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Tomivosertib Combined With Pembrolizumab in Subjects With PD-L1 Positive NSCLC (KICKSTART) (KICKSTART)

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ClinicalTrials.gov Identifier: NCT04622007
Recruitment Status : Active, not recruiting
First Posted : November 9, 2020
Last Update Posted : April 30, 2024
Sponsor:
Collaborators:
Medpace, Inc.
ICON plc
Information provided by (Responsible Party):
Effector Therapeutics

Study Description
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Brief Summary:
Tomivosertib combined with pembrolizumab in Subjects with PD-L1 positive NSCLC

Condition or disease Intervention/treatment Phase
Non-small Cell Lung Cancer Drug: Tomivosertib Biological: Pembrolizumab Drug: Pemetrexed Phase 2

Detailed Description:
A Randomized, Double-Blind, Placebo-Controlled Trial of Tomivosertib in Combination With Anti-PD-(L)1 Therapy in Subjects With Non-Small Cell Lung Cancer as First Line Therapy or When Progressing on Single-Agent First-Line Anti PD (L)1 Therapy
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 68 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: In each Cohort approximately 60 eligible Subjects were targeted to be randomized to receive tomivosertib or matching placebo in combination with pembrolizumab (and pemetrexed, Cohort C). Cohorts A and C were closed to enrollment early due to recruitment challenges. In Cohort B, 54 subjects received blinded IP (tomivosertib or matching placebo) in combination with pembrolizumab as first line therapy.
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: In all cohorts, investigational product (IP, tomivosertib or placebo) will be blinded and pembrolizumab will be open label. On Cohort C, pembrolizumab and pemetrexed will be open label.
Primary Purpose: Treatment
Official Title: A Randomized, Double-Blind, Placebo-Controlled Trial of Tomivosertib in Combination With Anti-PD-(L)1 Therapy in Subjects With NSCLC as First Line Therapy or When Progressing on Single-Agent First-Line Anti PD (L)1 Therapy
Actual Study Start Date : June 2, 2021
Estimated Primary Completion Date : October 14, 2024
Estimated Study Completion Date : December 9, 2024

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: A1 Tomi + Current Pembro
Subjects who have initiated pembrolizumab as a single agent and in accordance with the package insert will receive tomivosertib in addition to pembrolizumab.
 Drug: Tomivosertib
Tomivosertib (eFT508) will be taken at 100 mg twice daily (bid) with meals
Other Name: eFT508

Biological: Pembrolizumab
Subjects will initiate or continue to receive pembrolizumab at either 200 mg intravenously (IV) at a frequency of every 3 weeks or 400 mg IV at a frequency of every 6 weeks.
Other Name: Keytruda®
Placebo Comparator: Pbo + Current Pembro
Subjects who have initiated pembrolizumab as a single agent and in accordance with the package insert, will receive matching placebo in addition to pembrolizumab.
 Biological: Pembrolizumab
Subjects will initiate or continue to receive pembrolizumab at either 200 mg intravenously (IV) at a frequency of every 3 weeks or 400 mg IV at a frequency of every 6 weeks.
Other Name: Keytruda®
Experimental: B1 Tomi + Pembro
Subjects will initiate pembrolizumab as first-line therapy and receive tomivosertib.
 Drug: Tomivosertib
Tomivosertib (eFT508) will be taken at 100 mg twice daily (bid) with meals
Other Name: eFT508

Biological: Pembrolizumab
Subjects will initiate or continue to receive pembrolizumab at either 200 mg intravenously (IV) at a frequency of every 3 weeks or 400 mg IV at a frequency of every 6 weeks.
Other Name: Keytruda®
Placebo Comparator: Pbo + Pembro
Subjects will initiate pembrolizumab as first-line therapy and receive matching placebo.
 Biological: Pembrolizumab
Subjects will initiate or continue to receive pembrolizumab at either 200 mg intravenously (IV) at a frequency of every 3 weeks or 400 mg IV at a frequency of every 6 weeks.
Other Name: Keytruda®
Experimental: C1 Tomi + Pembro + Pemetrexed (Non-sqamous) or Tomi + Pembro (Squamous)
Subjects who have completed 4 to 6 cycles of platinum-based chemotherapy doublet will receive tomi plus pembrolizumab and pemetrexed (non-squamous NSCLC) or tomi plus pembro as a single agent (squamous) in accordance with the package insert.
 Drug: Tomivosertib
Tomivosertib (eFT508) will be taken at 100 mg twice daily (bid) with meals
Other Name: eFT508

Biological: Pembrolizumab
Subjects will initiate or continue to receive pembrolizumab at either 200 mg intravenously (IV) at a frequency of every 3 weeks or 400 mg IV at a frequency of every 6 weeks.
Other Name: Keytruda®

Drug: Pemetrexed
Subjects will initiate pemetrexed at 500 mg/m2 intravenously (IV) at a frequency of every 3 weeks.
Other Name: Alimta®
Placebo Comparator: Pbo + Pembro + Pemetrexed (Non-sqamous) or Pbo + Pembro (Squamous)
Subjects who have completed 4 to 6 cycles of platinum-based chemotherapy doublet will receive placebo plus pembrolizumab and pemetrexed (non-squamous NSCLC) or placebo plus pembro as a single agent (squamous) in accordance with the package insert.
 Biological: Pembrolizumab
Subjects will initiate or continue to receive pembrolizumab at either 200 mg intravenously (IV) at a frequency of every 3 weeks or 400 mg IV at a frequency of every 6 weeks.
Other Name: Keytruda®

Drug: Pemetrexed
Subjects will initiate pemetrexed at 500 mg/m2 intravenously (IV) at a frequency of every 3 weeks.
Other Name: Alimta®


Outcome Measures
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Primary Outcome Measures :
  1. To characterize the progression-free survival (PFS) of tomivosertib when added to pembrolizumab as a first-line treatment; and [ Time Frame: 2 years ]
    Defined as the time from randomization to the first occurrence of disease progression as assessed by the Investigator using RECIST 1.1 or death from any cause, whichever occurs earlier.

  2. To characterize the PFS of tomivosertib when added to pembrolizumab as first line therapy. [ Time Frame: 2 years ]
    Defined as the time from randomization to the first occurrence of disease progression as assessed by the Investigator using RECIST 1.1 or death from any cause, whichever occurs earlier.

  3. To characterize the PFS of tomivosertib when added to pembrolizumab and pemetrexed in non-squamous NSCLC, and pembrolizumab in squamous NSCLC as first line maintenance therapy. [ Time Frame: 2 years ]
    Defined as the time from randomization to the first occurrence of disease progression as assessed by the Investigator using RECIST 1.1 or death from any cause, whichever occurs earlier.


Secondary Outcome Measures :
  1. To characterize the PFS of tomivosertib when added to pembrolizumab in Cohorts A, B, and B C individually and combined [ Time Frame: 2 years ]
    Defined as the time from randomization to the first occurrence of disease progression as assessed by the Investigator using RECIST 1.1 or death from any cause, whichever occurs earlier.

  2. To characterize the PFS of tomivosertib when added to pembrolizumab as a first-line treatment in subjects with NSCLC [ Time Frame: 2 years ]
    Defined as the time from randomization to the first occurrence of disease progression as assessed by the Investigator using RECIST 1.1 or death from any cause, whichever occurs earlier. Objective response per RECIST 1.1, as assessed by the BIRC.

  3. To characterize the PFS of tomivosertib when added to pembrolizumab and pemetrexed in non-squamous NSCLC, and pembrolizumab in squamous NSCLC as a first-line maintenance treatment in subjects with NSCLC. [ Time Frame: 2 years ]
    Defined as the time from randomization to the first occurrence of disease progression as assessed by the Investigator using RECIST 1.1 or death from any cause, whichever occurs earlier. Objective response per RECIST 1.1, as assessed by the BIRC.

  4. To characterize the PFS of tomivosertib when added to pembrolizumab after first radiographic progression on pembrolizumab monotherapy [ Time Frame: 2 years ]
    Defined as the time from randomization to the first occurrence of disease progression as assessed by the Investigator using RECIST 1.1 or death from any cause, whichever occurs earlier. Objective response per RECIST 1.1, as assessed by the BIRC


Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Inclusion Criteria for Cohort A: Subjects who meet all of the following criteria will be eligible to participate in Cohort A of the study:

1. Have initiated first-line therapy for NSCLC with pembrolizumab and satisfy the following:

  • Have tumor PD-L1 ≥1% by 22C3 IHC;
  • Are judged by the Principal Investigator as tolerating pembrolizumab monotherapy; and
  • Have been on pembrolizumab for at least 3 months (measured from actual first dose date to first dose date of the current study) and the most recent scans are the first scans to objectively demonstrate Progressive Disease per RECIST 1.1
  • The first scan conducted a minimum of 21 days after first dose of anti-PD-(L)1 therapy must have shown either SD, PR, or CR (ie, not Progressive Disease) per RECIST 1.1; and
  • The 2 most recent scans (including 1 demonstrating Progressive Disease) are available to be reviewed

Inclusion Criterion for Cohort B

Subjects who meet the following criterion will be eligible to participate in Cohort B of the study:

1. Are eligible for single-agent pembrolizumab for advanced/metastatic NSCLC in accordance with the package insert and have tumor PD-L1 ≥50% by 22C3 IHC

• Must not have been treated previously with platinum-based chemotherapy in the advanced/metastatic setting. Note: Subjects may have received chemotherapy and/or anti PD (L)1 therapy in the neo/adjuvant setting, provided the last dose of therapy was >9 months prior to randomization.

All cohorts require PD-L1 testing (TPS as determined by an FDA-approved test: subjects in Cohort B must specifically have PD-L1 testing using the PD-L1 IHC 22C3 pharmDx test kit). Subjects in Cohort B for whom PD-L1 testing was not performed with the required IHC 22C3 pharmDx test kit may be randomized if all other study criteria have been met, pending retest with the required IHC 22C3 pharmDx test kit.

Subjects who meet the following criterion will be eligible to participate in Cohort C of the study:

1. Have initiated IL therapy for NSCLC and completed all planned (eg, 4 to 6 cycles) platinum-based chemotherapy with at least 2 cycles in combination with pembrolizumab; must not have had progressive disease on tumor staging imaging scans following completion of all planned platinum chemotherapy

  • Are eligible for maintenance therapy with pembrolizumab ± pemetrexed in accordance with the package insert
  • Have tumor PD-L1 ≥1%
  • The last dose of platinum-based chemotherapy must be within 8 weeks of the first dose of the study drug in this study

Inclusion Criterion for All Cohorts

  • Subjects must also meet all of the following criteria to be eligible to participate in the study:

    1. Have histologically confirmed NSCLC that is inoperable, locally advanced or metastatic (Stage IIIb/IV)
    2. Have available at the site a representative formalin-fixed, paraffin-embedded tumor specimen that enabled diagnosis of NSCLC in a tissue block (preferred) or 10 unstained, serial slides, accompanied by an associated pathology report. Note: If the archival tissue is neither sufficient nor available, the subject may still be eligible, upon discussion with the Medical Monitor
    3. Have provided written informed consent and any authorizations required by local law
    4. Are ≥18 years of age
    5. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

Exclusion Criteria:

  1. Have NSCLC with epidermal growth factor receptor or anaplastic lymphoma kinase genomic tumor aberrations
  2. Have gastrointestinal (GI) disease (eg, gastric or intestinal bypass surgery, pancreatic enzyme insufficiency, malabsorption syndrome, symptomatic inflammatory bowel disease, chronic diarrheal illness, and/or bowel obstruction) that may interfere with drug absorption or with interpretation of GI AEs
  3. Have known symptomatic brain metastases requiring >10 mg/day of prednisone (or its equivalent). Subjects with previously diagnosed brain metastases are eligible if they have completed their treatment, have recovered from the acute effects of radiation therapy or surgery prior to randomization, fulfill the steroid requirement for these metastases, the 2 most recent serial magnetic resonance imaging (MRI) scans conducted >28 days apart show no central nervous system progression, and are neurologically stable and asymptomatic
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04622007


Locations
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Sponsors and Collaborators
Effector Therapeutics
Medpace, Inc.
ICON plc
Investigators
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Study Director: Douglas Warner, MD EFFECTOR Therapeutics, Inc.
More Information
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Responsible Party: Effector Therapeutics
ClinicalTrials.gov Identifier: NCT04622007    
Other Study ID Numbers: eFT508-0011
First Posted: November 9, 2020    Key Record Dates
Last Update Posted: April 30, 2024
Last Verified: April 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Carcinoma, Non-Small-Cell Lung
Carcinoma, Bronchogenic
Bronchial Neoplasms
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
 Pembrolizumab
Pemetrexed
Antineoplastic Agents, Immunological
Antineoplastic Agents
Immune Checkpoint Inhibitors
Molecular Mechanisms of Pharmacological Action
Enzyme Inhibitors
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors