This is a multi-center, open-labeled, non-randomized, single arm investigator-initiated trial to evaluate the safety and efficacy of GEN0101 and Pembrolizmub combination in patients with advanced melanoma.
1\. Primary Objective \& Hypothesis 1. Objective: Efficacy of the combination therapy The combination therapy with intracutaneous injections of GEN0101 + intravenous infusions of Pembrolizumab is given to patients with confirmed SD or unconfirmed PD after anti-PD-1 antibody therapy. When the last subject completes Week 13 (Day 85th), the RECIST v1.1-based antitumor effect is assessed for all the subjects up to Week 17 (Day 113th) and then the ORR is calculated in both treatment groups, which are tested to examine the significant difference to historical data of KEYNOTE-002. 2. Hypothesis: The antitumor effect and the induction of antitumor immunity of the combination therapy would be enhanced. 2\. Secondary Objectives \& Hypothesises 1. Objectives: Efficacy and safety of the combination therapy The combination therapy with intracutaneous injections of GEN0101 + intravenous infusions of Pembrolizumab is given to patients with confirmed SD or unconfirmed PD after anti-PD-1 antibody therapy. When the last subject completed Week 17 (Day 113th), antitumor effect in Week 13 (Day 85th, unconfirmed) and Week 17 (Day 113th, confirmed) is assessed based on RECIST v1.1, irRC, and irRECIST for all subjects and then the ORR is calculated. Likewise, changes in individual tumor sizes in Week 13 (Day 85th, unconfirmed) and Week 17 (Day 113th, confirmed) are measured, and then percent changes in tumor sizes (percent tumor shrinkage or growth) are calculated. In each subject, the induction of antitumor immunity in Week 13 (Day 85th) is investigated with the index of activated NK cells in peripheral blood. When the last subject completed Week 53 (Day 365th), antitumor effect is assessed for all the subjects based on OS and RECIST v1.1, irRC, and irRECIST-based ORR, BOR and PFS, which are tested to examine significant difference to historical data of KEYNOTE-002. When the last subject completed Week 105 (Day 729th), antitumor effect is assessed for all the subjects based on OS and RECIST v1.1, irRC, and irRECIST-based ORR, BOR and PFS, which are tested to examine significant difference to historical data of KEYNOTE-002. On the basis of these results, the antitumor effect and the induction of antitumor immunity of the combination therapy is investigated. These are secondary objectives in the trial. As another secondary objective, AEs are investigated in all the subjects for safety evaluation of the combination therapy until the last subject completed Week 105 (Day 729th). 2. Hypothesis: The antitumor effect and the induction of antitumor immunity of the combination therapy would be enhanced and the safety would be acceptable. 3\. Exploratory Objective Objective: Storage and use of samples for future exploratory evaluation
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
46
New Combination immunotherapy GEN0101 and Pembrolizmub
Nagoya University Hospital
Nagoya, Aichi-ken, Japan
NOT_YET_RECRUITINGSapporo Medical University Hospital
Sapporo, Hokkaido, Japan
NOT_YET_RECRUITINGKumamoto University Hospital
Kuramoto, Kumamoto, Japan
Overall response rate (ORR), central review
As overall tumor response in all the tumors in each subject, the ORR is calculated based on the assessment results in Week 9 (Day 57th), Week 13 (Day 85th) and Week 17 (Day 113th) as confirmatory assessment.
Time frame: until Week17 (Day113th)
Overall response rate (ORR) and Best overall response (BOR), investigator assessment and central review
In all the tumors in each subject, the RECIST v1.1-based, the irRC-based and the irRECIST-based overall tumor response is assessed by the site investigator until Week 105 (Day 729th). Then, based on the assessment results, the ORR and BOR are calculated.
Time frame: until Week 105 (Day 729th)
Percent change in individual tumor sizes
Until Week 105 (Day 729th) in each subject, the size of each tumor is calculated by the longest diameter the perpendicular diameter of each tumor, and then percent changes in individual tumor sizes (percent shrinkage or growth) and the local Response Rates are calculated
Time frame: Until Week 105 (Day 729th)
Progression free survival (PFS)
When the last subject completed Week 22 (Day 148th) (and Week 26 as confirmatory assessment of PD) and Week 53 (Day 365th) and Week 105 (Day 729th) of GEN0101, the RECIST v1.1-based PFS is assessed for all the subjects, where the assessment results in Week 8 should not be used and the central assessment results since Week 13 (Day 85th) only are used for all the subjects.
Time frame: Until Week 105 (Day 729th)
Overall survival (OS)
When the last subject completes Week 22 (Day 148th) and Week 53 (Day 365th) and Week 105 (Day 729th) of GEN0101, OS is calculated for all the subjects.
Time frame: Until Week 105 (Day 729th)
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Shizuoka Cancer Center
Nakatogari, Shizuoka, Japan
NOT_YET_RECRUITINGTokyo Medical and Dental University
Bunkyo-ku, Tokyo, Japan
NOT_YET_RECRUITINGNational Cancer Center Hospital
Chuo-ku, Tokyo, Japan
RECRUITINGOsaka International Cancer Institute
Osaka, Japan
NOT_YET_RECRUITINGInduction of antitumor immunity
In Week 9 (Day 57th) and Week 13 (Day 85th) of GEN0101 in each subject, the induction of antitumor immunity after the combination therapy is investigated with the index of peripheral blood activated NK cells.
Time frame: Week 13 (Day 85th)
Adverse Events
AEs occurring in each subject up to Week 105 (Day 729th) of GEN0101 are evaluated with CTCAE v4.03
Time frame: up to Week 105 (Day 729th)