Non Small Cell Lung Cancer
Conditions
Brief summary
To compare the efficacy of pegilodecakin in combination with pembrolizumab versus pembrolizumab alone in participants with metastatic non-small cell lung cancer as measured by objective response rate.
Detailed description
This is an open-label, multi-center, randomized, Phase 2 study designed to compare the efficacy and safety of pegilodecakin in combination with pembrolizumab versus pembrolizumab alone in participants with stage IV / metastatic wild type non-small cell lung cancer and tumors with high expression of PD-L1 (\> 50%).
Interventions
Pegilodecakin plus Pembrolizumab
Pembrolizumab Alone
Sponsors
Study design
Eligibility
Inclusion criteria
1. Participants must have histologically or cytologically confirmed WT NSCLC that is stage IV / metastatic or recurrent 2. Participants with tumor tissue high expression of PD-L1 as defined by Tumor Proportion Score (TPS) ≥ 50% 3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 4. Participants with measurable disease by spiral CT or MRI per RECIST v.1.1 criteria. 5. Participants that have completed prior radiotherapy or radiosurgery at least 2 weeks prior to randomization. 6. Participants must be naïve to therapy for the advanced stage of the disease. Previous neoadjuvant or adjuvant therapy is allowed for participants who successfully underwent complete radical surgery and ONLY if the last treatment was administered more than 12 months prior to the start of the trial treatment
Exclusion criteria
1. Participants with active central nervous system (CNS) metastases or carcinomatous meningitis 2. Participants with any serious or uncontrolled medical disorder or active infection with the hepatitis virus or the human immunodeficiency virus (HIV) 3. Participants with Grade 1 (NCI-CTCAE v.4.03) toxicities attributed to prior anti-cancer therapy other than alopecia and fatigue prior to randomization 4. Participants that have received pembrolizumab 5. Participants with a history of severe hypersensitivity reactions to monoclonal antibodies 6. Pregnant or lactating women 7. Participants receiving any investigational agent within 28 days of first administration of trial treatment 8. Participants that have received therapy with anti-tumor vaccines or other immunostimulatory antitumor agents 9. Participants that have received therapy with anti-PD-1, anti-PD-L1, anti-PD-L-2, anti-CD-137, and/or anti CTLA-4 antibodies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Achieved an Objective Response Rate (ORR) | From Date of Randomization to Progressive Disease, Death from Any cause (Up to 24 Months) | ORR defined as the percentage of participants who achieve a CR or PR as assessed by RECIST v.1.1. The ORR is the number of participants with a complete response (CR) or partial response (PR) divided by the number of randomized participants recorded between the date of randomization and the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever comes first. Complete response (CR) is defined as disappearance of all target (and non-target) lesions, and normalization of tumor marker level. Partial response (PR) is defined as at least a 30% decrease in the sum of longest diameters of target lesions, taking as reference the baseline sum of longest diameters. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall Survival (OS) | From Date of Randomization to Death Due to Any Cause (Up to 24 Months) | OS is defined as the time from date of randomization to death due to any cause. Participants who were alive at the end of the follow-up period or lost to follow-up were censored on the last date the participant was known to be alive. |
| Progression Free Survival (PFS) | From Date of Randomization to Progressive Disease (PD) or Death Due to Any Cause (Up to 24 Months) | PFS is defined as the time from date of randomization to the earlier of first documentation of disease progression or death due to any cause. Progressive disease (PD) is defined by at least a 20% increase in the sum of longest diameters of target lesions, taking as reference the baseline sum of longest diameters or the presence of one or more new lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression determined by scans. Participants who did not progress, who discontinued treatment for toxicity or a reason other than documented progression, or who were lost to follow up before documented progression and death or were censored at the date of last adequate tumor assessment, participants or new anticancer therapy started and not tumor progression or death were censored at the last adequate tumor assessment before the start of new anticancer therapy. |
| Percentage of Participants Who Achieved a Disease Control Rate (DCR) | From Date of Randomization to Objective Progressive Disease or Start of New Anti-Cancer Therapy (Up to 24 Months) | DCR is defined as the percentage of participants in the analysis population who have achieved a complete response (CR), partial response (PR) or stable disease (SD) response prior to disease progression. CR is defined as disappearance of all target (and non-target) lesions, and normalization of tumor marker level. PR is defined as at least a 30% decrease in the sum of longest diameters of target lesions, taking as reference the baseline sum of longest diameters. SD is defined as neither sufficient shrinkage of target lesions to qualify for partial response, nor sufficient increase to qualify for progressive disease, taking as reference the baseline sum of longest diameters. |
| Duration of Response (DOR) | From Date of Response to Death Due to Any Cause (Up to 24 Months) | DOR is defined as the time from the earliest date of qualifying response until earliest date of disease progression per RECIST v1.1 or death from any cause, whichever comes first. Duration of response was analyzed in participants who had CR or PR. Duration of response was censored on the date of the last tumor assessment on trial for participants who did not have objective tumor progression and who did not die due to any cause while on trial. For participants who discontinued participation in the trial or discontinued from tumor scan assessments before disease progression, the duration of response was censored at the date of the last tumor assessment. |
Countries
United States
Participant flow
Pre-assignment details
Participants that had a recorded death on study or are alive and being followed at the end of the trial but off treatment are considered as completed group
Participants by arm
| Arm | Count |
|---|---|
| Pegilodecakin + Pembrolizumab Participants received pegilodecakin SQ at 0.8 mg (≤80 kg body weight) or 1.6 mg (\>80 kg body weight) QD in the abdomen, thigh or back of upper arm.
Pembrolizumab administered as an IV infusion at 200 mg on Day 1 of a 21-day cycle. | 51 |
| Pebrolizumab Participants received pembrolizumab as an IV infusion at 200 mg on Day 1 of a 21-day cycle. | 50 |
| Total | 101 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Ineligibility Determined | 0 | 1 |
| Overall Study | Lost to Follow-up | 0 | 1 |
| Overall Study | Sponsor's decision | 31 | 28 |
| Overall Study | Withdrawal by Subject | 0 | 5 |
Baseline characteristics
| Characteristic | Pegilodecakin + Pembrolizumab | Total | Pebrolizumab |
|---|---|---|---|
| Age, Continuous | 67.5 Years STANDARD_DEVIATION 7.7 | 67.3 Years STANDARD_DEVIATION 8.3 | 67.1 Years STANDARD_DEVIATION 9 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 3 Participants | 5 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 40 Participants | 87 Participants | 47 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 8 Participants | 9 Participants | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) Black or African American | 6 Participants | 10 Participants | 4 Participants |
| Race (NIH/OMB) More than one race | 3 Participants | 7 Participants | 4 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 3 Participants | 4 Participants | 1 Participants |
| Race (NIH/OMB) White | 39 Participants | 77 Participants | 38 Participants |
| Region of Enrollment United States | 51 Participants | 101 Participants | 50 Participants |
| Sex: Female, Male Female | 23 Participants | 41 Participants | 18 Participants |
| Sex: Female, Male Male | 28 Participants | 60 Participants | 32 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 19 / 50 | 13 / 48 |
| other Total, other adverse events | 48 / 50 | 48 / 48 |
| serious Total, serious adverse events | 28 / 50 | 25 / 48 |
Outcome results
Percentage of Participants Who Achieved an Objective Response Rate (ORR)
ORR defined as the percentage of participants who achieve a CR or PR as assessed by RECIST v.1.1. The ORR is the number of participants with a complete response (CR) or partial response (PR) divided by the number of randomized participants recorded between the date of randomization and the date of objectively documented progression or the date of subsequent anti-cancer therapy, whichever comes first. Complete response (CR) is defined as disappearance of all target (and non-target) lesions, and normalization of tumor marker level. Partial response (PR) is defined as at least a 30% decrease in the sum of longest diameters of target lesions, taking as reference the baseline sum of longest diameters.
Time frame: From Date of Randomization to Progressive Disease, Death from Any cause (Up to 24 Months)
Population: All randomized participants who had adequate baseline and at least 1 post-baseline tumor assessments.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Pegilodecakin + Pembrolizumab | Percentage of Participants Who Achieved an Objective Response Rate (ORR) | 47.1 percentage of participants |
| Pembrolizumab | Percentage of Participants Who Achieved an Objective Response Rate (ORR) | 44.0 percentage of participants |
Duration of Response (DOR)
DOR is defined as the time from the earliest date of qualifying response until earliest date of disease progression per RECIST v1.1 or death from any cause, whichever comes first. Duration of response was analyzed in participants who had CR or PR. Duration of response was censored on the date of the last tumor assessment on trial for participants who did not have objective tumor progression and who did not die due to any cause while on trial. For participants who discontinued participation in the trial or discontinued from tumor scan assessments before disease progression, the duration of response was censored at the date of the last tumor assessment.
Time frame: From Date of Response to Death Due to Any Cause (Up to 24 Months)
Population: All randomized participants.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Pegilodecakin + Pembrolizumab | Duration of Response (DOR) | 14.23 Months |
| Pembrolizumab | Duration of Response (DOR) | NA Months |
Overall Survival (OS)
OS is defined as the time from date of randomization to death due to any cause. Participants who were alive at the end of the follow-up period or lost to follow-up were censored on the last date the participant was known to be alive.
Time frame: From Date of Randomization to Death Due to Any Cause (Up to 24 Months)
Population: All randomized participants. Censored participants in the Pegilodecakin + Pembrolizumab arm is 32 and the Pembrolizumab arm is 39.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Pegilodecakin + Pembrolizumab | Overall Survival (OS) | 16.33 Months |
| Pembrolizumab | Overall Survival (OS) | NA Months |
Percentage of Participants Who Achieved a Disease Control Rate (DCR)
DCR is defined as the percentage of participants in the analysis population who have achieved a complete response (CR), partial response (PR) or stable disease (SD) response prior to disease progression. CR is defined as disappearance of all target (and non-target) lesions, and normalization of tumor marker level. PR is defined as at least a 30% decrease in the sum of longest diameters of target lesions, taking as reference the baseline sum of longest diameters. SD is defined as neither sufficient shrinkage of target lesions to qualify for partial response, nor sufficient increase to qualify for progressive disease, taking as reference the baseline sum of longest diameters.
Time frame: From Date of Randomization to Objective Progressive Disease or Start of New Anti-Cancer Therapy (Up to 24 Months)
Population: All randomized participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Pegilodecakin + Pembrolizumab | Percentage of Participants Who Achieved a Disease Control Rate (DCR) | 62.7 percentage of participants |
| Pembrolizumab | Percentage of Participants Who Achieved a Disease Control Rate (DCR) | 62.0 percentage of participants |
Progression Free Survival (PFS)
PFS is defined as the time from date of randomization to the earlier of first documentation of disease progression or death due to any cause. Progressive disease (PD) is defined by at least a 20% increase in the sum of longest diameters of target lesions, taking as reference the baseline sum of longest diameters or the presence of one or more new lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered progression determined by scans. Participants who did not progress, who discontinued treatment for toxicity or a reason other than documented progression, or who were lost to follow up before documented progression and death or were censored at the date of last adequate tumor assessment, participants or new anticancer therapy started and not tumor progression or death were censored at the last adequate tumor assessment before the start of new anticancer therapy.
Time frame: From Date of Randomization to Progressive Disease (PD) or Death Due to Any Cause (Up to 24 Months)
Population: All randomized participants. Censored participants in the Pegilodecakin + Pembrolizumab arm is 24 and Pembrolizumab arm is 22.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Pegilodecakin + Pembrolizumab | Progression Free Survival (PFS) | 6.28 Months |
| Pembrolizumab | Progression Free Survival (PFS) | 6.08 Months |