Phase 3
N=422
Efficacy and Safety of Pembrolizumab (MK-3475) With Lenvatinib (E7080/MK-7902) vs. Docetaxel in Participants With Metastatic Non-Small Cell Lung Cancer (NSCLC) and Progressive Disease (PD) After Platinum Doublet Chemotherapy and Immunotherapy (MK-7902-008/E7080-G000-316/LEAP-008)
Metastatic Non-Small Cell Lung Cancer
Bottom Line
View on ClinicalTrials.gov: NCT03976375 ↗Enrolled (actual)
422
Serious AEs
47.7%
Results posted
Aug 2024
Primary outcome: Primary: Overall Survival (OS) — 11.3; 12.0 Months — p=0.4342
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Pembrolizumab (Biological); Lenvatinib (Drug); Docetaxel (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Merck Sharp & Dohme LLC
- Primary completion
- Aug 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Overall Survival (OS) |
11.3; 12.0 | 0.4342 |
| PRIMARY Progression-free Survival (PFS) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) |
5.6; 4.2 | 0.1563 |
| SECONDARY Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) - Pembrolizumab+Lenvatinib vs. Docetaxel |
22.7; 14.3 | 0.01818 sig |
| SECONDARY Objective Response Rate (ORR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) - Pembrolizumab+Lenvatinib vs. Lenvatinib Monotherapy |
22.7; 12.5 | 0.06009 |
| SECONDARY Duration of Response (DOR) Per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) |
6.9; 6.8 | — |
| SECONDARY Number of Participants Experiencing an Adverse Event (AE) |
179; 174; 47 | — |
| SECONDARY Number of Participants Discontinuing Study Treatment Due to an AE |
68; 43; 13 | — |
| SECONDARY Change From Baseline in European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) Combined Global Health Status / Quality of Life (Items 29 & 30) Scale Combined Score |
-2.48; -1.12 | 0.4998 |
| SECONDARY Change From Baseline in EORTC Quality of Life Questionnaire Lung Cancer Module 13 (QLQ-LC13) Cough (Item 31) Scale Score |
-4.17; -0.32 | 0.1531 |
| SECONDARY Change From Baseline in EORTC QLQ-LC13 Chest Pain (Item 40) Scale Score |
-1.40; -3.88 | 0.3084 |
| SECONDARY Change From Baseline in EORTC QLQ-C30 Dyspnea (Item 8) Scale Score |
-2.92; 5.12 | 0.0058 sig |
| SECONDARY Change From Baseline in EORTC QLQ-C30 Physical Functioning (Items 1 to 5) Scale Combined Score |
-5.58; -8.47 | 0.1681 |
| SECONDARY Time to True Deterioration (TTD) in EORTC QLQ-C30 Combined Global Health Status / Quality of Life (Items 29 & 30) Scale Combined Score |
8.51; 9.59 | 0.6145 |
| SECONDARY Time to True Deterioration (TTD) in EORTC QLQ-LC13 Cough (Item 31) Scale Score |
NA; NA | 0.0398 sig |
| SECONDARY Time to True Deterioration (TTD) in EORTC QLQ-LC13 Chest Pain (Item 40) Scale Score |
NA; NA | 0.8724 |
| SECONDARY Time to True Deterioration (TTD) in EORTC QLQ-C30 Dyspnea (Item 8) Scale Score |
NA; NA | 0.1944 |
| SECONDARY Time to True Deterioration (TTD) in EORTC QLQ-C30 Physical Functioning (Items 1 to 5) Scale Combined Score |
6.70; 7.03 | 0.9837 |
| SECONDARY Time to True Deterioration (TTD) in EORTC Composite Symptom Score for Cough (QLQ-LC13 Item 31), Chest Pain (QLQ-LC13 Item 40), or Dyspnea (QLQ-C30 Item 8) |
9.20; 5.55 | 0.2903 |
Summary
This study will evaluate the efficacy and safety of pembrolizumab (MK-3475) with lenvatinib (E7080/MK-7902) vs. docetaxel in participants with metastatic non-small cell lung cancer (NSCLC) and progressive disease (PD) after platinum doublet chemotherapy and treatment with one prior anti-PD-1/PD-L1 monoclonal antibody (mAb). The primary hypotheses of this study are that pembrolizumab + lenvatinib (compared with docetaxel) prolongs: 1) overall survival (OS); and progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) based on blinded independent central review (BICR).
Eligibility Criteria
Inclusion Criteria
- Has a histologically or cytologically confirmed diagnosis of metastatic squamous or nonsquamous Non-Small Cell Lung Cancer (NSCLC) -Stage IV: M1a, M1b, M1c.
- Has progressive disease (PD) on treatment with one prior anti-programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) monoclonal antibody (mAb) administered either as monotherapy or in combination with other checkpoint inhibitors or other therapies.
- Retreatment with the same anti-PD-L1/PD-L1 mAb is acceptable in the overall course of treatment
- Has PD during/after platinum doublet chemotherapy for metastatic disease.
- Has confirmation that EGFR-, ALK-, or ROS1-directed therapy is not indicated as primary therapy (documentation of absence of tumor-activating EGFR mutations [eg, DEL19 or L858R], and absence of ALK and ROS1 gene rearrangements OR presence of a K-ras mutation).
- Has submitted pre-study imaging that confirmed evidence of PD following initiation of an anti-PD-1/PD-L1 inhibitor.
- Has at least 1 measurable lesion by computerized tomography (CT) or magnetic resonance imaging (MRI) per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, as determined by the local site assessment.
- Has provided tumor tissue for PD-L1 biomarker analysis from an archival sample (defined as: from initial diagnosis of NSCLC and prior to receiving immunotherapy [antiPD-1/PD-L1], from the primary lesion or a metastatic lesion).
- Has provided prior to allocation tissue from a newly obtained formalin-fixed sample from a new biopsy (defined as: after completion of immunotherapy [anti-PD-1/PD-L1] and before receiving a randomization number), of a tumor lesion not previously irradiated.
- Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 7 days before the first dose of study intervention but before randomization.
- Has a life expectancy of at least 3 months.
- Male participants receiving pembrolizumab ± lenvatinib or lenvatinib must agree to refrain from donating sperm, and either 1) be abstinent from heterosexual intercourse; or 2) follow contraceptive guidance during the treatment period or 7 days after the last dose of lenvatinib. Male participants receiving docetaxel agree to adhere to the same conditions during the treatment period and for ≥90 days after the last dose of study treatment.
- Female participants must not be pregnant, not be breastfeeding, and not be a woman of child-bearing potential (WOCBP). If a WOCBP, agrees to not donate eggs and either use contraception, or be abstinent from heterosexual intercourse during the treatment period and for ≥120 days after the last dose of pembrolizumab or 30 days after the last dose of lenvatinib, whichever occurs last. If a WOCBP receiving docetaxel, agrees to adhere to the same conditions during the treatment period and for ≥30 days after the last dose of study treatment.
- Has adequately controlled blood pressure (BP) with or without antihypertensive medications, defined as BP ≤150/90 mm Hg and no change in antihypertensive medications within 1 week before randomization.
- If participant received major surgery or radiation therapy of >30 Gy, they have recovered from the toxicity and/or complications from the intervention.
- Has adequate organ function.
Exclusion Criteria
- Has received docetaxel as monotherapy or in combination with other therapies.
- Has received lenvatinib as monotherapy or in combination with an anti-PD-1/PD-L1 mAb.
- Has received: 1) radiotherapy within 2 weeks before the first dose of study treatment; or 2) lung radiation therapy >30 Gy within 6 months before the first dose of study treatment.
- Has received a live vaccine within 30 days before the first dose of study treatment.
- Has clinically significant hemoptysis or tumor bleeding within 2 weeks before the first dose of study treatment.
- Has radiographic evidence of intratumoral cavitation, encasement, or invasion of a major blood vessel.
- Has clinically significant cardio
Data sourced from ClinicalTrials.gov (NCT03976375). 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.