Trial Outcomes & Findings for Pembrolizumab for the Treatment of Recurrent High Grade Neuroendocrine Carcinoma (NCT NCT03190213)

NCT ID: NCT03190213

Last Updated: 2021-06-22

Results Overview

Overall response was measured using Immune Related Response Evaluation Criteria in Solid Tumors (irRECIST). At baseline, lesions found on CT or MRI imaging are cataloged as "target" or "non-target" lesions, and the longest dimensions of target lesions (or shortest dimension of target lymph nodes) are summed. irRECIST defines Complete Response (irCR) as a complete disappearance of all lesions after baseline. Partial Response (irPR) is defined as a 30% or more decrease in the target lesion measurements. Overall response rate is defined the percentage of participants with a best response of irCR + irPR.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

6 participants

Primary outcome timeframe

planned for up to two years from baseline; actual time was up to 230 days (average of 70.5 days)

Results posted on

2021-06-22

Participant Flow

Participant milestones

Participant milestones
Measure
Pembrolizumab: All Patients
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Overall Study
STARTED
6
Overall Study
COMPLETED
6
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Pembrolizumab for the Treatment of Recurrent High Grade Neuroendocrine Carcinoma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Pembrolizumab: All Patients
n=6 Participants
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
5 Participants
n=5 Participants
Age, Categorical
>=65 years
1 Participants
n=5 Participants
Age, Continuous
44 years
n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
5 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants

PRIMARY outcome

Timeframe: planned for up to two years from baseline; actual time was up to 230 days (average of 70.5 days)

Overall response was measured using Immune Related Response Evaluation Criteria in Solid Tumors (irRECIST). At baseline, lesions found on CT or MRI imaging are cataloged as "target" or "non-target" lesions, and the longest dimensions of target lesions (or shortest dimension of target lymph nodes) are summed. irRECIST defines Complete Response (irCR) as a complete disappearance of all lesions after baseline. Partial Response (irPR) is defined as a 30% or more decrease in the target lesion measurements. Overall response rate is defined the percentage of participants with a best response of irCR + irPR.

Outcome measures

Outcome measures
Measure
Pembrolizumab: All Patients
n=6 Participants
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Overall Response Rate
0 percentage of participants
Interval 0.0 to 45.9

SECONDARY outcome

Timeframe: planned for up to two years from baseline; actual time was up to 230 days (average of 70.5 days)

Clinical benefit was measured using irRECIST. At baseline, lesions found on CT or MRI imaging are cataloged as "target" or "non-target" lesions, and the longest dimensions of target lesions (or shortest dimension of target lymph nodes) are summed. irRECIST defines irCR as a complete disappearance of all lesions after baseline. irPR is defined as a 30% or more decrease in the target lesion measurements. Progressive Disease (irPD) is a defined as a 20% or more increase in target lesion measurements. Stable Disease (irSD) is neither a sufficient shrinkage to qualify as irPR or irCR nor an increase that would qualify as irPD. Clinical Benefit Rate is defined as the percentage of participants with a best response of irCR + irPR + irSD.

Outcome measures

Outcome measures
Measure
Pembrolizumab: All Patients
n=6 Participants
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Clinical Benefit Rate
16.7 percentage of participants
Interval 0.4 to 64.1

SECONDARY outcome

Timeframe: planned for up to four years from baseline; actual time was up to 230 days (average of 70.5 days)

Progression free survival (PFS) is the length of time during and after treatment that a participant lives and the disease does not get worse. PFS was measured as the time from first dose of pembrolizumab until disease progression by irRECIST criteria (\>= 20% increase in target lesion measurements), and is reported as the median number of days patients survived without disease progression as calculated by the Kaplan-Meier method.

Outcome measures

Outcome measures
Measure
Pembrolizumab: All Patients
n=6 Participants
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Median Progression Free Survival
42.5 days
Interval 40.0 to
Value is infinity because there were too few patients to get a number.

SECONDARY outcome

Timeframe: planned for up to four years from baseline; actual time was up to 230 days (average of 70.5 days)

Overall survival (OS) is the length of time from the start of treatment that a participant lives. OS was measured as the time from first dose of pembrolizumab until the death of the participant or the end of follow-up (whichever was first), and is reported as the median number of days patients survived as calculated by the Kaplan-Meier method. This study was intended to follow participants up to four years after the initiation of study treatment, but the study and the follow-up period were terminated prematurely. The maximum follow up was 360 days.

Outcome measures

Outcome measures
Measure
Pembrolizumab: All Patients
n=6 Participants
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Median Overall Survival
262 days
Interval 108.0 to
Value is infinity because there were too few patients to get a number.

SECONDARY outcome

Timeframe: planned for up to two years of treatment plus 90 days; actual time was up to 338 days (average of 170 days)

Adverse Events were reported using the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Each adverse event reported is assigned a severity grade from 1 to 5, where 1 is mild, 2 is moderate, 3 is severe, 4 is life threatening, and 5 indicates the event resulted in death. The number of patients experiencing any Grade 1-2 event and the number of patients experiencing any Grade 3 event are reported. There were no Grade 4 or Grade 5 events reported on this study. AEs were reported during study treatment and up to 90 days after last dose of treatment.

Outcome measures

Outcome measures
Measure
Pembrolizumab: All Patients
n=6 Participants
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Number of Patients With Adverse Events Reported
Grade 1-2 Event
5 Participants
Number of Patients With Adverse Events Reported
Grade 3 Event
5 Participants

Adverse Events

Pembrolizumab: All Patients

Serious events: 4 serious events
Other events: 6 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Pembrolizumab: All Patients
n=6 participants at risk
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Gastrointestinal disorders
Abdominal pain
33.3%
2/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Metabolism and nutrition disorders
Dehydration
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Metabolism and nutrition disorders
Hyponatremia
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Vomiting
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.

Other adverse events

Other adverse events
Measure
Pembrolizumab: All Patients
n=6 participants at risk
Pembrolizumab 200 mg will be administered as an IV infusion every 3 weeks.
Gastrointestinal disorders
Abdominal pain
50.0%
3/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Immune system disorders
Allergic reaction
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Anal pain
16.7%
1/6 • Number of events 2 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Metabolism and nutrition disorders
Anorexia
33.3%
2/6 • Number of events 3 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Immune system disorders
Autoimmune disorder
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Constipation
33.3%
2/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Metabolism and nutrition disorders
Dehydration
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Diarrhea
50.0%
3/6 • Number of events 5 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Dyspepsia
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Respiratory, thoracic and mediastinal disorders
Dyspnea
16.7%
1/6 • Number of events 2 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
General disorders
Edema limbs
33.3%
2/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
General disorders
Fatigue
50.0%
3/6 • Number of events 4 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Nervous system disorders
Headache
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Vascular disorders
Hot flashes
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Metabolism and nutrition disorders
Hyperglycemia
16.7%
1/6 • Number of events 2 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Respiratory, thoracic and mediastinal disorders
Hypoxia
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Infections and infestations
Infections and infestations - Other: Thrush
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
General disorders
Infusion related reaction
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Psychiatric disorders
Insomnia
16.7%
1/6 • Number of events 2 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Blood and lymphatic system disorders
Lymph node pain
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Investigations
Lymphocyte count decreased
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Nausea
66.7%
4/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Nervous system disorders
Nervous system disorders - Other: Allodynia
16.7%
1/6 • Number of events 2 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
General disorders
Pain
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Reproductive system and breast disorders
Pelvic pain
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Skin and subcutaneous tissue disorders
Pruritus
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Rectal pain
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Psychiatric disorders
Restlessness
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Nervous system disorders
Seizure
16.7%
1/6 • Number of events 2 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Small intestinal obstruction
16.7%
1/6 • Number of events 2 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Nervous system disorders
Spasticity
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Infections and infestations
Urinary tract infection
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.
Gastrointestinal disorders
Vomiting
16.7%
1/6 • from the first dose of pembrolizumab until 30 days (for other adverse events) or 90 days (for serious adverse events) after last dose of pembrolizumab (average duration of 170 days, max duration of 338 days)
The occurrence of adverse events was sought by non-directive questioning of the patient at each visit or phone contact during the study. Adverse events were also detected when they were volunteered by the patient during or between visits or through physical examination, laboratory test, or other assessments.

Additional Information

Data Manager

Huntsman Cancer Institute Research Compliance Office

Phone: 8015850601

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place