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University of Massachusetts Chan Medical School | Medicine Department - Rheumatology Division

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Lenvatinib (E7080/MK-7902) in Combination With Pembrolizumab (MK-3475) vs. Standard Chemotherapy and Lenvatinib Monotherapy in Participants With Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma That Progressed After Platinum Therapy and Immunotherapy (MK-7902-009/E7080-G000-228/LEAP-009)

Merck Sharp & Dohme (MSD) logo

Merck Sharp & Dohme (MSD)

Status and phase

Enrolling
Phase 2

Conditions

Squamous Cell Carcinoma of Head and Neck

Treatments

Drug: Cetuximab
Drug: Capecitabine
Drug: Lenvatinib
Drug: Docetaxel
Drug: Paclitaxel
Biological: Pembrolizumab

Study type

Interventional

Funder types

Industry

Identifiers

NCT04428151
7902-009
E7080-G000-228 (Other Identifier)
2019-000569-19 (EudraCT Number)
MK-7902-009 (Other Identifier)
LEAP-009 (Other Identifier)

Details and patient eligibility

About

Researchers are looking for new ways to treat people with head and neck cancer whose cancer has come back after treatment (recurrent) or whose cancer has spread to other parts of the body (metastatic). Some people with recurrent or metastatic head and neck cancer are treated with chemotherapy and immunotherapy, but the cancer gets worse.

The goal of this study is to learn if more people who receive lenvatinib and pembrolizumab have their cancer respond to treatment (the cancer gets smaller or goes away) than people who receive standard chemotherapy treatment.

Enrollment

400 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Pathologically confirmed recurrent (not amenable to curative treatment with local and/or systemic therapies) or metastatic (disseminated) HNSCC of the oral cavity, oropharynx, hypopharynx, and/or larynx that is considered incurable by local therapies

  • Disease progression at any time during or after treatment with a platinum-containing (e.g., carboplatin or cisplatin) regimen

  • Disease progression on or after treatment with an anti-PD-1/PD-L1 mAb (programmed cell death protein 1/programmed death-ligand 1 monoclonal antibody)

  • Pre-study imaging that demonstrates evidence of disease progression based on investigator review of at least 2 pre-study images per RECIST 1.1, following initiation of treatment with a PD-1/PD-L1 inhibitor

  • Measurable disease by CT or MRI based on Response Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as verified by blinded independent central review (BICR). Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions

  • ECOG performance status of 0 or 1 assessed within 7 days of the first dose of study intervention

  • Male participants are eligible to participate if they agree to the following during the intervention period and for at least 1 week after the last dose of lenvatinib, 3 months after the last dose of capecitabine and paclitaxel, and and 6 months after the last dose of docetaxel:

    • Refrain from donating sperm
    • Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent; or must agree to use contraception unless confirmed to be azoospermic
    • Contraceptive use by men should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies
  • A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:

    • Is not a woman of childbearing potential (WOCBP)
    • Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), with low user dependency or be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis), during the intervention period and for at least 120 days post pembrolizumab or 1 month post lenvatinib, whichever occurs last (Arms 1 and 3), or during the intervention period and for at least 6 months after the last dose of capecitabine, docetaxel, paclitaxel; and 2 months after the last dose of cetuximab (Arm 2)
    • Female participants who randomize to Arm 2 must also agree not to donate or freeze/store eggs during the intervention period and for at least 6 months after the last dose of capecitabine, docetaxel, paclitaxel; and 2 months after the last dose of cetuximab
  • Adequately controlled blood pressure (BP) with or without antihypertensive medications

  • Participants who are hepatitis B surface antigen (HBsAg) positive are eligible if they have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load prior to randomization

  • Participants with history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at screening

  • Adequate organ function

Exclusion criteria

  • Disease that is suitable for local therapy administered with curative intent
  • Life expectancy of less than 3 months and/or has rapidly progressing disease in the opinion of the treating investigator
  • History of (noninfectious) pneumonitis/interstitial lung disease that required steroids, or has current pneumonitis/interstitial lung disease
  • Active infection requiring systemic therapy
  • Diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study drug
  • Known active central nervous system (CNS) metastases and/or carcinomatous meningitis
  • Known additional malignancy that is progressing or has required active systemic treatment within the past 3 years, except basal cell carcinoma of the skin, squamous cell carcinoma of the skin, superficial bladder cancer, or carcinoma in situ that have undergone potentially curative therapy
  • Active autoimmune disease that has required systemic treatment in the past 2 years
  • Had an allogeneic tissue/solid organ transplant
  • Known history of human immunodeficiency virus (HIV) infection
  • History of any contraindication or has a severe hypersensitivity to any components of pembrolizumab, lenvatinib or SOC chemotherapy.
  • Pre-existing ≥Grade 3 gastrointestinal or non-gastrointestinal fistula
  • History of a gastrointestinal malabsorption or any other condition or procedure that may affect oral study drug absorption
  • Had major surgery within 3 weeks prior to first dose of study interventions
  • Clinically significant cardiovascular impairment within 12 months of the first dose of study drug
  • Active tuberculosis
  • Has difficulty swallowing capsules or ingesting a suspension orally, or by a feeding tube
  • Prior treatment with lenvatinib
  • Prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to Study Day 1 or has not recovered from adverse events (AEs) due to a previously administered agent. Participants with endocrine-related AEs Grade ≤2 requiring treatment or hormone replacement may be eligible
  • Has received a live or live attenuated vaccine within 30 days prior to the first dose of study intervention. Note: Administration of killed vaccines is allowed
  • Previously treated with 4 or more systemic regimens given for recurrent/metastatic disease
  • Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration
  • Known psychiatric or substance abuse disorder that would interfere with the participant's ability to cooperate with the requirements of the study

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

400 participants in 3 patient groups

Lenvatinib + Pembrolizumab
Experimental group
Description:
Participants will be treated with the combination of lenvatinib (once daily 20 mg oral dose) plus pembrolizumab (200 mg 30-minute intravenous (IV) infusion on Day 1 of each 21-day cycle for 35 cycles), until centrally verified disease progression, or until a protocol-specified discontinuation criterion is met. Participants may receive up to an additional 17 cycles of pembrolizumab as Second Course treatment, with or without lenvatinib.
Treatment:
Biological: Pembrolizumab
Drug: Lenvatinib
Drug: Lenvatinib
SOC Chemotherapy
Active Comparator group
Description:
Participants will be treated with investigator's choice of standard of care (SOC) chemotherapy (docetaxel, paclitaxel, cetuximab, or capecitabine) until centrally verified disease progression, or until a protocol-specified discontinuation criterion is met.
Treatment:
Drug: Paclitaxel
Drug: Docetaxel
Drug: Capecitabine
Drug: Cetuximab
Lenvatinib Monotherapy
Active Comparator group
Description:
Participants will be treated with lenvatinib monotherapy (once daily 24 mg oral dose) until centrally verified disease progression, or until a protocol-specified discontinuation criterion is met.
Treatment:
Drug: Lenvatinib
Drug: Lenvatinib

Trial contacts and locations

120

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Central trial contact

Toll Free Number

Data sourced from clinicaltrials.gov

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