Description:
This phase II trial investigates how well pembrolizumab and carboplatin work in treating
patients with ovarian, fallopian tube, or primary peritoneal cancer that has come back
(recurrent). Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the
body's immune system attack the cancer, and may interfere with the ability of tumor cells to
grow and spread. Chemotherapy drugs, such as carboplatin, work in different ways to stop the
growth of tumor cells, either by killing the cells, by stopping them from dividing, or by
stopping them from spreading. Giving pembrolizumab together with carboplatin may work better
in treating patients with recurrent ovarian, fallopian tube, or primary peritoneal cancer.
Title
- Brief Title: Pembrolizumab and Carboplatin for the Treatment of Recurrent Ovarian, Fallopian Tube, or Primary Peritoneal Cancer
- Official Title: A Phase II Study of Anti-PD-1 in Combination With Carboplatin to Prevent Progression After Serologic Detection of Recurrent Ovarian Cancer
Clinical Trial IDs
- ORG STUDY ID:
RG1007137
- SECONDARY ID:
NCI-2020-02615
- SECONDARY ID:
10312
- SECONDARY ID:
P30CA015704
- SECONDARY ID:
W81XWH1910009
- NCT ID:
NCT04387227
Conditions
- Recurrent Fallopian Tube Carcinoma
- Recurrent Ovarian Carcinoma
- Recurrent Primary Peritoneal Carcinoma
Interventions
Drug | Synonyms | Arms |
---|
Carboplatin | Blastocarb, Carboplat, Carboplatin Hexal, Carboplatino, Carboplatinum, Carbosin, Carbosol, Carbotec, CBDCA, Displata, Ercar, JM-8, Nealorin, Novoplatinum, Paraplatin, Paraplatin AQ, Paraplatine, Platinwas, Ribocarbo | Treatment (carboplatin, pembrolizumab) |
Pembrolizumab | Keytruda, Lambrolizumab, MK-3475, SCH 900475 | Treatment (carboplatin, pembrolizumab) |
Purpose
This phase II trial investigates how well pembrolizumab and carboplatin work in treating
patients with ovarian, fallopian tube, or primary peritoneal cancer that has come back
(recurrent). Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the
body's immune system attack the cancer, and may interfere with the ability of tumor cells to
grow and spread. Chemotherapy drugs, such as carboplatin, work in different ways to stop the
growth of tumor cells, either by killing the cells, by stopping them from dividing, or by
stopping them from spreading. Giving pembrolizumab together with carboplatin may work better
in treating patients with recurrent ovarian, fallopian tube, or primary peritoneal cancer.
Detailed Description
OUTLINE:
Patients receive carboplatin intravenously (IV) over 30 minutes on day -2 of cycle 1 only.
Patients also receive pembrolizumab IV over 30 minutes on day 1 of each cycle. Cycles repeat
every 6 weeks for up to 2 years in the absence of disease progression or unacceptable
toxicity.
After the completion of study treatment, patients are followed up at 30 days, then every 3
months for year 1, and every 6 months for year 2.
Trial Arms
Name | Type | Description | Interventions |
---|
Treatment (carboplatin, pembrolizumab) | Experimental | Patients receive carboplatin IV over 30 minutes on day -2 of cycle 1 only. Patients also receive pembrolizumab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 6 weeks for up to 2 years in the absence of disease progression or unacceptable toxicity. | |
Eligibility Criteria
Inclusion Criteria:
- Have a diagnosis of ovarian, fallopian tube, or primary peritoneal cancer who have
received systemic chemotherapy including platinum-based chemotherapy
- Have a cancer antigen (CA)-125 that normalized after first-line therapy
- CA-125 increased to more than twice the upper limit of normal or two times the nadir
value after most recent second or later line of treatment
- Have no measurable disease based on Response Evaluation Criteria in Solid Tumors
(RECIST) 1.1. Ascites and pleural effusions are not measurable disease, if
asymptomatic
- All patients who are having sex that can lead to pregnancy must agree to contraception
for the duration of the study
- Have estimated life expectancy of at least 3 months
- Be willing and able to provide written informed consent/assent for the trial
- Have a performance status of 0 or 1 on the on the Eastern Cooperative Oncology Group
(ECOG) performance scale
- Absolute neutrophil count (ANC) >= 1,500/mcL (performed within 10 days of treatment
initiation)
- Platelets >= 100,000/mcL (performed within 10 days of treatment initiation)
- Hemoglobin (Hgb) >= 9 g/dL or >= 5.6 mmol/L without transfusion or erythropoietin
(EPO) dependency (within 7 days of assessment)
- Creatinine =< 1.5 x upper limit of normal (ULN) OR measured or calculated creatinine
clearance >= 30 mL/min for subject with creatinine levels > 1.5 x institutional ULN
- Serum total bilirubin =< 1.5 X ULN OR direct bilirubin =< ULN for subjects with total
bilirubin levels > 1.5 X ULN (performed within 10 days of treatment initiation)
- Aspartate transaminase (AST) (serum glutamic-oxaloacetic transaminase [SGOT]) and
alanine transferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 2.5 X ULN
OR =< 5 X ULN for subjects with liver metastases (performed within 10 days of
treatment initiation)
- International normalized ratio (INR) or prothrombin time (PT) =< 1.5 X ULN unless
patient is receiving anticoagulant therapy (as long as PT or partial thromboplastin
time [PTT] is within therapeutic range of intended use of anticoagulants) (performed
within 10 days of treatment initiation)
- Activated partial thromboplastin time (aPTT) =< 1.5 X ULN unless patient is receiving
anticoagulant therapy (as long as PT or PTT is within therapeutic range of intended
use of anticoagulants) (performed within 10 days of treatment initiation)
Exclusion Criteria:
- Is currently participating and receiving study therapy or has participated in a study
of an investigational agent and received study therapy within 4 weeks of the first
dose of treatment
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy (if
dosing exceeding 10 mg daily of prednisone equivalent) or any other form of
immunosuppressive therapy within 7 days prior to the first dose of trial treatment
- Short-term administration of systemic steroids (i.e., for allergic reactions or the
management of immune-related adverse events [irAEs]) is allowed
- Has symptomatic ascites or pleural effusions
- History of borderline or low malignant potential ovarian cancer
- 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 (i.e., =< grade 1 or at baseline) from adverse events
due to agents administered more than 4 weeks earlier
- Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy
within 2 weeks prior to study day 1 or who has not recovered (i.e., =< grade 1 or at
baseline) from adverse events due to a previously administered agent.
- Note: Patients with =< grade 2 neuropathy are an exception to this criterion and
may qualify for the study
- Note: If a patient received major surgery, they must have recovered adequately
from the toxicity and/or complications from the intervention prior to starting
therapy
- 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
- Has known active central nervous system (CNS) metastases and/or carcinomatous
meningitis. Patients with previously treated brain metastases may participate provided
they are stable (without evidence of progression by imaging for at least four weeks
prior to the first dose of trial treatment and any neurologic symptoms have returned
to baseline), have no evidence of new or enlarging brain metastases, and are not using
steroids for at least 14 days prior to trial treatment. This exception does not
include carcinomatous meningitis which is excluded regardless of clinical stability
- 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
- Has a history of (non-infectious) pneumonitis that required steroids or current
pneumonitis
- Has an active infection requiring systemic therapy
- Has a history or current evidence of any condition, therapy, or laboratory abnormality
that might confound the results of the trial, interfere with the patient's
participation for the full duration of the trial, or is not in the best interest of
the patient 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 children within the projected
duration of the trial, starting with the pre-screening or screening visit through 120
days after the last dose of trial treatment
- Clinically significant cardiovascular disease
- Known severe hypersensitivity reactions to monoclonal antibodies or carboplatin >=
grade 3, any history of anaphylaxis, or uncontrolled asthma
- Has received prior therapy with pembrolizumab
- Has a known history of human immunodeficiency virus (HIV) (HIV 1/2 antibodies)
- Has known active hepatitis B (e.g., hepatitis B surface antigen [HBsAg] reactive) or
hepatitis C (e.g., hepatitis C virus [HCV] ribonucleic acid [RNA] [qualitative] is
detected)
- Has received a live vaccine within 30 days of planned start of study therapy.
- Note: Seasonal influenza vaccines for injection are generally inactivated flu
vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist)
are live attenuated vaccines, and are not allowed
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Progression-free survival |
Time Frame: | At 6 months |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Programmed cell death ligand 1 (PD-L1) expression |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | Evaluated by immunohistochemistry staining in combined tumor and inflammatory cells in which positivity will be defined by > 1% staining. |
Measure: | PD-L2 expression |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | Evaluated by immunohistochemistry staining in combined tumor and inflammatory cells in which positivity will be defined by > 1% staining. |
Measure: | Changes in T cell activation |
Time Frame: | Baseline and 2 years |
Safety Issue: | |
Description: | Flow cytometry will be performed on peripheral blood mononuclear cells |
Measure: | Overall survival |
Time Frame: | Up to 2 years |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | University of Washington |
Last Updated
June 16, 2021