Pembrolizumab + Chemotherapy + Radiation for Lung Cancer

Not currently recruiting at 2 trial locations
Age: 18+
Sex: Any
Trial Phase: Phase 1
Sponsor: Rutgers, The State University of New Jersey
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a combination of treatments for individuals with stage II-IIIB non-small cell lung cancer that cannot be surgically removed. The researchers aim to determine the safest and most effective dose of pembrolizumab (an immunotherapy drug) when combined with the chemotherapy drugs paclitaxel and carboplatin, along with radiation therapy. Participants should have non-small cell lung cancer that requires chemoradiation and has not spread to the brain. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this novel combination therapy.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are on systemic steroid therapy or any immunosuppressive therapy, you must stop these at least 7 days before starting the trial treatment.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that pembrolizumab is usually well-tolerated in many cancer treatments. In a study with 2,799 patients, researchers found its safety to be manageable, although some side effects occurred. Its use in several types of cancer suggests a reliable safety record.

Paclitaxel and carboplatin, two chemotherapy drugs in the study, can cause side effects like a low white blood cell count. These effects are common in cancer treatments and usually manageable. The FDA has approved them for non-small cell lung cancer, indicating a known safety profile.

The radiation therapies involved, 3D conformal radiation and intensity-modulated radiation therapy (IMRT), are standard treatments for lung cancer. They have been widely used and can cause side effects like fatigue and skin irritation, but they are generally considered safe and effective.

Overall, while each treatment may have potential side effects, previous studies and approvals suggest they are generally well-tolerated.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about this treatment combination for lung cancer because it brings together pembrolizumab, a cutting-edge immunotherapy drug, with traditional chemotherapy and radiation. Unlike standard treatments which mainly involve chemotherapy and radiation, pembrolizumab works by helping the immune system recognize and attack cancer cells more effectively. This approach has the potential to enhance the overall effectiveness of treatment, potentially leading to better outcomes for patients. Additionally, the combination aims to maximize cancer cell destruction while minimizing damage to healthy tissues, offering hope for improved quality of life during treatment.

What evidence suggests that this trial's treatments could be effective for lung cancer?

In this trial, participants will receive a combination of pembrolizumab, paclitaxel, carboplatin, and radiation therapy to treat non-small cell lung cancer (NSCLC). Research has shown that using pembrolizumab with chemotherapy more than doubles the average survival time compared to chemotherapy alone. This means patients lived longer with this treatment. Studies also indicate that this combination helps prevent the cancer from spreading or worsening for a longer period. Additionally, this treatment plan has proven safe and effective for both main types of NSCLC. These findings suggest that this approach could be a strong option for targeting lung cancer cells.678910

Who Is on the Research Team?

Salma Jabbour, MD | Rutgers Cancer ...

Salma Jabbour, MD

Principal Investigator

Rutgers Cancer Institute of New Jersey

Are You a Good Fit for This Trial?

This trial is for adults with stage II-IIIB non-small cell lung cancer who haven't had prior treatments that conflict with the study. They must have good organ function, no active infections or autoimmune diseases, not be pregnant or breastfeeding, and agree to use contraception. People with certain medical conditions or those who've received specific treatments recently are excluded.

Inclusion Criteria

My kidney function, measured by creatinine or GFR, is within the normal range.
I agree to use birth control during and for 4 months after the study.
Absolute neutrophil count (ANC) >= 1,500/mcL
See 16 more

Exclusion Criteria

I have another cancer, but it's either being treated or not worsening, except for certain skin cancers or cervical cancer.
You are allergic to pembrolizumab or any of the ingredients in it.
I have not received a live vaccine in the last 30 days.
See 20 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Chemoradiation

Patients receive paclitaxel and carboplatin intravenously and undergo radiation therapy for 6 weeks

6 weeks
5 visits per week (in-person)

Pembrolizumab Treatment

Patients receive pembrolizumab intravenously every 21 days for up to 18 courses

Up to 54 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

5 years
30 days post-treatment, then every 12 weeks for 1 year, every 16 weeks for 1 year, every 6 months for 3 years, and annually thereafter

What Are the Treatments Tested in This Trial?

Interventions

  • 3-Dimensional Conformal Radiation Therapy
  • Carboplatin
  • Intensity-Modulated Radiation Therapy
  • Paclitaxel
  • Pembrolizumab
Trial Overview The trial tests pembrolizumab (an antibody therapy) combined with chemotherapy drugs paclitaxel and carboplatin, alongside radiation therapy. It aims to find the safest doses and how well they work together in treating patients by stopping tumor growth and spread.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Treatment (paclitaxel, carboplatin, radiation, pembrolizumab)Experimental Treatment6 Interventions

3-Dimensional Conformal Radiation Therapy is already approved in United States, European Union, Canada, Japan, China, Switzerland for the following indications:

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Approved in United States as 3D-CRT for:
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Approved in European Union as 3D-CRT for:
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Approved in Canada as 3D-CRT for:
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Approved in Japan as 3D-CRT for:
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Approved in China as 3D-CRT for:
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Approved in Switzerland as 3D-CRT for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Rutgers, The State University of New Jersey

Lead Sponsor

Trials
471
Recruited
81,700+

Merck Sharp & Dohme LLC

Industry Sponsor

Trials
4,096
Recruited
5,232,000+
Chirfi Guindo profile image

Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis profile image

Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Rutgers Cancer Institute of New Jersey

Collaborator

Trials
72
Recruited
22,200+

Published Research Related to This Trial

The combination of carboplatin and dose-dense pemetrexed with involved field radiotherapy is feasible for treating locally advanced and oligometastatic non-small cell lung cancer (NSCLC), as shown in a phase I study with 18 enrolled patients.
Despite some dose-limiting toxicities observed, the treatment resulted in a median survival time of 28.6 months, with 13 out of 16 evaluable patients showing a local regional response, indicating promising efficacy for this approach.
Phase i study of 'dose-dense' pemetrexed plus carboplatin/radiotherapy for locally advanced non-small cell lung carcinoma.Shen, X., Denittis, A., Werner-Wasik, M., et al.[2021]
In a phase 2 study involving 216 patients with stage III non-small cell lung cancer (NSCLC), the combination of pembrolizumab and concurrent chemoradiation therapy (cCRT) showed a high objective response rate of approximately 70.5% in cohort A and 70.6% in cohort B, indicating strong antitumor activity.
The treatment was associated with manageable safety, with grade 3 or higher pneumonitis occurring in 8.0% of cohort A and 6.9% of cohort B, suggesting that while there are risks, the benefits of this treatment approach may outweigh them for patients with locally advanced NSCLC.
Pembrolizumab Plus Concurrent Chemoradiation Therapy in Patients With Unresectable, Locally Advanced, Stage III Non-Small Cell Lung Cancer: The Phase 2 KEYNOTE-799 Nonrandomized Trial.Jabbour, SK., Lee, KH., Frost, N., et al.[2022]
In a study of 98 patients with advanced non-small-cell lung cancer (NSCLC), those who had previously received radiotherapy experienced significantly longer progression-free survival (4.4 months) and overall survival (10.7 months) when treated with pembrolizumab compared to those without prior radiotherapy.
The safety profile was acceptable, with similar rates of severe pulmonary toxicity between patients who had and had not received thoracic radiotherapy, suggesting that combining radiotherapy with pembrolizumab may be a beneficial treatment strategy for NSCLC.
Previous radiotherapy and the clinical activity and toxicity of pembrolizumab in the treatment of non-small-cell lung cancer: a secondary analysis of the KEYNOTE-001 phase 1 trial.Shaverdian, N., Lisberg, AE., Bornazyan, K., et al.[2022]

Citations

Phase I/II Trial of Carboplatin, Nab-paclitaxel, and ...Carboplatin, nab-paclitaxel, and pembrolizumab are a safe and effective regimen for patients with both squamous and nonsquamous NSCLC.
Five-Year Data for Merck's KEYTRUDA® (pembrolizumab ...At five years, KEYTRUDA plus pemetrexed and cisplatin or carboplatin more than doubled the median OS compared to chemotherapy alone (22.0 months versus 10.6 ...
NCT02775435 | A Study of Carboplatin-Paclitaxel/Nab ...The primary hypotheses are that treatment with pembrolizumab prolongs: 1) Progression-free Survival (PFS) by Response Evaluation Criteria in Solid Tumors ...
5-Year Update of the Phase III KEYNOTE-407 StudyPembrolizumab plus chemotherapy maintained an OS and PFS benefit versus placebo plus chemotherapy in previously untreated, metastatic squamous NSCLC.
results from a clinical trial for keytruda with chemotherapySee results of a clinical trial for a combination therapy for certain patients with advanced squamous non–small cell lung cancer.
Comparison of Toxicity between Intensity-Modulated ...We compared acute toxicity and oncologic outcomes in a large cohort of patients treated with IMRT or 3D conformal radiation therapy (3DCRT), ...
Radiation Injury of the Lung After Three-Dimensional ...Three-dimensional conformal radiation therapy results in three patterns of radiation fibrosis that differ from the conventional radiation-induced lung injury.
3D CRT (Three-Dimensional Conformal Radiation Therapy)If 3D CRT is recommended for a patient, a radiologist will create three-dimensional images of a tumor and the surrounding structures.
Comparative Effectiveness of Intensity-Modulated Versus ...IMRT is increasingly preferred to 3D-RT. However, among patients receiving potentially curative radiation there was no significant difference in overall ...
Three Dimensional (3D) Conformal Radiation Therapy3D CRT is a cancer treatment that allows doctors to direct radiation beams to conform to tumor shapes. In the past, beams only matched the height and width ...
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