Phase 3
N=130
Pembrolizumab (MK-3475) Plus Lenvatinib (E7080/MK-7902) Versus Chemotherapy for Endometrial Carcinoma (ENGOT-en9 / MK-7902-001) - China Extension Study
Endometrial Neoplasms
Bottom Line
View on ClinicalTrials.gov: NCT04865289 ↗Enrolled (actual)
130
Serious AEs
44.2%
Results posted
Oct 2024
Primary outcome: Primary: Progression-free Survival (PFS) Based on Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR) in Mismatch Repair Proficient (pMMR) Participants — 10.3; 10.2 Months
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Lenvatinib (Drug); Pembrolizumab (Biological); Paclitaxel (Drug); Carboplatin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- Female
- Sponsor
- Merck Sharp & Dohme LLC
- Primary completion
- Oct 2023
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Progression-free Survival (PFS) Based on Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR) in Mismatch Repair Proficient (pMMR) Participants |
10.3; 10.2 | — |
| PRIMARY PFS Based on RECIST 1.1 as Assessed by BICR in All Randomized Participants |
11.7; 10.3 | — |
| PRIMARY Overall Survival (OS) in pMMR Participants |
37.1; NA | 0.5831415 |
| PRIMARY OS in All Randomized Participants |
NA; NA | 0.52046 |
| SECONDARY Objective Response Rate (ORR) Based on RECIST 1.1 as Assessed by BICR in pMMR Participants |
50.9; 61.4 | 0.8497 |
| SECONDARY ORR Based on RECIST 1.1 as Assessed by BICR in All Randomized Participants |
56.9; 66.1 | 0.8522 |
| SECONDARY Mean Change From Baseline in European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30) Global Health Status/Quality of Life (Items 29 and 30) Score in pMMR Participants |
-7.00; -4.87 | 0.6138 |
| SECONDARY Mean Change From Baseline in EORTC QLQ-C30 Global Health Status/Quality of Life (Items 29 and 30) Score in All Randomized Participants |
-6.69; -5.96 | 0.8398 |
| SECONDARY Number of Participants Experiencing an Adverse Event (AE) |
72; 56 | — |
| SECONDARY Number of Participants Experiencing a Serious Adverse Event (SAE) |
40; 17 | — |
| SECONDARY Number of Participants Experiencing an Immune-related AE (irAE) |
49; 10 | — |
| SECONDARY Number of Participants Discontinuing From Study Treatment Due to an AE(s) |
32; 8 | — |
Summary
The purpose of this study is to compare the efficacy of pembrolizumab + lenvatinib to chemotherapy in female participants with Stage III, IV, or recurrent endometrial carcinoma. It is hypothesized that the combination of pembrolizumab + lenvatinib will be superior to chemotherapy for progression-free survival (PFS) per Response Evaluation Criteria In Solid Tumors version 1.1 (RECIST 1.1) by blinded independent central review (BICR). It is also hypothesized that the combination of pembrolizumab + lenvatinib will be superior to chemotherapy for overall survival (OS).
As of Amendment 7 eligible participants on study completion will be able to transition to an extension study, if available, in which they can continue to receive pembrolizumab monotherapy, lenvatinib monotherapy, or a combination of both pembrolizumab and lenvatinib as received in the parent study.
Eligibility Criteria
Inclusion Criteria
- Has Stage III, Stage IV, or recurrent, histologically-confirmed endometrial carcinoma with disease that is either measurable or nonmeasurable but radiographically apparent, per RECIST 1.1 as assessed by BICR (note: may have received prior chemotherapy only if administered concurrently with radiation; may have received prior radiation without concurrent chemotherapy; may have received prior hormonal therapy for treatment of endometrial carcinoma, provided that it was discontinued ≥1 week prior to randomization; and may have received 1 prior line of systemic platinum-based adjuvant and/or neoadjuvant chemotherapy)
- Has provided archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion that was not previously irradiated, for determination of mismatch repair (MMR) status
- Has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, as assessed within 7 days prior to the first dose of study intervention
- Is not pregnant or breastfeeding, and is either not a woman of childbearing potential (WOCBP) or is a WOCBP who agrees to use contraception during the study and for ≥120 days after pembrolizumab, ≥30 days after lenvatinib, or ≥180 days after (chemotherapy) [if a WOCBP, a pregnancy test will be required within 24 hours of first dose of study drug]
- Has adequately controlled blood pressure within 7 days prior to randomization
- Has adequate organ function based on assessment within 7 days prior to the first dose of study intervention
Exclusion Criteria
- Has carcinosarcoma (malignant mixed Műllerian tumor), endometrial leiomyosarcoma or other high grade sarcomas, or endometrial stromal sarcomas
- Has a central nervous system (CNS) metastasis, unless local therapy (e.g., whole brain radiation therapy, surgery, or radiosurgery) has been completed and have discontinued use of corticosteroids for this indication for ≥4 weeks prior to starting study medication (major surgery within 3 weeks of the first dose of study drug will be exclusionary)
- Has a known additional malignancy (other than endometrial carcinoma) that is progressing or has required active treatment in the last 3 years
- Has gastrointestinal malabsorption or any other condition that might affect the absorption of lenvatinib
- Has a pre-existing Grade ≥3 gastrointestinal or nongastrointestinal fistula
- Has radiographic evidence of major blood vessel invasion/infiltration
- Has active hemoptysis (bright red blood of ≥0.5 teaspoon) within 3 weeks prior to the first dose of study intervention, or tumor bleeding within 2 weeks prior to randomization
- Has clinically significant cardiovascular disease within 12 months from first dose of study intervention including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability
- Has any infection requiring systemic treatment
- Has not recovered adequately from any toxicity and/or complications from major surgery prior to randomization
- Has a known history of human immunodeficiency virus (HIV) infection (HIV test is required at screening)
- Has a known history of hepatitis B (defined as hepatitis B surface antigen [HBsAg] reactive) or known active hepatitis C virus (hepatitis B and C testing is required at screening)
- Has a history of (noninfectious) pneumonitis that required treatment with steroids, or has current pneumonitis
- Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the participant's participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator
- Has a known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the study
- Has a diagnosis of immunodeficiency or i
Data sourced from ClinicalTrials.gov (NCT04865289). 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.