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Bempegaldesleukin and Pembrolizumab With or Without Chemotherapy in Locally Advanced or Metastatic Solid Tumors

Trial Status: Active

This study is to assess the safety and tolerability, and to assess the preliminary clinical benefit of NKTR-214 when combined with pembrolizumab (KEYTRUDA®) with or without chemotherapy. The study is comprised of two groups; dose optimization and dose expansion cohorts. Dose Optimization will include first-line and second-line melanoma, non-small cell lung cancer (NSCLC), urothelial carcinoma, head and neck squamous cell carcinoma (HNSCC), and hepatocellular carcinoma (HCC) regardless of PD-L1 expression status. This cohort will include patients enrolled in a 3 + 3 dose escalation and intra-patient step-up dose schemas. The dose expansion cohort will include first-line NSCLC patients regardless of PD-L1 expression status.

Inclusion Criteria

  • Willing and able to provide written informed consent.
  • Male or female patients, age 18 years or older at the time of signing the informed consent form (ICF).
  • Life expectancy > 12 weeks from the time of enrollment as determined by the Investigator.
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
  • Oxygen saturation ≥ 92% on room air for all indications.
  • Measurable disease per RECIST 1.1.
  • Patients with brain metastases are eligible if certain criteria are met.
  • Availability of fresh or archival tumor tissue
  • Patients must have a minimum of 6 months of response to any nonpalliative cancer-directed treatment Dose Optimization Inclusion Criteria (Multiple Solid Tumors):
  • Melanoma:
  • Histologically confirmed stage IV (metastatic) melanoma.
  • Non-small Cell Lung Cancer:
  • Histologically confirmed diagnosis of stage IV NSCLC
  • Must not have received systemic anti-PD-L1 therapy for metastatic disease.
  • Patients with actionable mutations with approved targeted therapy in NSCLC are excluded. Testing for mutations should be performed in accordance with standard of care.
  • Urothelial Carcinoma:
  • Histologically confirmed diagnosis of metastatic urothelial carcinoma
  • Head and Neck Squamous Cell Carcinoma (HNSCC)
  • Histologically confirmed diagnosis of metastatic HNSCC
  • Hepatocellular Carcinoma (HCC)
  • Histologically confirmed diagnosis of metastatic HCC Dose Expansion Inclusion Criteria (Non-Small Cell Lung Cancer):
  • Histologically confirmed diagnosis of stage IV NSCLC.
  • Patients must have a minimum of 6 months of response to any nonpalliative cancer-directed treatment.
  • Patients with actionable mutations with approved targeted therapy in NSCLC are excluded. Testing for mutations should be performed per standard of care.
  • Must not have received anti-cancer therapy for treatment of metastatic lung cancer
  • Must not have received prior immunotherapy

Exclusion Criteria

  • Use of an investigational agent or an investigational device within 28 days before administration of first dose of study drug(s).
  • Females who are pregnant or breastfeeding.
  • Patients who have an active autoimmune disease
  • History of allergy or hypersensitivity to study drug components
  • Evidence of clinically significant interstitial lung disease or active, noninfectious pneumonitis.
  • Prior surgery or radiotherapy within 14 days of therapy.
  • For Dose Optimization Cohort 1 only: Chemotherapy or biological therapy within 28 days of enrollment. Targeted therapy (e.g., tyrosine kinase inhibitors) within 14 days of enrollment. Patients with ongoing AEs related to prior cancer therapies will be excluded.
  • Participant's inability to adhere to or tolerate protocol or study procedures

Colorado

Aurora
University of Colorado Hospital
Status: TEMPORARILY_CLOSED_TO_ACCRUAL

Georgia

Atlanta
Emory University Hospital / Winship Cancer Institute
Status: ACTIVE

Kansas

Kansas City
University of Kansas Cancer Center
Status: TEMPORARILY_CLOSED_TO_ACCRUAL
Contact: Adam Hisham AlDouri
Phone: 913-945-7547

Missouri

Saint Louis
Siteman Cancer Center at Washington University
Status: ACTIVE

Nebraska

Omaha
University of Nebraska Medical Center
Status: ACTIVE

New Jersey

New Brunswick
Rutgers Cancer Institute of New Jersey
Status: ADMINISTRATIVELY_COMPLETE

New York

New York
Laura and Isaac Perlmutter Cancer Center at NYU Langone
Status: ACTIVE
NYP / Columbia University Medical Center / Herbert Irving Comprehensive Cancer Center
Status: CLOSED_TO_ACCRUAL

Pennsylvania

Philadelphia
Fox Chase Cancer Center
Status: ACTIVE
Contact: systems coordinator
Phone: 215-214-1558

Texas

Houston
M D Anderson Cancer Center
Status: ACTIVE

NKTR-214 is a cytokine (investigational agent) that is designed to target CD122, a protein

which is found on certain immune cells (known as CD8+ T Cells and Natural Killer Cells) to

expand these cells to promote their anti-tumor effects. Pembrolizumab is a programmed death

receptor -1 (PD-1) blocking, fully humanized, engineered monoclonal antibody of IgG1 isotype

that promotes anti-tumor effects.

The study will evaluate the clinical benefit, safety and tolerability of combining NKTR-214

with pembrolizumab with or without chemotherapy. Each dose expansion cohort will enroll

approximately 100 new patients.

Dose Optimization: will evaluate an every three-week dose regimen (q3w) of NKTR-214 in

combination with pembrolizumab in approximately 40 patients given that the optimal dose and

dosing schedule of NKTR-214 in combination with pembrolizumab remains unknown. The previously

established recommended Phase 2 dose (0.006 mg/kg) of NKTR-214 was studied in combination

with nivolumab. Tumors to be studied include first-line and second-line melanoma, non-small

cell lung cancer (NSCLC), urothelial carcinoma, head and neck squamous cell carcinoma

(HNSCC), and hepatocellular carcinoma (HCC). NKTR-214 will be administered at a starting dose

of 0.008 mg/kg q3w. Pembrolizumab will be administered at a dose of 200 mg q3w. Patients will

undergo a fixed 3+3 dose escalation followed by intra-patient step-up dose escalation at a

dose determined by the safety review committee after reviewing the data in the fixed 3+3 dose

escalation.

Dose Expansion: NKTR-214 in combination with pembrolizumab in approximately 58 patients will

be evaluated in first-line non-small cell lung cancer (NSCLC). The NKTR-214 dose to be

studied is 0.006 mg/kg q3w. This dose is based on the recommended phase 2 dose noted in the

monotherapy trial with NKTR-214 (Study 15-214-01, NCT02869295) and an ongoing combination

trial (16-214-02, NCT02983045). Pembrolizumab will be administered at a dose of 200mg q3w.

Following data review for safety and efficacy, additional patients may be dosed using the

findings from the dose optimization cohorts.

Trial Phase Phase I/II

Trial Type Treatment

Lead Organization
Nektar

  • Primary ID 16-214-05
  • Secondary IDs NCI-2018-00751
  • Clinicaltrials.gov ID NCT03138889