This phase I trial studies the best dose of sonidegib when given together with pembrolizumab and to see how well they work in treating patients with solid tumor that has spread to other places in the body (advanced). Sonidegib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Giving sonidegib and pembrolizumab may work better than standard treatment in treating patients with advanced solid tumors.
PRIMARY OBJECTIVES: I. To determine the maximum tolerated dose (MTD) of sonidegib in combination with pembrolizumab in participants with advanced solid tumors as part of the dose escalation phase. (Part A) II. To estimate the response rate of sonidegib in combination with pembrolizumab in participants with non-small cell lung cancer (NSCLC) or head and neck squamous cell carcinoma (HNSCC) as part of the expansion cohort based on Response Evaluation Criteria in Solid Tumors (RECIST) criteria. (Part B) SECONDARY OBJECTIVES: I. To characterize the safety profile and tolerability of sonidegib and pembrolizumab. II. To obtain preliminary estimates of efficacy as measured by response rate (based on RECIST criteria), disease control rate at 6 months, duration of response, overall survival (OS), and progression free survival (PFS) of sonidegib and pembrolizumab in patients with selected advanced solid tumors. CORRELATIVE RESEARCH OBJECTIVE: I. To estimate the immunologic effects of sonidegib and pembrolizumab by investigating the changes in circulating tumor cells, immune cell markers, cytokines, and soluble PD-L1 in blood. OUTLINE: This is a dose-escalation study of sonidegib. Patients receive sonidegib orally (PO) once daily (QD) on days 1-8 and pembrolizumab intravenously (IV) over 30 minutes on day 8. Treatment repeats every 21 days for up to 24 cycles in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up within 30 days.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
36
Given IV
Given PO
Mayo Clinic in Arizona
Scottsdale, Arizona, United States
Mayo Clinic in Florida
Jacksonville, Florida, United States
Mayo Clinic in Rochester
Rochester, Minnesota, United States
Maximum tolerated dose (MTD) of sonidegib in combination with pembrolizumab (Part A)
MTD is defined as the dose level below the lowest dose that induces dose- limiting toxicity (DLT) in at least one-third of patients. Three patients will be treated at a given dose level combination and observed for at least 21 days from start of treatment to assess toxicity.
Time frame: Up to 21 days
Response rate of sonidegib in combination with pembrolizumab (Part B)
Assessed by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.
Time frame: Up to 30 days post treatment
Incidence of adverse events
Assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v)5.0. Number of severity of all adverse events will be tabulated and summarized. The grade 3+ adverse events will also be described and summarized in a similar fashion. Overall toxicity incidence as well as toxicity profiles by dose level and patient will be explored and summarized.
Time frame: Up to 30 days post treatment
Response profile
Responses will be calculated based on RECIST 1.1 for this study. Best response is defined to be the best objective status recorded from the start of the treatment until disease progression/recurrence (taking as reference for progressive disease the smallest measurements recorded since the treatment started). Responses will be summarized by simple descriptive summary statistics delineating complete and partial responses as well as stable and progressive disease in this patient population.
Time frame: Up to 30 days post treatment
Duration of response (DOR)
Determined only for patients with confirmed response. Participants who achieve a confirmed objective response who have not experienced radiographic or clinical progression will be censored at the date of the last available post-baseline evaluable tumor assessment.
Time frame: From the date on which an objective response is first determined until the first date on which radiographic disease progression is determined, assessed up to 30 days
Disease control rate (DCR)
Assessed by RECIST v1.1. DCR defined as proportion of participants who achieve complete response (CR), partial response (PR), or stable disease and do not experience subsequent radiographic progressive disease for \>= 6 months from the time of treatment initiation.
Time frame: At 6 months
Overall survival (OS)
OS is defined as the length of time from study entry until death from any cause.
Time frame: Up to 30 days post treatment
Progression-free survival (PFS)
PFS is defined as the length of time from study entry until either disease progression or death from any cause.
Time frame: Up to 30 days post treatment
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