This is a single-arm phase II study of continuation immunotherapy with pembrolizumab following initial benefit (CR, PR, or SD ≥ 3 months) with a PD-1 or PD-L1 inhibitor.
OUTLINE: This is a multi-center study. Patients who have been treated with a PD-1 or PD-L1 inhibitor and experienced a PFS of ≥3 months will be enrolled within 6 weeks of last dose of PD-1 or PD-L1 inhibitor. On Day 1 of each 3-week cycle, subjects will first receive pembrolizumab at a dose of 200mg IV every three weeks in combination with chemotherapy. Partner chemotherapy will be either gemcitabine 1000mg/m2 IV D1 and D8 every three weeks, docetaxel 75mg/m2 IV D1 every three weeks, or pemetrexed 500mg/m2 IV D1 every 3 weeks (pemetrexed for non-squamous histologies only). Subjects will continue to receive this combination until progression or intolerable toxicity. Administration Sequence: First Sequence \- Pembrolizumab 200mg IV on Day 1 (cycle = 21 days) Administration Sequence: Second Sequence * Gemcitabine 1000mg/m\^2 IV on Days 1,8 (cycle = 21 days) * Docetaxel 75mg/\^2 IV on Days 1,8 (cycle = 21 days) * Pemetrexed 500mg/m\^2 IV on Day 1 (cycle -= 21 days)
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
35
Pembrolizumab 200mg IV every 21 days \+ Physician's choice chemotherapy with one of the following every 21 days: * Docetaxel 75mg/m2 IV * Pemetrexed 500mg/m2 IV (non-squamous only) * Gemcitabine 1000mg/m2 IV on days 1 and 8
University of Illinois Cancer Center
Chicago, Illinois, United States
Indiana University Melvin and Bren Simon Cancer Center
Indianapolis, Indiana, United States
University of Iowa Hospital Clinics
Iowa City, Iowa, United States
University of Minnesota Medcical Center
Minneapolis, Minnesota, United States
Progression Free Survival (PFS)
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter(LD) of target lesions; Progressive Disease (PD): \>= 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions; Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started. PFS was defined as time from starting treatment to disease progression met by RECIST 1.1, start of additional anticancer therapy before progression, or death from any cause.
Time frame: Time of treatment start until the criteria for disease progression or death, up to a maximum of 28 months
Clinical Benefit Rate (CBR)
Per Response Evaluation Criteria In Solid Tumors Criteria (RECIST): Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter(LD) of target lesions; Progressive Disease (PD) \>= 20% increase in tumor burden relative to nadir or the appearance of one or more new lesions; Stable Disease (SD), not meet criteria for CR/PR/PD. Per Immune-Related RECIST (irRECIST): Complete Response(irCR), Disappearance of all measurable and non-measurable lesions; Partial Response (irPR) \>=30% decrease in tumor burden relative to baseline; Progressive Disease (irPD), \>= 20% increase in tumor burden relative to nadir or the appearance of one or more new lesions confirmed by a consecutive assessment at least 4 week after first documentation; Stable Disease (irSD), not meeting criteria for irCR or irPR, in absence of irPD CBR is defined as any subject with SD for ≥ 3 months, PR or CR assessed via RECIST 1.1 and irRECIST.
Time frame: Up to a maximum of 28 months
Objective Response Rate (ORR)
Per RECIST: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter(LD) of target lesions; Progressive Disease (PD) \>= 20% increase in tumor burden relative to nadir or the appearance of one or more new lesions; Stable Disease (SD), not meet criteria for CR/PR/PD. Per irRECIST: Complete Response(irCR), Disappearance of all measurable and non-measurable lesions; Partial Response (irPR) \>=30% decrease in tumor burden relative to baseline; Progressive Disease (irPD), \>= 20% increase in tumor burden relative to nadir or the appearance of one or more new lesions confirmed by a consecutive assessment at least 4 week after first documentation; Stable Disease (irSD), not meeting criteria for irCR or irPR, in absence of irPD ORR is defined as the proportion of all subjects with confirmed PR or CR according to RECIST 1.1 and irRECIST, from the start of treatment until disease progression/recurrence
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University of Wisconsin
Madison, Wisconsin, United States
Time frame: Up to a maximum of 28 months
Overall Survival (OS)
Time from date of treatment start to date of death from any cause
Time frame: Time of treatment start until death or up to a maximum of 40 months
Number of Participants With Adverse Events
Toxicity will be graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events version 4
Time frame: Adverse events were recorded from time of registration until 30 days after discontinuation of study drug(s) up to a maximum of 25 months.
Progression Free Survival (PFS) by irRECIST
Per Immune-Related RECIST (irRECIST): Complete Response(irCR), Disappearance of all measurable and non-measurable lesions; Partial Reponse (irPR): \>=30% decrease in in tumor burden relative to baseline; Progressive Disease (irPD), \>= 20% increase in tumor burden relative to nadir or the appearance of one or more new lesions confirmed by a consecutive assessment at least 4 week after first documentation; Stable Disease (irSD), not meeting criteria for irCR or irPR, in absence of irPD. PFS is defined as time from the date of treatment start until the criteria for disease progression is met as defined by irRECIST or death occurs.
Time frame: Time of treatment start until the criteria for disease progression or death, up to a maximum of 28 months