A:platinum-resistant or partially platinum-sensitive recurrent ovarian cancer (OC) who received 1 but no more than 3 prior lines of anticancer regimens/local standard following primary or interval debulking surgery with a platinum free interval or treatment-free interval of 3-12 months based on last regimen received B:recurrent OC who received 3-5 prior lines of anticancer regimens/local standard with a platinum-free interval or treatment-free interval >or=3months based on last regimen received
Conditions
Sponsors
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Be willing and able to provide written informed consent for the trial. The subject may also provide consent for Future Biomedical Research. However, the subject may participate in the main trial without participating in Future Biomedical Research. 2. Be > or = 18 years of age on day of signing informed consent. 3. Have histologically confirmed epithelial ovarian cancer, fallopian tube cancer or primary peritoneal cancer 4. Have received a front line platinum-based regimen (administered via either IV or IP route) per local standard of care or treatment guideline following the primary or interval debulking surgery with documented disease recurrence. Note: Maintenance treatment following the front line treatment is permitted and counted together as part of the front line treatment. 5. Have fulfilled the following additional requirements regarding prior treatments for ROC depending on the cohort subject is to be enrolled. Each subject must have documented evidence of clinical response or disease stabilization to the last regimen received. Cohort A: Have received 0 to 2 additional prior lines for treating ROC (or 1 to 3 total prior lines counting the front line) and must have a PFI of > or = 3 to 12 months if the last regimen received is a platinum-based, or a TFI of > or = 3 to 12 months if the last regimen received is a non-platinum-based. Cohort B: Have received 3 to 5 additional prior lines for treating ROC (or 4 to 6 total prior lines counting the front line) and must have a PFI of > or =3 months if the last regimen received is a platinum-based, or a TFI of > or = 3 months if the last regimen received is a non-platinum-based. Note: PFI is defined as the time elapsed between the last dose of platinum and the documented evidence of disease progression per RECIST 1.1. Treatment-free interval is defined as the time elapsed between the last dose of the regimen received and the documented evidence of disease progression per RECIST 1.1. 6. Have measurable disease at baseline based on RECIST 1.1 as determined by the central imaging vendor. Note: Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions. 7. Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 8. Have a life expectancy of > or =16 weeks. 9. Have provided a tumor tissue sample either collected from prior cytoreductive surgery or fresh newly obtained tumor tissue at screening. Formalin-fixed paraffin-embedded block specimens are preferred to slides. Additional samples may be requested if tumor tissue provided is not adequate for quality and/or quantity as assessed by the central laboratory. Note 1: Tumor tissue samples from recent biopsy are much preferred as it represents the current disease status and is much more informative for understanding the correlation between clinical activity and tumor microenvironment. If available, paired tumor tissue samples from prior cytoreductive surgery and recent biopsy are strongly encouraged in order to understand the changes in tumor microenvironment during the course of the treatments. Note 2: For archival tumor tissue samples, block specimens are much preferred than slides. If submitting unstained cut slides, freshly cut slides should be submitted to the testing laboratory within 14 days from when the slides are cut. See Section 4.2.3.3 in protocol for an explanation. 10. Have demonstrated adequate organ
Exclusion criteria
Exclusion criteria: 1. Is currently participating in or has participated in a clinical study and received an investigational agent or used an investigational device within 4 weeks prior to the first dose of study treatment. Note: Subjects who have entered the follow-up phase of an investigational study may participate as long as it has been 4 weeks since the last dose of the previous investigational agent or device. 2. Has an active autoimmune disease that has required systemic treatment in the past 2 years (i.e. use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment. 3. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the planned first dose of the study. The use of physiologic doses of corticosteroids may be approved after consultation with the Sponsor. 4. Has had prior anti-cancer mAb chemotherapy, targeted small molecule therapy, or radiation therapy within 4 weeks prior to the planned first dose of the study 5. Has not recovered from AE to < or = Grade 1 or prior treatment level due to a previously administered agent. Note: Subjects with < or = Grade 2 neuropathy or alopecia of any grade are an exception to this criterion and may qualify for the study. Note: If subject received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy. 6. Has EOC with mucinous histology subtype. 7. Has a known additional malignancy that progressed or required active treatment within the last 5 years. 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. 8. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they have stable brain metastases. 9. Has known history of, or any evidence of active, non-infectious pneumonitis. 10. Has an active infection requiring systemic therapy. 11. Has symptoms of bowel obstruction in the past 3 months 12. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject’s participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator. 13. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial. 14. Is pregnant or breastfeeding, or expecting to conceive children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of trial treatment. 15. Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor (e.g. CTLA-4, OX-40, CD137) or has participated in prior pembrolizumab trials. 16. Has a known history of human immunodeficiency virus (HIV) (HIV 1/2 antibodies). 17. Has known active hepatitis B (e.g., Hepatitis B surface antigen reactive) or hepatitis C (e.g., hepatitis C virus RNA [qualitative] is detected). 18. Has received a
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: (1) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on overall response rate (ORR) as assessed by BICR per RECIST 1.1 in Cohort A-All Comer group (2) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on ORR as assessed by BICR per RECIST 1.1 in Cohort A- PD-L1 High (PD-L1H) subgroup using a PD-L1 expression cutpoint established in the training set. (3) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on ORR as assessed by BICR per RECIST 1.1 in Cohort B-All Comer group (4) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on ORR as assessed by BICR per RECIST 1.1 in Cohort B PD-L1H subgroup using a PD-L1 expression cutpoint established in the training set from Cohort A ;Secondary Objective: 1 Evaluate duration of response (DOR), disease control rate (DCR) and progression-free survival (PFS) as assessed by BICR per RECIST1.1 in Cohort A-All Comer group, Cohort A-PD-L1H subgroup, Cohort B-All Comer group, Cohort B-PD-L1H subgroup. PFS rate at 6,12,18 months 2 Evaluate ORR, DOR, DCR, and PFS as assessed by investigator per RECIST1.1 in Cohort A-All Comer group, Cohort A-PD-L1H subgroup, Cohort B-All Comer group, Cohort B-PD-L1H subgroup 3 Evaluate ORR, DOR, DCR and PFS as assessed by BICR and by investigator per RECIST1.1, in Cohort A-All Comer subgroup with PFI/TFI>or=3 to 6 months and the subgroup with PFI/TFI>6 to 12 months 4 Evaluate OS in Cohort A-All Comer group, Cohort A-PD-L1H subgroup,Cohort A-All Comer subgroup with PFI/TFI>or=3 to 6 months and the subgroup with PFI/TFI >6 to 12 months, Cohort B-All Comer group,Cohort B-PD-L1H subgroup 5 Evaluate and characterize tolerability and safety profile of entire study population, cohorts and subgroups ;Primary end point(s): Overall response rate (ORR) based on the disease assessment by BICR per RECIST 1.1 ;Timepoint(s) of evaluation of this end point: At least 8 months after the last subjec | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): 1) Duration of Response (DOR), Disease Control Rate (DCR) , Progression-Free Survival (PFS) , per RECIST 1.1 as assessed by BICR; 2) ORR, DOR, DCR, PFS per RECIST 1.1 as assessed by investigator; 3) Overall survival; 4) Proportions of PFS at 6, 12 and 18 months and proportions of survival at 6, 12, 18, and 24 months;Timepoint(s) of evaluation of this end point: The final clinical cutoff for the study (i.e., study completion) will be 3 years after the last subject is enrolled for final OS analysis | — |
Countries
Australia, Belgium, Canada, Finland, France, Germany, Israel, Italy, Japan, Lithuania, Netherlands, Poland, Russian Federation, South Africa, Spain, Sweden, United Kingdom, United States
Contacts
Public ContactGlobal Clinical Trials Operations
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
Outcome results
None listed