Hematological Malignancies
Conditions
Brief summary
The purpose of the study is to determine the safety and tolerability of pembrolizumab/vibostolimab (MK-7684A) in hematological malignancies. This study will also evaluate the overall response rate (ORR), the duration of response (DOR), and disease control rate (DCR) following administration of pembrolizumab/vibostolimab. In addition, this study will characterize pharmacokinetic (PK) profile of vibostolimab (MK-7684).
Interventions
Pembrolizumab 200 mg + vibostolimab 200 mg/20 mL vial IV infusion Q3W up to approximately 2 years.
Sponsors
Study design
Eligibility
Inclusion criteria
\- Have confirmed relapsed/refractory classic Hodgkins Lymphoma (cHL), Primary mediastinal B-cell lymphoma (PMBCL), Follicular Lymphoma (FL), Diffuse large B-cell lymphoma (DLBCL) or Non-Hodgkins Lymphoma (NHL), or multiple myeloma (MM). For PMBCL, DLBCL, FL, and MM: \- Must be relapsed or refractory to CAR-T-cell therapy or unable to receive it. For DLBCL and NHL: \- Must have exhausted or be ineligible for or intolerant to all treatments, which in the opinion of the investigator are standard of care for their disease. For NHL: \- Participants with Mantle cell lymphoma (MCL) must have received prior Bruton's tyrosine kinase inhibitor therapy. All participants: * Have measurable disease. * Have adequate organ function. * Participants who are Hepatitis B surface antigen (HBsAg) positive are eligible if they have received Hepatitis B (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load before allocation. * Must be able to provide newly obtained bone marrow biopsy or aspirate material for disease assessment. * Female participants are eligible to participate if not pregnant or breastfeeding, and at least one of the following conditions applies: Is not a woman of non child-bearing potential (WONCBP) OR Is a woman of childbearing potential (WOCBP) and using a contraceptive method that is highly effective, or be abstinent from heterosexual intercourse as their preferred and usual lifestyle.
Exclusion criteria
For DLBCL and NHL: \- Has lymphoplasmacytic lymphomas, Waldenstrom's macroglobulinemia, chronic lymphocytic leukemia (not associated with small lymphocytic lymphoma), Burkitt (-like) lymphoma, mature T cell and NK cell neoplasms, immunodeficiency associated lymphoproliferative neoplasms, or histiocytic and dendritic cell neoplasms. For MM: * Has oligo-secretory myeloma, plasma cell leukemia, smoldering multiple myeloma, or monoclonal gammopathy of undetermined significance. * Has a history of primary amyloidosis, hyperviscosity or POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes). * Has known prior or current central nervous system (CNS) involvement. For Epstein Barr virus (EBV) positive DLBCL: \- Associated with a solid organ transplant. For all participants: * A WOCBP who has a positive urine pregnancy test within 72 hours before study intervention allocation. * Has clinically significant cardiovascular disease within 12 months from first dose of study intervention. * Has a history of a second malignancy. * Any PMBCL participants that require the use of urgent cytoreductive therapy. * If the participant had major surgery, the participant must have recovered adequately from the procedure and/or any complications from the surgery before starting study intervention. * Has received prior radiotherapy within 2 weeks of start of study intervention. * Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention. * Is currently participating in or has participated in a study of an investigational agent or has used an investigational device within 4 weeks before the first dose of study intervention. * Has a known severe hypersensitivity to MK-7684A, vibostolimab or pembrolizumab and/or any of its excipients. * Has a known history of Human Immunodeficiency Virus (HIV) infection. * Has an active autoimmune disease that has required systemic treatment in past 2 years. * Has an active infection requiring systemic therapy. * Has a known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study. * Has present or progressive accumulation of pleural, ascitic, or pericardial fluid requiring drainage or diuretic drugs within 2 weeks before enrollment. * Has dual active HBV infection (HBsAg (+) and /or detectable HBV DNA) and Hepatitis C (HCV) infection (anti-HCV Ab (+) and detectable HCV RNA) at study entry.. * Has had an allogenic hematopoietic stem cell/solid organ transplantation within the last 5 years.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With a Dose-Limiting Toxicity (DLT) | Up to approximately 6 weeks | A DLT is defined as an event with toxicity including the type, severity, time of onset, time of resolution, and the probable association with study treatment that are not due to pre-existing conditions as defined by the Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE 5.0). Percentage of participants who experience a DLT per CTCAE 5.0 are reported. |
| Percentage of Participants Who Experienced an Adverse Event (AE) | Up to approximately 27 months | An AE is any unfavorable 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. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event. The number of participants who experience an AE are reported. |
| Percentage of Participants Who Discontinued Study Treatment Due to an AE | Up to approximately 24 months | An AE is any unfavorable 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. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event. The number of participants discontinued from the study treatment due to an AE are reported. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate (ORR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | Up to approximately 37 months | ORR for Cohorts A-D and F was assessed based on the Lugano 2014 Classification. ORR is defined as the percentage of the participants who had complete response (CR) or partial response (PR) and was evaluated using computed tomography (CT) and positron emission tomography (PET)-CT. CR is complete metabolic (no/minimal fluorodeoxyglucose \[FDG\] uptake) and radiologic response (target lesions regress to ≤5 cm in longest transverse diameter of a lesion) and no new lesions. PR is partial metabolic (moderate/high FDG uptake) and radiologic response (≥50% decrease in sum of product diameters for multiple lesions of up to 6 target measurable nodes and extranodal sites, no increase in lesions, and spleen regressed by \>50% in length beyond normal). ORR for Cohorts A-D and F is presented. Cohort E is presented separately. |
| ORR as Assessed by the 2016 International Myeloma Working Group (IMWG) Response Criteria (Cohort E) | Up to approximately 37 months | ORR for Cohort E was measured by 2016 IMWG Response Criteria. ORR is defined as the percentage of the participants with either a stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) according to the International Myeloma Working Group (IMWG) Response Criteria. CR = negative immunofixation of serum and urine AND disappearance of any soft tissue plasmacytomas AND \<5% plasmacytomas in the bone marrow; sCR=stringent complete response, CR as above PLUS normal serum free light-chain (FLC) assay ratio and absence of clonal cells in bone marrow; VGPR = serum and urine M-component detectable by immunofixation but not on electrophoresis OR ≥ 90% reduction in serum M-component plus urine M-component \<100 mg/24 hr; PR = ≥50% reduction of serum Mprotein and reduction in 24-hour urinary M-protein by ≥90% or to \<200 mg/24 hours. The ORR for Cohort E is presented. Cohorts A-D and F were presented in a previous outcome measure. |
| Duration of Response (DOR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | Up to approximately 37 months | For participants who demonstrate a confirmed complete response (CR) or partial response (PR), DOR is defined as the time from CR or PR to documented disease progression or death. Participants are assessed using computed tomography (CT) and positron emission tomography (PET)- CT and response was evaluated based on the Lugano 2014 Classification (Cheson et al, Journal of Clinical Oncology, 2014). CR is complete metabolic (no/minimal fluorodeoxyglucose \[FDG\] uptake) and radiologic response (target lesions regress to ≤5 cm in longest transverse diameter of a lesion) and no new lesions. PR is partial metabolic (moderate/high FDG uptake) and radiologic response (≥50% decrease in sum of product diameters (SPD) for multiple lesions of up to 6 target measurable nodes and extranodal sites, no increase in lesions, and spleen regressed by \>50% in length beyond normal). DOR for Cohorts A-D and F are presented. Cohort E is presented separately. |
| DOR as Assessed by 2016 IMWG Response Criteria (Cohort E) | Up to approximately 37 months | DOR is defined as the time from CR or PR to documented disease progression or death. DOR for Cohort E was measured by the 2016 IMWG Response Criteria with response criteria defined as participants with either a stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR). CR = negative immunofixation of serum and urine AND disappearance of any soft tissue plasmacytomas AND \<5% plasmacytomas in the bone marrow; sCR=CR as above PLUS normal serum free light-chain (FLC) assay ratio and absence of clonal cells in bone marrow; VGPR = serum and urine M-component detectable by immunofixation but not on electrophoresis OR ≥ 90% reduction in serum M-component plus urine M-component \<100 mg/24 hr; PR = ≥50% reduction of serum Mprotein and reduction in 24-hour urinary M-protein by ≥90% or to \<200 mg/24 hours. The DOR for Cohort E is presented. Cohorts A-D and F were presented in a previous outcome measure. |
| Disease Control Rate (DCR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | Up to approximately 37 months | DCR is % of participants who had tumor response per response criteria or have stable disease (SD) for ≥ 12 weeks before any evidence of progressive disease (PD). CR or PR were evaluated with CT and PET-CT. CR: complete metabolic (no/minimal FDG uptake) and radiologic response (target lesions regress to ≤5 cm in longest transverse diameter of a lesion) and no new lesions. PR: partial metabolic (moderate/high FDG uptake) and radiologic response (≥50% decrease in sum of product diameters for multiple lesions of up to 6 target measurable nodes and extranodal sites, no increase in lesions, and spleen regressed by \>50% in length beyond normal). SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD: At least a 20% increase in the sum of diameters of target lesions and an absolute increase of at least 5 mm. DCR for Cohorts A-D \& F are presented. Cohort E is presented in a separate outcome measure. |
| DCR as Assessed by 2016 IMWG Response Criteria (Cohort E) | Up to approximately 37 months | DCR: percentage of participants who have achieved tumor response or have shown SD for at least 12 weeks before any evidence of PD per IMWG response criteria 2016. Response criteria are defined as participants with either a sCR, CR, VGPR, or PR. CR = negative immunofixation of serum and urine AND disappearance of any soft tissue plasmacytomas AND \<5% plasmacytomas in the bone marrow; sCR=CR as above PLUS normal serum FLC assay ratio and absence of clonal cells in bone marrow; VGPR = serum and urine M-component detectable by immunofixation but not on electrophoresis OR ≥ 90% reduction in serum M-component plus urine M-component \<100 mg/24 hr; PR = ≥50% reduction of serum Mprotein and reduction in 24-hour urinary M-protein by ≥90% or to \<200 mg/24 hours. SD = Not meeting criteria for CR, VGPR, PR, or PD. PD as defined by prespecified 2016 IMWG response criteria. DCR for Cohort E is presented. Cohorts A-D and F were presented in a previous outcome measure. |
| Lowest Plasma Concentration (Ctrough) of Vibostolimab | Predose at Cycles 1, 3, 7, 11, 15, 19, 23, 27 and 31. Cycle = 3 weeks | Ctrough is the lowest concentration reached by a drug before the next dose is administered. Blood samples collected predose were used to determine Ctrough of Vibostolimab. |
| Maximum Concentration (Cmax) of Vibostolimab | Postdose: after end of infusion (up to ~10 minutes) at Cycles 1 and 8. Cycle = 3 weeks | Cmax is the maximum concentration of the drug observed in plasma. Blood samples collected post dose were used to determine Cmax of Vibostolimab. |
Countries
Brazil, Canada, Chile, Denmark, France, Germany, Hungary, Israel, Italy, Poland, Russia, Spain, Taiwan, Turkey (Türkiye), Ukraine, United States
Contacts
Merck Sharp & Dohme LLC
Participant flow
Pre-assignment details
One hundred ninety-two participants were allocated, 1 participant was allocated but did not receive treatment due to worsening of underlying disease. No participants were enrolled into Part 2 of the study (The study was closed with amendment 5 after the last subject completed 35 cycles of the first course of Part 1).
Participants by arm
| Arm | Count |
|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation Participants with classic Hodgkin's lymphoma (cHL) or primary mediastinal B-cell lymphoma (PMBCL) who are relapsed or refractory to at least 1 line of prior therapy (cHL) of at least 2 lines of prior therapies (PMBCL) received pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion once every 3 weeks (Q3W) for up to 35 cycles up to approximately 2 years. | 42 |
| Cohort B Pembrolizumab/Vibostolimab Coformulation Participants with cHL or PMBCL who are relapsed or refractory to at least 2 lines of prior therapies (cHL) of at least 3 lines of prior therapies (PMBCL) received pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion once every 3 weeks (Q3W) for up to 35 cycles up to approximately 2 years. | 42 |
| Cohort C Pembrolizumab/Vibostolimab Coformulation Participants with relapsed or refractory follicular lymphoma (FL) following at least 2 lines of therapy received pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion once every 3 weeks (Q3W) for up to 35 cycles up to approximately 2 years. | 20 |
| Cohort D Pembrolizumab/Vibostolimab Coformulation Participants with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) following at least 2 lines of therapy received pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion once every 3 weeks (Q3W) for up to 35 cycles up to approximately 2 years. | 30 |
| Cohort E Pembrolizumab/Vibostolimab Coformulation Participants with relapsed or refractory multiple myeloma (MM) following at least 3 lines of therapy and have exhausted all approved lines of therapy received pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion once every 3 weeks (Q3W) for up to 35 cycles up to approximately 2 years. | 25 |
| Cohort F Pembrolizumab/Vibostolimab Coformulation Participants with relapsed or refractory non-Hodgkin's lymphoma (NHL) following at least 2 lines of therapy received pembrolizumab/vibostolimab (coformulation of 200 mg pembrolizumab and 200 mg vibostolimab) via intravenous IV infusion once every 3 weeks (Q3W) for up to 35 cycles up to approximately 2 years. | 33 |
| Total | 192 |
Baseline characteristics
| Characteristic | Cohort A Pembrolizumab/Vibostolimab Coformulation | Cohort B Pembrolizumab/Vibostolimab Coformulation | Cohort C Pembrolizumab/Vibostolimab Coformulation | Cohort D Pembrolizumab/Vibostolimab Coformulation | Cohort E Pembrolizumab/Vibostolimab Coformulation | Cohort F Pembrolizumab/Vibostolimab Coformulation | Total |
|---|---|---|---|---|---|---|---|
| Age, Continuous | 41.5 Years STANDARD_DEVIATION 16.5 | 46.7 Years STANDARD_DEVIATION 17.6 | 63.6 Years STANDARD_DEVIATION 12.8 | 60.7 Years STANDARD_DEVIATION 12.7 | 64.4 Years STANDARD_DEVIATION 10.8 | 66.0 Years STANDARD_DEVIATION 14.4 | 55.1 Years STANDARD_DEVIATION 17.7 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 6 Participants | 3 Participants | 3 Participants | 5 Participants | 1 Participants | 3 Participants | 21 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 36 Participants | 33 Participants | 15 Participants | 22 Participants | 24 Participants | 29 Participants | 159 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 6 Participants | 2 Participants | 3 Participants | 0 Participants | 1 Participants | 12 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 2 Participants | 2 Participants | 3 Participants | 7 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants | 1 Participants | 0 Participants | 1 Participants | 3 Participants | 1 Participants | 10 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 6 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 6 Participants |
| Race (NIH/OMB) White | 38 Participants | 35 Participants | 20 Participants | 27 Participants | 20 Participants | 29 Participants | 169 Participants |
| Sex: Female, Male Female | 18 Participants | 16 Participants | 8 Participants | 15 Participants | 15 Participants | 13 Participants | 85 Participants |
| Sex: Female, Male Male | 24 Participants | 26 Participants | 12 Participants | 15 Participants | 10 Participants | 20 Participants | 107 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk |
|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 14 / 42 | 10 / 42 | 9 / 20 | 24 / 30 | 14 / 25 | 15 / 33 |
| other Total, other adverse events | 35 / 42 | 39 / 42 | 15 / 20 | 21 / 30 | 16 / 25 | 24 / 32 |
| serious Total, serious adverse events | 17 / 42 | 11 / 42 | 8 / 20 | 11 / 30 | 8 / 25 | 13 / 32 |
Outcome results
Percentage of Participants Who Discontinued Study Treatment Due to an AE
An AE is any unfavorable 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. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event. The number of participants discontinued from the study treatment due to an AE are reported.
Time frame: Up to approximately 24 months
Population: All allocated participants who received at least 1 dose of study intervention.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Discontinued Study Treatment Due to an AE | 19.0 Percentage of Participants |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Discontinued Study Treatment Due to an AE | 4.8 Percentage of Participants |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Discontinued Study Treatment Due to an AE | 15.0 Percentage of Participants |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Discontinued Study Treatment Due to an AE | 13.3 Percentage of Participants |
| Cohort E Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Discontinued Study Treatment Due to an AE | 4.0 Percentage of Participants |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Discontinued Study Treatment Due to an AE | 12.5 Percentage of Participants |
Percentage of Participants Who Experienced an Adverse Event (AE)
An AE is any unfavorable 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. Any worsening of a preexisting condition that is temporally associated with the use of the Sponsor's product, is also an adverse event. The number of participants who experience an AE are reported.
Time frame: Up to approximately 27 months
Population: All allocated participants who received at least 1 dose of study intervention.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Experienced an Adverse Event (AE) | 92.9 Percentage of Participants |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Experienced an Adverse Event (AE) | 97.6 Percentage of Participants |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Experienced an Adverse Event (AE) | 95.0 Percentage of Participants |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Experienced an Adverse Event (AE) | 80.0 Percentage of Participants |
| Cohort E Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Experienced an Adverse Event (AE) | 80.0 Percentage of Participants |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants Who Experienced an Adverse Event (AE) | 87.5 Percentage of Participants |
Percentage of Participants With a Dose-Limiting Toxicity (DLT)
A DLT is defined as an event with toxicity including the type, severity, time of onset, time of resolution, and the probable association with study treatment that are not due to pre-existing conditions as defined by the Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE 5.0). Percentage of participants who experience a DLT per CTCAE 5.0 are reported.
Time frame: Up to approximately 6 weeks
Population: All participants who received at least one dose of study intervention and that finished the DLT evaluation period without a DLT or experienced a DLT in the DLT evaluation period.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants With a Dose-Limiting Toxicity (DLT) | 4.8 Percentage of Participants |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants With a Dose-Limiting Toxicity (DLT) | 2.4 Percentage of Participants |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants With a Dose-Limiting Toxicity (DLT) | 0.0 Percentage of Participants |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants With a Dose-Limiting Toxicity (DLT) | 5.0 Percentage of Participants |
| Cohort E Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants With a Dose-Limiting Toxicity (DLT) | 0.0 Percentage of Participants |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Percentage of Participants With a Dose-Limiting Toxicity (DLT) | 8.0 Percentage of Participants |
DCR as Assessed by 2016 IMWG Response Criteria (Cohort E)
DCR: percentage of participants who have achieved tumor response or have shown SD for at least 12 weeks before any evidence of PD per IMWG response criteria 2016. Response criteria are defined as participants with either a sCR, CR, VGPR, or PR. CR = negative immunofixation of serum and urine AND disappearance of any soft tissue plasmacytomas AND \<5% plasmacytomas in the bone marrow; sCR=CR as above PLUS normal serum FLC assay ratio and absence of clonal cells in bone marrow; VGPR = serum and urine M-component detectable by immunofixation but not on electrophoresis OR ≥ 90% reduction in serum M-component plus urine M-component \<100 mg/24 hr; PR = ≥50% reduction of serum Mprotein and reduction in 24-hour urinary M-protein by ≥90% or to \<200 mg/24 hours. SD = Not meeting criteria for CR, VGPR, PR, or PD. PD as defined by prespecified 2016 IMWG response criteria. DCR for Cohort E is presented. Cohorts A-D and F were presented in a previous outcome measure.
Time frame: Up to approximately 37 months
Population: All participants who have received at least one dose of study intervention and were evaluated using 2016 IMWG Response Criteria.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort E Pembrolizumab/Vibostolimab Coformulation | DCR as Assessed by 2016 IMWG Response Criteria (Cohort E) | 16.0 Percentage of Participants |
Disease Control Rate (DCR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F)
DCR is % of participants who had tumor response per response criteria or have stable disease (SD) for ≥ 12 weeks before any evidence of progressive disease (PD). CR or PR were evaluated with CT and PET-CT. CR: complete metabolic (no/minimal FDG uptake) and radiologic response (target lesions regress to ≤5 cm in longest transverse diameter of a lesion) and no new lesions. PR: partial metabolic (moderate/high FDG uptake) and radiologic response (≥50% decrease in sum of product diameters for multiple lesions of up to 6 target measurable nodes and extranodal sites, no increase in lesions, and spleen regressed by \>50% in length beyond normal). SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD: At least a 20% increase in the sum of diameters of target lesions and an absolute increase of at least 5 mm. DCR for Cohorts A-D & F are presented. Cohort E is presented in a separate outcome measure.
Time frame: Up to approximately 37 months
Population: All participants who have received at least one dose of study intervention and were evaluated using Lugano 2014 Classification.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Disease Control Rate (DCR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 73.8 Percentage of Participants |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Disease Control Rate (DCR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 59.5 Percentage of Participants |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Disease Control Rate (DCR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 25.0 Percentage of Participants |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Disease Control Rate (DCR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 16.7 Percentage of Participants |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Disease Control Rate (DCR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 31.3 Percentage of Participants |
DOR as Assessed by 2016 IMWG Response Criteria (Cohort E)
DOR is defined as the time from CR or PR to documented disease progression or death. DOR for Cohort E was measured by the 2016 IMWG Response Criteria with response criteria defined as participants with either a stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR). CR = negative immunofixation of serum and urine AND disappearance of any soft tissue plasmacytomas AND \<5% plasmacytomas in the bone marrow; sCR=CR as above PLUS normal serum free light-chain (FLC) assay ratio and absence of clonal cells in bone marrow; VGPR = serum and urine M-component detectable by immunofixation but not on electrophoresis OR ≥ 90% reduction in serum M-component plus urine M-component \<100 mg/24 hr; PR = ≥50% reduction of serum Mprotein and reduction in 24-hour urinary M-protein by ≥90% or to \<200 mg/24 hours. The DOR for Cohort E is presented. Cohorts A-D and F were presented in a previous outcome measure.
Time frame: Up to approximately 37 months
Population: All participants who have received at least one dose of study intervention and had a response measured by measured by 2016 IMWG Response Criteria. No participants met the pre-specified analysis criteria for DOR in Cohort E (i.e., no participants with a response) and therefore DOR is unavailable for Cohort E.
Duration of Response (DOR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F)
For participants who demonstrate a confirmed complete response (CR) or partial response (PR), DOR is defined as the time from CR or PR to documented disease progression or death. Participants are assessed using computed tomography (CT) and positron emission tomography (PET)- CT and response was evaluated based on the Lugano 2014 Classification (Cheson et al, Journal of Clinical Oncology, 2014). CR is complete metabolic (no/minimal fluorodeoxyglucose \[FDG\] uptake) and radiologic response (target lesions regress to ≤5 cm in longest transverse diameter of a lesion) and no new lesions. PR is partial metabolic (moderate/high FDG uptake) and radiologic response (≥50% decrease in sum of product diameters (SPD) for multiple lesions of up to 6 target measurable nodes and extranodal sites, no increase in lesions, and spleen regressed by \>50% in length beyond normal). DOR for Cohorts A-D and F are presented. Cohort E is presented separately.
Time frame: Up to approximately 37 months
Population: All participants who have received at least one dose of study intervention and had a response measured by measured by Lugano 2014 Classification.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Duration of Response (DOR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 5.4 Months |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Duration of Response (DOR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 3.0 Months |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Duration of Response (DOR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 2.8 Months |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Duration of Response (DOR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | NA Months |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Duration of Response (DOR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 3.4 Months |
Lowest Plasma Concentration (Ctrough) of Vibostolimab
Ctrough is the lowest concentration reached by a drug before the next dose is administered. Blood samples collected predose were used to determine Ctrough of Vibostolimab.
Time frame: Predose at Cycles 1, 3, 7, 11, 15, 19, 23, 27 and 31. Cycle = 3 weeks
Population: All participants who received at least one dose of intervention and had data for the corresponding cycle.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) |
|---|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 15 | 26.2 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 11 | 22.6 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 7 | 21.0 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 31 | 31.7 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 27 | 40.6 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 23 | 36.5 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 19 | 34.8 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 3 | 15.3 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 1 | 8.06 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 31 | 31.6 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 1 | 9.86 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 3 | 17.0 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 7 | 19.5 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 11 | 24.2 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 15 | 25.6 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 19 | 24.2 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 23 | 24.8 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 27 | 19.3 ug/mL |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 7 | 38.1 ug/mL |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 11 | 28.9 ug/mL |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 3 | 22.6 ug/mL |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 1 | 10.0 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 15 | 40.6 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 27 | 48.9 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 19 | 31.1 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 3 | 14.5 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 1 | 9.64 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 11 | 40.7 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 31 | 38.0 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 23 | 51.5 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 7 | 25.8 ug/mL |
| Cohort E Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 3 | 17.9 ug/mL |
| Cohort E Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 1 | 9.86 ug/mL |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 7 | 22.1 ug/mL |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 1 | 9.52 ug/mL |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Lowest Plasma Concentration (Ctrough) of Vibostolimab | Cycle 3 | 20.2 ug/mL |
Maximum Concentration (Cmax) of Vibostolimab
Cmax is the maximum concentration of the drug observed in plasma. Blood samples collected post dose were used to determine Cmax of Vibostolimab.
Time frame: Postdose: after end of infusion (up to ~10 minutes) at Cycles 1 and 8. Cycle = 3 weeks
Population: All participants who received at least one dose of intervention and had data for the corresponding cycle.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) |
|---|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 8 | 84.8 ug/mL |
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 1 | 85.8 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 8 | 75.8 ug/mL |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 1 | 85.4 ug/mL |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 1 | 42.6 ug/mL |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 8 | 112 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 8 | 77.4 ug/mL |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 1 | 64.2 ug/mL |
| Cohort E Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 1 | 53.2 ug/mL |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 8 | 80.9 ug/mL |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Maximum Concentration (Cmax) of Vibostolimab | Cycle 1 | 55.2 ug/mL |
Objective Response Rate (ORR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F)
ORR for Cohorts A-D and F was assessed based on the Lugano 2014 Classification. ORR is defined as the percentage of the participants who had complete response (CR) or partial response (PR) and was evaluated using computed tomography (CT) and positron emission tomography (PET)-CT. CR is complete metabolic (no/minimal fluorodeoxyglucose \[FDG\] uptake) and radiologic response (target lesions regress to ≤5 cm in longest transverse diameter of a lesion) and no new lesions. PR is partial metabolic (moderate/high FDG uptake) and radiologic response (≥50% decrease in sum of product diameters for multiple lesions of up to 6 target measurable nodes and extranodal sites, no increase in lesions, and spleen regressed by \>50% in length beyond normal). ORR for Cohorts A-D and F is presented. Cohort E is presented separately.
Time frame: Up to approximately 37 months
Population: All participants who have received at least one dose of study intervention and had ORR measured by Lugano 2014 Classification.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort A Pembrolizumab/Vibostolimab Coformulation | Objective Response Rate (ORR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 64.3 Percentage of Participants |
| Cohort B Pembrolizumab/Vibostolimab Coformulation | Objective Response Rate (ORR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 35.7 Percentage of Participants |
| Cohort C Pembrolizumab/Vibostolimab Coformulation | Objective Response Rate (ORR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 15.0 Percentage of Participants |
| Cohort D Pembrolizumab/Vibostolimab Coformulation | Objective Response Rate (ORR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 16.7 Percentage of Participants |
| Cohort F Pembrolizumab/Vibostolimab Coformulation | Objective Response Rate (ORR) as Assessed by Lugano 2014 Classification (Cohorts A-D & F) | 18.8 Percentage of Participants |
ORR as Assessed by the 2016 International Myeloma Working Group (IMWG) Response Criteria (Cohort E)
ORR for Cohort E was measured by 2016 IMWG Response Criteria. ORR is defined as the percentage of the participants with either a stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) according to the International Myeloma Working Group (IMWG) Response Criteria. CR = negative immunofixation of serum and urine AND disappearance of any soft tissue plasmacytomas AND \<5% plasmacytomas in the bone marrow; sCR=stringent complete response, CR as above PLUS normal serum free light-chain (FLC) assay ratio and absence of clonal cells in bone marrow; VGPR = serum and urine M-component detectable by immunofixation but not on electrophoresis OR ≥ 90% reduction in serum M-component plus urine M-component \<100 mg/24 hr; PR = ≥50% reduction of serum Mprotein and reduction in 24-hour urinary M-protein by ≥90% or to \<200 mg/24 hours. The ORR for Cohort E is presented. Cohorts A-D and F were presented in a previous outcome measure.
Time frame: Up to approximately 37 months
Population: All participants who have received at least one dose of study intervention and had ORR measured by the 2016 IMWG Response Criteria.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cohort E Pembrolizumab/Vibostolimab Coformulation | ORR as Assessed by the 2016 International Myeloma Working Group (IMWG) Response Criteria (Cohort E) | 0.0 Percentage of Participants |