Study Comparing Pembrolizumab With Dual MAPK Pathway Inhibition Plus Pembrolizumab in Melanoma Patients

NCT ID: NCT02625337

Last Updated: 2017-09-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2018-12-31

Brief Summary

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This is a Phase 2 trial consisting of 24 patients receiving the combination of dabrafenib + trametinib + pembrolizumab in 3 different dosing schemes and 8 patients receiving pembrolizumab standard monotherapy. All patients start with pembrolizumab standard therapy for 6 weeks and will then be randomized to continue pembrolizumab monotherapy or to receive additional intermitted/short-term dabrafenib + trametinib.

Stratification will be baseline LDH level and baseline PD-L1 expression.

Detailed Description

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Conditions

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Metastatic Melanoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pembrolizumab mono

Pembrolizumab monotherapy

Group Type ACTIVE_COMPARATOR

Pembrolizumab

Intervention Type DRUG

Biopsy

Intervention Type PROCEDURE

Biopsies will be taken during screening, before randomization, at week 8 (only arm 2-4) after 12 weeks, at week 18 and if PD.

Blood taking

Intervention Type PROCEDURE

Blood will be taken for PBMCs during screening (twice), before randomization, at weeks 12 at week 18 and if PD.

Pembrolizumab with dabrafenib+trametinib short

Pembrolizumab combined with a short scheme of dabrafenib+trametinib

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type DRUG

Dabrafenib

Intervention Type DRUG

Trametinib

Intervention Type DRUG

Biopsy

Intervention Type PROCEDURE

Biopsies will be taken during screening, before randomization, at week 8 (only arm 2-4) after 12 weeks, at week 18 and if PD.

Blood taking

Intervention Type PROCEDURE

Blood will be taken for PBMCs during screening (twice), before randomization, at weeks 12 at week 18 and if PD.

Pembrolizumab with dabrafenib+trametinib intermediate

Pembrolizumab combined with an intermediate scheme of dabrafenib+trametinib

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type DRUG

Dabrafenib

Intervention Type DRUG

Trametinib

Intervention Type DRUG

Biopsy

Intervention Type PROCEDURE

Biopsies will be taken during screening, before randomization, at week 8 (only arm 2-4) after 12 weeks, at week 18 and if PD.

Blood taking

Intervention Type PROCEDURE

Blood will be taken for PBMCs during screening (twice), before randomization, at weeks 12 at week 18 and if PD.

Pembrolizumab with dabrafenib+trametinib long

Pembrolizumab combined with a long scheme of dabrafenib+trametinib

Group Type EXPERIMENTAL

Pembrolizumab

Intervention Type DRUG

Dabrafenib

Intervention Type DRUG

Trametinib

Intervention Type DRUG

Biopsy

Intervention Type PROCEDURE

Biopsies will be taken during screening, before randomization, at week 8 (only arm 2-4) after 12 weeks, at week 18 and if PD.

Blood taking

Intervention Type PROCEDURE

Blood will be taken for PBMCs during screening (twice), before randomization, at weeks 12 at week 18 and if PD.

Interventions

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Pembrolizumab

Intervention Type DRUG

Dabrafenib

Intervention Type DRUG

Trametinib

Intervention Type DRUG

Biopsy

Biopsies will be taken during screening, before randomization, at week 8 (only arm 2-4) after 12 weeks, at week 18 and if PD.

Intervention Type PROCEDURE

Blood taking

Blood will be taken for PBMCs during screening (twice), before randomization, at weeks 12 at week 18 and if PD.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Adults at least 18 years of age
* World Health Organization (WHO) Performance Status 0-2
* Histologically/cytologically confirmed stage IV BRAF V600E or K metastatic melanoma
* Measurable disease according to RECIST 1.1
* At least one easy accessible lesion (s.c., lymph node) that can be repeatedly biopsied
* Patient willing to undergo triple tumor biopsies during screening, at week 6, week 8 (cohorts 2-4 only), week 12, at week 18, and in case of disease progression.
* No prior immunotherapy targeting PD-1 or PD-L1 (CTLA-4 targeting therapy is allowed)
* No prior BRAF and/or MEK targeting therapy
* No immunosuppressive medications
* Screening laboratory values must meet the following criteria:

WBC ≥ 2.0x109/L, Neutrophils ≥ 1.0x109/L, Platelets ≥ 100 x109/L, Hemoglobin ≥ 5.0 mmol/L Creatinine ≤ 2x ULN AST, ALT ≤ 2.5 x ULN (≤5 x ULN for patients with liver metastases) Bilirubin ≤2 X ULN

* Female subject of childbearing potential should have a negative urine or serum pregnancy within 72 hours prior to receiving the first dose of study medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
* Women of child bearing potential must agree to use a reliable form of contraceptive during the study treatment period and for at least 120 days following the last dose of study drug
* Men must agree to the use of male contraception during the study Treatment Period and for at least 180 days after the last dose of study drug.

Exclusion Criteria

A potential subject who meets any of the following criteria will be excluded from this study:

* Is currently participating in or has participated in a study of an investigational agent or using an investigational device within 4 weeks of the first dose of treatment.
* Presence of symptomatic brain or leptomeningeal metastases; patients with asymptomatic brain metastases detected during screening for this study are allowed to participate in this study
* Prior PD-1/PD-L1 targeting immunotherapy
* Has an active automimmune disease requiring systemic treatment within the past 3 months or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents. Subjects with vitiligo or resolved childhood asthma/atopy would be an exception to this rule. Subjects that require intermittent use of bronchodilators or local steroid injections would not be excluded from the study. Subjects with hypothyroidism stable on hormone replacement or Sjorgen's syndrome will not be excluded from the study.
* Has had a prior monoclonal antibody within 4 weeks prior to study day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier.
* Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent.

* Note: Subjects with ≤ Grade 2 neuropathy are an exception to this criterion and may qualify for the study.
* Note: If subject received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.
* Has evidence of interstitial lung disease or active, non-infectious pneumonitis.
* Known history of Human Immunodeficiency Virus;
* Active infection requiring therapy, positive tests for Hepatitis B surface antigen or Hepatitis C ribonucleic acid (RNA);
* Has active tuberculosis
* Has received a live vaccine within 30 days prior to the first dose of trial treatment.
* Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy. Patients that have had another malignancy, but are free of tumor for more than 2 years are allowed for inclusion.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

The Netherlands Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christian U. Blank, Prof.

Role: PRINCIPAL_INVESTIGATOR

Medical oncologist/researcher

Locations

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Antoni van Leeuwenhoek ziekenhuis

Amsterdam, North Holland, Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Christian U. Blank, Prof.

Role: CONTACT

+31205122570

Facility Contacts

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Christian U. Blank, Prof.

Role: primary

References

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Rozeman EA, Versluis JM, Sikorska K, Hoefsmit EP, Dimitriadis P, Rao D, Lacroix R, Grijpink-Ongering LG, Lopez-Yurda M, Heeres BC, van de Wiel BA, Flohil C, Sari A, Heijmink SWTPJ, van den Broek D, Broeks A, de Groot JWB, Vollebergh MA, Wilgenhof S, van Thienen JV, Haanen JBAG, Blank CU. IMPemBra: a phase 2 study comparing pembrolizumab with intermittent/short-term dual MAPK pathway inhibition plus pembrolizumab in patients with melanoma harboring the BRAFV600 mutation. J Immunother Cancer. 2023 Jul;11(7):e006821. doi: 10.1136/jitc-2023-006821.

Reference Type DERIVED
PMID: 37479483 (View on PubMed)

Other Identifiers

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N15IMP

Identifier Type: -

Identifier Source: org_study_id