This is a phase II clinical trial evaluating activity, safety and patients reported outcomes of first-line pembrolizumab plus cisplatin (or carboplatin) plus 5-FU for patients with advanced penile squamous cell carcinoma. The primary endpoint is overall responsa rate according to RECIST v1.1 at week 24.
Advanced penile squamous cell carcinoma is associated with dismal survival rates and a major impact on the quality of life. To date, unresectable or metastatic disease is managed by systemic therapy with platinum-based chemotherapy for patients with good performance status. The median PFS and OS on first-line platinum-based chemotherapy vary between 3-4 and 7-15 months, respectively. Chemotherapy induces objective responses in only 20-30% of penile cancer patients with rare complete responses and systemic treatment has not changed for decades. Therefore, this study's rationale is to explore the efficacy and safety of pembrolizumab combined with standard-of-care cisplatin(or carboplatin) plus 5-fluorouracil as part of the first-line therapy. Patients will receive pembrolizumab 200mg IV every three weeks with a maximum duration of 2 years (34 cycles-counting the combination with chemotherapy) in case of no progressive disease or intolerance. The investigators hypothesized that the combination of immunotherapy with standard cytotoxic chemotherapy may improve the overall response rate by RECIST v1.1 in this patient population.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
37
Patients will receive pembrolizumab at the dose of 200mg IV Q3W with maximum duration of 2 years (34 cycles-counting the part combined with chemotherapy)
Ciplastin 70mg/m² IV D1(or carboplatin AUC 5) plus 5-Fluouracil 1000mg/m²/day IV( continuous infusion on Days 1-4) Q3W for 6 cycles
Oncocentro Ceará (Rede D'or)
Fortaleza, Ceará, Brazil
ICC - Instituto do Câncer do Ceará
Fortaleza, Ceará, Brazil
Hospital Universitário de Brasília (HUB-UnB)
Brasília, Federal District, Brazil
Overall response rate (ORR)
Proportion of patients with partial or complete response by investigator-assessed RECIST v1.1
Time frame: 24 weeks
Progression Free Survival (PFS)
Time from enrollment to progression by investigator-assessed RECIST 1.1 or death
Time frame: 24 months
Overall survival (OS)
Time from enrollment to death due to any cause.
Time frame: 36 months
Clinical Benefit Rate (CBR)
Proportion of patients who have complete, partial response or stable disease by investigator-assessed RECIST v1.1
Time frame: 24 weeks
Health Related Quality of Life (QoL)
Comparison of initial and final scores of the European Organization for Research and Treatment (EORTC) C30 questionnaires.
Time frame: 24 weeks
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Hospital Erasto Gaertner
Curitiba, Paraná, Brazil
COB - Clínica Oncológica do Brasil
Belém, Pará, Brazil
CPO - Centro de Pesquisa em Oncologia do Hospital São Lucas da PUCRS
Porto Alegre, Rio Grande do Sul, Brazil
Hospital de Amor de Barretos
Barretos, São Paulo, Brazil
INCA - Instituto Nacional de Câncer
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Hospital Amaral Carvalho de Jaú
Jaú, São Paulo, Brazil
ICESP - Instituto do Câncer do Estado de São Paulo
São Paulo, Brazil
...and 1 more locations