Azacitidine Combined With Pembrolizumab and Epacadostat in Subjects With Advanced Solid Tumors (ECHO-206)

NCT ID: NCT02959437

Last Updated: 2025-10-21

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: PHASE1/PHASE2
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-02-27
• Study Completion Date: 2020-03-02

Brief Summary

This is an open-label, Phase 1/2 study in subjects with advanced or metastatic solid tumors. The study has three separate treatment groups where separate epigenetic agents are evaluated with an immunotherapy combination. Treatment Group A will evaluate the DNA methyltransferase inhibitor azacitidine in combination with the programmed death receptor-1 (PD-1) inhibitor pembrolizumab and the indoleamine 2,3-dioxygenase (IDO-1) inhibitor epacadostat; Treatment Group B will evaluate the bromodomain and extra-terminal (BET) inhibitor INCB057643 with pembrolizumab and epacadostat; and Treatment Group C will evaluate the lysine-specific demethylase 1A (LSD1) inhibitor INCB059872 with pembrolizumab and epacadostat. The study will be divided into 2 parts (Part 1 and 2). Part 1 is a dose-escalation assessment to evaluate the safety and tolerability of the combination therapies. Once the recommended doses have been determined, subjects with previously treated NSCLC, microsatellite-stable colorectal cancer (CRC), head and neck squamous cell carcinoma, urothelial carcinoma, and melanoma will be enrolled into expansion cohorts in Part 2.

Conditions

Solid Tumors; Advanced Malignancies; Metastatic Cancer

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Treatment Group A: Azacitidine + Pembrolizumab + Epacadostat

Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 21 days. Part 2 will evaluate the recommended dose determined in Part 1.

Group Type: EXPERIMENTAL

Azacitidine

Intervention Type: DRUG

Five doses of azacitidine will be administered by subcutaneous injection or intravenously (IV) over Days 1 to 7 in Cycles 1 through 6.

Pembrolizumab

Intervention Type: DRUG

Pembrolizumab will be administered in a 30-minute IV infusion every 3 weeks on Day 1 of each 21-day cycle.

Epacadostat

Intervention Type: DRUG

Epacadostat tablets will be administered orally twice daily.

Treatment Group B: INCB057643 + Pembrolizumab + Epacadostat

Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 42 days. Part 1 will also contain dose-expansion cohorts in previously treated NSCLC and MSS CRC. Part 2 will evaluate the recommended dose determined in Part 1.

Group Type: EXPERIMENTAL

INCB057643

Intervention Type: DRUG

INCB057643 will be orally self- administered once daily beginning on Cycle 1 Day 1 and continuously thereafter in 21-day cycles.

Pembrolizumab

Intervention Type: DRUG

Pembrolizumab will be administered in a 30-minute IV infusion every 3 weeks of each 21-day cycle starting on Cycle 2 Day 1.

Epacadostat

Intervention Type: DRUG

Epacadostat tablets will be administered orally twice daily starting at Cycle 2 Day 1.

Treatment Group C: INCB059872 + Pembrolizumab + Epacadostat

Part 1 is an open-label 3 + 3 + 3 dose-escalation design based on observing each dose level for a period of 42 days. Part 1 will also contain dose-expansion cohorts in previously treated NSCLC and MSS CRC. Part 2 will evaluate the recommended dose determined in Part 1.

Group Type: EXPERIMENTAL

Pembrolizumab

Intervention Type: DRUG

Pembrolizumab will be administered in a 30-minute IV infusion every 3 weeks of each 21-day cycle starting on Cycle 2 Day 1.

Epacadostat

Intervention Type: DRUG

Epacadostat tablets will be administered orally twice daily starting at Cycle 2 Day 1.

INCB059872

Intervention Type: DRUG

INCB059872 will be orally self- administered once daily OR every other day beginning on Cycle 1 Day 1 and continuously thereafter in 21-day cycles.

Interventions

Azacitidine

Five doses of azacitidine will be administered by subcutaneous injection or intravenously (IV) over Days 1 to 7 in Cycles 1 through 6.

Intervention Type: DRUG

Pembrolizumab

Pembrolizumab will be administered in a 30-minute IV infusion every 3 weeks on Day 1 of each 21-day cycle.

Intervention Type: DRUG

Epacadostat

Epacadostat tablets will be administered orally twice daily.

Intervention Type: DRUG

INCB057643

INCB057643 will be orally self- administered once daily beginning on Cycle 1 Day 1 and continuously thereafter in 21-day cycles.

Intervention Type: DRUG

Pembrolizumab

Pembrolizumab will be administered in a 30-minute IV infusion every 3 weeks of each 21-day cycle starting on Cycle 2 Day 1.

Intervention Type: DRUG

Epacadostat

Epacadostat tablets will be administered orally twice daily starting at Cycle 2 Day 1.

Intervention Type: DRUG

INCB059872

INCB059872 will be orally self- administered once daily OR every other day beginning on Cycle 1 Day 1 and continuously thereafter in 21-day cycles.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Willingness to provide written informed consent for the study.
• Willingness to undergo a pretreatment and on-treatment tumor biopsy to obtain tumor tissue.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
• Part 1: Subjects with histologically or cytologically confirmed advanced or metastatic solid tumors that have failed prior standard therapy (disease progression; subject refusal or intolerance is also allowable).
• Part 2:

*Note: Subjects must have failed available therapies that are known to confer clinical benefit as indicated below, unless they are ineligible, intolerant, or refused standard treatment.

• Subjects with histologically or cytologically confirmed NSCLC:

• Metastatic (Stage IV) or recurrent NSCLC (according to American Joint Committee on Cancer 7th edition guidelines) who have had disease progression after available therapies for advanced or metastatic disease that are known to confer clinical benefit, been intolerant to treatment, or refused standard treatment.
• Prior systemic regimens must include previously approved therapies, including a platinum-containing chemotherapy regimen; a tyrosine kinase inhibitor for tumors with driver mutations; and checkpoint inhibitors where approved.
• Must have disease progression on a prior PD-1-pathway targeted agent.
• Subjects with recurrent (unresectable) or metastatic CRC:

• Have histologically confirmed microsatellite stable (MSS) CRC.
• Stage IV MSS CRC (according to American Joint Committee on Cancer 7th edition guidelines) who have had disease progression after available therapies for advanced or metastatic disease that are known to confer clinical benefit, been intolerant to treatment, or refused standard treatment.
• Prior systemic regimens must include previously approved therapies, including fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy; an anti-VEGF therapy (if no contraindication); and if negative for KRAS, NRAS, and BRAF mutations and no contraindication, an anti-epidermal growth factor receptor (EGFR) therapy; and progressed after the last administration of approved therapy.
• Subjects with HNSCC:

• Histologically confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx.
• Carcinomas of the nasopharynx, salivary gland, or nonsquamous cell histology are excluded.
• Must have received prior treatment with a platinum-based therapy
• Must have had documented disease progression while on a prior PD-1 pathway-targeted agent.
• Subjects with melanoma:

• Histologically or cytologically confirmed melanoma.
• Unresectable Stage III or Stage IV melanoma, as per American Joint Committee on Cancer staging system not amenable to local therapy.
• Subjects with urothelial carcinoma:

• Histologically or cytologically confirmed urothelial carcinoma of the renal pelvis, ureter, urinary bladder, or urethra that is transitional cell or mixed transitional/nontransitional (predominantly transitional) cell type.
• Stage IV locally advanced or metastatic urothelial carcinoma (according to American Joint Committee on Cancer 7th edition guidelines) with documented disease progression while on a PD-1 pathway targeted therapy.

Exclusion Criteria

• Laboratory parameters not within the protocol-defined range.
• Receipt of anticancer medications or investigational drugs within a defined interval before the first administration of study drug.
• Has not recovered from toxic effects of prior therapy to ≤ Grade 1.
• Active or inactive autoimmune disease or syndrome.
• Active infection requiring systemic therapy.
• Known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
• History or presence of an abnormal ECG that, in the investigator's opinion, is clinically meaningful.
• Has received a live vaccine within 30 days of planned start of study therapy.
• Prior receipt of an IDO inhibitor.
• Subjects with uncontrolled type I or type II diabetes mellitus (defined as HgbA1c > 8).
• Prior receipt of a BET inhibitor (Treatment Group B only).
• Subjects with a history of bleeding related to cancer under study requiring a medical intervention (eg, embolization procedure, RBC transfusion, or hospitalization) within 30 days of study enrollment (Treatment Groups B and C only).
• Clinically significant bleeding within 14 days of Cycle 1 Day 1 (Treatment Groups B and C only).
• Prior receipt of an LSD1 inhibitor including INCB059872 (Treatment Group C only).

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Incyte Corporation

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Kevin O'Hayer, MD

Role: STUDY_DIRECTOR

Incyte Corporation

Locations

City of Hope National Medical Center

Duarte, California, United States

University of California San Diego

La Jolla, California, United States

The University of Chicago

Chicago, Illinois, United States

University of Pennsylvania Health System

Philadelphia, Pennsylvania, United States

Sarah Cannon

Nashville, Tennessee, United States

Vanderbilt-Ingram Cancer Center

Nashville, Tennessee, United States

MD Anderson Cancer Center

Houston, Texas, United States

University of Washington

Seattle, Washington, United States

Vall D Hebron Univ

Barcelona, , Spain

Univ De Navarra

Pamplona, , Spain

University College London Hospitals (Uclh)

London, , United Kingdom

Churchill Hospital

Oxford, , United Kingdom

Countries

United States; Spain; United Kingdom

Provided Documents

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

2016-004289-25

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

INCB 24360-206 / ECHO-206

Identifier Type: -

Identifier Source: org_study_id