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Trial record 1 of 1 for:    MK 6482-016
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Pembrolizumab Plus Lenvatinib in Combination With Belzutifan in Solid Tumors (MK-6482-016)

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ClinicalTrials.gov Identifier: NCT04976634
Recruitment Status : Recruiting
First Posted : July 26, 2021
Last Update Posted : May 10, 2024
Sponsor:
Information provided by (Responsible Party):
Merck Sharp & Dohme LLC

Study Description
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Brief Summary:
The purpose of this study is to determine the safety and efficacy of belzutifan in combination with pembrolizumab and lenvatinib in multiple solid tumors including hepatocellular carcinoma (HCC), colorectal cancer (CRC), pancreatic ductal adenocarcinoma (PDAC), biliary tract cancer (BTC), endometrial cancer (EC),and esophageal squamous cell carcinoma (ESCC). There is no formal hypothesis testing in this study.

Condition or disease Intervention/treatment Phase
Carcinoma, Hepatocellular Colorectal Neoplasms Pancreatic Ductal Adenocarcinoma Biliary Tract Neoplasms Endometrial Neoplasms Esophageal Neoplasms Drug: Pembrolizumab Drug: Belzutifan Drug: Lenvatinib Phase 2

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 730 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: An Open-label, Multicenter, Phase 2 Study to Evaluate the Efficacy and Safety of Pembrolizumab Plus Lenvatinib in Combination With Belzutifan in Multiple Solid Tumors
Actual Study Start Date : August 18, 2021
Estimated Primary Completion Date : March 22, 2027
Estimated Study Completion Date : March 22, 2027

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Arms and Interventions
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Arm Intervention/treatment
Experimental: Arm 1: Pembrolizumab + Belzutifan + Lenvatinib
Participants will receive pembrolizumab 400 mg PLUS belzutifan 120 mg PLUS lenvatinib 20 mg (For HCC: 8 mg [body weight <60kg] or 12 mg [body weight ≥ 60 kg]). Pembrolizumab will be administered via intravenous (IV) infusion once every 6 weeks (Q6W) for a maximum of 18 doses (approximately 2 years). Belzutifan and lenvatinib will be administered orally once daily (QD) until progressive disease or discontinuation.
 Drug: Pembrolizumab
Pembrolizumab 400 mg administered Q6W via IV infusion
Other Names:
  • MK-3475
  • KEYTRUDA®

Drug: Belzutifan
Belzutifan 120 mg administered QD via oral tablet
Other Names:
  • MK-6482
  • PT2977
  • WELIREG™

Drug: Lenvatinib
Lenvantinib dose for HCC is 8 mg QD for body weight <60 kg and 12 mg QD for body weight ≥ 60 kg administered via oral capsule. For all other tumors, the lenvatinib dose is 20 mg QD administered via oral capsule
Other Names:
  • MK-7902
  • E7080
  • LENVIMA®
Experimental: Arm 2: Pembrolizumab + Lenvatinib
Participants with IO resistant ESCC will receive pembrolizumab 400 mg PLUS lenvatinib 20 mg. Pembrolizumab will be administered via intravenous (IV) infusion once every 6 weeks (Q6W) for a maximum of 18 doses (approximately 2 years). Lenvatinib will be administered orally once daily (QD) until progressive disease or discontinuation.
 Drug: Pembrolizumab
Pembrolizumab 400 mg administered Q6W via IV infusion
Other Names:
  • MK-3475
  • KEYTRUDA®

Drug: Lenvatinib
Lenvantinib dose for HCC is 8 mg QD for body weight <60 kg and 12 mg QD for body weight ≥ 60 kg administered via oral capsule. For all other tumors, the lenvatinib dose is 20 mg QD administered via oral capsule
Other Names:
  • MK-7902
  • E7080
  • LENVIMA®


Outcome Measures
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Primary Outcome Measures :
  1. Arm 1: Number of Participants Who Experience at Least One Dose-limiting Toxicity (DLT) [ Time Frame: Up to approximately 21 days ]
    Occurrence of any of the following will be considered a DLT if possibly, probably, or definitely related to study treatment administration: Grade 4 nonhematologic toxicity; Grade 4 hematologic toxicity lasting >7 days; Grade 4 thrombocytopenia-any duration; Grade 3 thrombocytopenia if associated with clinically significant hemorrhage; Febrile neutropenia Grade 3 or Grade 4; Grade 3 nonhematologic toxicity lasting >5 days despite optimal supportive care; Grade 3 hypertension not controlled by antihypertensive medication(s); Grade 3 or Grade 4 nonhematologic laboratory abnormality (if medical intervention is required, or leads to hospitalization, or persists for >1 week) ; Elevated bilirubin if persists >4 weeks (for HCC and BTC participants only); Designated alanine aminotransferase (ALT) or aspartate aminotransferase (AST) liver test abnormalities; Treatment-related toxicity resulting in participant discontinuation of study intervention during the DLT window; Grade 5 toxicity.

  2. Arm 1: Number of Participants Who Experience at Least One Adverse Event (AE) [ Time Frame: Up to approximately 60 months ]
    An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experience one or more AEs will be presented.

  3. Arm 1: Number of Participants Who Discontinue Study Treatment Due to an AE [ Time Frame: Up to approximately 59 months ]
    An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinue study treatment due to an AE will be presented separately for the safety lead-in phase (up to 21 days) and the main study.

  4. Confirmed Objective Response Rate (ORR) Per Response Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR) [ Time Frame: Up to approximately 60 months ]
    ORR is defined as the percentage of participants who have a Complete Response (CR) or a Partial Response (PR) per RECIST 1.1, as assessed by blinded independent central review (BICR).


Secondary Outcome Measures :
  1. Duration of Response (DOR) Per RECIST 1.1 as Assessed by BICR [ Time Frame: Up to approximately 60 months ]
    DOR is defined as the time from first documented evidence of CR or PR until progressive disease (PD) or death due to any cause, whichever occurs first. The DOR per RECIST 1.1 will be assessed by BICR.

  2. Disease Control Rate (DCR) Per RECIST 1.1 as Assessed by BICR [ Time Frame: Up to approximately 60 months ]
    DCR is defined as the percentage of participants who have a CR, PR, or Stable Disease (SD). The best overall response of CR, PR, or SD after ≥ 6 weeks will be assessed per RECIST 1.1 by BICR.

  3. Progression-Free Survival (PFS) Per RECIST 1.1 as Assessed by BICR [ Time Frame: Up to approximately 60 months ]
    PFS is defined as the time from first day of study intervention to the first documented progressive disease (PD) per RECIST1.1 as assessed by BICR, or death due to any cause, whichever occurs first.

  4. Overall Survival (OS) [ Time Frame: Up to approximately 60 months ]
    OS is defined as the time from the first day of study intervention to death due to any cause.

  5. ORR Per Modified Response Criteria in Solid Tumors Version 1.1 (mRECIST 1.1) for Hepatocellular Carcinoma (HCC) as Assessed by BICR [ Time Frame: Up to approximately 60 months ]
    ORR is defined as the percentage of participants who have a CR or a PR per mRECIST 1.1 for HCC, as assessed by BICR.

  6. DOR Per mRECIST 1.1 for HCC as Assessed by BICR [ Time Frame: Up to approximately 60 months ]
    DOR is defined as the time from the first documented evidence of CR or PR until either progressive disease (PD) or death due to any cause, whichever occurs first. The DOR per mRECISIT 1.1 for HCC willl be assessed by BICR.

  7. DCR Per mRECIST 1.1 for HCC as Assessed by BICR [ Time Frame: Up to approximately 60 months ]
    DCR is defined as the percentage of participants who have a CR or PR or SD. The best overall response of CR, PR, or SD after ≥ 6 weeks per mRECIST 1.1 for HCC will be assessed by BICR.

  8. PFS Per mRECIST 1.1 for HCC as Assessed by BICR [ Time Frame: Up to approximately 60 months ]
    PFS is defined as the time from first day of study intervention to the first documented PD per mRECIST 1.1 for HCC as assessed by BICR, or death due to any cause, whichever occurs first.

  9. Arm 2: Number of Participants Who Experienced an Adverse Event (AE) [ Time Frame: Up to approximately 60 months ]
    An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experience an AE after administration of pembrolizumab plus lenvatinib will be presented.

  10. Arm 2: Number of Participants Who Discontinued Study Treatment Due to an AE [ Time Frame: Up to approximately 59 months ]
    An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinue study treatment of pembrolizumab plus lenvatinib after an AE will be presented.


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:

  • Diagnosis of one of the following advanced (unresectable and/or metastatic) solid tumors, documented by histopathology or cytopathology:

    • Hepatocellular carcinoma (HCC)
    • Colorectal cancer (CRC) (non-microsatellite instability-high [non-MSI-H]/deficient mismatch repair [dMMR])
    • Pancreatic ductal adenocarcinoma (PDAC).
    • Biliary tract cancer (BTC) (includes intrahepatic, extrahepatic cholangiocarcinoma [CCA] and gall bladder cancer)
    • Endometrial cancer (EC)
    • Esophageal squamous cell carcinoma (ESCC)
  • Disease progression on or since the most recent treatment (does not apply to newly diagnosed unresectable or metastatic HCC or EC).
  • Measurable disease per RECIST v1.1 as assessed locally (by investigator) and verified by BICR
  • Submission of an archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated
  • Male participants are abstinent from heterosexual intercourse or agree to follow contraceptive guidance during and for at least 7 days after last dose of study intervention with belzutifan and lenvatinib
  • Female participants are not pregnant or breastfeeding, not a woman of child-bearing potential (WOCBP), or is a WOCBP and agrees to follow contraceptive guidance during the intervention period and and for at least 120 days after the last dose of pembrolizumab or for at least 30 days after last dose of lenvatinib or belzutifan, whichever occurs last
  • Adequate organ function
  • Adequately controlled blood pressure with or without antihypertensive medications
  • HCC Specific Inclusion Criteria: No prior systemic chemotherapy, including anti-VEGF therapy, anti-programmed cell-death (PD-1)/PD-L1 or any systemic investigational anticancer agents for advanced/unresectable HCC (1L)
  • CRC ([non-MSI-H/dMMR) Specific Inclusion Criteria: Received at least 2 prior lines of systemic therapy for unresectable or metastatic disease which includes fluoropyrimidine, irinotecan and oxaliplatin
  • PDAC Specific Inclusion Criteria: Prior therapy with at least 1 (platinum or gemcitabine containing regimen) but no more than 2 prior systemic therapies for unresectable or metastatic pancreatic cancer
  • BTC Specific Inclusion Criteria: Received at least 1 prior line of systemic therapy (containing gemcitabine or fluoropyrimidine) for unresectable or metastatic disease
  • EC Specific Inclusion Criteria: Study treatment is for 1L therapy of EC and participants should not have received prior systemic chemotherapy. Exception: May have received 1 prior line of line of systemic platinum-based adjuvant and/or neoadjuvant chemotherapy in the setting of a curative-intent resection, if the recurrence occurred ≥6 months after the last dose of chemotherapy or may have received prior radiation with or without chemotherapy
  • ESCC Specific Inclusion Criteria: Have experienced radiographic or clinical progression on one prior line of standard systemic therapy (immune oncology (IO) naïve participants) or an anti-PD-1/PD-L1 (IO resistant participants)

Exclusion Criteria:

  • Unable to swallow orally administered medication or presence of a gastrointestinal (GI) disorder that may affect study intervention absorption
  • History of a second malignancy that is progressing or has required active treatment within 3 years
  • A pulse oximeter reading <92% at rest, or requirement of intermittent supplemental oxygen/ chronic supplemental oxygen
  • Presence of central nervous system (CNS) metastases and/or carcinomatous meningitis
  • Clinically significant cardiovascular disease within 6 months of first dose of study intervention
  • Symptomatic pleural effusion, unless clinically stable after treatment
  • Preexisting ≥ Grade 3 gastrointestinal (GI) or non-GI fistula
  • Moderate to severe hepatic impairment
  • Clinically significant history of bleeding within 3 months before screening
  • Presence of serious active nonhealing wound/ulcer/bone fracture
  • Requirement for hemodialysis or peritoneal dialysis
  • History of human immunodeficiency virus (HIV) infection
  • History of Hepatitis B or active Hepatis C virus infections. with exceptions for HCC and BTC
  • Prior therapy with a PD-1, anti-PD-L1, anti-PD-L2 agent, vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) or hypoxia-inducible factor 2α (HIF-2α)
  • Radiographic evidence of intratumoral cavitation, or invasion/infiltration of a major blood vessel
  • EC specific exclusion criteria: History of carcinosarcoma, endometrial leiomyosarcoma or other high-grade sarcomas, or endometrial stromal sarcomas
  • ESCC specific exclusion criteria: Has clinically apparent ascites or pleural effusion or experienced weight loss >20% over approximately 3 months before first dose of study therapy
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): NCT04976634


Contacts
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Contact: Toll Free Number 1-888-577-8839 Trialsites@merck.com

Locations
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Sponsors and Collaborators
Merck Sharp & Dohme LLC
Investigators
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Study Director: Medical Director Merck Sharp & Dohme LLC
More Information
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Additional Information:

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Responsible Party: Merck Sharp & Dohme LLC
ClinicalTrials.gov Identifier: NCT04976634    
Other Study ID Numbers: 6482-016
MK-6482-016 ( Other Identifier: Merck )
2020-005007-40 ( EudraCT Number )
First Posted: July 26, 2021    Key Record Dates
Last Update Posted: May 10, 2024
Last Verified: May 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
URL: http://engagezone.msd.com/ds_documentation.php

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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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Neoplasms
Colorectal Neoplasms
Carcinoma, Hepatocellular
Esophageal Neoplasms
Endometrial Neoplasms
Biliary Tract Neoplasms
Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
 Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Liver Neoplasms
Liver Diseases
Head and Neck Neoplasms
Esophageal Diseases
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Uterine Diseases
Genital Diseases, Female
Female Urogenital Diseases
Female Urogenital Diseases and Pregnancy Complications