This is a phase II, single arm, open-label, interventional trial of pembrolizumab (MK-3475) in patients with osteosarcoma who have experienced disease relapse or progression after at least one line of systemic treatment, and who are not eligible for curative surgery.
Patients with osteosarcoma, who are not eligible for surgery of curative intent and have completed at least one line of systemic therapy, will be considered for treatment with pembrolizumab. Patients who are considered medically unfit for chemotherapy and where no other treatment options are believed to be of major benefit may also be considered. Patients will receive pembrolizumab for up to 35 cycles. Patients, who have received 35 cycles of pembrolizumab or discontinued study treatment of another reason than progression, will in the follow-up period be assessed for safety and treatment-related toxicity (for up to 90 days), progression and survival. Patients who have achieved a clinically meaningful response after 35 cycles of pembrolizumab, defined as complete response (CR), partial response (PR), and stable disease (SD) assessed by the Investigator by using RECIST, v1.1, and have not experienced any clinically significant toxicity of study treatment, may be considered for reintroduction of pembrolizumab, if progression is detected \> 8 weeks after cycle 35. Due to the low incidence of osteosarcoma, the inclusion rate is expected to be low, thus a Simon's two-stage design is suggested. Evaluation of efficacy and safety in stage one will be performed after the first 12 patients have been treated for 18 weeks: * In case of ≤2 responders; the trial ends. * If ≥3 responders, the trial will continue into stage II to a total number of 25 patients.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Pembrolizumab is a humanized antibody used in cancer immunotherapy.
Istituto Ortopedico Rizzoli
Bologna, Italy
Oslo University Hospital
Oslo, Norway
Clinical benefit rate
The percentage of patients with unresectable osteosarcoma who have achieved clinical response; complete response (CR), partial response (PR), or stable disease (SD) at 18 weeks as assessed using RECIST v1.1.
Time frame: At 18 weeks
Overall response rate (ORR)
The percentage of patients with unresectable osteosarcoma who have achieved objective response during treatment; complete response (CR), partial response (PR), as assessed using RECIST v1.1.
Time frame: Assessments every 6-9 weeks up to 2 years
Progression-free survival (PFS)
Time frame: Up to 4 years
Response rate by immune-related Response Criteria (ir-RC)
Time frame: Assessments every 6-9 weeks up to 2 years
Overall survival (OS)
Time frame: Through study completion, up to 4 years after enrollment of last patient
Number and type of Adverse Events related to pembrolizumab treatment in osteosarcoma patients as assessed by CTCAE v4.0
To evaluate the safety and tolerability of pembrolizumab in patients with osteosarcoma.
Time frame: Assessments every 6-9 weeks up to 2 years
Health-related quality of life changes using EORTC QLQ-C30
To evaluate health-related quality of life changes from baseline in patients with osteosarcoma, receiving pembrolizumab, using EORTC QLQ-C30.
Time frame: Assessments every 6-9 weeks up to 4 years
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