Researchers are looking for new ways to treat esophageal squamous cell carcinoma (ESCC). ESCC is a type of cancer that starts in certain cells that line the esophagus. The esophagus is the tube that connects the throat to the stomach. This study will look at ESCC that is either locally advanced unresectable, which means it has spread into tissue near where it started and cannot be completely removed by surgery, or metastatic, which means it has spread to other body parts. Available treatments for these types of ESCC include pembrolizumab and chemotherapy. Pembrolizumab is an immunotherapy, which is a treatment that helps the immune system fight cancer. Chemotherapy is medicine that destroys cancer cells or stops them from growing. Researchers want to learn about giving pembrolizumab and investigational agents, with or without chemotherapy to treat ESCC. Ifinatamab deruxtecan (I-DXd), is an antibody-drug conjugate (ADC). An ADC attaches to a protein on cancer cells and delivers treatment to destroy those cells. The main goal of this study is to learn about the safety of investigational agents and pembrolizumab with or without chemotherapy and if people tolerate them. Researchers also want to learn how cancer responds (gets smaller or goes away) to the study treatments.
The master protocol is MK-3475-U06
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
298
IV infusion
IV infusion
IV infusion
IV infusion
IV Infusion
IV infusion
IV infusion
Includes 5-HT3 receptor antagonist, NK-1 receptor antagonist, and corticosteroid for Arms 2, 3, and 4, and H1 receptor antagonist, H2 receptor antagonist, acetaminophen, and dexamethasone for Arm 5, administered per approved product label
UPMC Hillman Cancer Center ( Site 1904)
Pittsburgh, Pennsylvania, United States
RECRUITINGLiga Norte Riograndense Contra o Cancer ( Site 1301)
Natal, Rio Grande do Norte, Brazil
RECRUITINGHospital Nossa Senhora da Conceicao ( Site 1300)
Porto Alegre, Rio Grande do Sul, Brazil
RECRUITINGClínica Puerto Montt ( Site 1406)
Port Montt, Los Lagos Region, Chile
Percentage of Participants who Experience Dose Limiting Toxicities (DLTs) During the Safety Lead-In Phase
Percentage of participants experiencing toxicities that are possibly, probably, or definitely related to study intervention; that meet pre-defined severity criteria; and result in a change in the given dose.
Time frame: Up to approximately 28 days
Percentage of Participants who Experience an Adverse Event (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 experience an AE will be reported.
Time frame: Up to approximately 77 months
Objective Response Rate (ORR)
ORR is defined as a confirmed complete response (CR: the disappearance of all target lesions) or partial response (PR: at least a 30% decrease in the sum of diameters of target lesions) per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 as assessed by blinded independent central review (BICR). The percentage of participants who experience CR or PR as assessed by BICR will be presented.
Time frame: Up to approximately 77 months
Duration of Response (DOR)
For participants who demonstrate a confirmed Complete Response (CR: disappearance of all target lesions) or Partial Response (PR: at least a 30% decrease in the sum of diameters of target lesions) per RECIST 1.1, DOR is defined as the time from first documented evidence of CR or PR until PD or death. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. DOR as assessed by BICR will be presented.
Time frame: Up to approximately 77 months
Progression-Free Survival (PFS)
PFS is defined as the time from randomization to the first documented progressive disease (PD) or death from any cause, whichever occurs first. Per RECIST 1.1, PD is defined as at least a 20% increase in the sum of diameters of target lesions. In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm. The appearance of one or more new lesions is also considered PD. PFS as assessed by BICR will be presented.
Time frame: Up to approximately 77 months
Overall Survival (OS)
OS is defined as the time from allocation/randomization to death due to any cause.
Time frame: Up to approximately 77 months
Disease Control Rate (DCR)
DCR is defined as a confirmed complete response (CR) or partial response (PR), or stable disease (SD) with at least 6 months PFS per RECIST 1.1 as assessed by BICR.
Time frame: Up to approximately 77 months
Maximum Plasma Concentration (Cmax) of I-DXd
Cmax is defined as the peak level I-DXd reaches in the blood plasma. Blood samples collected predose and at multiple timepoints postdose will be used to determine the Cmax of I-DXd when co-administered with other investigational agents.
Time frame: At designated time points up to approximately 65 months
Time to Maximum Plasma Concentration (Tmax) of I-DXd
Tmax is defined as the time it took I-DXd to reach its peak level in blood plasma. Blood samples collected predose and at designated timepoints postdose will be used to determine the Tmax of I-DXd when co-administered with other investigational agents.
Time frame: At designated time points up to approximately 65 months
Area Under the Concentration-Time Curve from Time 0 to Last Measurable Plasma Concentration (AUClast) of I-DXd
AUClast is defined as the area under the concentration-time curve from time 0 to the last measurable concentration of I-DXd in the blood plasma. Blood samples collected at predose and at designated timepoints postdose will be used to determine the AUClast of I-DXd in combination with other agents.
Time frame: At designated time points up to approximately 65 months
Area Under the Concentration-Time Curve from Time 0 to the End of the Dosing Period (AUCtau) of I-DXd
AUCtau is defined as the area under the concentration-time curve from time zero to the end of the dosing period. Blood samples collected at predose and at designated timepoints postdose will be used to determine the AUCtau of I-DXd in combination with other agents.
Time frame: At designated time points up to approximately 65 months
The Percentage of Participants with Antidrug Antibodies (ADA) Against I-DXd
Blood samples collected at designated timepoints will be used to determine the ADA response to I-DXd. The percentage of participants with ADA will be reported.
Time frame: Up to approximately 65 months
The Percentage of Participants with Treatment-Emergent ADA Against I-DXd
Blood samples collected at designated timepoints will be used to determine the treatment-emergent ADA response to I-DXd. The percentage of participants who have treatment-emergent I-DXd ADA will be reported.
Time frame: Up to approximately 65 months
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FALP ( Site 1400)
Santiago, Region M. de Santiago, Chile
RECRUITINGCentro de Oncología de Precisión ( Site 1402)
Santiago, Region M. de Santiago, Chile
RECRUITINGClínica UC San Carlos de Apoquindo ( Site 1403)
Santiago, Region M. de Santiago, Chile
RECRUITINGBradfordhill ( Site 1401)
Santiago, Region M. de Santiago, Chile
RECRUITINGBradford Hill Norte ( Site 1405)
Antofagasta, Chile
RECRUITINGThe Second Affiliated Hospital of Anhui Medical University ( Site 9511)
Hefei, Anhui, China
RECRUITING...and 31 more locations