Participants with Stage IV nonsquamous non-small cell lung cancer (NSCLC) without prior systemic treatment will be treated with standard of care pembrolizumab combined with platinum-doublet chemotherapy for 4 cycles, then pembrolizumab plus pemetrexed maintenance for up to 31 additional cycles. The platinum doublet would be pemetrexed plus the investigator's choice of either cisplatin or carboplatin. The primary objective is to evaluate if total baseline tumor mutation burden (TMB) in cell-free circulating tumor deoxyribonucleic acid (ctDNA) is predictive of objective response per Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) by the investigator by estimating the level of association.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
118
Pembrolizumab, 200 mg, Day 1 of each 21-day cycle (Q3W), intravenous infusion (IV), standard of care in most countries
Pemetrexed, 500 mg/m\^2 infusion, standard of care, Q3W, IV
Carboplatin AUC 5 mg/mL/min, IV infusion, Day 1 of each 21-day cycle for 4 cycles (Cycles 1 - 4). Investigator's choice of either cisplatin or carboplatin.
Cisplatin, 75 mg/m\^2, IV infusion, Day 1 of each 21-day cycle for 4 cycles (Cycles 1 - 4). Investigator's choice of either cisplatin or carboplatin.
University Of Colorado ( Site 0908)
Aurora, Colorado, United States
Harry & Jeanette Weinberg Cancer Institute ( Site 0901)
Baltimore, Maryland, United States
Henry Ford Health System ( Site 0903)
Detroit, Michigan, United States
Kingston General Hospital ( Site 0800)
Kingston, Ontario, Canada
CISSS de la Monteregie-Centre ( Site 0801)
Greenfield Park, Quebec, Canada
Orszagos Koranyi TBC es Pulmonologiai Intezet ( Site 0400)
Budapest, Hungary
Petz Aladar Megyei Oktato Korhaz ( Site 0402)
Győr, Hungary
Jasz Nagykun Szolnok Megyei Hetenyi Geza Korhaz Rendelointezet ( Site 0401)
Szolnok, Hungary
Meir Medical Center ( Site 0501)
Kfar Saba, Israel
Chaim Sheba Medical Center ( Site 0500)
Ramat Gan, Israel
...and 5 more locations
Objective Response Rate
Objective response rate is the proportion of participants who have a confirmed complete response (CR) or partial response (PR). Objective response rate is assessed by investigator review according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to \<10 mm. Partial Response (PR): At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. Participants with missing data are considered non-responders. The percentage of participants with an ORR is presented.
Time frame: Up to ~25 months
Tumor Mutation Burden (TMB) in Cell-free Circulating Tumor Deoxyribonucleic Acid (ctDNA)
Cell-free ctDNA allows the exploration of tumor features from blood samples. TMB is a measure of mutational load in tumor cells and expressed as the number of somatic mutations per megabase (mut/MB) of DNA. The mean TMB in cell-free ctDNA of participants is presented.
Time frame: Baseline (Day 1)
Progression Free Survival (PFS)
PFS is defined as the time from enrollment to the first documented disease progression or death due to any cause, whichever occurs first as assessed by investigator review according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1). The Kaplan-Meier estimate of median PFS using the product-limit (Kaplan-Meier) method for censored data is presented.
Time frame: Up to ~36 months
Overall Survival (OS)
OS is defined as the time from the start of treatment to death due to any cause. The Kaplan-Meier estimate of median PFS using the product-limit (Kaplan-Meier) method for censored data is presented.
Time frame: Up to ~36 months
Percentage of Participants Who Experienced One or More Adverse Events (AEs)
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants who experienced an AE is presented.
Time frame: Up to ~31 months
Percentage of Participants Discontinuing Study Intervention Due to an AE.
An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The percentage of participants who discontinued the study intervention due to an AE is presented.
Time frame: Up to ~28 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.