Description:
The purpose of the study is to determine the safety and test the efficacy of the combination
of radium-223 dichloride and pembrolizumab in patients with stage IV non-small cell lung
cancer (NSCLC) with bone metastases who either have not received any systemic therapy for
their advanced disease or have progressed on prior immunologic checkpoint blockade with
antibodies against the programmed cell death protein-(ligand) 1 (PD-1/PD-L1). In this study
researchers want to measure tumor shrinkage in response to treatment and how long that
shrinkage lasts and gather information on safety. Pembrolizumab is an immunologic checkpoint
blocker that promotes an immune response against the tumor. Radium-223 dichloride is an alpha
particle-emitting radioactive agent which kills cancer cells.
Title
- Brief Title: Study to Test the Safety and How Radium-223 Dichloride an Alpha Particle-emitting Radioactive Agent Works in Combination With Pembrolizumab an Immune Checkpoint Inhibitor in Patients With Stage IV Non-small Cell Lung Cancer With Bone Metastases
- Official Title: An Open-label, Multicenter, Phase 1/2 Study of Radium-223 Dichloride in Combination With Pembrolizumab in Participants With Stage IV Non-small Cell Lung Cancer
Clinical Trial IDs
- ORG STUDY ID:
19781
- SECONDARY ID:
2018-003704-39
- NCT ID:
NCT03996473
Conditions
- Carcinoma, Non-Small-Cell Lung
Interventions
Drug | Synonyms | Arms |
---|
Radium-223 dichloride (Xofigo, BAY 88-8223) | | Phase 1: Radium-223+Pembrolizumab |
Pembrolizumab | | Phase 1: Radium-223+Pembrolizumab |
Purpose
The purpose of the study is to determine the safety and test the efficacy of the combination
of radium-223 dichloride and pembrolizumab in patients with stage IV non-small cell lung
cancer (NSCLC) with bone metastases who either have not received any systemic therapy for
their advanced disease or have progressed on prior immunologic checkpoint blockade with
antibodies against the programmed cell death protein-(ligand) 1 (PD-1/PD-L1). In this study
researchers want to measure tumor shrinkage in response to treatment and how long that
shrinkage lasts and gather information on safety. Pembrolizumab is an immunologic checkpoint
blocker that promotes an immune response against the tumor. Radium-223 dichloride is an alpha
particle-emitting radioactive agent which kills cancer cells.
Trial Arms
Name | Type | Description | Interventions |
---|
Phase 1: Radium-223+Pembrolizumab | Experimental | Participants will receive radium-223 dichloride every 6 weeks in combination with pembrolizumab every 3 weeks | - Radium-223 dichloride (Xofigo, BAY 88-8223)
- Pembrolizumab
|
Phase 2 Cohort 1: Radium-223+Pembrolizumab | Experimental | Participants will receive radium-223 dichloride every 6 weeks in combination with pembrolizumab every 3 weeks | - Radium-223 dichloride (Xofigo, BAY 88-8223)
- Pembrolizumab
|
Phase 2 Cohort 1: Pembrolizumab alone | Active Comparator | Participants will receive pembrolizumab every 3 weeks | |
Phase 2 Cohort 2: Radium-223+Pembrolizumab | Experimental | Participants will receive radium-223 dichloride every 6 weeks in combination with pembrolizumab every 3 weeks | - Radium-223 dichloride (Xofigo, BAY 88-8223)
- Pembrolizumab
|
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed diagnosis of stage IV NSCLC.
- Phase 2 Cohort 1: No Epidermal Growth Factor Receptor (EGFR) / v-Raf murine
sarcoma viral oncogene homolog B (BRAF) mutation or anaplastic lymphoma kinase
(ALK)/ROS1 rearrangement. Treatment naïve (no prior systemic therapy) for their
metastatic NSCLC.
- Phase 2 Cohort 2: progression on prior treatment with an immune checkpoint
inhibitor inhibitor. Prior treatment with platinum-based chemotherapy in
combination or in sequence in line with local standard of care.
- Phase 1 includes participants meeting either Cohort 1 or Cohort 2 criteria.
- Measurable disease per RECIST v1.1.
- At least 2 skeletal metastases.
- Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0 or 1.
- Adequate bone marrow and organ function.
- Participants must be on a bone health agent (BHA) treatment, such as bisphosphonates
or denosumab treatment unless such treatment is contraindicated or not recommended per
investigator's judgement.
Exclusion Criteria:
- Previous or concurrent cancer within 3 years prior to enrollment.
- Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent or with
an agent directed to another stimulatory or co-inhibitory T-cell receptor. Phase 2
Cohort 2: was discontinued from that treatment due to a Grade 3 or higher
immune-related AEs (irAEs).
- Known active central nervous system metastases and/or carcinomatous meningitis.
Participants with previously treated brain metastases may participate provided they
are radiologically stable, clinically stable, and without requirement of steroid
treatment for at least 14 days prior to first dose of study treatment.
- Active autoimmune disease that has required systemic treatment in the past 2 years.
- History of (non-infectious) pneumonitis that required steroids or has current
pneumonitis.
- Known history or presence of osteonecrosis of jaw.
- Ongoing infection >Grade 2 NCI-CTCAE v.5.0 requiring systemic therapy.
- Significant acute GI disorders with diarrhea as a major symptom e.g., Crohn's disease,
malabsorption, or ≥ NCI-CTCAE v.5.0 Grade 2 diarrhea of any etiology.
- History of osteoporotic fracture.
- Prior treatment with radium-223 dichloride or any therapeutic radiopharmaceutical.
- Prior radiotherapy within 21 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: | Number of participants with adverse events (AEs) in Phase 1 |
Time Frame: | Until 30 days after the last dose of the study intervention (up to 3 years) |
Safety Issue: | |
Description: | ORR is defined as the percentage of participants with best overall response of complete response (CR) or partial response (PR) during the course of the study. |
Secondary Outcome Measures
Measure: | ORR per RECIST v1.1 in Phase 1 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | |
Measure: | Duration of response (DoR) per RECIST v1.1 in Phase 1 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | DoR is defined as the time interval from the date of first response (CR or PR) to the date of disease progression or death, whichever comes first. |
Measure: | Disease control rate (DCR) per RECIST v1.1 in Phase 1 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | DCR is defined as the percentage of participants with CR or PR, or SD for at least 6 weeks during the course of the study. |
Measure: | DoR per RECIST v1.1 in Phase 2 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | |
Measure: | DCR per RECIST v1.1 in Phase 2 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | |
Measure: | Progression free survival (PFS) per RECIST v1.1 in Phase 2 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | PFS is defined as the time period until the date of radiological progression or death whichever occurs first. |
Measure: | Overall survival (OS) in Phase 2 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | OS is defined as the time period until the death due to any cause. |
Measure: | Number of participants with AE in Phase 2 |
Time Frame: | Until 30 days after the last dose of the study intervention (up to 5 years) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 1/Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Bayer |
Trial Keywords
Last Updated
August 18, 2021