Pembrolizumab + Chemotherapy for Lung Cancer

Recruiting in Palo Alto (17 mi)

+1238 other locations

Overseen byHossein Borghaei

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Phase 3

Waitlist Available

Sponsor: National Cancer Institute (NCI)

No Placebo Group

Pivotal Trial (Near Approval)

Prior Safety Data

Breakthrough Therapy

Trial Summary

What is the purpose of this trial?

This phase III trial studies whether pembrolizumab alone as a first-line treatment, followed by pemetrexed and carboplatin with or without pembrolizumab after disease progression is superior to induction with pembrolizumab, pemetrexed and carboplatin followed by pembrolizumab and pemetrexed maintenance in treating patients with stage IV non-squamous non-small cell lung cancer. 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. Chemotherapy drugs, such as pemetrexed, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Carboplatin is in a class of medications known as platinum-containing compounds. It works in a way similar to the anticancer drug cisplatin, but may be better tolerated than cisplatin. Carboplatin works by killing, stopping or slowing the growth of cancer cells. It is not yet known whether giving first-line pembrolizumab followed by pemetrexed and carboplatin with or without pembrolizumab works better in treating patients with non-squamous non-small cell cancer.

Research Team

Hossein Borghaei

Principal Investigator

ECOG-ACRIN Cancer Research Group

Eligibility Criteria

Adults with stage IV non-squamous non-small cell lung cancer, who have not had previous systemic chemotherapy for advanced disease. They must have a PD-L1 expression TPS of at least 1%, be in good physical condition (ECOG 0-1), and may have treated brain metastases if stable. Patients should not be pregnant or breastfeeding, must agree to use contraception, and cannot have certain serious illnesses or organ dysfunctions.

Inclusion Criteria

I am fully active or restricted in physically strenuous activity but can do light work.

I took low-dose Methotrexate for a non-cancer condition and stopped at least 14 days ago.

My hepatitis B is under control or I am cured of hepatitis C.

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Exclusion Criteria

My heart is healthy and I haven't had serious heart disease or treatments that could harm my heart.

I have NSCLC but haven't had checkpoint inhibitors for it. I've waited the required time after any previous treatments.

I haven't needed treatment for an autoimmune disease in the last 2 years.

See 7 more

Treatment Details

Interventions

Carboplatin (Alkylating agents)
Pembrolizumab (Monoclonal Antibodies)
Pemetrexed (Anti-metabolites)

Trial OverviewThe trial is testing the effectiveness of pembrolizumab alone as an initial treatment followed by pemetrexed and carboplatin with/without continued pembrolizumab after disease progression versus starting with all three drugs together then maintaining with pembrolizumab and pemetrexed. It aims to see which method is better for treating patients.

Participant Groups

3Treatment groups

Experimental Treatment

Active Control

Group I: Arm B (pembrolizumab, pemetrexed, carboplatin)Experimental Treatment7 Interventions

Patients receive pembrolizumab IV over 30 minutes on day 1. Cycles repeat every 21 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Within 6 weeks of disease progression, patients receive pembrolizumab IV over 30 minutes, pemetrexed IV over 10 minutes, and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive pembrolizumab IV over 30 minutes and pemetrexed IV over 10 minutes on day 1. Cycles repeat every 21 days for up to 2 years for pembrolizumab in the absence of disease progression or unacceptable toxicity and until to disease progression for pemetrexed. Patients undergo MRI during screening, CT scan and blood sample collection throughout the study, and may undergo PET scan throughout the study.

Group II: Arm A (pembrolizumab, pemetrexed, carboplatin)Experimental Treatment7 Interventions

Patients receive pembrolizumab IV over 30 minutes on day 1. Cycles repeat every 21 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Within 6 weeks of disease progression, patients receive pemetrexed IV over 10 minutes and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then may receive pemetrexed IV over 10 minutes on day 1. Cycles repeat every 21 days in the absence of disease progression or unacceptable toxicity. Patients undergo MRI during screening, CT scan and blood sample collection throughout the study, and may undergo PET scan throughout the study.

Group III: Arm C (pembrolizumab, pembrolizumab, carboplatin)Active Control7 Interventions

Patients receive pembrolizumab IV over 30 minutes, pemetrexed IV over 10 minutes, and carboplatin IV over 30 minutes on day 1. Treatment repeats every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients then receive pembrolizumab IV over 30 minutes and pemetrexed IV over 10 minutes on day 1. Cycles repeat every 21 days for up to 2 years for pembrolizumab in the absence of disease progression or unacceptable toxicity and until to disease progression for pemetrexed. Patients undergo MRI during screening, CT scan and blood sample collection throughout the study, and may undergo PET scan throughout the study.

Carboplatin is already approved in Canada for the following indications: