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Combination Therapy With Entinostat and Pembrolizumab in Relapsed and Refractory Lymphomas

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ClinicalTrials.gov Identifier: NCT03179930
Recruitment Status : Recruiting
First Posted : June 7, 2017
Last Update Posted : April 8, 2019
Sponsor:
Collaborators:
Merck Sharp & Dohme Corp.
Syndax Pharmaceuticals
Information provided by (Responsible Party):
Memorial Sloan Kettering Cancer Center

Brief Summary:
The purpose of this study is to test any good and bad effects of the study drugs called Pembrolizumab and Entinostat when used in combination to treat lymphoma. This combination could shrink the lymphoma but it could also cause side effects. Researchers also hope to learn whether adding entinostat to pembrolizumab can be more effective for patients with lymphoma than either drug alone.

Condition or disease Intervention/treatment Phase
Lymphoma Relapsed Refractory Drug: Entinostat Drug: Pembrolizumab Phase 2

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 78 participants
Intervention Model: Single Group Assignment
Intervention Model Description: This is a protocol comprised of a single institution phase II study in FL and HL
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Study of Pembrolizumab and Entinostat in Patients With Relapsed and Refractory Lymphomas
Actual Study Start Date : June 7, 2017
Estimated Primary Completion Date : June 2020
Estimated Study Completion Date : June 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Lymphoma

Arm Intervention/treatment
Experimental: Entinostat and Pembrolizumab
patients will be assigned to receive therapy with entinostat given by mouth once weekly and pembrolizumab given intravenously every 3 weeks
Drug: Entinostat
Entinostat 5 mg PO on D1, 8, and 15 of a 21 day cycle. If treatment is well tolerated the dose of entinostat will be increased to 7 mg PO on D1, 8, and 15 from cycle 2 onward.

Drug: Pembrolizumab
pembrolizumab 200 mg IV on D1




Primary Outcome Measures :
  1. Response using the 2014 Lugano Classification [ Time Frame: 2 years ]
    will be evaluated in this study using the 2014 Lugano Classification.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient is ≥ 18 years of age at the time of signing Informed Consent
  • Patient has histologically confirmed diagnosis of follicular lymphoma or Hodgkin lymphoma
  • Hodgkin lymphoma patients must have received at least 2 prior regimens and received, declined, or be ineligible for autologous transplant
  • Follicular lymphoma patients must have received at least 3 prior lines of therapy; patients are eligible regardless of whether they have received an autologous transplant.
  • Prior HDAC inhibitor and/or anti-PD1, anti-PDL1, anti-PD-L2, anti-CD137 or anti-cytotoxic T- lymphocyte associated antigen 4 (CTLA-4) antibody allowed as long patient received clinical benefit from it, best response was not progressive disease and it was not the most recent treatment
  • Patients who have undergone an allogeneic HSCT within the last 5 yrs are eligible for enrollment if they have no signs or symptoms of active GvHD and are off all immune suppressive medications.
  • Patient has at least one measurable nodal lesion (≥ 2.0 cm)
  • Patient has an Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1
  • Patient has adequate bone marrow and organ function by:

    • Absolute neutrophil count (ANC) ≥ 1.0 x 10^9/L
    • Platelets ≥75 x 10^9/L
    • Hemoglobin (Hgb) ≥ 9.0 g/dL
    • Serum Creatinine ≤ 1.5 x upper limit of normal (ULN)
    • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 1.5 x ULN (or

      ≤3 x ULN if liver involved with disease

    • Total serum bilirubin ≤ 1.5 x ULN ( ≤ 3 x ULN with direct bilirubin within normal range in patients with documented hepatic involvement, well documented Gilbert‟s Syndrome)
    • International Normalized Ratio (INR) or Prothrombin
    • Time (PT) ≤1.5×ULN unless patient is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants
    • Activated Partial Thromboplastin Time (aPTT) ≤1.5×ULN unless patient is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants
  • Female subject of childbearing potential should have a negative urine or serum pregnancy within 72 hours prior to receiving the first dose of study medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
  • Female subjects of childbearing potential must be willing to use an adequate method of contraception as outlined in Contraception, for the course of the study through 120 days after the last dose of study medication. Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.
  • Male subjects of childbearing potential (Section 9.8.2) must agree to use an adequate method of contraception as outlined in Section 9.8.2- Contraception, starting with the first dose of study therapy through 120 days after the last dose of study therapy.

Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.

Exclusion Criteria:

  • Diagnosed or treated for malignancy other than the indication under study except for

    • Malignancy treated with curative intent and with no known active disease present for

      ≥ 3 years before the first dose of study treatment

    • Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
    • Adequately treated cervical carcinoma in situ without evidence of disease
  • History of Human Immunodeficiency Virus (HIV)
  • Active Hepatitis B or C infection
  • History of active TB (Bacillus Tuberculosis)
  • Concurrent enrollment in another therapeutic investigational clinical study or has participated in a study of an investigational agent and received study therapy or used a n investigational device within 4 weeks of the first dose of study drug
  • Prior anti-tumor therapy within 2 weeks
  • Known CNS lymphoma involvement
  • Any uncontrolled active systemic infection or any life-threatening illness, medical condition, or organ system dysfunction which, in the investigator‟s opinion, could compromise the subject‟s safety, interfere with the absorption or metabolism of entinostat capsules, or put the study outcomes at undue risk.
  • Any history of (non-infectious) pneumonitis that required steroids, evidence of interstitial lung disease or active, non- infectious pneumonitis
  • Myocardial infarction or arterial thromboembolic events within 6 months prior to baseline or severe or unstable angina, New York Heart Association (NYHA) Class III or IV disease, or a QTc interval > 470 msec.
  • History of Torsades de pointes, ventricular tachycardia, or ventricular fibrillation
  • Uncontrolled heart failure or hypertension or uncontrolled diabetes mellitus
  • Any active autoimmune disease or a documented history of autoimmune disease (excluded/exception to the rule: subjects with vitiligo or resolved childhood asthma/atopy, type I diabetes mellitus, subjects with hypothyroidisms stable on hormone replacement, Sjorgen‟s syndrome, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger).
  • Any syndrome that requires systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 7 days of study drug administration. Of note: Inhaled or topical steroids, and adrenal replacement doses > 10 mg daily prednisone equivalents, are permitted in the absence of active autoimmune disease.
  • A woman who is pregnant or breast feeding
  • Has received a live vaccine within 30 days of planned start of study therapy. Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist®) are live attenuated vaccines, and are not allowed
  • Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier.
  • Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent
  • Allergy to benzamide or inactive components of entinostat

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03179930


Contacts
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Contact: Anas Younes, MD 212-639-7715 younesa@mskcc.org
Contact: Alison Moskowitz, MD 212-639-4839

Locations
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United States, New Jersey
Memorial Sloan Kettering Basking Ridge Recruiting
Basking Ridge, New Jersey, United States, 07920
Contact: Anas Younes, MD    212-639-7715      
Memorial Sloan Kettering Monmouth Recruiting
Middletown, New Jersey, United States, 07748
Contact: Anas Younes, MD    212-639-7715      
Memorial Sloan Kettering Bergen Recruiting
Montvale, New Jersey, United States, 07645
Contact: Anas Younes, MD    212-639-7715      
United States, New York
Memorial Sloan Kettering Commack Recruiting
Commack, New York, United States, 11725
Contact: Anas Younes, MD    212-639-7715      
Memorial Sloan Kettering Westchester Recruiting
Harrison, New York, United States, 10604
Contact: Anas Younes, MD    212-639-7715      
Memorial Sloan Kettering Cancer Center Recruiting
New York, New York, United States, 10065
Contact: Anas Younes, MD    212-639-7715      
Contact: Allison Moskowitz, MD    212-639-4839      
Principal Investigator: Anas Younes, MD         
Memorial Sloan Kettering Rockville Centre Recruiting
Rockville Centre, New York, United States, 11570
Contact: Anas Younes, MD    212-639-7715      
Memorial Sloan Kettering Nassau Recruiting
Uniondale, New York, United States, 11553
Contact: Anas Younes, MD    212-639-7715      
Sponsors and Collaborators
Memorial Sloan Kettering Cancer Center
Merck Sharp & Dohme Corp.
Syndax Pharmaceuticals
Investigators
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Principal Investigator: Anas Younes, MD Memorial Sloan Kettering Cancer Center

Additional Information:
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Responsible Party: Memorial Sloan Kettering Cancer Center
ClinicalTrials.gov Identifier: NCT03179930     History of Changes
Other Study ID Numbers: 17-073
First Posted: June 7, 2017    Key Record Dates
Last Update Posted: April 8, 2019
Last Verified: April 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Memorial Sloan Kettering Cancer Center:
Entinostat
Pembrolizumab
17-073

Additional relevant MeSH terms:
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Entinostat
Lymphoma
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Pembrolizumab
Antineoplastic Agents, Immunological
Antineoplastic Agents
Histone Deacetylase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action