Clinical Trials /

A Study of Pembrolizumab and Radiation Therapy in People With Mesothelioma

NCT04897022

Description:

The purpose of this study is to find out whether IMPRINT in combination with pembrolizumab is a safe treatment for people with malignant pleural mesothelioma (MPM).The highest dose of IMPRINT that causes few or mild side effects when given in combination with pembrolizumab will be found. Once the highest safe dose of IMPRINT is found, it will be tested in combination with pembrolizumab in future participants to see whether the combination may be an effective treatment for MPM.

Related Conditions:
  • Malignant Pleural Mesothelioma
Recruiting Status:

Recruiting

Phase:

Phase 1

Trial Eligibility

Document

Title

  • Brief Title: A Study of Pembrolizumab and Radiation Therapy in People With Mesothelioma
  • Official Title: Phase I Dose Escalation and Local Control Study of Pembrolizumab + Intensity-Modulated Pleural Radiation Therapy (IMPRINT) for Malignant Pleural Mesothelioma

Clinical Trial IDs

  • ORG STUDY ID: 21-197
  • NCT ID: NCT04897022

Conditions

  • Malignant Pleural Mesothelioma

Interventions

DrugSynonymsArms
PembrolizumabParticipants with malignant pleural mesothelioma (MPM)

Purpose

The purpose of this study is to find out whether IMPRINT in combination with pembrolizumab is a safe treatment for people with malignant pleural mesothelioma (MPM).The highest dose of IMPRINT that causes few or mild side effects when given in combination with pembrolizumab will be found. Once the highest safe dose of IMPRINT is found, it will be tested in combination with pembrolizumab in future participants to see whether the combination may be an effective treatment for MPM.

Trial Arms

NameTypeDescriptionInterventions
Participants with malignant pleural mesothelioma (MPM)ExperimentalParticipants will be diagnosed with malignant pleural mesothelioma and be deemed unresectable per thoracic surgeon assessment
  • Pembrolizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Pathologically confirmed diagnosis of malignant pleural mesothelioma

          -  Unresectable per thoracic surgeon assessment

          -  ECOG 0-1

          -  PFTs: DLCO >40% predicted, FEV1 >50% predicted

          -  Male/female participants who are at least 18 years of age on the day of signing
             informed consent

        Male participants:

          -  A male participant must agree to use a contraception as detailed in Appendix 1 of this
             protocol during the treatment period and for at least 30 days, corresponding to time
             needed to eliminate any study treatment(s) (pembrolizumab and or any active
             comparator/combination) plus an additional 120 days (a spermatogenesis cycle) for
             study treatments with evidence of genotoxicity at any dose after the last dose of
             study treatment and refrain from donating sperm during this period.

        Female participants:

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

               1. Not a woman of childbearing potential (WOCBP) as defined in Appendix 1 OR

               2. A WOCBP who agrees to follow the contraceptive guidance in Appendix 1 during the
                  treatment period and for at least 120 days (corresponding to time needed to
                  eliminate any study treatment(s) (pembrolizumab and or any active
                  comparator/combination) plus 30 days (a menstruation cycle) for study treatments
                  with risk of genotoxicity after the last dose of study treatment.

          -  The participant (or legally authorized representative if applicable) provides written
             informed consent for the trial.

          -  Have a ECOG performance status of 0 to 1. Evaluation of ECOG is to be performed within
             30 days prior to the date of allocation.

          -  Have adequate organ function as defined in the following table (Table 1). Specimens
             must be collected within 45 days prior to the start of study treatment.

        Table 1: Adequate Organ Function Laboratory Values

        System: Hematological Absolute neutrophil count (ANC) ≥ 1.5 K/mcL Platelets ≥ 100 K/mcL
        Hemoglobin ≥ 9.0 g/dL

        System: Renal Creatinine OR Measured or calculated^b creatinine clearance (GFR can also be
        used in place of creatinine or CrCl): ≤ 1.5 x ULN OR ≥ 30 mL/min for participant with
        creatinine levels >1.5 x institutional ULN

        System: Hepatic Total bilirubin: ≤ 1.5 x ULN OR direct bilirubin ≤ ULN for participants
        with total bilirubin levels >1.5 x ULN AST (SGOT) and ALT (SGPT): ≤ 2.5 x ULN (≤ 5 x ULN
        for participants with liver metastases)

        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.

        ^b: 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:

          -  Prior thoracic radiation therapy, immunotherapy or intrapleural therapy

          -  Bulky disease in the fissure preventing IMPRINT

          -  Evidence of metastatic disease

          -  Serious infection, concurrent active malignancies, or other serious medical illness

          -  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 (eg, CTLA-4,
             OX-40, CD137).

          -  Has received a live vaccine within 30 days prior to the first dose of study drug.
             Examples of live vaccines include, but are not limited to, the following: measles,
             mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus
             Calmette-Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection
             are generally killed virus vaccines and are allowed; however, intranasal influenza
             vaccines (eg, FluMist®) are live attenuated vaccines and are not 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 treatment.

        Note: Participants who have entered the follow-up phase of an investigational study may
        participate as long as it has been 4 weeks after the last dose of the previous
        investigational agent.

          -  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 drug.

          -  Has a known additional malignancy that is progressing or has required active treatment
             within the past 2 years. Note: Participants with basal cell carcinoma of the skin,
             squamous cell carcinoma of the skin, or carcinoma in situ (e.g. breast carcinoma,
             cervical cancer in situ) that have undergone potentially curative therapy are not
             excluded. Low grade malignancies not requiring active treatment are not excluded.

          -  Has known active CNS metastases and/or carcinomatous meningitis. Participants with
             previously treated brain metastases may participate provided they are radiologically
             stable, i.e. without evidence of progression, clinically stable and without
             requirement of steroid treatment for at least 14 days prior to first dose of study
             treatment.

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

          -  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 (eg., 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 has current
             pneumonitis.

          -  Has a known history of Human Immunodeficiency Virus (HIV).

          -  Has a known history of Hepatitis B (defined as Hepatitis B surface antigen [HBsAg]
             reactive) or known active Hepatitis C virus (defined as HCV RNA [qualitative] is
             detected) infection.

          -  Has a known history of active TB (Bacillus Tuberculosis).

          -  Has a history or current evidence of any condition, therapy, or laboratory abnormality
             that might confound the results of the study, interfere with the subject's
             participation for the full duration of the study, or is not in the best interest of
             the subject 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 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.

          -  Has undergone major surgery <4 weeks from starting pembrolizumab.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Maximum Tolerated Dose (MTD) of IMPRINT
Time Frame:6 months
Safety Issue:
Description:The first primary objective of this study is to determine the MTD of IMPRINT among the three candidate doses: 400cGy x5 fractions, 500cGy x5 fractions and 600cGy x5 fractions. These dose levels will be evaluated using a modified Continuous Reassessment Method (CRM) starting with the lowest dose level 400cGy x5 fractions. Determined by the first 12 participants enrolled to the study.

Details

Phase:Phase 1
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Memorial Sloan Kettering Cancer Center

Trial Keywords

  • malignant pleural mesothelioma
  • MPM
  • intensity-modulated pleural radiation therapy
  • IMPRINT
  • Pembrolizumab
  • 21-197
  • Memorial Sloan Kettering Cancer Center

Last Updated

August 18, 2021