A Phase II Study of Eribulin and Pembrolizumab in Soft Tissue Sarcomas

Inclusion Criteria

• Histologically confirmed liposarcoma, leiomyosarcoma, or undifferentiated/unclassified pleomorphic sarcoma by a Dana-Farber Cancer Institute or Massachusetts General Hospital pathologist
• Participants must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as ≥20 mm with conventional techniques or as ≥10 mm with spiral CT scan, MRI, or calipers by clinical exam. See Section 11 for the evaluation of measurable disease.
• Participants must have received at least one prior line of chemotherapy. No limit on prior lines of therapy.
• Age ≥ 18 years.
• ECOG performance status of 0 or 1 (see Appendix A).
• Participants must have normal organ and marrow function as defined below:
• leukocytes ≥3,000/mcL
• absolute neutrophil count ≥1,500/mcL
• platelets ≥100,000/mcL
• Hemoglobin ≥ 8 g/dL within the first 2 weeks prior to the first dose of study drugs, transfusion is allowed.
• total bilirubin ≤1.5× institutional upper limit of normal (ULN) (except participants with Gilbert Syndrome, who can have total bilirubin 10 mg/day prednisone equivalents) for at least 2 weeks prior to study drug administration. Treatment for brain metastases may have included whole brain radiotherapy, radiosurgery, surgery, or a combination as deemed appropriate by the treating physician.
• Have 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.
• Inability to comply with study and/or follow-up procedures.
• History of severe hypersensitivity reaction (≥Grade 3) to any monoclonal antibody.
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to Eribulin or Pembrolizumab.
• Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations which in the PI's opinion makes it undesirable for the participant to participate in the trial or which would jeopardize compliance with the trial and study requirements.
• Pregnant women (WOCBP who had a positive serum pregnancy test on screening or 72 hours prior to initiation of study protocol) are excluded from this study because the effects of Eribulin and Pembrolizumab on the developing fetus are unknown. There is the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with Eribulin and Pembrolizumab, breastfeeding should be discontinued if the mother is treated with Eribulin and Pembrolizumab.
• Because the effects of pembrolizumab on chronic viral infection are not well known, participants should be excluded if they have known history of testing positive for human immunodeficiency virus (HIV) (true positive) or known acquired immunodeficiency syndrome (AIDS) or if they have a positive test for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV antibody) indicating acute or chronic infection.
• Participants with active autoimmune disease or history of autoimmune disease that might recur, which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids, are excluded. These include but are not limited to participants with a history of immune related neurologic disease such as multiple sclerosis, autoimmune (demyelinating) neurop