This research study is studying an investigational combination of drugs as a possible treatment for advanced solid tumors: melanoma, ovarian, renal, or colorectal cancer. The drugs involved in this study are: * Pembrolizumab * AMG386
This research study is a Phase Ib clinical trial, which tests the safety of an investigational combination of drugs and also tries to define the appropriate dose of the investigational drugs to use for further studies. "Investigational" means that the drug is being studied. FDA (the U.S. Food and Drug Administration) has not approved of the combination of the study drugs pembrolizumab and AMG386 as a treatment for any disease. However, the FDA has approved pembrolizumab by itself for melanoma and non-small cell lung cancer. Pembrolizumab is a humanized monoclonal antibody, or specialized type of protein, produced in the laboratory for use in treating patients with the participant disease. Pembrolizumab is designed to augment the natural ability of the immune system to recognize and target cancer cells. AMG386 is a drug that may kill tumor cells and blocks blood vessels that supply the tumor with nutrients and oxygen. Drugs that block blood vessel formation are called "anti-angiogenic" therapies. AMG386 has been used and is currently being used in other clinical trials treating different types of cancer. Information from these other clinical trials suggests that this drug may help stop tumor growth. In this research study, the investigators are interested in looking at the combination of AMG386 with pembrolizumab because research done in the laboratory has suggested that the immunotherapy effect could be limited by the presence of tumor vessels in a process called angiogenesis. Adding AMG386 to pembrolizumab may help overcome this limitation and augment the effect of pembrolizumab. This combination of study drugs is being researched to: * Determine the safety and tolerability of pembrolizumab and AMG386 at different dose levels. * Determine the side effects of pembrolizumab and AMG386 when they are given in combination * Determine if pembrolizumab in combination with AMG386 is a possible treatment for cancer * Determine if pembrolizumab in combination with AMG386 changes immune cells in the blood or tumor
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
62
Pembrolizumab is designed to augment the natural ability of the immune system to recognize and target cancer cells
AMG386 is a drug that may kill tumor cells and blocks blood vessels that supply the tumor with nutrients and oxygen
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States
Dana Farber Cancer Institute
Boston, Massachusetts, United States
Number of Participants Experienced Dose Limit Toxicities (DLT)
A standard 3+3 dose-escalation design was used during dose escalation period. DLT was defined in protocol section 5.5.
Time frame: 3 weeks
Maximum Tolerated Dose (MTD) of Trebananib
MTD will be defined as the dose level at which fewer than one-third of participants experience a dose-limiting toxicity attributable to pembrolizumab and trebananib, as determined using a standard 3+3 dose-escalation design.
Time frame: 3 weeks
Grade 3 or Higher Toxicity Rate in Expansion Cohort
The percentage of participants who experienced grade 3 or higher event based on the Common Toxicity Criteria for Adverse Events Version 4.0 (CTCAEv4).
Time frame: The median follow up time was 3.3 months (range: 0.6 to 25.3 months).
Objective Response Rate (ORR)
ORR was defined as the percentage of participants achieving complete response (CR) or partial response (PR) on treatment based on RECIST 1.1 criteria. Per RECIST 1.1 for target lesions: CR is complete disappearance of all target lesions and PR is at least a 30% decrease in the sum of longest diameter (LD) of target lesions, taking as reference baseline sum LD. PR or better overall response assumes at a minimum incomplete response/stable disease (SD) for the evaluation of non-target lesions and absence of new lesions.
Time frame: Median follow-up was 29.3 months (range 0.9 - 42.0 months).
Progression Free Survival at 6 Months (PFS6)
PFS6 is the percent probability estimate at 6 months based on the Kaplan-Meier method. PFS is defined as the duration of time from study entry to documented disease progression (PD) requiring removal from the study or death. Participants alive without PD were censored at the earliest of the date of the last disease evaluation or start of new anticancer therapy. Per RECIST 1.1 for target lesions: PD is at least a 20% increase in sum LD, taking as reference the smallest sum on study with at least 5 mm absolute increase. For non-target lesions, progression-free means no new lesions or unequivocal progression on existing non-target lesions or not evaluated.
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Time frame: 6 months
Overall Survival at 1 Year (OS1)
OS1 is the percent probability estimate at 1 year based on the Kaplan-Meier method. O is defined as the time from start of trial treatment to death from any cause. For patients who are lost to follow-up or who have no documentation of death at the time of final analysis, follow-up will be censored at the date of last assessment of vital status. Per RECIST 1.1 for target lesions: PD is at least a 20% increase in sum LD, taking as reference the smallest sum on study with at least 5 mm absolute increase. For non-target lesions, progression-free means no new lesions or unequivocal progression on existing non-target lesions or not evaluated.
Time frame: 1 year
Median Time To Progression (TTP)
TTP based on Kaplan-Meier method is defined as the time interval between the dates of the start of trial treatment and first documentation of progressive disease. In the absence of documented progressive disease, follow-up would be censored at date of last disease assessment. Deaths without prior progression would be censored events.
Time frame: ian follow-up was 29.3 months (range 0.9 - 42.0 months).