Carcinoma, Non-Small-Cell Lung, Melanoma
Conditions
Keywords
programmed cell death 1 (PD-1, PD1), programmed cell death ligand 1 (PD-L1, PDL1), programmed cell death ligand 2 (PD-L2, PDL2)
Brief summary
This study has been designed to evaluate the safety of pembrolizumab in participants in India with unresectable or metastatic melanoma and participants with non-small cell lung cancer (NSCLC) who are either untreated (programmed cell death ligand 1 \[PD-L1\] ≥50%) or have experienced disease progression after a platinum-containing systemic therapy (PD-L1 ≥1%).
Interventions
DRUGPembrolizumab
Administered as an intravenous (IV) infusion every 3 weeks (Q3W)
Sponsors
Merck Sharp & Dohme LLC
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Melanoma Participant: * Has a histologically confirmed diagnosis of unresectable Stage III or metastatic melanoma (Stage IV) not amenable to local therapy * Has received no more than 1 line of prior systemic therapy for unresectable Stage III or Stage IV melanoma including mitogen activated protein kinase inhibitors * Has a Lactate Dehydrogenase (LDH) ≤1.5 times ULN NSCLC Participant-First Line Treatment: * Has a histologically or cytologically confirmed diagnosis of Stage IV NSCLC * Has a tumor that demonstrate PD-L1 strong expression (PD-L1 ≥50%) * Do not have an EGFR sensitizing mutation AND are anaplastic lymphoma kinase (ALK) translocation negative * Has received no systemic anti-cancer therapy for their metastatic NSCLC NSCLC Participant-Second Line Treatment and Beyond: * Has a histologically or cytologically confirmed diagnosis of stage IIIB//IIIC/IV (including any future updates to the American Joint Committee on Cancer \[AJCC\] guideline) or recurrent NSCLC * Has a tumor that expresses programmed cell death ligand 1 (PD-L1) ≥1% * Has received prior treatment with at least two cycles of a platinum-containing doublet for Stage IIIB/IV or recurrent disease * Has received an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (either erlotinib, gefitinib, or afatinib) if they have an EGFR sensitizing mutation * Has received crizotinib if they have an ALK translocation NSCLC participants must also meet the following requirements: * Have a life expectancy of at ≥3 months * Provide a formalin fixed tumor tissue sample for PD-L1 biomarker analysis from a recent biopsy of a tumor lesion not previously irradiated; For first line, biopsies obtained PRIOR to the administration of any systemic therapy administered for the treatment of a tumor (such as neoadjuvant/adjuvant/definitive therapy) will not be permitted for analysis. For second line treatment and beyond, no systemic antineoplastic therapy may be administered between the PD-L1 biopsy and initiating study medication * Have documented evidence of the EGFR mutation status or ALK translocation status. If unable to provide documentation of these molecular changes, formalin-fixed paraffin-embedded tumor tissue of any age should be submitted for testing * Have measurable disease per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1) as assessed by the local site investigator/radiologist * Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 * Women of childbearing potential (WOCP) must have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of trial treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required * WOCP must be willing to use an adequate method of contraception for the course of the study through 120 days after the last dose of trial treatment * Men of childbearing potential must agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study therapy
Exclusion criteria
* For NSCLC Participant only: Has a tumor specimen that is not evaluable for PD-L1 expression by the laboratory * Is currently participating in or has participated in a trial of an investigational agent or has used an investigational device within 4 weeks prior to the first dose of trial treatment * Has received prior therapy with an anti- programmed cell death 1 (PD-1), anti-PD-L1, or anti- programmed cell death ligand 2 (PD-L2) agent or with an agent directed to another T-cell receptor (i.e., cytotoxic T-lymphocyte antigen-4 \[CTLA-4\], OX-40, CD137) or has previously participated in a clinical trial for pembrolizumab (MK-3475) * Has received prior anti-cancer therapy including investigational agent or device within 4 weeks, or completed palliative radiotherapy within 7 days, prior to enrollment * Has recovered from all AEs due to previous therapies to ≤ Grade 1 or baseline * Has recovered adequately from the toxicity and/or complications from major surgery prior to starting trial treatment * Is expected to require any other form of antineoplastic therapy while participating in the trial * Is on systemic corticosteroid therapy within 7 days before the planned date for first dose of treatment or any other form of immunosuppressive medication * Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (exceeding 10 mg daily dose of prednisone or equivalent) or any other form of immunosuppressive therapy within 7 days before the first dose of trial treatment * Has an active autoimmune disease that has required systemic treatment in the past 2 years * Has a known additional malignancy that is progressing or requires active treatment with the exception of basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (e.g., cervical cancer in situ, breast carcinoma) that have undergone potentially curative therapy * Has had an allogeneic tissue/solid organ transplant * Has a history of or current radiographically detectable central nervous system metastases and/or carcinomatous meningitis * Has a severe hypersensitivity (≥ Grade 3) to any excipients in pembrolizumab * Has a history of (noninfectious) pneumonitis/interstitial lung disease that required steroids or current pneumonitis/interstitial lung disease * Has an active infection requiring systemic therapy including known history of active tuberculosis (Bacillus tuberculosis) * Has a known history of human immunodeficiency virus (HIV) infection * Has a known history of or is positive for hepatitis B (hepatitis B surface antigen \[HbsAg\] reactive) or hepatitis C (HCV) ribonucleic acid (RNA) \[qualitative\] is detected * Has a known psychiatric or substance abuse disorder that would interfere with cooperation with the requirements of the trial * If participant received prior radiation therapy to a symptomatic metastatic lesion, has recovered to Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 Grade 1 or Grade 0 AEs due to radiation therapy * Is a regular user of any illicit drug or has a recent history (within the last 3 months) of substance abuse including alcohol * Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of trial treatment * Has received a live vaccine within 30 days before the first dose of trial treatment * Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with participation for the full duration of the study, or is not in the best interest of the participant to participate, in the opinion of the treating investigator
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With an Adverse Event (AE) | Up to approximately 66.5 months | An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. The number of participants with an AE was reported. |
| Number of Participants With a Serious Adverse Event (SAE) | Up to approximately 66.5 months | An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. An SAE was any adverse event occurring at any dose or during any use of Sponsor's product that resulted in death; was life threatening; resulted in persistent or significant disability/incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly/birth defect; was another important medical event. The number of participants with an SAE was reported. |
| Number of Participants With a Drug-Related AE | Up to approximately 66.5 months | An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. A drug-related AE was defined as an AE that was determined by the investigator to be possibly, probably, or definitely related to drug. The number of participants with a drug-related AE was reported. |
| Number of Participants With a Drug-Related SAE | Up to approximately 66.5 months | An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An SAE was any AE occurring at any dose or during any use of Sponsor's product that resulted in death; was life threatening; resulted in persistent or significant disability/incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly/birth defect; was another important medical event. A drug-related SAE was defined as an SAE that was determined by the investigator to be possibly, probably, or definitely related to drug. The number of participants with a drug-related SAE was reported. |
| Number of Participants Who Discontinued Study Drug Due to an AE | Up to approximately 26 months | An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. The number of participants who discontinued study drug due to an AE was reported |
Other
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With an Adverse Event of Special Interest (AEOSI) | Up to approximately 66.5 months | An AEOSI was defined as an AE (serious or non-serious) of scientific and medical concern specific to the sponsor's product or program, for which ongoing monitoring and rapid communication by the investigator to the sponsor was appropriate. Pembrolizumab AEOSIs included immune-mediated events (pneumonitis, colitis, hepatitis, nephritis, adrenal insufficiency, hypophysitis, hyperthyroidism, hypothyroidism, thyroiditis, type 1 diabetes mellitus, severe skin reactions including Stevens-Johnson Syndrome \[SJS\] and Toxic Epidermal Necrolysis \[TEN\], uveitis, pancreatitis, myositis, Guillain-Barre Syndrome, myocarditis, encephalitis, sarcoidosis, myasthenic syndrome, myelitis, vasculitis, cholangitis sclerosing, hypoparathyroidism, arthritis, haemophagocytic lymphohistiocytosis, optic neuritis, gastritis, haemolytic anaemia, exocrine pancreatic insufficiency, pericarditis) and infusion reactions. The number of participants with an AEOSI was reported. |
Countries
India
Participant flow
Recruitment details
Participants with unresectable or metastatic melanoma, or Non-small Cell Lung Cancer (NSCLC) who were either treatment naïve or had disease progression after prior treatment, were recruited to the study.
Pre-assignment details
Of 284 participants screened, 150 were allocated to receive pembrolizumab.
Participants by arm
| Arm | Count |
|---|---|
| Pembrolizumab 200 mg IV Q3W Participants with melanoma or NSCLC received 200 mg of pembrolizumab as an IV infusion Q3W for up to 35 cycles. | 150 |
| Total | 150 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Death | 13 |
| Overall Study | Lost to Follow-up | 2 |
| Overall Study | Physician Decision | 93 |
| Overall Study | Withdrawal by Subject | 26 |
Baseline characteristics
| Characteristic | Pembrolizumab 200 mg IV Q3W |
|---|---|
| Age, Continuous | 55.3 Years STANDARD_DEVIATION 13 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 150 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 150 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 0 Participants |
| Sex: Female, Male Female | 64 Participants |
| Sex: Female, Male Male | 86 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 13 / 150 |
| other Total, other adverse events | 105 / 150 |
| serious Total, serious adverse events | 31 / 150 |
Outcome results
Primary
Number of Participants Who Discontinued Study Drug Due to an AE
An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. The number of participants who discontinued study drug due to an AE was reported
Time frame: Up to approximately 26 months
Population: All participants who received at least 1 dose of trial treatment were analyzed.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pembrolizumab 200 mg IV Q3W | Number of Participants Who Discontinued Study Drug Due to an AE | 11 Participants |
Primary
Number of Participants With a Drug-Related AE
An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. A drug-related AE was defined as an AE that was determined by the investigator to be possibly, probably, or definitely related to drug. The number of participants with a drug-related AE was reported.
Time frame: Up to approximately 66.5 months
Population: All participants who received at least 1 dose of trial treatment were analyzed.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pembrolizumab 200 mg IV Q3W | Number of Participants With a Drug-Related AE | 61 Participants |
Primary
Number of Participants With a Drug-Related SAE
An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An SAE was any AE occurring at any dose or during any use of Sponsor's product that resulted in death; was life threatening; resulted in persistent or significant disability/incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly/birth defect; was another important medical event. A drug-related SAE was defined as an SAE that was determined by the investigator to be possibly, probably, or definitely related to drug. The number of participants with a drug-related SAE was reported.
Time frame: Up to approximately 66.5 months
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pembrolizumab 200 mg IV Q3W | Number of Participants With a Drug-Related SAE | 10 Participants |
Primary
Number of Participants With an Adverse Event (AE)
An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. The number of participants with an AE was reported.
Time frame: Up to approximately 66.5 months
Population: All participants who received at least 1 dose of trial treatment were analyzed.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pembrolizumab 200 mg IV Q3W | Number of Participants With an Adverse Event (AE) | 131 Participants |
Primary
Number of Participants With a Serious Adverse Event (SAE)
An AE was defined as any untoward medical occurrence in a participant administered a pharmaceutical product and which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. An SAE was any adverse event occurring at any dose or during any use of Sponsor's product that resulted in death; was life threatening; resulted in persistent or significant disability/incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly/birth defect; was another important medical event. The number of participants with an SAE was reported.
Time frame: Up to approximately 66.5 months
Population: All participants who received at least 1 dose of trial treatment were analyzed.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pembrolizumab 200 mg IV Q3W | Number of Participants With a Serious Adverse Event (SAE) | 31 Participants |
Other Pre-specified
Number of Participants With an Adverse Event of Special Interest (AEOSI)
An AEOSI was defined as an AE (serious or non-serious) of scientific and medical concern specific to the sponsor's product or program, for which ongoing monitoring and rapid communication by the investigator to the sponsor was appropriate. Pembrolizumab AEOSIs included immune-mediated events (pneumonitis, colitis, hepatitis, nephritis, adrenal insufficiency, hypophysitis, hyperthyroidism, hypothyroidism, thyroiditis, type 1 diabetes mellitus, severe skin reactions including Stevens-Johnson Syndrome \[SJS\] and Toxic Epidermal Necrolysis \[TEN\], uveitis, pancreatitis, myositis, Guillain-Barre Syndrome, myocarditis, encephalitis, sarcoidosis, myasthenic syndrome, myelitis, vasculitis, cholangitis sclerosing, hypoparathyroidism, arthritis, haemophagocytic lymphohistiocytosis, optic neuritis, gastritis, haemolytic anaemia, exocrine pancreatic insufficiency, pericarditis) and infusion reactions. The number of participants with an AEOSI was reported.
Time frame: Up to approximately 66.5 months
Population: All participants who received at least 1 dose of trial treatment were analyzed.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Pembrolizumab 200 mg IV Q3W | Number of Participants With an Adverse Event of Special Interest (AEOSI) | 33 Participants |