Clinical Trials /

Pembrolizumab in Early Stage Colon Cancer

NCT04231526

Description:

This study will gather information on the safety and effectiveness of pembrolizumab, an immunotherapy drug. The purpose of this study is to target early stage colon cancer before it has developed resistance to immunotherapy.

Related Conditions:
  • Colon Adenocarcinoma
Recruiting Status:

Not yet recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Pembrolizumab in Early Stage Colon Cancer
  • Official Title: A Window of Opportunity Study of Pembrolizumab in Colon Cancer

Clinical Trial IDs

  • ORG STUDY ID: IRB19-1411
  • NCT ID: NCT04231526

Conditions

  • Colon Cancer

Interventions

DrugSynonymsArms
PembrolizumabARM A - Pembrolizumab + Surgery

Purpose

This study will gather information on the safety and effectiveness of pembrolizumab, an immunotherapy drug. The purpose of this study is to target early stage colon cancer before it has developed resistance to immunotherapy.

Trial Arms

NameTypeDescriptionInterventions
ARM A - Pembrolizumab + SurgeryExperimental
  • Pembrolizumab
ARM B - SurgeryActive Comparator

    Eligibility Criteria

            Inclusion Criteria:
    
              1. Patients must have histologically confirmed colon adenocarcinoma.
    
              2. No prior chemotherapy, targeted therapy, or immunotherapy for colon cancer.
    
              3. Deemed to have surgically resectable disease.
    
              4. Archival tissue block containing colon adenocarcinoma must be confirmed available
                 prior to enrollment. MSI testing should be obtained prior to starting therapy.
    
              5. Be willing and able to provide written informed consent/assent for the trial.
    
              6. Be 18 years of age or older on day of signing informed consent.
    
              7. Have a measurable primary lesion by lower endoscopy or CT-imaging with a diameter of 1
                 or more centimeters.
    
              8. Have a performance status of 0 or 1 on the ECOG Performance Scale.
    
              9. Have no histologically confirmed disseminated disease by CT or PET-CT staging.
    
             10. Male participant must agree to use a contraception as detailed in Appendix 3 of this
                 protocol during the treatment period and for at least 120 days after the last dose of
                 study treatment and refrain from donating sperm during this period.
    
             11. A female participant is eligible to participate if she is not pregnant (see Appendix
                 3), not breastfeeding, and at least one of the following conditions applies:
    
                   1. Not a woman of childbearing potential (WOCBP) as defined in Appendix 3 OR
    
                   2. A WOCBP who agrees to follow the contraceptive guidance in Appendix 3 during the
                      treatment period and for at least 90 days after the last dose of study treatment.
    
             12. Demonstrate adequate organ function as defined below. All screening labs should be
                 performed within 14 days of treatment initiation.
    
                   -  Adequate Organ Function Laboratory Values
    
                        -  Hematological
    
                   -  Absolute neutrophil count (ANC) - ≥1500/µL
    
                   -  Platelets - ≥100 000/µL
    
                   -  Hemoglobin - ≥7.0 g/dL or ≥5.6 mmol/La
    
                        -  Renal
    
                   -  Creatinine OR measured or calculated creatinine clearance (GFR can also be used
                      in place of creatinine or CrCl) - ≤1.5 × ULN OR
    
                        -  30 mL/min for participant with creatinine levels >1.5 × institutional ULN
    
                             -  Hepatic
    
                   -  Total bilirubin - ≤1.5 ×ULN OR direct bilirubin ≤ULN for participants with total
                      bilirubin levels >1.5 × ULN
    
                   -  AST (SGOT) and ALT (SGPT) - ≤2.5 × ULN (≤5 × ULN for participants with liver
                      metastases)
    
                        -  Coagulation
    
                   -  International normalized ratio (INR) OR prothrombin time (PT)/ Activated partial
                      thromboplastin time (aPTT) - ≤1.5 × ULN unless participant is receiving
                      anticoagulant therapy as long as PT or aPTT is within therapeutic range of
                      intended use of anticoagulants
    
                        -  ALT (SGPT)=alanine aminotransferase (serum glutamic pyruvic transaminase);
                           AST (SGOT)=aspartate aminotransferase (serum glutamic oxaloacetic
                           transaminase); GFR=glomerular filtration rate; ULN=upper limit of normal.
    
                   -  Criteria must be met without erythropoietin dependency and without packed red
                      blood cell (pRBC) transfusion within last 2 weeks.
    
                   -  Creatinine clearance (CrCl) should be calculated per institutional standard.
                      Note: This table includes eligibility-defining laboratory value requirements for
                      treatment; laboratory value requirements should be adapted according to local
                      regulations and guidelines for the administration of specific chemotherapies.
    
            Exclusion Criteria:
    
              1. A WOCBP who has a positive urine pregnancy test during screening (see Appendix 3). If
                 the urine test is positive or cannot be confirmed as negative, a serum pregnancy test
                 will be required.
    
              2. Is currently participating and receiving study therapy or has participated in a study
                 of an investigational agent and received study therapy or used 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 a known history of active TB (Bacillus Tuberculosis)
    
              5. Known hypersensitivity to pembrolizumab or any of its excipients.
    
              6. If subject received major surgery, they must have recovered adequately from the
                 toxicity and/or complications from the intervention prior to starting therapy.
    
              7. Has a known additional malignancy that is progressing or requires active treatment.
                 Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the
                 skin that has undergone potentially curative therapy or in situ cervical cancer.
    
              8. Has known active central nervous system (CNS) metastases and/or carcinomatous
                 meningitis.
    
              9. Has active autoimmune disease that has required systemic treatment in the past 2 years
                 (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive
                 drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid
                 replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a
                 form of systemic treatment.
    
             10. Has a history of (non-infectious) pneumonitis that required steroids or has current
                 pneumonitis.
    
             11. Has an active infection requiring systemic therapy.
    
             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. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
    
             15. Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
    
             16. Has known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA
                 [qualitative] is detected).
    
             17. Has received a live vaccine within 30 days of planned start of study therapy.
    
             18. Is pregnant or breastfeeding, or expecting to conceive or father children within the
                 projected duration of the study, starting with the screening visit through 120 days
                 after the last dose of trial treatment.
    
             19. Has complications from colon cancer including but not limited to organ fistulas,
                 bleeding and obstruction.
          
    Maximum Eligible Age:N/A
    Minimum Eligible Age:18 Years
    Eligible Gender:All
    Healthy Volunteers:No

    Primary Outcome Measures

    Measure:To measure the feasibility of neoadjuvant pembrolizumab in early stage colon cancer
    Time Frame:14 months
    Safety Issue:
    Description:Measured using RECIST 1.1

    Secondary Outcome Measures

    Measure:Measure the tumor response in early stage colon cancer after neoadjuvant pembrolizumab
    Time Frame:14 months
    Safety Issue:
    Description:Measured using RECIST 1.1
    Measure:Measure the immune response in early stage colon cancer after neoadjuvant pembrolizumab
    Time Frame:14 months
    Safety Issue:
    Description:Measured using RECIST 1.1

    Details

    Phase:Phase 2
    Primary Purpose:Interventional
    Overall Status:Not yet recruiting
    Lead Sponsor:University of Chicago

    Last Updated

    January 15, 2020