Clinical Trials /

Coformulation of Pembrolizumab/Vibostolimab (MK-7684A) Versus Pembrolizumab (MK-3475) Monotherapy for Programmed Cell Death 1 Ligand 1 (PD-L1) Positive Metastatic Non-Small Cell Lung Cancer (MK-7684A-003)

NCT04738487

Description:

The primary hypotheses are that coformulated pembrolizumab/vibostolimab is superior to pembrolizumab alone with respect to progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 by blinded independent central review (BICR), and with respect to overall survival (OS), in participants with non-small cell lung cancer.

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

Recruiting

Phase:

Phase 3

Trial Eligibility

Document

Title

  • Brief Title: Coformulation of Pembrolizumab/Vibostolimab (MK-7684A) Versus Pembrolizumab (MK-3475) Monotherapy for Programmed Cell Death 1 Ligand 1 (PD-L1) Positive Metastatic Non-Small Cell Lung Cancer (MK-7684A-003)
  • Official Title: A Phase 3, Multicenter, Randomized, Double-Blind Study of MK-7684 With Pembrolizumab as a Coformulation (MK-7684A) Versus Pembrolizumab Monotherapy as First Line Treatment for Participants With PD-L1 Positive Metastatic Non-Small Cell Lung Cancer

Clinical Trial IDs

  • ORG STUDY ID: 7684A-003
  • SECONDARY ID: MK-7684A-003
  • SECONDARY ID: 2020-004049-35
  • SECONDARY ID: jRCT2021210025
  • NCT ID: NCT04738487

Conditions

  • Lung Neoplasms
  • Non-Small-Cell Lung Carcinoma

Interventions

DrugSynonymsArms
Pembrolizumab/VibostolimabMK-7684APembrolizumab/Vibostolimab
PembrolizumabMK-3475, KeytrudaPembrolizumab

Purpose

The primary hypotheses are that coformulated pembrolizumab/vibostolimab is superior to pembrolizumab alone with respect to progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 by blinded independent central review (BICR), and with respect to overall survival (OS), in participants with non-small cell lung cancer.

Trial Arms

NameTypeDescriptionInterventions
Pembrolizumab/VibostolimabExperimentalParticipants will receive pembrolizumab/vibostolimab as a coformulation (MK-7684A).
  • Pembrolizumab/Vibostolimab
PembrolizumabActive ComparatorParticipants will receive pembrolizumab (MK-3475) alone.
  • Pembrolizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Has a histologically or cytologically confirmed diagnosis of Stage IV: M1a, M1b, or
             M1c non-small cell lung cancer (NSCLC) per the American Joint Committee on Cancer
             (AJCC) Staging Manual, version 8

          -  Has measurable disease based on Response Evaluation Criteria in Solid Tumors (RECIST)
             1.1, as determined by the local site assessment

          -  Has confirmation that epidermal growth factor receptor (EGFR)-, anaplastic lymphoma
             kinase (ALK)-, or reactive oxygen species proto-oncogene 1 (ROS1)-directed therapy is
             not indicated as primary therapy and absence of ALK and ROS1 gene rearrangements

          -  Has provided tumor tissue that demonstrates Programmed Cell Death 1 Ligand 1 (PD-L1)
             expression in ≥1% of tumor cells as assessed by immunohistochemistry (IHC) at a
             central laboratory

          -  Has an Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1 assessed
             within 7 days prior to randomization

          -  Has a life expectancy of at least 3 months

          -  A female participant is eligible to participate if she is not pregnant or
             breastfeeding, and at least one of the following conditions applies:

               -  Is not a woman of childbearing potential (WOCBP)

               -  Is a WOCBP and using a contraceptive method that is highly effective (with a
                  failure rate of <1% per year), with low user dependency or be abstinent from
                  heterosexual intercourse as their preferred and usual lifestyle (abstinent on a
                  long term and persistent basis), during the intervention period and for at least
                  120 days after the last dose of study intervention

          -  Has adequate organ function

        Exclusion Criteria:

          -  Has a known history of an additional malignancy, except if the participant has
             undergone potentially curative therapy with no evidence of that disease recurrence for
             at least 3 years since initiation of that therapy

          -  Has received prior systemic chemotherapy or other targeted or biological
             antineoplastic therapy for their metastatic NSCLC.

               -  Prior treatment with chemotherapy and/or radiation as part of
                  neoadjuvant/adjuvant or chemoradiation therapy for nonmetastatic NSCLC is allowed
                  as long as therapy was completed at least 6 months before the diagnosis of
                  metastatic NSCLC.

               -  Participants must have recovered from all AEs due to previous therapies to Grade
                  ≤1 or baseline. Participants with Grade ≤2 neuropathy may be eligible.
                  Participants with endocrine-related AEs Grade ≤2 requiring treatment or hormone
                  replacement may be eligible.

          -  Has received prior therapy with an anti-programmed cell death receptor 1 (PD-1),
             anti-programmed cell death receptor ligand 1 (PD-L1), or anti-programmed cell death
             receptor ligand 2 (PD-L2) agent or with an agent directed to another stimulatory or
             co-inhibitory T-cell receptor (eg, cytotoxic T-lymphocyte-associated protein 4
             (CTLA-4), OX-40, CD137)

          -  Has received previous treatment with another agent targeting the T cell immunoreceptor
             with immunoglobulin (Ig) and immunoreceptor tyrosine-based inhibition motif (ITIM)
             domains (TIGIT) receptor pathway

          -  Has received radiotherapy within 2 weeks of start of study intervention. Participants
             must have recovered from all radiation-related toxicities, not require
             corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted
             for palliative radiation (≤2 weeks of radiotherapy) to non-central nervous system
             (CNS) disease

          -  Has received a live or live-attenuated vaccine within 30 days prior to the first dose
             of study intervention. Administration of killed vaccines is allowed

          -  Is currently participating in or has participated in a study of an investigational
             agent or has used an investigational device within 4 weeks prior to the first dose of
             study intervention

          -  Has known active or untreated CNS metastases and/or carcinomatous meningitis.
             Participants with previously treated brain metastases may participate provided they
             are radiologically stable for at least 4 weeks by repeat imaging, clinically stable,
             and without requirement of steroid treatment for at least 14 days prior to first dose
             of study intervention

          -  Has severe hypersensitivity (≥Grade 3) to pembrolizumab/vibostolimab or pembrolizumab
             and/or any of its excipients

          -  Has an active autoimmune disease that has required systemic treatment in past 2 years
             (ie, with use of disease modifying agents, corticosteroids, or immunosuppressive
             drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid
             replacement therapy for adrenal or pituitary insufficiency) is not considered a form
             of systemic treatment and is allowed.

          -  Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
             (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of
             immunosuppressive therapy within 7 days prior to the first dose of study intervention

          -  Has a history of (non-infectious) pneumonitis that required steroids or has current
             pneumonitis

          -  Has a known history of interstitial lung disease. Lymphangitic spread of the NSCLC is
             not exclusionary.

          -  Has an active infection requiring systemic therapy

          -  Has a known history of human immunodeficiency virus (HIV) infection. No HIV testing is
             required unless mandated by local health authority

          -  Has a known history of Hepatitis B or known active Hepatitis C virus infection

          -  Has a known psychiatric or substance abuse disorder that would interfere with the
             participant's ability to cooperate with the requirements of the study
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Progression-Free Survival (PFS)
Time Frame:Up to approximately 38 months
Safety Issue:
Description:PFS is defined as the time from randomization to the first documented progressive disease (PD) or death due to any cause, whichever occurs first. Per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of ≥5 mm. The appearance of one or more new lesions is also considered PD. PFS as assessed by blinded independent central review will be presented.

Secondary Outcome Measures

Measure:Objective Response Rate (ORR)
Time Frame:Up to approximately 2 years
Safety Issue:
Description:ORR is defined as the percentage of participants who have a Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The percentage of participants who experience a CR or PR as assessed by blinded independent central review based on RECIST 1.1 will be presented.
Measure:Duration of Response (DOR)
Time Frame:Up to approximately 46 months
Safety Issue:
Description:For participants who demonstrate a Complete Response (CR: Disappearance of all target lesions) or Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, DOR is defined as the time from first documented evidence of CR or PR until progressive disease (PD) or death. Per RECIST 1.1, PD is defined as ≥20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. The DOR as assessed by blinded independent central review will be presented.
Measure:Change from Baseline in the Global Health Status/Quality of Life (Items 29 and 30) Combined Score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:Change from baseline in the score of EORTC QLQ-C30 Items 29 and 30 will be presented. The EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Participant responses to Items 29 and 30 ("How would you rate your overall health during the past week?" and "How would you rate your overall quality of life during the past week?") are scored on a 7-point scale (1=Very Poor to 7=Excellent). A higher score indicates a better overall outcome.
Measure:Change from Baseline in Physical Functioning (Items 1-5) Combined Score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:Change from baseline in the score of EORTC QLQ-C30 Items 1-5 will be presented. The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant responses to 5 questions about their physical functioning are scored on a 4-point scale (1=Not at All to 4=Very Much). Higher scores indicate a worse level of function.
Measure:Change from Baseline in Dyspnea Score (Item 8) on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:Change from baseline in the score of EORTC QLQ-C30 Item 8 will be presented. The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant response to the question "Were you short of breath?" is scored on a 4-point scale (1=Not at All to 4=Very Much). A higher score indicates a worse level of dyspnea.
Measure:Change from Baseline in Cough Score (Item 31) on the European Organization for Research and Treatment of Cancer Quality of Life Lung Cancer-Specific Questionnaire Module (EORTC QLQ-LC13)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:Change from baseline in the score of EORTC QLQ-C13 Item 31 will be presented. The EORTC QLQ-C13 is a lung cancer specific health-related quality-of life (QoL) questionnaire. Participant response to the question "Have you coughed?" is scored on a 4-point scale (1=Not at All to 4=Very Much). A higher score indicates more frequent coughing.
Measure:Change from Baseline in Chest Pain Score (Item 40) on the European Organization for Research and Treatment of Cancer Quality of Life Lung Cancer-Specific Questionnaire Module (EORTC QLQ-LC13)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:Change from baseline in the score of EORTC QLQ-C13 Item 40 will be presented. The EORTC QLQ-C13 is a lung cancer specific health-related quality-of life (QoL) questionnaire. Participant response to the question "Have you had pain in your chest?" is scored on a 4-point scale (1=Not at All to 4=Very Much). A higher score indicates a worse level of chest pain.
Measure:Time to Deterioration (TTD) in the Global Health Status/Quality of Life (Items 29 and 30) Combined Score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:TTD in the score of EORTC QLQ-C30 Items 29 and 30 will be presented. The EORTC-QLQ-C30 is a 30-item questionnaire developed to assess the quality of life of cancer patients. Participant responses to Items 29 and 30 ("How would you rate your overall health during the past week?" and "How would you rate your overall quality of life during the past week?") are scored on a 7-point scale (1=Very Poor to 7=Excellent). A higher score indicates a better overall outcome. TTD is defined as the time to first onset of 10 or more (out of 100) deterioration from baseline and confirmed by a second adjacent 10 or more deterioration from baseline.
Measure:TTD in Physical Functioning (Items 1-5) Combined Score on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:TTD in the score of EORTC QLQ-C30 Items 1-5 will be presented. The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant responses to 5 questions about their physical functioning are scored on a 4-point scale (1=Not at All to 4=Very Much). Higher scores indicate a worse level of function. TTD is defined as the time to first onset of 10 or more (out of 100) deterioration from baseline and confirmed by a second adjacent 10 or more deterioration from baseline.
Measure:TTD in Dyspnea Score (Item 8) on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:TTD in the score of EORTC QLQ-C30 Item 8 will be presented. The EORTC QLQ-C30 is a cancer specific health-related quality-of life (QoL) questionnaire. Participant response to the question "Were you short of breath?" is scored on a 4-point scale (1=Not at All to 4=Very Much). A higher score indicates a worse level of dyspnea. TTD is defined as the time to first onset of 10 or more (out of 100) deterioration from baseline and confirmed by a second adjacent 10 or more deterioration from baseline.
Measure:TTD in Cough Score (Item 31) on the European Organization for Research and Treatment of Cancer Quality of Life Lung Cancer-Specific Questionnaire Module (EORTC QLQ-LC13)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:TTD in the score of EORTC QLQ-C13 Item 31 will be presented. The EORTC QLQ-C13 is a lung cancer specific health-related quality-of life (QoL) questionnaire. Participant response to the question "Have you coughed?" is scored on a 4-point scale (1=Not at All to 4=Very Much). A higher score indicates more frequent coughing. TTD is defined as the time to first onset of 10 or more (out of 100) deterioration from baseline and confirmed by a second adjacent 10 or more deterioration from baseline.
Measure:TTD in Chest Pain Score (Item 40) on the European Organization for Research and Treatment of Cancer Quality of Life Lung Cancer-Specific Questionnaire Module (EORTC QLQ-LC13)
Time Frame:Baseline and up to approximately 107 weeks
Safety Issue:
Description:TTD in the score of EORTC QLQ-C13 Item 40 will be presented. The EORTC QLQ-C13 is a lung cancer specific health-related quality-of life (QoL) questionnaire. Participant response to the question "Have you had pain in your chest?" is scored on a 4-point scale (1=Not at All to 4=Very Much). A higher score indicates a worse level of chest pain. TTD is defined as the time to first onset of 10 or more (out of 100) deterioration from baseline and confirmed by a second adjacent 10 or more deterioration from baseline.
Measure:Number of Participants Who Experienced One or More Adverse Events (AEs)
Time Frame:Up to approximately 115 weeks
Safety Issue:
Description:The number of participants who experienced an adverse event (AE) will be presented. An AE is defined as any untoward medical occurrence in a participant administered study treatment and which did not necessarily have to have a causal relationship with this treatment.
Measure:Number of Participants Who Discontinued Study Intervention Due to an Adverse Event (AE)
Time Frame:Up to approximately 103 weeks
Safety Issue:
Description:The number of participants who discontinue study intervention due to an adverse event (AE) will be presented. An AE is defined as any untoward medical occurrence in a participant administered study treatment and which did not necessarily have to have a causal relationship with this treatment.

Details

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

Trial Keywords

  • Programmed Cell Death-1 (PD1, PD-1)
  • Programmed Cell Death 1 Ligand 1 (PDL1, PD-L1)
  • Programmed Cell Death 1 Ligand 2 (PDL2, PD-L2)

Last Updated

August 20, 2021