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SNCTP000001845 | NCT02563002 | BASEC2016-00061

Eine Phase-III-Studie zur Pembrolizumab-Monotherapie im Vergleich mit Chemotherapie bei Patienten mit Kolorektalkarzinom

Data source: BASEC (Imported from 26.04.2024), WHO (Imported from 25.04.2024)
Changed: Dec 23, 2023, 4:46 PM
Disease category: Colon and Rectal Cancer

Brief description of trial (Data source: BASEC)

Bei der Kontrolle von Tumoren spielt das Immunsystem eine wichtige Rolle. Pembrolizumab ist ein Antikörper, der die Täuschung des Immunsystems durch den Tumor unterbindet und so die körpereigene Bekämpfung steigert, sofern der Tumor das Merkmal PD-L1 aufweist. In dieser Studie soll die Wirksamkeit des experimentellen Arzneimittels Pembrolizumab (MK-3475) im Vergleich zu anderen standardchemo-therapeutischen Wirkstoffen (nach Wahl des Arztes: FOLFOX, FOLFIRI, Bevacizumab und Cetuximab) bei Patienten mit Dickdarmkrebs im Stadium IV geprüft werden. Die Studienpatienten werden nach dem Zufallsprinzip einer von zwei Behandlungsgruppen zugewiesen: In der ersten Behandlungsgruppe (Arm 1) erhalten die Patienten bis zu 35 Behandlungen mit Pembrolizumab ungefähr alle 3 Wochen. In der zweiten Behandlungsgruppe (Arm 2) erhalten die Patienten eine Behandlung nach Wahl des Arztes aus sechs möglichen Standardtherapien alle 2 Wochen. Im Rahmen der Studientermine wird eine körperliche Untersuchung mit Messung von Blutdruck, Herzfrequenz, Temperatur, Atemfrequenz und Körpergewicht durchgeführt. Darüber hinaus wird ein Elektrokardiogramm (EKG) aufgezeichnet. Ausserdem werden Blut- und Urinproben gesammelt. Falls bei den Patienten des Behandlungsarms 1 die CT- oder MRT-Untersuchung eine Verschlechterung ihres Krankheitsbildes aufzeigt, werden sie dazu aufgefordert, mindestens 4 Wochen später eine erneute radiologische Untersuchung durchzuführen. Falls bei den Patienten des Behandlungsarms 2 die CT- oder MRT-Untersuchung eine Verschlechterung ihres Krankheitsbildes aufzeigt, müssen sie die Studie abbrechen. Es besteht dann die Möglichkeit, in den Crossover-Behandlungsarm überzutreten. Die Teilnahme an der Studie dauert ca. 2 Jahre.

Health conditions investigated(Data source: BASEC)

Hoch mikrosatelliteninstabiles oder Mismatch-Reparaturprotein-defizientes Stadium IV-Kolorektalkarzinom

Health conditions (Data source: WHO)

Colorectal Carcinoma

Rare disease (Data source: BASEC)

No

Intervention investigated (e.g. drug, therapy or campaign) (Data source: BASEC)

Die Teilnehmer erhalten per Randomisierung im Verhältnis 1:1 entweder Pembrolizumab (experimenteller Studienarm) oder eine Standard-(SOC-)Chemotherapie nach Wahl des Arztes (Kontrollarm). Die Wahl der Chemotherapie muss vor der Randomisierung erfolgen.

Interventions (Data source: WHO)

Drug: mFOLFOX6;Drug: FOLFIRI;Biological: pembrolizumab;Biological: bevacizumab;Biological: cetuximab

Criteria for participation in trial (Data source: BASEC)

1. Zum Zeitpunkt der Unterzeichnung der Einwilligungserklärung muss das 18. Lebensjahr erreicht sein.
2. Vorliegen eines lokal bestätigten MMR-defizitären (dMMR) oder hoch mikrosatelliteninstabilen (MSI-H) Kolorektalkarzinoms im Stadium IV.
3. Bei Studienbeginn Vorliegen einer auf Grundlage von RECIST 1.1 messbaren Erkrankung, gemäss radiologischer/prüfärztlicher Beurteilung im jeweiligen Prüfzentrum.

Exclusion criteria (Data source: BASEC)

1. Systemische Vorbehandlung gegen Stadium-IV-KRK.
2. Bekannte aktive Metastasen im Zentralnervensystem (ZNS) und/oder karzinomatöse Meningitis. Patienten mit vorbehandel-ten Hirnmetastasen sind für die Teilnahme geeignet, wenn sie mindestens vier Wochen vor der ersten Gabe des Studienmedi-kaments stabile Hirnmetastasen aufweisen.
3. Frühere Behandlung mit einem (z. B. gegen PD-1, PD-L1, PD-L2 oder CTLA-4 etc. gerichteten) Immun-Checkpoint-Inhibitor.

Inclusion/Exclusion Criteria (Data source: WHO)

Gender: All
Maximum age: N/A
Minimum age: 18 Years

Inclusion Criteria:

- Locally confirmed dMMR or MSI-H stage IV colorectal carcinoma

- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 within 10 days
prior to study start

- Life expectancy of at least 3 months

- Measurable disease

- Female participants of childbearing potential must be willing to use adequate
contraception for the course of the study starting with the first dose of study
medication through 180 days after the last dose of standard of care (SOC) therapy or
120 days after the last pembrolizumab dose

- Male participants must agree to use adequate contraception for the course of the study
starting with the first dose of study medication through 180 days after the last dose
of study medication for chemotherapy arm (no contraception requirement for
pembrolizumab [MK-3475] arm)

- Adequate organ function

Exclusion Criteria:

- Has received prior systemic therapy for Stage IV colorectal cancer. May have received
prior adjuvant chemotherapy for colorectal cancer as long as it was completed at least
6 months prior to randomization on this study

- Currently participating and receiving treatment in another study, or participated in a
study of an investigational agent and received treatment, or used an investigational
device within 4 weeks of randomization

- Active autoimmune disease that has required systemic treatment in past 2 years

- Diagnosis of immunodeficiency or receiving systemic steroid therapy or any other form
of immunosuppressive therapy within 7 days prior to randomization on this study

- Radiation therapy within 4 weeks prior to randomization on this study and not
recovered to baseline from adverse events due to radiation therapy

- Known active central nervous system (CNS) metastases and/or carcinomatous meningitis

- Major surgical procedure, open biopsy or significant traumatic injury within 28 days
prior to randomization on this study

- Has received prior therapy with an immune checkpoint inhibitor (e.g., anti-programmed
cell death [PD]-1, anti-PD ligand 1 [L1], anti-PD-L2 agent, or anti-cytotoxic
T-lymphocyte-associated protein 4 [CTLA-4] agent, etc.)

- Another malignancy that is progressing or requires active treatment with the exception
of non-melanomatous skin cancer that has undergone potentially curative therapy and in
situ cervical carcinoma

- Received a live or a live attenuated vaccine within 30 days of planned start of study
medication

- Known history of Human Immunodeficiency Virus (HIV), Hepatitis B or C

- Known history of, or any evidence of interstitial lung disease or active,
non-infectious pneumonitis

- Known history of active tuberculosis (Bacillus tuberculosis [TB])

- Active infection requiring systemic therapy

- Known psychiatric or substance abuse disorders that would interfere with cooperation
with the requirements of the study

- Pregnant, breastfeeding, or expecting to conceive or father children within the
projected duration of the study, starting with the screening visit through 180 days
after the last dose of SOC (for male and female participants) or 120 days after the
last dose of pembrolizumab (for female participants only)

Further information on the trial in WHO primary registry

https://clinicaltrials.gov/ct2/show/NCT02563002

Further information on the trial from WHO database (ICTRP)

https://trialsearch.who.int/Trial2.aspx?TrialID=NCT02563002
Further information on trial

Recruitment status

Completed

Academic title (Data source: WHO)

A Phase III Study of Pembrolizumab (MK-3475) vs. Chemotherapy in Microsatellite Instability-High (MSI-H) or Mismatch Repair Deficient (dMMR) Stage IV Colorectal Carcinoma (KEYNOTE-177)

Type of trial (Data source: WHO)

Interventional

Design of the trial (Data source: WHO)

Allocation: Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: None (Open Label).

Phase (Data source: WHO)

Phase 3

Primary end point (Data source: WHO)

Progression-Free Survival (PFS) Per RECIST1.1 As Assessed by Central Imaging Vendor;Overall Survival (OS)

Secundary end point (Data source: WHO)

Overall Response Rate (ORR) Per RECIST1.1 as Assessed by Central Imaging Vendor;Number of Participants Who Experienced an Adverse Event (AE);Number of Participants Who Discontinued Study Treatment Due to an AE

Contact information (Data source: WHO)

Please refer to primary and secondary sponsors

Trial results (Data source: WHO)

Results summary

no information available yet

Link to the results in the primary register

https://clinicaltrials.gov/ct2/show/results/NCT02563002

Information on the availability of individual participant data

no information available yet

Trial sites

Trial sites in Switzerland (Data source: BASEC)

Basel, Geneva, St. Gallen, Zurich

Countries (Data source: WHO)

Australia, Belgium, Brazil, Canada, Denmark, Finland, France, Germany, Ireland, Israel, Italy, Japan, Korea, Netherlands, Norway, Republic of, Singapore, South Africa, Spain, Sweden, Switzerland, Taiwan, United Kingdom, United States

Contact for further information on the trial

Details of contact in Switzerland (Data source: BASEC)

Klaudia Georgi
+41 58 618 33 88
klaudia.georgi@msd.com

Contact for general information (Data source: WHO)

Medical Director
Merck Sharp & Dohme LLC

Contact for scientific information (Data source: WHO)

Medical Director
Merck Sharp & Dohme LLC

Authorisation by the ethics committee (Data source: BASEC)

Name of the authorising ethics committee (for multicentre studies only the lead committee)

Ethikkommission Nordwest- und Zentralschweiz EKNZ

Date of authorisation by the ethics committee

28.04.2016

Further trial identification numbers

Trial identification number of the ethics committee (BASEC-ID) (Data source: BASEC)

2016-00061

Secondary ID (Data source: WHO)

163238
MK-3475-177
KEYNOTE-177
2015-002024-89
3475-177
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