Pembrolizumab With Ataluren in Patients With Metastatic pMMR and dMMR Colorectal Carcinoma or Metastatic dMMR Endometrial Carcinoma: the ATAPEMBRO Study

Estado del programa

Reclutamiento

Fase

Fase 1

Inmunoterapia previa permitida

No

Ensayo dirigido por el CRC

Drogas

Ataluren + Pembrolizumab, Keytruda

Etiquetas

MSS/ MMRp

Comentarios

Pembrolizumab: anti PD-1, Keytruda
Ataluren: formerly PTC124, brand name Translarna; approved in the EU for the treatment of Duchenne muscular dystrophy. A a “drug promoting premature stop-codon read-through”. The mechanism of action of Ataluren seems to be subject of investigation (see Helpful Links)
“Ataluren is designed to allow the protein making apparatus (the ribosome) in cells to skip over a premature stop codon (PTC), allowing the cells to translate the sequence downstream of a premature termination codon (PTC) in mRNA transcripts. This may result in the translation of additional out-of-frame code, which is available in abundance in dMMR tumors. We argue that this may result in new target peptides for the immune-system to recognize cancer cells.
The investigators hypothesize that the formation of these peptides by Ataluren can enhance the effect of Pembrolizumab anti-PD1 therapy.”
Key inclusion criteria.
Patients have received at least 1 prior cancer therapy regimen for metastatic CRC, or have refused palliative chemotherapy.
No prior checkpoint inhibitor allowed

Ubicación Situación
Países Bajos
Amsterdam UMC, AMC
Amsterdam, Noord-Holland 1105 AZ
Reclutamiento

Contactos

Adriaan D Bins, MD PhD
Póngase en contacto con
0031205662339 adbins@amc.uva.nl
Ide T Spaanderman, MD
Póngase en contacto con
0031205666776 i.t.spaanderman@amc.uva.nl

Criterios de inclusión

In order to be eligible for participation in this trial, the subject must:

Have at least one lesion with measurable disease as defined by 10mm in longest diameter for a soft tissue lesions or 15mm in short axis for a lymph node by RECIST 1.1 and irRC criteria for response assessment.
Have received at least 1 prior cancer therapy regimen for metastatic CRC, or have refused palliative chemotherapy. In the latter case this should have been documented.
Have a life expectancy of greater than 3 months.
Have normal organ and marrow function as defined in protocol
Be willing and able to provide written informed consent/assent for the trial.
Be at least 18 years of age on day of signing informed consent.
Be willing to provide tissue from a newly obtained pre-treatment core or excisional biopsy of a metastatic tumor lesion and the primary tumor lesion (when in place). Subjects for whom newly-obtained samples cannot be provided (e.g. inaccessible by colonoscopy or CT-guided approaches or due to safety concerns) may submit an archived specimen only upon agreement from the Sponsor.
Be willing to provide tissue post-treatment of a core or excisional biopsy of a metastatic tumor lesion (when still in place) or of the primary tumor (when in place).
Have a performance status of 0 or 1 on the ECOG Performance Scale.
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.
Male subjects of childbearing potential (Section 4.7.2) must agree to use an adequate method of contraception as outlined in Section 4.7.2- Contraception, starting with the first dose of study therapy through 120 days after the last dose of study therapy.

Subject must be excluded from participating in the trial if the subject:

Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 1 week prior to trial treatment.
Has a history of prior treatment with anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, anti-OX-40, anti-CD40, or anti-CTLA-4 antibodies.
Has received growth factors including, but not limited to, granulocyte-colony stimulating factor (G-CSF), granulocyte macrophage-colony stimulating factor (GM-CSF), erythropoietin, etc. within 2 weeks of study drug administration. Use of such agents while on study is also prohibited. Prior use of growth factors should be documented in the patient's medical history.
Has an uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Has a history of any autoimmune disease: Patients with a history of inflammatory bowel disease, including ulcerative colitis and Crohn's Disease, are excluded from this study, as are patients with a history of symptomatic disease (e.g., rheumatoid arthritis, systemic progressive sclerosis [scleroderma], systemic lupus erythematosus, autoimmune vasculitis [e.g., Wegener's Granulomatosis]); CNS or motor neuropathy considered of autoimmune origin (e.g., Guillain-Barre Syndrome and Myasthenia Gravis, multiple sclerosis). Patients with thyroid disease will be allowed. Autoimmune diagnoses not listed here must be approved by the protocol chair.
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 trial treatment.
Has a known history of active TB (Bacillus Tuberculosis)
Hypersensitivity to pembrolizumab or ataluren or any of their excipients.
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.
Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
Padece una enfermedad autoinmune activa que ha requerido tratamiento sistémico en los últimos 2 años (es decir, con uso de agentes modificadores de la enfermedad, corticosteroides o fármacos inmunosupresores). La terapia de sustitución (p. ej., tiroxina, insulina o terapia fisiológica de sustitución de corticosteroides para la insuficiencia suprarrenal o hipofisaria, etc.) no se considera una forma de tratamiento sistémico.
Has known history of, or any evidence of active, non-infectious pneumonitis.
Tiene una infección activa que requiere tratamiento sistémico.
Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject's participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
Tiene trastornos psiquiátricos o de abuso de sustancias conocidos que interferirían con la cooperación con los requisitos del ensayo.
Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the pre-screening or screening visit through 120 days after the last dose of trial treatment.
Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
Has known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).
Has received a live vaccine within 30 days of planned start of study therapy.
Has received amino glucoside antibiotics within 3 days of planned start of study therapy

NCT ID

NCT04014530

Fecha en que se añadió el juicio

2019-07-10

Fecha de actualización

2023-02-01