Objective: To determine the Overall Response Rate (ORR) to Imprime PGG + pembrolizumab in subjects with advanced melanoma or metastatic TNBC Safety: To characterize the safety of Imprime PGG + pembrolizumab given in combination Hypothesis: Restore (for melanoma) or enhance (for TNBC) sensitivity to checkpoint inhibitors (CPI) by appropriate and effective stimulation of the subject's innate and adaptive immune systems in those subjects who have failed 1st line therapy The study will incorporate Simon's optimal 2-stage design with sample size fixed at 12 subjects each in Stage 1 for advanced melanoma and for Triple Negative Breast Cancer (TNBC) subjects. The safety criterion of ≤ 4 (or ≤ 33%) subjects with Grade 3/4 adverse events in Cycle 1 within either tumor type must be met in order to proceed to Stage 2. The starting dose is 4 mg/kg for Imprime PGG. In the event there are a total of \> 4 (or \> 33%) of subjects with Grade 3/4 adverse events in Cycle 1, the dose of Imprime PGG will be reduced to 2 mg/kg, and Stage 1 will be repeated at a dose of 2 mg/kg with an additional cohort of n=12 subjects. For the dose that meets the safety criterion in Stage 1, at least 1 response in melanoma subjects and 2 responses in TNBC subjects amongst the 12 subjects within each tumor type must be observed in order to proceed to Stage 2. Stage 2 will enroll an additional 17 subjects with melanoma, and 30 subjects with TNBC. For the dose that meets the Stage 1 safety criterion, success will be declared if at least 4 amongst the total of up to 29 subjects with melanoma, and 13 amongst the total of up to 42 subjects with TNBC achieve an objective response.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
64
Imprime PGG is a soluble, β-1,3/1,6 glucan isolated from the cell wall of a proprietary Saccharomyces cerevisiae yeast strain. Imprime PGG acts as a Pathogen-Associated Molecular Pattern (PAMP). Imprime will be administered at a dose of 4 mg/kg IV over a 2-hour infusion time on Days 1, 8 and 15 of each 3-week treatment cycle.
Pembrolizumab is a humanized monoclonal antibody against the programmed death receptor-1 protein. Pembrolizumab will be given at a fixed dose of 200 mg IV over 30 minutes on Day 1 of each 3-week treatment cycle after the Imprime infusion.
Arizona Center for Cancer Care
Avondale, Arizona, United States
John Wayne Cancer Institute
Santa Monica, California, United States
University of Colorado Cancer Center
Aurora, Colorado, United States
Sarah Cannon Research Institute
Denver, Colorado, United States
University Cancer and Blood Center
Athens, Georgia, United States
Piedmont Cancer Institute
Atlanta, Georgia, United States
Stony Brook University Cancer Center
Stony Brook, New York, United States
Thomas Jefferson University Sidney Kimmel Cancer Center
Philadelphia, Pennsylvania, United States
Sarah Cannon Research Institute
Nashville, Tennessee, United States
Millennium Oncology
Houston, Texas, United States
The Primary Efficacy Endpoint Was ORR, Defined as the Proportion of Subjects Demonstrating CR or PR Based on RECIST v1.1 Criteria.
The best response was defined as the best response recorded from the start of study treatment until the first PD based on RECIST v1.1 or start of new cancer therapy, whichever occurred earlier. Response assessment occurred every 6 weeks after the first dose of study drug.
Time frame: From the start of study treatment until the first PD based on RECIST v1.1 or start of new cancer therapy, whichever occurred earlier, up to 24 months.
Time to Response (TTR) Using RECIST v1.1 Criteria
For the subset of subjects with a confirmed CR or PR (RECIST v1.1), TTR was defined as time from the date of the first dose to the first response (the CR/PR prior to the confirmation).
Time frame: TTR was defined as time from the date of the first dose to the first response, up to 24 months.
Complete Response Rate (CRR)
Complete response rate (CRR) using RECIST v1.1 criteria
Time frame: The time from the date of the first dose to the first response (CR), up to 24 months.
Duration of Overall Response (DoR) Using RECIST v1.1 Criteria
For the subset of subjects with a confirmed CR or PR (RECIST v1.1), DoR was defined as the time from the first documented evidence of CR or PR (the response prior to the confirmation) until the time of documented PD (based on radiological assessments per RECIST v1.1) or death due to any cause, whichever occurred earlier.
Time frame: time from the first documented evidence of CR or PR (the response prior to the confirmation) until the time of documented PD (based on radiological assessments per RECIST v1.1) or death due to any cause, whichever occurred earlier.
Progression-Free Survival (PFS) Per RECISTv1.1
Progression free survival was defined as the time from the date of the first dose until the first PD or death due to any cause, whichever occurred first.
Time frame: time from the date of the first dose until the first PD or death due to any cause, whichever occurred first.
Overall Survival (OS)
Overall survival was defined as the time from the date of the first dose until the date of death due to any causes.
Time frame: Time from date of study day 1 until date of death due to any cause.
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