Clinical Trials /

GR-MD-02 + Pembrolizumab Versus Pembrolizumab Monotherapy in Melanoma and Squamous Cell Head and Neck Cancer Patients

NCT04987996

Description:

The purpose of this study is to test the safety & efficacy of combination drugs versus placebo to treat metastatic melanoma and head and neck squamous cell carcinoma.

Related Conditions:
  • Head and Neck Squamous Cell Carcinoma
  • Melanoma
Recruiting Status:

Not yet recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: GR-MD-02 + Pembrolizumab Versus Pembrolizumab Monotherapy in Melanoma and Squamous Cell Head and Neck Cancer Patients
  • Official Title: Randomized Double-Blind Placebo Controlled Phase II Study of a Galectin Inhibitor (GR-MD-02) and Pembrolizumab Versus Pembrolizumab and Placebo in Patients With Metastatic Melanoma and Head and Neck Squamous Cell Carcinoma

Clinical Trial IDs

  • ORG STUDY ID: 2020000655
  • NCT ID: NCT04987996

Conditions

  • Metastatic Melanoma
  • Head and Neck Squamous Cell Carcinoma

Interventions

DrugSynonymsArms
GR-MD-02Galactoarabino-rhamnogalactouronateGR-MD-02 + pembrolizumab
PlaceboPembrolizumab Monotherapy
PembrolizumabKeytrudaGR-MD-02 + pembrolizumab

Purpose

The purpose of this study is to test the safety & efficacy of combination drugs versus placebo to treat metastatic melanoma and head and neck squamous cell carcinoma.

Detailed Description

      Eligible patients will be registered, stratified by diagnosis (melanoma versus OHN cancer),
      and the number of prior systemic therapies, and randomized to receive either GR-MD-02 +
      pembrolizumab or pembrolizumab + placebo.

      In addition to monitoring for toxicity and clinical response, blood and tumor samples will be
      obtained to assess immunologic measures relevant to galectin biology and pembrolizumab T-cell
      checkpoint inhibition.
    

Trial Arms

NameTypeDescriptionInterventions
GR-MD-02 + pembrolizumabExperimental4 mg/kg GR-MD-02 in combination with standard pembrolizumab treatment.
  • GR-MD-02
  • Pembrolizumab
Pembrolizumab MonotherapyPlacebo Comparator4 mg/kg placebo in combination with standard pembrolizumab treatment.
  • Placebo
  • Pembrolizumab

Eligibility Criteria

        Inclusion Criteria:

          -  Patients with unresectable or metastatic melanoma including unknown primary, mucosal
             or uveal melanomas. Histological confirmation of melanoma will be required by previous
             biopsy or cytology. Patients with recurrent or metastatic head and neck squamous cell
             carcinoma (HNSCC) with disease progression during or after platinum-containing
             chemotherapy are eligible. PD-L1 testing is not needed for OHN cancers.

          -  Patients who have received anti-PD1 or anti-PD-L1 in the past are eligible if it has
             been at least 6 months since the last anti-PD-1 or PD-L1 dose, they meet all other
             eligibility criteria and progression of malignancy has been documented on imaging.
             Progression for this patient subset is defined as the appearance of one or more new
             metastatic sites, or a 5% or greater increase in the sum of diameter of target lesions
             or an unequivocal increase in non-target site. Treatment naïve melanoma patients are
             eligible.

          -  Patients must be ≥ 18 years of age.

          -  ECOG performance status of 0-2.

          -  Women of childbearing potential must have a serum or urine pregnancy test performed
             within 72 hours prior to the start of protocol treatment. The results of this test
             must be negative in order for the patient to be eligible. In addition, women of
             childbearing potential as well as male patients must agree to take appropriate
             precautions to avoid pregnancy.

          -  No active bleeding.

          -  Anticipated lifespan greater than 12 weeks.

          -  Patients must sign a study-specific consent document.

        Exclusion Criteria:

          -  Patients who have previously received a galectin antagonist.

          -  Patients with active autoimmune disease except for autoimmune thyroiditis or vitiligo
             (see Appendix C).

          -  Patients with history of autoimmune colitis.

          -  Patients with untreated brain metastases. Patients with treated brain metastases who
             demonstrate control of brain metastases with follow-up imaging 4 or more weeks after
             initial therapy are eligible.

          -  Patients requiring other systemic oncologic therapy, including experimental therapies.

          -  Patients with active infection requiring antibiotics.

          -  Pregnant or lactating women, as treatment involves unforeseeable risks to the embryo
             or fetus.

          -  Need for steroids at greater than physiologic replacement doses. Inhaled
             corticosteroids are acceptable.

          -  Laboratory exclusions (to be performed within 28 days of enrollment):

               -  WBC < 3.0 x 109/L

               -  Hgb < 9.0 g/dL

               -  AST or ALT > 1.5 times ULN

               -  Total bilirubin > 1.9 g/dL, unless due to Gilbert's Syndrome. If Gilbert's
                  Syndrome is present by clinical history, then direct bilirubin must by < 3.0
                  g/dl.

               -  Known history of HIV

               -  Known history of Hepatitis B

               -  Known history of Hepatitis C

               -  INR > 1.5x ULN

          -  Inability to give informed consent and comply with the protocol. Patients must be
             judged able to understand fully the investigational nature of the study and the risks
             associated with the therapy.

          -  Any medical condition that in the opinion of the Principal Investigator would
             compromise the safety or conduct of the study procedures.

          -  Unresolved immune-mediated pneumonitis, diarrhea, elevation of hepatocellular enzymes
             or other toxicities requiring greater than physiological replacement doses of
             steroids.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Overall response rate based on disease imaging
Time Frame:From date of randomization until the date of first documented progression, assessed up to 63 weeks.
Safety Issue:
Description:Determine the objective response of GR-MD-02 + pembrolizumab versus pembrolizumab monotherapy in patients with advanced MM or HNSCC

Secondary Outcome Measures

Measure:Evaluation of GAL-3 expression
Time Frame:Screening and Day 68
Safety Issue:
Description:Compare GAL-3 expression in paired biopsies after GR-MD-02 + pembrolizumab or pembrolizumab monotherapy.
Measure:Evaluation of predictive biomarker
Time Frame:Day 85
Safety Issue:
Description:Characterize MDSC expression over time as a predictive biomarker of response after GRMD02 + pembrolizumab or pembrolizumab monotherapy
Measure:Frequency of Immune-mediated adverse events
Time Frame:From time of informed consent to week 63
Safety Issue:
Description:Compare the frequency of immune-mediated adverse events after GR-MD-02 + pembrolizumab versus pembrolizumab + placebo
Measure:Evaluation of antiviral immunity
Time Frame:Day 85
Safety Issue:
Description:Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring CD4+T cells with a memory phenotype (CD3+CD4+Ki67+CD25+FoxP3-CCR7-CD45RA-CD27+CD28+/-).
Measure:Evaluation of antiviral immunity
Time Frame:Day 85
Safety Issue:
Description:Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring CD8+ T cells with effector phenotype (CD3+CD8+CD28-CD95+).
Measure:Evaluation of antiviral immunity
Time Frame:Day 85
Safety Issue:
Description:Assess the biological activity of GR-MD-02 + pembrolizumab and in comparison to pembrolizumab monotherapy by measuring tumor-specific T cells using autologous and/or HLA-matched tumor when available.

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Not yet recruiting
Lead Sponsor:Providence Health & Services

Trial Keywords

  • HNSCC
  • MM
  • pembrolizumab
  • GR-MD-02
  • Galectin Inhibitor
  • GRMD-02
  • GRMD002

Last Updated

August 3, 2021