles of induction therapy and who meet eligibility criteria will be randomly assigned to
      receive pembrolizumab plus maintenance olaparib OR pembrolizumab plus maintenance pemetrexed.
      In the Maintenance Phase, participants receive pembrolizumab for up to 31 cycles plus
      maintenance olaparib OR maintenance pemetrexed until progressive disease (PD), intolerable
      toxicities, or physician decision.
    

Trial Arms

NameTypeDescriptionInterventions
Pembrolizumab + Pemetrexed + Platinum Therapy + OlaparibExperimentalFor the Induction Phase, participants receive 4 cycles: Pembrolizumab 200 mg intravenous (IV) on Day 1 of each 21-day cycle (cycles 1 through 4) PLUS Pemetrexed 500 mg/m^2 IV on Day 1 of each 21-day cycle (cycles 1 through 4) PLUS Platinum chemotherapy, investigator's choice: carboplatin area under the curve (AUC) 5 mg/mL/min IV on Day 1 of 21-day cycle (Cycles 1 through 4) OR cisplatin 75 mg/m^2 IV on Day 1 of 21-day cycle (Cycles 1 through 4). If the participant has a complete or partial response or stable disease to induction therapy, the participant is randomized to maintenance therapy. For the Maintenance Phase, participants receive Pembrolizumab IV on Day 1 of each 21-day cycle for up to 31 cycles PLUS maintenance oral olaparib 300 mg twice daily. In the Maintenance Phase, the participant continues to receive maintenance olaparib until progressive disease, physician decision or intolerable toxicity.
  • Pembrolizumab
  • Pemetrexed
  • Carboplatin
  • Cisplatin
  • Olaparib
Pembrolizumab + Pemetrexed + Platinum Therapy + PemetrexedActive ComparatorFor the Induction Phase, participants receive 4 cycles: Pembrolizumab 200 mg intravenous (IV) on Day 1 of each 21-day cycle (cycles 1 through 4) PLUS Pemetrexed 500 mg/m^2 IV on Day 1 of each 21-day cycle (cycles 1 through 4) PLUS Platinum chemotherapy, investigator's choice: carboplatin area under the curve (AUC) 5 mg/mL/min IV on Day 1 of 21-day cycle (Cycles 1 through 4) OR cisplatin 75 mg/m2 IV on Day 1 of 21-day cycle (Cycles 1 through 4). If the participant has a complete or partial response or stable disease to induction therapy, the participant is randomized to maintenance therapy. For the Maintenance Phase, participants receive Pembrolizumab IV on Day 1 of each 21 day-cycle for up to 31 cycles PLUS maintenance pemetrexed IV 500 mg/m^2 on Day 1 of each 21-day cycle. In the maintenance phase, the participant continues to receive maintenance pemetrexed until progressive disease, physician decision or intolerable toxicity.
  • Pembrolizumab
  • Pemetrexed
  • Carboplatin
  • Cisplatin

Eligibility Criteria

        Inclusion Criteria:

          1. Have a histologically or cytologically confirmed diagnosis nonsquamous NSCLC.

          2. Have stage IV nonsquamous NSCLC.

          3. Have confirmation that epidermal growth factor receptor (EGFR), anaplastic lymphoma
             kinase (ALK), or Proto-oncogene tyrosine-protein kinase (ROS1)-directed therapy is not
             indicated.

          4. Have measurable disease based on RECIST 1.1.

          5. Have provided archival tumor tissue sample or newly obtained core or incisional biopsy
             of a tumor lesion not previously irradiated.

             Note: Adequacy of biopsy specimen for the above analyses must be confirmed by the
             central laboratory before the participant can start the induction phase. Submission of
             another tumor specimen may be required prior to enrolling the participant, if adequate
             tumor tissue was not provided the first time.

          6. Have a life expectancy of at least 3 months.

          7. Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG)
             Performance Status assessed within 7 days prior to the administration of study
             intervention.

          8. Have not received prior systemic treatment for their advanced/metastatic NSCLC.

          9. Have adequate organ function.

         10. Male and female participants who are not pregnant and of childbearing potential must
             follow contraceptive guidance during the treatment period and for 180 days afterwards.

         11. Male participants must refrain from donating sperm during the treatment period and for
             180 days afterwards.

        Exclusion Criteria:

          1. Has predominantly squamous cell histology NSCLC.

          2. Has a known additional malignancy that is progressing or has progressed within the
             past 3 years requiring active treatment.

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

          4. Has a severe hypersensitivity (≥Grade 3) to pembrolizumab and/or any of its
             excipients.

          5. Has a known hypersensitivity to any components or excipients of cisplatin,
             carboplatin, pemetrexed, or olaparib.

          6. Has an active autoimmune disease that has required systemic treatment in past 2 years.

          7. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy.

          8. Has a known history of human immunodeficiency virus (HIV) infection, a known history
             of hepatitis B infection, or known active hepatitis C virus infection.

          9. Has interstitial lung disease, or history of pneumonitis requiring systemic steroids
             for treatment.

         10. Has received prior therapy with olaparib or with any other polyadenosine 5'
             diphosphoribose (polyADP ribose) polymerization (PARP) inhibitor.

         11. Has received prior therapy with an agent directed to programmed cell death ligand 1
             (PD-L1), anti PD-L2, or directed to a stimulatory or co-inhibitory T-cell receptor
             (e.g., cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), OX-40, CD137).

         12. Has myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) or with features
             suggestive of MDS/AML.

         13. Has not completed palliative radiotherapy within 7 days of the first dose.
             Participants must have recovered from all radiation-related toxicities and not require
             corticosteroids.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Progression-free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1)
Time Frame:Up to approximately 3 years
Safety Issue:
Description:Progression-free survival is the time from the date of randomization until either documented disease progression or death due to any cause, whichever occurs first.

Secondary Outcome Measures

Measure:Number of Participants Experiencing an Adverse Event (AE)
Time Frame:Up to approximately 5 years
Safety Issue:
Description:An adverse event (AE) is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.
Measure:Number of Participants Discontinuing Study Treatment Due to Adverse Event (AE)
Time Frame:Up to approximately 5 years
Safety Issue:
Description:An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.
Measure:Change from Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) Global Health Status / Quality of Life (Items 29 and 30) Scale Score
Time Frame:Baseline (at randomization) and Week 18 post-randomization
Safety Issue:
Description:The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to the question "How would you rate your overall health during the past week?" are scored on a 7-point scale (1= Very poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better overall health status. The change from baseline in EORTC QLQ-C30 Items 29 and 30 scores will be presented.
Measure:Change from Baseline in EORTC Quality of Life Questionnaire Lung Cancer Module 13 (QLQ-LC13) Cough (Item 1) Scale Score
Time Frame:Baseline (at randomization) and Week 18 post-randomization
Safety Issue:
Description:The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30 questionnaire. Participant responses to the question "How much did you cough?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. The change from baseline in EORTC QLQ-LC13 cough (Item 1) score will be presented.
Measure:Change from Baseline in EORTC QLQ-LC13 Chest Pain (Item 10) Scale Score
Time Frame:Baseline (at randomization) and Week 18 post-randomization
Safety Issue:
Description:The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30 questionnaire. Participant responses to the question "How was your chest pain?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. The change from baseline in EORTC QLQ-LC13 chest pain (Item 10) score will be presented.
Measure:Change from Baseline in EORTC QLQ-C30 Dyspnea (Item 8) Scale Score
Time Frame:Baseline (at randomization) and Week 18 post-randomization
Safety Issue:
Description:The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to the question "Were you short of breath?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. The change from baseline in EORTC QLQ-LC13 dyspnea (Item 8) score will be presented.
Measure:Change from Baseline in EORTC QLQ-C30 Physical Functioning (Items 1 to 5) Scale Score
Time Frame:Baseline (at randomization) and Week 18 post-randomization
Safety Issue:
Description:The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to 5 questions about their physical functioning are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better quality of life. The change from baseline in Physical Functioning (EORTC QLQ-C30 Items 1-5) score will be presented.
Measure:Time to True Deterioration (TTD) in EORTC QLQ-C30 Global Health Status / Quality of Life (Items 29 & 30) Scale Score
Time Frame:Up to approximately 5 years
Safety Issue:
Description:The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to the question "How would you rate your overall health during the past week?" are scored on a 7-point scale (1= Very poor to 7=Excellent). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better overall health status. TTD was defined as the time from baseline (at randomization) to the first onset of a ≥10-point decrease with confirmation by the subsequent visit of a ≥10-point decrease in EORTC QLQ-C30 Items 29 and 30 scale scores.
Measure:Time to True Deterioration (TTD) in EORTC Quality of Life Questionnaire Lung Cancer Module 13 (QLQ-LC13) Cough (Item 1) Scale Score
Time Frame:Up to approximately 5 years
Safety Issue:
Description:The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30 questionnaire. Participant responses to the question "How much did you cough?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. TTD was defined as the time from baseline (at randomization) to the first onset of a ≥10-point decrease with confirmation by the subsequent visit of a ≥10-point decrease in cough EORTC QLQ-LC13 cough (Item 1) scale score.
Measure:Time to True Deterioration (TTD) in EORTC (QLQ-LC13 Chest Pain (Item 10) Scale Score
Time Frame:Up to approximately 5 years
Safety Issue:
Description:The EORTC QLQ-LC13 is a lung cancer-specific supplemental questionnaire used in combination with the EORTC QLQ-C30 questionnaire. Participant responses to the question "How was your chest pain?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. TTD was defined as the time from baseline (at randomization) to the first onset of a ≥10-point decrease with confirmation by the subsequent visit of a ≥10-point decrease in EORTC QLQ-LC13 chest pain (Item 10) scale score.
Measure:Time to True Deterioration (TTD) in EORTC QLQ-C30 Dyspnea (Item 8) Scale Score
Time Frame:Up to approximately 5 years
Safety Issue:
Description:The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to the question "Were you short of breath?" are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A lower score indicates a better outcome. TTD was defined as the time from baseline (at randomization) to the first onset of a ≥10-point decrease with confirmation by the subsequent visit of a ≥10-point decrease in EORTC QLQ-C30 dyspnea (Item 8) scale score.
Measure:Time to True Deterioration (TTD) in EORTC QLQ-C30 Physical Functioning (Items 1 to 5) Scale Score
Time Frame:Up to approximately 5 years
Safety Issue:
Description:The EORTC QLQ-C30 is a questionnaire to assess the overall quality of life of cancer patients. Participant responses to 5 questions about their physical functioning are scored on a 4-point scale (1=Not at All to 4=Very Much). Using linear transformation, raw scores are standardized, so that scores range from 0 to 100. A higher score indicates a better quality of life. TTD was defined as the time from baseline (at randomization) to the first onset of a ≥10-point decrease with confirmation by the subsequent visit of a ≥10-point decrease in EORTC QLQ-C30 physical functioning (Items 1 to 5) scale scores.

Details

Phase:Phase 3
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Merck Sharp & Dohme Corp.

Trial Keywords

  • Lung cancer
  • PD-1
  • PD L1
  • PD L2

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