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

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ClinicalTrials.gov Identifier: NCT03138889
Recruitment Status : Recruiting
First Posted : May 3, 2017
Last Update Posted : December 1, 2021
Sponsor:
Information provided by (Responsible Party):
Nektar Therapeutics

Study Description
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Brief Summary:

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 included first-line and second-line advanced or metastatic solid tumors including non-small cell lung cancer (NSCLC)

The dose expansion cohort will include first-line NSCLC patients.


Condition or disease Intervention/treatment Phase
Non-Small Cell Lung Cancer Drug: NKTR-214 Drug: Pembrolizumab Drug: Cisplatin Drug: Carboplatin Drug: Nab paclitaxel Drug: Paclitaxel Drug: Pemetrexed Phase 1 Phase 2

Detailed Description:

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 evaluated an every three-week dose regimen (q3w) of NKTR-214 in combination with pembrolizumab 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.

Dose Expansion: NKTR-214 in combination with pembrolizumab 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.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 240 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1/2, Open-Label, Multicenter Study to Investigate the Safety and Preliminary Efficacy of Combined Bempegaldesleukin (NKTR-214) and Pembrolizumab With or Without Chemotherapy in Patients With Locally Advanced or Metastatic Solid Tumors
Actual Study Start Date : June 9, 2017
Estimated Primary Completion Date : September 2023
Estimated Study Completion Date : January 2024

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Dose Optimization, Combo of NKTR-214 + Pembrolizumab(KEYTRUDA®)
Cohort 1: NKTR-214 will be combined with pembrolizumab
 Drug: NKTR-214
NKTR-214: The dose will be 0.008 mg/kg intravenous (IV) infusion administered over 30 (± 5) minutes q3w. The maximum dose of NKTR-214 will be 0.012 mg/kg. This will include a fixed 3+3 dose escalation followed by intra-patient step-up dose escalation based on tolerability.
Other Name: CD122-Biased Cytokine

Drug: Pembrolizumab
Pembrolizumab (anti-PD-1) will be dosed as per the pharmacy manual.
Other Name: Keytruda®
Experimental: Dose Expansion, Combo of NKTR-214 + Pembrolizumab(KEYTRUDA®)
Cohort 2: NKTR-214 will be combined with pembrolizumab
 Drug: Pembrolizumab
Pembrolizumab (anti-PD-1) will be dosed as per the pharmacy manual.
Other Name: Keytruda®

Drug: NKTR-214
NKTR-214: The dose will be 0.006 mg/kg intravenous (IV) infusion.
Other Name: CD122-Biased Cytokine
Experimental: Dose Expansion, Combo of NKTR-214 + Pembrolizumab (KEYTRUDA®)
Cohort 3: NKTR-214 will be combined with pembrolizumab
 Drug: Pembrolizumab
Pembrolizumab (anti-PD-1) will be dosed as per the pharmacy manual.
Other Name: Keytruda®

Drug: NKTR-214
NKTR-214: The dose will be 0.010 mg/kg intravenous (IV) infusion.
Other Name: CD122-Biased Cytokine
Experimental: Dose Expansion, NKTR-214 + Pembrolizumab and either Cisplatin, or Carboplatin and Pemetrexed
Cohort 4: NKTR-214 will be dosed in combination with pembrolizumab and either cisplatin, or carboplatin and pemetrexed, per investigator discretion
 Drug: Pembrolizumab
Pembrolizumab (anti-PD-1) will be dosed as per the pharmacy manual.
Other Name: Keytruda®

Drug: NKTR-214
NKTR-214: The dose will be 0.006 mg/kg intravenous (IV) infusion.
Other Name: CD122-Biased Cytokine

Drug: Cisplatin
Cisplatin will be dosed per the pharmacy manual
Other Name: Platinol®

Drug: Carboplatin
Carboplatin will be dosed per the pharmacy manual
Other Name: Paraplatin®

Drug: Pemetrexed
Pemetrexed will be dosed per the pharmacy manual
Other Name: Alimta®
Experimental: Dose Expansion, NKTR-214 + Pembrolizumab and Carboplatin and either Nab-paclitaxel or Paclitaxel
Cohort 5: NKTR-214 will be dosed in combination with pembrolizumab and carboplatin and either nab-paclitaxel or paclitaxel, per investigator discretion
 Drug: Pembrolizumab
Pembrolizumab (anti-PD-1) will be dosed as per the pharmacy manual.
Other Name: Keytruda®

Drug: NKTR-214
NKTR-214: The dose will be 0.006 mg/kg intravenous (IV) infusion.
Other Name: CD122-Biased Cytokine

Drug: Carboplatin
Carboplatin will be dosed per the pharmacy manual
Other Name: Paraplatin®

Drug: Nab paclitaxel
Nab-paclitaxel will be dosed per local practice and label
Other Name: Abraxane®

Drug: Paclitaxel
Paclitaxel will be dosed per local practice and label
Other Name: Taxol®


Outcome Measures
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Primary Outcome Measures :
  1. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] of NKTR-214 in combination with pembrolizumab (Keytruda®) [ Time Frame: 100 days after last dose ]
    Safety and Tolerability of NKTR-214 in combination with pembrolizumab (Keytruda®) as evaluated by incidence of drug-emergent Adverse Events (AEs), Serious Adverse Events (SAEs), AEs leading to drug discontinuation, and fatal AEs.

  2. Recommended Phase 2 Dose (RP2D) or Maximum Tolerated Dose (MTD) or optimal dosing schedule of NKTR-214 in combination with pembrolizumab (Keytruda®) [ Time Frame: 100 days after last dose ]
    To define the Recommended Phase 2 Dose (RP2D), or Maximum Tolerated Dose (MTD), or optimal dosing schedule of NKTR-214 in combination with pembrolizumab (Keytruda®), by evaluating the incidence of Dose Limiting Toxicities (DLTs) within the DLT window (21 days after first dose), drug-related AEs, SAEs, adverse events leading to discontinuation, deaths and overall tolerability.

  3. Objective response rate (ORR) per blinded independent central review (BICR) by RECIST 1.1 of NKTR-214 plus pembrolizumab with or without systemic chemotherapy in patients with untreated metastatic NSCLC [ Time Frame: 100 days after last dose ]
    ORR is defined as the proportion of enrolled participants who achieved a Best Overall Response (BOR) of CR or PR. CR is defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) had to have reduction in short axis to < 10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. ORR is calculated as the sum of CR and PR.


Secondary Outcome Measures :
  1. Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability] of NKTR-214 plus pembrolizumab (Keytruda®) with or without systemic chemotherapy in untreated metastatic NSCLC. [ Time Frame: 100 days after last dose ]
    Safety and Tolerability of NKTR-214 plus pembrolizumab (Keytruda®) with or without systemic chemotherapy as evaluated by incidence of drug-related Adverse Events (AEs), Serious Adverse Events (SAEs), and adverse events leading to discontinuation, deaths, and overall tolerability.

  2. Objective response rate (ORR) per RECIST 1.1 in Dose Optimization [ Time Frame: Through study completion, an expected average of 2 years ]
    ORR is defined as the proportion of enrolled participants who achieved a Best Overall Response (BOR) of CR or PR. CR is defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) had to have reduction in short axis to < 10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters. ORR is calculated as the sum of CR and PR.

  3. Duration of response (DOR) using RECIST 1.1 [ Time Frame: Through study completion, an expected average of 2 years ]
    DOR for patients who have confirmed complete response (CR) or confirmed partial response (PR) as the date from first documented CR or PR to the date of the first objectively documented disease progression per RECIST 1.1 or death due to any cause, whichever is earlier. CR is defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) had to have reduction in short axis to < 10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

  4. Clinical benefit rate (CBR) using RECIST 1.1 [ Time Frame: Through study completion, an expected average of 2 years ]
    CBR is defined as the number of patients with confirmed complete response, confirmed partial response, or stable disease (≥ 7 weeks).

  5. Time to Response (TTR) using RECIST 1.1 [ Time Frame: Through study completion, an expected average of 2 years ]
    TTR will be defined for patients who had confirmed CR or confirmed PR as the time from the date of first dose to date of first documented CR or PR per RECIST 1.1. CR is defined as disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) had to have reduction in short axis to < 10 mm. PR is defined as at least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

  6. Progression-Free Survival (PFS) using RECIST 1.1 [ Time Frame: Through study completion, an expected average of 2 years ]
    PFS is defined as the time from date of first dose to the date of the first objectively documented tumor progression or death due to any cause

  7. Overall Survival (OS) [ Time Frame: Through study completion, an expected average of 2 years ]
    OS is defined as the time from date of first dose to the date of death.

  8. To assess the association between efficacy measures and PD L1 expression in tumors. [ Time Frame: Through study completion, an expected average of 2 years ]
    Efficacy measures are defined as ORR and changes in PD-L1 expression from on treatment biopsy in Dose Optimization.


Eligibility Criteria
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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:

Dose Optimization and Dose Expansion 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 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

NOTE: Other protocol defined Inclusion/Exclusion criteria may apply

Contacts and Locations
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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): NCT03138889


Contacts
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Contact: Nektar Recruitment 855-482-8676 StudyInquiry@nektar.com
Contact: Medical Affairs Department medicalaffairs@nektar.com

Locations
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Sponsors and Collaborators
Nektar Therapeutics
Investigators
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Study Director: Study Director Nektar Therapeutics
More Information
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Responsible Party: Nektar Therapeutics
ClinicalTrials.gov Identifier: NCT03138889    
Other Study ID Numbers: 16-214-05
First Posted: May 3, 2017    Key Record Dates
Last Update Posted: December 1, 2021
Last Verified: November 2021
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 Nektar Therapeutics:
NKTR-214
Metastatic Non-Small Cell Lung Cancer
Pembrolizumab
 Keytruda®
NSCLC
Bempegaldesleukin
Additional relevant MeSH terms:
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Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Neoplasms
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms
Paclitaxel
Albumin-Bound Paclitaxel
Carboplatin
 Pembrolizumab
Pemetrexed
Antineoplastic Agents, Phytogenic
Antineoplastic Agents
Tubulin Modulators
Antimitotic Agents
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Immunological
Enzyme Inhibitors
Folic Acid Antagonists
Nucleic Acid Synthesis Inhibitors