Pembrolizumab and Hypofractionated Radiation Therapy for the Treatment of Mucosal Melanoma
Adjuvant Pembrolizumab and Hypofractionated Radiation Therapy for the Treatment of Mucosal Melanoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: George Ansstas, M.D.
- Phone Number: 314-362-5677
- Email: gansstas@wustl.edu
Study Locations
-
-
Missouri
-
St Louis, Missouri, United States, 63110
- Recruiting
- Washington University School of Medicine
-
Sub-Investigator:
- Ningying Wu, Ph.D.
-
Contact:
- George Ansstas, M.D.
- Phone Number: 314-362-5677
- Email: gansstas@wustl.edu
-
Principal Investigator:
- George Ansstas, M.D.
-
Sub-Investigator:
- Jennifer De Los Santos, M.D.
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically or cytologically confirmed mucosal melanoma that has undergone surgical resection. Patient must not have received prior radiation therapy within the area of interest.
- At least 16 years of age.
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (Karnofsky ≥ 70%)
Normal bone marrow and organ function as defined below:
- Absolute neutrophil count ≥ 1,200/mcL
- Platelets ≥ 100,000/mcL
- Total bilirubin ≤ 1.5 x institutional upper limit of normal (IULN)
- AST(SGOT)/ALT(SGPT) ≤ 3.0 x IULN
- Creatinine clearance > 30 mL/min by Cockcroft-Gault
- The effects of pembrolizumab on the developing human fetus are unknown. For this reason, women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry, for the duration of study participation, and 6 months after last dose of pembrolizumab. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of the study, and 6 months after last dose of pembrolizumab.
- Ability to understand and willingness to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable).
Exclusion Criteria:
- A history of other malignancy with the exception of malignancies for which all treatment was completed at least 2 years before registration and the patient has no evidence of disease.
- Received radiation therapy within the area of interest.
- Currently receiving any other investigational agents.
- Metastatic disease.
- A history of allergic reactions attributed to compounds of similar chemical or biologic composition to pembrolizumab or other agents used in the study.
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or cardiac arrhythmia.
- Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study treatment. The use of up to 10 mg/day of prednisone or equivalent is approved and does not exclude the patient from the trial.
- Active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, > 10 mg of prednisone per day, or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment. The use of up to 10 mg/day of prednisone or equivalent is approved and does not exclude the patient from the trial.
- Has a history of (non-infectious) pneumonitis/Interstitial lung disease that required maintenance steroids (>10 mg of prednisone) or current pneumonitis/interstitial lung disease.
- Has received a live vaccine or live-attenuated vaccination within 30 days of planned treatment start. Administration of killed vaccines is allowed.
- Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 14 days of study entry.
- Patients with HIV are eligible unless their CD4+ T-cell counts are < 350 cells/mcL or they have a history of AIDS-defining opportunistic infection within the 12 months prior to registration. Concurrent treatment with effective ART according to DHHS treatment guidelines is recommended.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Pembrolizumab + Hypofractionated radiation therapy
|
Pembrolizumab is commercially available
Other Names:
It is preferred to leave at least 48 hours between fractions.
Daily imaging to verify accurate set-up is mandatory.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Local tumor control rate
Time Frame: 1 year after completion of treatment (estimated to be 2 years)
|
Tumor control rate is defined as the percentage of subjects at 12 months who are free of local recurrence, regional recurrence, distant recurrence, second primary cancer, or death.
|
1 year after completion of treatment (estimated to be 2 years)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Relapse-free survival (RFS)
Time Frame: At 3 years after completion of treatment (estimated to be 4 years)
|
-Defined as the duration of time from the start date of study treatment to the date of earliest disease relapse or death, whichever occurs first.
Patients who neither relapse nor die by the data cutoff date will be censored at the last follow up date.
|
At 3 years after completion of treatment (estimated to be 4 years)
|
|
Distant metastasis-free survival
Time Frame: At 3 years after completion of treatment (estimated to be 4 years)
|
-Defined as the duration of time from the start date of study treatment to the date of appearance of a distant metastasis or death, whichever occurs first.
Patients who neither develop distant metastasis nor die by the data cutoff date will be censored at the last follow up date.
|
At 3 years after completion of treatment (estimated to be 4 years)
|
|
Overall survival
Time Frame: At 3 years after completion of treatment (estimated to be 4 years)
|
-Defined as the duration of time from the start date of study treatment to death from any cause.
Patients who are alive by the data cutoff date will be censored at the last follow up date.
|
At 3 years after completion of treatment (estimated to be 4 years)
|
|
Number of treatment-related grade 3 or greater adverse events
Time Frame: Baseline through 90 days after end of treatment (estimated to be 15 months)
|
The total number of adverse events determined to be treatment related and grade 3 or higher as assessed using CTCAE v5.0 criteria.
|
Baseline through 90 days after end of treatment (estimated to be 15 months)
|
|
Number of treatment discontinuations due to treatment-related adverse events
Time Frame: Through end of treatment (estimated to be 1 year)
|
The total number of participants who discontinued treatment due to treatment-related adverse events as assessed using CTCAE v5.0 criteria.
|
Through end of treatment (estimated to be 1 year)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: George Ansstas, M.D., Washington University School of Medicine
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Skin Diseases
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroendocrine Tumors
- Nevi and Melanomas
- Skin Neoplasms
- Melanoma
- Antineoplastic Agents, Immunological
- Immune Checkpoint Inhibitors
- Antineoplastic Agents
- Molecular Mechanisms of Pharmacological Action
- pembrolizumab
Other Study ID Numbers
Other Study ID Numbers
- 202003124
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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