Phase 1
Completed N=1,260
Study of Pembrolizumab (MK-3475) in Participants With Progressive Locally Advanced or Metastatic Carcinoma, Melanoma, or Non-small Cell Lung Carcinoma (P07990/MK-3475-001/KEYNOTE-001)
Cancer, Solid Tumor
Source: ClinicalTrials.gov NCT01295827 ↗
Enrolled (actual)
1,260
Serious AEs
42.5%
Results posted
Dec 2019
Primary outcomePrimary: Number of Participants Experiencing Dose-Limiting Toxicities (DLTs) According to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 (NCI-CTCAE v.4.0) in Participants With Solid Tumors (Parts A and A1) — 0; 0; 0 Participants
Summary
The present study has 5 parts. In Parts A and A1, the dose of intravenous (IV) pembrolizumab (MK-3475) will be escalated from 1 to 10 mg/kg to determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) for participants with a histologically- or cytologically-confirmed diagnosis of any type of carcinoma or melanoma (MEL) by evaluating the Dose Limiting Toxicities (DLTs). Following completion of the dose escalation, additional patients will be enrolled in Part A2 to further define pharmacokinetic characteristics. Part B of the study will investigate the safety, tolerability, and efficacy of pembrolizumab (2 mg/kg and 10 mg/kg) in participants with advanced or metastatic MEL and compare every 2 week dosing (Q2W) to every 3 week dosing (Q3W). Part C of the study will investigate the safety, tolerability, and efficacy of pembrolizumab administered at 10 mg/kg Q3W in participants with non-small cell lung carcinoma (NSCLC) that is locally advanced or metastatic. Part D of the study will investigate the low and high doses of study drug identified in Parts A and B (2 mg/kg and 10 mg/kg) administered Q3W in participants with advanced or metastatic MEL. Part E (closed with Amendment 7) was planned to investigate low, medium, and high doses of pembrolizumab in combination with standard chemotherapy in participants with locally advanced or metastatic NSCLC. Part F will investigate low and high doses of pembrolizumab (2 mg/kg and 10 mg/kg) administered Q2W or Q3W in treatment-naive and previously-treated participants with NSCLC with programmed cell death 1 ligand (PD-L1) gene expression. The primary hypotheses are the following: that pembrolizumab will have acceptable safety and tolerability; that pembrolizumab will show a clinically meaningful response rate (RR) or disease-control rate (DCR) in participants with melanoma (ipilimumab-refractory or not) and NSCLC, and that pembrolizumab will show a more clinically meaningful RR in participants with either cancer whose tumors express PD-L1.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants Experiencing Dose-Limiting Toxicities (DLTs) According to National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0 (NCI-CTCAE v.4.0) in Participants With Solid Tumors (Parts A and A1) |
0; 0; 0 | — |
| PRIMARY Number of Participants Who Experienced an Adverse Event (AE) |
4; 3; 9; 4; 3; 6 | — |
| PRIMARY Overall Response Rate (ORR) According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Integrated Radiology and Oncology (IRO): Melanoma Participants (Parts B Plus D) |
30.2; 29.4; 36.7 | — |
| PRIMARY ORR According to RECIST 1.1 as Assessed by Independent Review Committee (IRC): Non-Small Cell Lung Cancer (NSCLC) Participants (Parts C Plus F) |
19.7; 21.6; 19.3 | — |
| SECONDARY ORR According to Immune-related Response Criteria (irRC) as Assessed by Investigator in Melanoma Participants (Parts B Plus D) |
35.2; 39.9; 45.6 | — |
| SECONDARY ORR According to irRC as Assessed by Investigator in NSCLC Participants (Parts C Plus F) |
23.0; 28.9; 22.3 | — |
| SECONDARY Area Under the Concentration-Time Curve of Pembrolizumab From Time 0 to Day 28 (AUC 0-28) in Solid Tumor Participants (Parts A and A1) |
157; 955; 2160 | — |
| SECONDARY Area Under the Concentration-Time Curve of Pembrolizumab From Time 0 to Infinity (AUC 0-inf) in Solid Tumor Participants (Parts A and A1) |
212; 1530; 3230 | — |
| SECONDARY Maximum Concentration (Cmax) of Pembrolizumab in Solid Tumor Participants (Parts A and A1) |
16.4; 107; 256 | — |
| SECONDARY Time to Maximum Concentration (Tmax) of Pembrolizumab in Solid Tumor Participants (Parts A and A1) |
0.05; 0.17; 0.17 | — |
| SECONDARY Terminal Half-Life (t ½) of Pembrolizumab in Solid Tumor Participants (Parts A and A1) |
14.1; 21.6; 17.5 | — |
| SECONDARY Area Under the Concentration-Time Curve of Pembrolizumab From Time 0 to Day 21 (AUC 0-21) in Solid Tumor Participants (Part A2) |
57.1; 50.4; 186 | — |
| SECONDARY Area Under the Concentration-Time Curve of Pembrolizumab From Day 21 to Day 42 (AUC21-42) in Solid Tumor Participants (Part A2) |
486; 348; 2280 | — |
| SECONDARY Lowest Plasma Concentration (Ctrough) of Pembrolizumab in Solid Tumor Participants (Parts A, A1, and A2) |
2.3; 1.9; 7.77; 2.19; 18.8; 41.7 | — |
| SECONDARY Ctrough of Pembrolizumab in Melanoma Participants (Parts B and D) |
63.7; 8.69; 48.5; 10.1; 62.6; 94.0 | — |
| SECONDARY Ctrough of Pembrolizumab in NSCLC Participants (Parts C and F) |
55.0; 52.0; 8.23; 43.6; 89.3; 11.8 | — |
| SECONDARY Maximum Change From Baseline (CFB) in Tumor Size Assessed by IRC Per RECIST 1.1 According to Programmed Death-Ligand 1 (PD-L1) Immunohistochemical (IHC) Expression Status in Ipilimumab (Ipi)-Exposed and Ipi-Naive Melanoma Participants (Parts B Plus D) |
93; 8; 25; 126; 94; 22 | — |
| SECONDARY Maximum Change From Baseline (CFB) in Tumor Size Assessed by IRC Per RECIST 1.1 According to PD-L1 IHC Expression Status in Prior Treatment (TRT)-Naïve and Previously-Treated NSCLC Participants (Parts C Plus F) |
16; 15; 2; 4; 37; 58 | — |
| SECONDARY Disease Control Rate (DCR) According to RECIST 1.1 as Assessed by IRO in Melanoma Participants (Parts B and D) |
48.1; 47.6; 56.1 | — |
| SECONDARY Duration of Response (DOR) According to RECIST 1.1 as Assessed by IRO in Melanoma Participants (Parts B and D) |
NA; NA; NA | — |
| SECONDARY Progression Free Survival (PFS) According to RECIST 1.1 as Assessed by IRO in Melanoma Participants (Parts B Plus D) |
4.9; 3.7; 5.6 | — |
| SECONDARY Overall Survival (OS) in Melanoma Participants (Parts B Plus D) |
23.1; 22.5; 26.8 | — |
| SECONDARY DCR According to irRC as Assessed by Investigator in Melanoma Participants (Parts B Plus D) |
62.3; 62.6; 69.4 | — |
| SECONDARY DOR According to irRC as Assessed by Investigator in Melanoma Participants (Parts B Plus D) |
NA; NA; NA | — |
| SECONDARY PFS According to irRC as Assessed by Investigator in Melanoma Participants (Parts B Plus D) |
8.2; 6.6; 9.6 | — |
| SECONDARY DCR According to RECIST 1.1 as Assessed by IRC in NSCLC Participants (Parts C Plus F) |
50.8; 51.6; 49.0 | — |
| SECONDARY DOR According to RECIST 1.1 as Assessed by IRC in NSCLC Participants (Parts C Plus F) |
NA; NA; 20.7 | — |
| SECONDARY PFS According to RECIST 1.1 as Assessed by IRC in NSCLC Participants (Parts C Plus F) |
3.3; 3.7; 3.4 | — |
| SECONDARY OS in NSCLC Participants (Parts C Plus F) |
8.9; 13.1; 13.4 | — |
| SECONDARY DCR According to irRC as Assessed by Investigator in NSCLC Participants (Parts C Plus F) |
57.4; 62.7; 65.3 | — |
| SECONDARY DOR According to irRC as Assessed by Investigator in NSCLC Participants (Parts C Plus F) |
NA; NA; NA | — |
| SECONDARY PFS According to irRC as Assessed by Investigator in NSCLC Participants (Parts C Plus F) |
4.3; 4.4; 5.6 | — |
Eligibility Criteria
Inclusion Criteria
- In Part A: Histological or cytological diagnosis of MEL or any type of carcinoma, progressive metastatic disease, or progressive locally advanced disease not amenable to local therapy. In Parts B and D of the study, histological or cytological diagnoses of metastatic MEL with progressive locally advanced or metastatic disease. In Parts C and F, histological or cytological diagnosis of NSCLC. In Part F1, participants with Stage IV NSCLC without prior systemic therapy may be eligible.
- Failure of established standard medical anti-cancer therapies for a given tumor type or intolerance to such therapy.
- In Parts B, C, D, or F of the study, MEL or NSCLC must be measurable by imaging.
- In Part F of the study, NSCLC with PD-L1 gene expression.
- Performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale.
- Adequate organ function.
- Female participants of childbearing potential should have a negative urine or serum pregnancy test prior to receiving study medication
- Female participants of childbearing potential must be willing to use adequate contraception from study start, through the course of the study, and for 120 days after the last dose of study medication
- Male participants of childbearing potential must agree to use adequate contraception from the first dose of study medication through 120 days after the last dose of study medication
Exclusion Criteria
- Chemotherapy, radioactive, or biological cancer therapy within 4 weeks prior to the first dose of study therapy, or not recovered to Common Terminology Criteria for Adverse Events (CTCAE) Grade 1 or better from the adverse events caused by therapy administered more than 4 weeks prior to first dose.
- Participation in a study of an investigational agent or using an investigational device within 30 days of administration of pembrolizumab, with the exception of participants in the follow-up phase.
- Other form(s) of antineoplastic therapy anticipated during the period of the study.
- History of non-infectious pneumonitis requiring treatment with steroids, or has a history of interstitial lung disease.
- Medical condition that requires chronic systemic steroid therapy, or on any other form of immunosuppressive medication, excepting use of inhaled steroids.
- Risk factors for bowel obstruction or bowel perforation (including a history of acute diverticulitis, intra-abdominal abscess, abdominal carcinomatosis).
- History of a hematologic malignancy, malignant primary brain tumor, malignant sarcoma, or another malignant primary solid tumor, unless no evidence of that disease for 5 years.
- Active central nervous system (CNS) metastases and/or carcinomatous meningitis.
- Previous severe hypersensitivity reaction to another monoclonal antibody (mAb).
- Active autoimmune disease or a documented history of autoimmune disease or syndrome that requires systemic steroids or immunosuppressive agents, except vitiligo or resolved childhood asthma/atopy.
- Prior therapy with another anti-programmed cell death (PD)-1 agent or previously enrolled in any pembrolizumab trial.
- Active infection requiring therapy.
- Positive for Human Immunodeficiency Virus (HIV), Hepatitis B (Hepatitis B Surface Antigen [HBsAg] reactive), or Hepatitis C virus (Hepatitis C Virus Ribonucleic Acid [HCV RNA] (qualitative) is detected).
- Regular use of illicit drugs or a recent history (within the last year) of substance abuse (including alcohol).
- Symptomatic ascites or pleural effusion.
- Participant is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the study.
Data sourced from ClinicalTrials.gov (NCT01295827). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.