Bemcentinib (BGB324) in Combination With Pembrolizumab in Patients With TNBC

NCT ID: NCT03184558

Last Updated: 2021-11-09

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

29 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-26

Study Completion Date

2018-08-20

Brief Summary

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This is an open label, single arm, multi-centre phase II study to assess the anti-tumour activity and safety of bemcentinib (BGB324) in combination with pembrolizumab in participants with previously treated, locally advanced and unresectable, or metastatic TNBC or TN-IBC. The primary objective is objective response rate.

Detailed Description

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Conditions

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Triple Negative Breast Cancer Inflammatory Breast Cancer Stage IV

Keywords

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bemcentinib TNBC pembrolizumab Keytruda BGB324

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Extension to Simon's 2-stage design allowing termination at the end of Stage 1 for either futility or efficacy.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Bemcentinib (BGB324) + pembrolizumab

Participants received Bemcentinib (BGB324) capsules orally once daily as a loading dose of 400 milligram (mg) on Days 1, 2, and 3. A dose of 200 mg pembrolizumab was given by intravenous infusion over 30 minutes every 3 weeks in all participants. Dosing of both drugs commenced on Day 1. On days when both BGB324 and pembrolizumab were given, pembrolizumab was given first and participants were observed for 1 hour after the end of infusion before BGB324 was administered. From Day 4 onward, participants received a daily maintenance dose of 200 mg along with Pembrolizumab 200 mg intravenous (IV) infusion over 30 minutes every 3 weeks until disease progression, until an unacceptable toxicity occurred that required treatment withdrawal or withdrawal of consent or until 106 weeks had passed.

Group Type EXPERIMENTAL

Bemcentinib; pembrolizumab

Intervention Type DRUG

Bemcentinib is a selective Axl kinase inhibitor; pembrolizumab is a programmed death receptor-1 (PD-1) inhibitor.

Interventions

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Bemcentinib; pembrolizumab

Bemcentinib is a selective Axl kinase inhibitor; pembrolizumab is a programmed death receptor-1 (PD-1) inhibitor.

Intervention Type DRUG

Other Intervention Names

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BGB324; Keytruda

Eligibility Criteria

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Inclusion Criteria

1. Provision of signed informed consent.
2. Male and non-pregnant females who are aged 18 years or older at the time of provision of informed consent.
3. Histopathologically or cytologically documented TNBC or TN-IBC. Tumors must have been confirmed negative for ER and partial response (PR) by immunohistochemistry (IHC) (\<1% positive tumor nuclei, as per ASCO-CAP guideline recommendations) and negative for human epidermal growth factor receptor 2 (HER2) by IHC or fluorescent or chromogenic in situ hybridization (FISH or CISH). Patients with equivocal HER2 results by IHC should have their negativity status confirmed by FISH.
4. Locally advanced and unresectable or metastatic TNBC or triple negative inflammatory breast cancer.
5. Received one or more prior therapies for TNBC or inflammatory breast cancer in the metastatic setting, and prior treatment (metastatic or (neo) adjuvant) must have included a prior taxane and/or anthracycline-based therapy.
6. Has measurable disease as defined by RECIST 1.1 on computed tomography (CT) or magnetic resonance imaging (MRI) and as determined by the site study team. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
7. Provision of suitable tumor tissue for the analysis of Axl kinase expression and PD-L1 expression.
8. Eastern Cooperative Oncology Group (ECOG) performance score 0 or 1.
9. Life expectancy of at least 3 months.
10. Adequate organ function confirmed at Screening and within 10 days of initiating treatment, as evidenced by:

* Platelet count ≥100,000 /mm3;
* Hemoglobin ≥9.0 g/dL (≥5.6 mmol/L);.
* Absolute neutrophil count (ANC) \>1,500 /mm\^3;
* Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) ≤2.5 times the upper limit of normal (ULN), or ≤5 times the ULN for patients with liver metastases;
* Total bilirubin ≤1.5 times the ULN, or direct bilirubin \<ULN for patients with total bilirubin levels \>1.5xULN;
* Creatinine ≤1.5 times the ULN and calculated creatinine clearance \>60 mL/min (by Cockcroft Gault formula);
* International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5 times the ULN and Activated Partial Thromboplastin Time (aPTT) ≤1.5 times the ULN. Note: If patient is receiving anticoagulant therapy, then PT or PTT must be within therapeutic range of intended use of anticoagulants;
* Lactate dehydrogenase (LDH) ≤2.5 times the ULN.
11. Female patients of childbearing potential must have a negative pregnancy test (either urine or serum pregnancy test) within 72 hours prior to the first dose of study treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
12. Have resolution of toxic effect(s) of the most recent prior chemotherapy to Grade 1 or less (except alopecia). If the patient received major surgery or radiation therapy of \>30 Gy, they must have recovered from the toxicity and/or complications from the intervention.
13. Patients of reproductive potential must be willing to practice highly effective methods of contraception throughout the study and for 120 days after the last dose of study medication. Abstinence is acceptable if this is the usual lifestyle of the patient.

Exclusion Criteria

1. Has disease that is suitable for local therapy administered with curative intent.
2. More than 3 previous lines of therapy in the metastatic setting.
3. Has received prior therapy with an immunomodulatory agent.
4. Has a known additional malignancy that is progressing or requires active treatment. Note: Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
5. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
6. History of the following cardiac conditions:

* Congestive cardiac failure of \>Grade II severity according to the New York Heart Association (NYHA);
* Ischemic cardiac event including myocardial infarction within 3 months prior to first dose;
* Uncontrolled cardiac disease, including unstable angina, uncontrolled hypertension (i.e. sustained systolic BP \>160 mmHg or diastolic BP \>90 mmHg), or need to change medication due to lack of disease control within 6 weeks prior to the provision of consent;
* History or presence of sustained bradycardia (≤55 BPM), left bundle branch block, cardiac pacemaker or ventricular arrhythmia. Note: Patients with a supraventricular arrhythmia requiring medical treatment, but with a normal ventricular rate are eligible;
* Family history of long QTc syndrome; personal history of long QTc syndrome or previous drug-induced QTc prolongation of at least Grade 3 (QTc \>500 ms).
7. Abnormal left ventricular ejection fraction on echocardiography or Multi Gated Acquisition Scan (MUGA) (less than the lower limit of normal for a patient of that age at the treating institution or \<45%, whichever is lower).
8. Current treatment with any agent known to cause Torsades de Pointes which cannot be discontinued at least five half-lives or two weeks prior to the first dose of study treatment.
9. Screening 12-lead ECG with a measurable QTc interval according to Fridericia's correction \>450 ms.
10. Is currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of study treatment.
11. 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 AEs due to a previously administered agent.
12. Received an anti-cancer monoclonal antibody (mAb) within 4 weeks prior to the first dose of study treatment or who has not recovered (i.e. ≤Grade 1 or baseline) from AEs due to agents administered more than 4 weeks earlier.
13. Major surgery within 28 days prior to start of study treatment and failure to have recovered adequately from the toxicity and/or complications from the intervention prior to the first dose of study treatment.
14. Received transfusion of blood products (including platelets or red blood cells) or administration of colony stimulating factors (including granulocyte-colony stimulating factor \[G-CSF\], Granulocyte-macrophage colony-stimulating factor \[GM-CSF\] or recombinant erythropoetin) within 4 weeks prior to the first dose of study treatment.
15. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment.
16. Active autoimmune disease that has required systemic treatment in past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs).
17. Known history of human immunodeficiency virus (HIV 1/2 antibodies)
18. Has known active infection with Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., Hepatitis C virus (HCV) RNA (qualitative) is detected).
19. Has received a live-virus vaccination within 30 days of planned treatment start. Note: Seasonal flu vaccines that do not contain live virus are permitted.
20. Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis.
21. Has a history of interstitial lung disease.
22. Inability to swallow or tolerate oral medication.
23. Existing gastrointestinal disease affecting drug absorption such as celiac disease or Crohn's disease, or previous bowel resection which is considered to be clinically significant or could interfere with absorption.
24. Known lactose intolerance.
25. Requires vitamin K antagonists. Note: Patients receiving low doses prescribed to maintain the patency of venous access devices may be included. Factor Xa antagonists are permitted.
26. Treatment with any of the following: histamine receptor 2 inhibitors, proton pump inhibitors or antacids within 7 days of start of study treatment.
27. Treatment with any medication which is predominantly metabolized by CYP3A4 and has a narrow therapeutic index.
28. Known severe hypersensitivity (≥Grade 3) to bemcentinib, pembrolizumab, and/or any of their excipients.
29. Has an active infection requiring systemic therapy (apart from cutaneous infections).
30. Has a history or current evidence of any condition, therapy, or laboratory abnormality that, in the opinion of the Investigator, might confound the results of the trial, interfere with the patient's participation and compliance in the trial, or means it is not in the best interests of the patient to participate.
31. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting from Screening through to 120 days after the last dose of study treatment.
32. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
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

BerGenBio ASA

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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City of Hope Cancer Center

Duarte, California, United States

Site Status

Sharp memorial Hospital, 7901 Frost Street,

San Diego, California, United States

Site Status

Saint Luke's Cancer Institute

Kansas City, Missouri, United States

Site Status

Dartmouth-Hitchcock Medical Center

Lebanon, New Hampshire, United States

Site Status

Magee-Womens Hospital, UPMC Cancer Pavilion

Pittsburgh, Pennsylvania, United States

Site Status

Haukeland University Hospital

Bergen, , Norway

Site Status

University General Hospital of Alicante

Alicante, , Spain

Site Status

Hospital Clinic i Provincial de Barcelona

Barcelona, , Spain

Site Status

Hospital Universitario Germans Trias i Pujol - Institut Catala d'Oncologia

Barcelona, , Spain

Site Status

Hospital Universitario Amau de Vilanova de Lieda, Servicio de Oncologia

Lleida, , Spain

Site Status

Hospital General Universitario Gregorio Maranon

Madrid, , Spain

Site Status

Hospital Universitario Ramon y Cajal

Madrid, , Spain

Site Status

Hospital Universitario Miguel Servet

Zaragoza, , Spain

Site Status

Beatson West of Scotland Cancer Centre

Glasgow, Scotland, United Kingdom

Site Status

Imperial College Healthcare NHS Trust, Charing Cross Hospital

London, , United Kingdom

Site Status

The Christie NHS Foundation Trust

Manchester, , United Kingdom

Site Status

Nottingham University Hospitals, City Campus, Hucknall Road

Nottingham, , United Kingdom

Site Status

Countries

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United States Norway Spain United Kingdom

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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MK-3475 PN530

Identifier Type: OTHER

Identifier Source: secondary_id

2016-003608-30

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

BGBC007

Identifier Type: -

Identifier Source: org_study_id