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Completed

NCT Number: NCT02733159

Pembrolizumab in Patients With Non-Small Cell Lung Cancer and a Performance Status 2

This study is to determine that pembrolizumab is safe and tolerable at the selected dose for the treatment of Non-Small Cell Lung Cancer (NSCLC) in patients with a performance status of 2. All patients will receive pembrolizumab.

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Key information

Conditions

Carcinoma, Non-Small-Cell Lung Bronchial Neoplasms Carcinoma, Bronchogenic Lung Diseases Lung Neoplasms Neoplasms Neoplasms by Site Respiratory Tract Diseases Respiratory Tract Neoplasms Thoracic Neoplasms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

The Christie NHS Foundation Trust, Manchester, Greater Manchester, United Kingdom

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About this study

Non-small cell lung cancer (NSCLC) is the most common type of lung cancer. There are several studies which demonstrate a role for the immune system in fighting lung cancer. However, there are multiple mechanisms by which cancer dampens this response. The PD-1 receptor-ligand interaction is one of the major pathways hijacked by tumours to help evade detection and elimination by the cells of the immune system. A number of compounds which block this pathway, including the drug pembrolizumab, have shown impressive results in some patients.

At present all of the trials with pembrolizumab reported thus far have been in patients with a good Performance Status (PS) of 0-1, a measure of daily activity. Unfortunately many patients with lung cancer have impaired performance status, making them ineligible for trials of new therapies including anti PD-1. Clinical trials of standard-of-care therapy have been successfully performed in the PS=2 only population demonstrating the feasibility of performing clinical trials in this population.

In this trial, the investigators would like to determine whether this drug can be used to treat Performance status 2 patients with a lower general daily activity. The purpose of this trial is to determine that pembrolizumab is safe and tolerable. The investigators would also like to see how well the treatment works, find out more information about tumour shrinkage, and learn more about the disease and how it changes over time.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Core Inclusion Criteria:

  • Histologically confirmed PD-L1 status defined NSCLC. Biopsy must be within 70 days of first treatment with pembrolizumab.
  • Eastern Cooperative Oncology Group (ECOG) performance status 2.
  • Life expectancy > 12 weeks.
  • Uni-dimensionally measurable disease according to Response Evaluation Criteria in Solid Tumours (RECIST) v1.1
  • Computerised Tomography (CT) scan of chest and abdomen within 28 days of starting pembrolizumab.
  • Adequate haematological function:
  • Platelet count ≥100 x 109 /L.
  • Neutrophils ≥1.5 x 109/L.
  • Haemoglobin ≥ 90 g/L.
  • Adequate hepatic function:
  • Serum bilirubin ≤1.5 x upper limit of normal (ULN).
  • Serum transaminases ≤2.5 x ULN.
  • Adequate renal function: Creatinine clearance <1.5 times ULN concurrent with creatinine clearance >50 ml/min.
  • Provision of signed and dated, written informed consent prior to any trial specific procedures, sampling and analyses.

Core Exclusion Criteria:

  • Patients who do not meet the criteria of performance status = 2 on the ECOG Performance scale.
  • Untreated symptomatic brain or leptomeningeal metastatic disease.
  • Medical or psychiatric conditions compromising informed consent.
  • Any medical condition which in the opinion of the investigator would compromise the ability of the patient to participate in the trial or which would jeopardise compliance with the protocol.
  • Radiotherapy within 28 days of trial treatment.
  • Active autoimmune disease that has required systemic treatment in past 2 years
  • Chronic usage of steroids or other immunosuppressant medication.
  • Previous history of pneumonitis.
  • Any evidence of clinical autoimmunity.

Treatment and study plan

Pembrolizumab

Drug

anti PD-1

Other names: MK-3475

Primary outcomes

  1. Toxicity Rate

    Time frame: Date of patient registration until 6 months after the administration of the last treatment (a maximum of 2 years treatment and 6 months followup after end of treatment)

    Adverse events will be recorded in relation to each cycle of treatment and graded according to CTCAE criteria. The toxicity co-primary outcome measure for the trial is defined as the occurrence of a treatment-related dose delay or treatment discontinuation due to toxicity.

  2. Durable Clinical Benefit

    Time frame: ≥18 weeks, up to maximum of 2 years

    Patients will have CT scans every 9 weeks from baseline until disease progression. On each occasion, overall tumour burden will be assessed using RECIST version 1.1. The efficacy co-primary outcome measure for the trial is durable clinical benefit defined as the occurrence of CR, PR or SD without prior progressive disease at or after the second scheduled CT scan (scheduled to occur at 18 weeks).

Secondary outcomes

  1. Objective Response

    Time frame: ≥18 weeks, up to maximum of 2 years

    Objective response (OR) is the occurrence of Complete Response (CR) or Partial Response (PR) as the best overall response. OR will be based on responses confirmed using the subsequent 9-weekly scan but OR based on unconfirmed responses will also be reported.

  2. Health Related Quality of Life

    Time frame: Through study completion, up to a maximum of 2 years

    This is defined as the functional effect of a medical condition and/or its consequent treatment upon a patient. The purpose of Health Related Quality of Life (HRQoL) measurement is to quantify the degree to which the medical condition or its treatment impacts the individual's life in a valid and reproducible way. HRQoL will be assessed over time using Functional Assessment of Cancer Therapy - Lung (FACT-L) questionnaire and EQ-5D questionnaire.

  3. Time to Progression

    Time frame: Time to progression up to 2 years

    This is defined as the time from commencement of trial treatment to the date of CT scan when progressive disease first recorded. Patients with no recorded progression at the time of analysis or who die without recorded progression will be censored at the date of the CT scan when they were last recorded with an evaluable measure that was not progression.

  4. Progression-free Survival Time

    Time frame: Progression-free survival time up to 2 years

    This is defined as the time from commencement of trial treatment to the date of CT scan when progressive disease first recorded or date of death without previously recorded progression. Patients who are alive with no recorded progression at the time of analysis will be censored at the date of the CT scan when they were last recorded with an evaluable measure that was not progression.

  5. Overall Survival Time

    Time frame: Survival time up to 2 years or date of death

    This is defined as the time from commencement of trial treatment to the date of death. Patients who are alive at the time of analysis will be censored at the date last seen alive.

  6. Duration of Objective Response

    Time frame: Survival time up to 2 years or date of death

    This is defined as the time from commencement of trial treatment to the date of the subsequent CT scan when progressive disease is first confirmed or date of death without previously recorded progression. This outcome is calculated and reported separately for patients who achieve an Objective Response (OR) or Stable Disease (SD). Patients experiencing OR or SD who are alive with no recorded progression at the time of analysis will be censored at the date of the CT scan when they were last recorded with an evaluable measure that was not progression.

  7. Duration of Stable Disease

    Time frame: Survival time up to 2 years or date of death

    This is defined as the time from commencement of trial treatment to the date of the subsequent CT scan when progressive disease is first confirmed or date of death without previously recorded progression. This outcome is calculated and reported separately for patients who achieve an Objective Response (OR) or Stable Disease (SD). Patients experiencing OR or SD who are alive with no recorded progression at the time of analysis will be censored at the date of the CT scan when they were last recorded with an evaluable measure that was not progression.

Sponsors and collaborators

Lead sponsor

University of Birmingham

Other

Collaborators

  • Merck Sharp & Dohme LLC

Registry information

Official study title

A Phase II Trial of Pembrolizumab in Patients With Non-small Cell Lung Cancer and a Performance Status of 2

Acronym: PePS2

Important dates

Study start
2017
Primary completion
2023
Study completion
2024
First posted
Apr 11, 2016
Registry last updated
Feb 10, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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