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NCT02178722

Study to Explore the Safety, Tolerability and Efficacy of MK-3475 in Combination With INCB024360 in Participants With Selected Cancers

Completed Phase 1, PHASE2 Results posted Last updated 14 February 2022
What this trial tests

Phase 1, PHASE2 trial testing MK-3475 in Microsatellite-instability (MSI) High Colorectal Cancer (CRC) in 444 participants. Completed in 6 November 2020.

Timeline
17 July 2014
Primary endpoint
26 November 2018
6 November 2020

Quick facts

Lead sponsorIncyte Corporation
PhasePhase 1, PHASE2
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment444
Start date17 July 2014
Primary completion26 November 2018
Estimated completion6 November 2020
Sites24 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Incyte Corporation — full company profile →

Who can join

18 and older, any sex, with Microsatellite-instability (MSI) High Colorectal Cancer (CRC) or Endometrial Cancer. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Phase 1: Percentage of Participants With Treatment-Emergent Adverse Events (TEAE) and Serious Treatment-Emergent Adverse Events Primary · Approximately 54 months

An adverse event is defined as the appearance of (or worsening of any pre-existing) undesirable sign(s), symptom(s), or medical condition(s) that occur after a participant provides informed consent. A TEAE is any adverse event either reported for the first time or worsening of a pre-existing event after first dose of study drug. Serious adverse event (SAE) is defined as an event that meets 1 of the following criteria: is fatal or life threatening, results in persistent or significant disability or incapacity, constitutes a congenital anomaly or birth defect, is clinically meaningful (i.e. defi

SAE
GroupValue95% CI
Phase 1: Epacadostat 25 mg BID0
Phase 1: Epacadostat 50 mg BID40.0
Phase 1: Epacadostat 100 mg BID50.0
Phase 1: Epacadostat 300 mg BID45.0
TEAS
GroupValue95% CI
Phase 1: Epacadostat 25 mg BID100.
Phase 1: Epacadostat 50 mg BID95.0
Phase 1: Epacadostat 100 mg BID94.4
Phase 1: Epacadostat 300 mg BID100.
Phase 2: Objective Response Rate (ORR) Primary · Approximately 54 months

ORR was percentage of participants with best overall response \[complete response (CR) or partial response (PR)\], per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0) for target lesions and assessed by MRI: Complete Response (CR), Disappearance of all target lesions; Partial Response (PR), \>=30% decrease in the sum of the longest diameter of target lesions; Overall Response (OR) = CR + PR.

Triple negative breast cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W11.1
Microsatellite-instability high colorectal cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W43.8
Gastric cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W22.2
Hepatocellular carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W16.7
Melanoma - immune checkpoint-naïve
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W60.5
Non-small cell lung cancer (NSCLC) (tumor proportion score (TPS) < 50% or indeterminate)
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W30.8
NSCLC programmed cell death ligand (PD-L1) low negative (TPS < 50%)
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W24.4
Ovarian cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W8.1
Phase 2: Duration of Response (DOR) Secondary · Up to 54 months

Duration of response is the time from the first overall response contributing to an objective response (complete or partial response) for DLBCL to the date of death or the date of first overall response of progressive diseasemeasured (by irRECIST for solid tumors or the Lugano Classification, whichever is earliest.

Hepatocellular Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNA2.04 – NA
Triple Negative Breast Cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNA0.92 – NA
Immune Checkpoint-naïve Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNA26.35 – NA
NSCLC high positive (PD-L1 TPS ≥ 50%)
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W12.442.10 – 16.53
NSCLC low/negative or indeterminate (PD-L1 TPS < 50% or indeterminate)
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W11.938.90 – 14.95
NSCLC (TPS 0%)
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNA7.43 – NA
NSCLC Unknown
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W10.844.14 – NA
Renal Cell Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W16.9512.58 – NA
Phase 2: Progression Free Survival (PFS) Secondary · Up to 54 months

Progression-free survival is defined as number of days from the first day of taking study drug to the earlier of death or disease progression by irRECIST v1.1 for select solid tumors and modified Lugano Classification for DLBCL.

Hepatocellular Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W5.492.69 – 10.28
Triple Negative Breast Cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W1.971.87 – 2.92
Immune Checkpoint-naïve Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W16.696.24 – NA
Primary Refractory Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W1.691.25 – 2.14
Relapsed Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W2.602.14 – 4.21
NSCLC
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4.092.14 – 7.36
Renal Cell Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4.502.33 – 6.24
Squamous Cell Carcinoma of the Head and Neck
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4.372.30 – 7.79
Phase 2: Duration of Disease Control Secondary · Up to 54 months

The duration of disease control is the time from the treatment start date to the first objective response of PD (by irRECIST v1.1 or Lugano Classification), death, or last tumor assessment date (if PD/death not present), for subjects with best overall response of SD or better.

Hepatocellular Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W10.385.49 – NA
Triple Negative Breast Cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W11.474.01 – 12.65
Immune Checkpoint-naïve Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W30.2925.03 – NA
Relapsed Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4.21NA – NA
NSCLC Total
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W14.428.51 – 19.45
Renal Cell Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W13.395.13 – 18.86
Squamous Cell Carcinoma of the Head and Neck
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W9.186.24 – 13.34
Transitional Cell Carcinoma of the GU Tract
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W15.368.41 – 22.74
Phase 2: Overall Survival (OS) Secondary · Up to 54 months

Overall survival is determined from the date of first dose until death due to any cause.

Hepatocellular Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNA8.94 – NA
Triple Negative Breast Cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W5.164.60 – 7.46
Immune Checkpoint-naïve Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNANA – NA
Primary Refractory Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNANA – NA
Relapsed Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNA2.60 – NA
NSCLC
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W14.629.72 – 24.38
Renal Cell Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3WNA18.40 – NA
Squamous Cell Carcinoma of the Head and Neck
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W8.344.37 – 15.41
Phase 2: Ordinal Categorical Response Score Secondary · Up to 54 months

Ordinal categorical response score, determined by radiographic disease assessments per irRECIST v1.1. The 5-category ordinal response endpoint is determined at a given timepoint by classifying response into one of the following groups: 1 = Complete response per irRECIST v1.1 2 = Very good response, defined as \> 60% tumor reduction 3 = Minor response, defined as \> 30% to ≤ 60% tumor reduction 4 = Stable disease per irRECIST v1.1 5 = Progressive disease per irRECIST v1.1

Hepatocellular Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W0
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W2
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W2
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W11
Triple Negative Breast Cancer
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W1
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W1
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W2
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W7
Immune Checkpoint-naïve Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W3
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W17
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W6
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W5
Primary Refractory Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W0
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W0
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W0
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W0
Relapsed Melanoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W3
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W5
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W8
NSCLC
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W3
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W8
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W15
Renal Cell Carcinoma
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W2
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W6
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W10
Squamous Cell Carcinoma of the Head and Neck
GroupValue95% CI
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W3
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W4
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W5
Epacadostat 100 mg BID+ Pembrolizumab 200 mg Q3W8
Phase 2: Percentage of Participants With Treatment-Emergent Adverse Events (TEAE) and Serious Treatment-Emergent Adverse Events Secondary · Up to 54 months
Treatment-Emergent Adverse Events (TEAE)
GroupValue95% CI
Phase 2: Epacadostat 100 mg BID100
Serious Treatment-Emergent Adverse Events
GroupValue95% CI
Phase 2: Epacadostat 100 mg BID51.0

Adverse events — posted to ClinicalTrials.gov

Time frame: Approximately 54 months. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Phase 1: Epacadostat 25 mg BID
Serious: 0/4 (0%)
Deaths: 2/4
Phase 1: Epacadostat 50 MG BID
Serious: 8/20 (40%)
Deaths: 13/20
Phase 1: Epacadostat 100 MG BID
Serious: 9/18 (50%)
Deaths: 12/18
Phase 1: Epacadostat 300 MG BID
Serious: 9/20 (45%)
Deaths: 14/20
Phase 2: Epacadostat 100 MG BID
Serious: 195/382 (51%)
Deaths: 209/382
Total
Serious: 221/444 (50%)
Deaths: 250/444

Serious adverse events (198 terms)

ReactionSystemPhase 1: Epacadostat 25 mg…Phase 1: Epacadostat 50 MG…Phase 1: Epacadostat 100 M…Phase 1: Epacadostat 300 M…Phase 2: Epacadostat 100 M…Total
Malignant neoplasm progressionNeoplasms benign, malignant and unspecified (incl cysts and polyps)
PneumoniaInfections and infestations
Abdominal painGastrointestinal disorders
NauseaGastrointestinal disorders
Pleural effusionRespiratory, thoracic and mediastinal disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Small intestinal obstructionGastrointestinal disorders
Disease progressionGeneral disorders
SepsisInfections and infestations
VomitingGastrointestinal disorders
Acute kidney injuryRenal and urinary disorders
ColitisGastrointestinal disorders
Pulmonary embolismRespiratory, thoracic and mediastinal disorders
AnaemiaBlood and lymphatic system disorders
DehydrationMetabolism and nutrition disorders
DiarrhoeaGastrointestinal disorders
HypotensionVascular disorders
Pericardial effusionCardiac disorders
PyrexiaGeneral disorders
Urinary tract infectionInfections and infestations
Acute respiratory failureRespiratory, thoracic and mediastinal disorders
ConstipationGastrointestinal disorders
Failure to thriveMetabolism and nutrition disorders
Pneumonia aspirationRespiratory, thoracic and mediastinal disorders
PneumonitisRespiratory, thoracic and mediastinal disorders
Other adverse events (280 terms — click to expand)

ReactionSystemPhase 1: Epacadostat 25 mg…Phase 1: Epacadostat 50 MG…Phase 1: Epacadostat 100 M…Phase 1: Epacadostat 300 M…Phase 2: Epacadostat 100 M…Total
FatigueGeneral disorders
NauseaGastrointestinal disorders
CoughRespiratory, thoracic and mediastinal disorders
DiarrhoeaGastrointestinal disorders
Decreased appetiteMetabolism and nutrition disorders
ConstipationGastrointestinal disorders
RashSkin and subcutaneous tissue disorders
PruritusSkin and subcutaneous tissue disorders
VomitingGastrointestinal disorders
ArthralgiaMusculoskeletal and connective tissue disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
PyrexiaGeneral disorders
HeadacheNervous system disorders
Back painMusculoskeletal and connective tissue disorders
Abdominal painGastrointestinal disorders
AnaemiaBlood and lymphatic system disorders
InsomniaPsychiatric disorders
Lipase increasedInvestigations
Aspartate aminotransferase increasedInvestigations
Pain in extremityMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
Oedema peripheralGeneral disorders
ChillsGeneral disorders
HyponatraemiaMetabolism and nutrition disorders
Alanine aminotransferase increasedInvestigations
Weight decreasedInvestigations
Amylase increasedInvestigations
Upper respiratory tract infectionInfections and infestations
Blood alkaline phosphatase increasedInvestigations
Musculoskeletal painMusculoskeletal and connective tissue disorders
AstheniaGeneral disorders
DehydrationMetabolism and nutrition disorders
HypokalaemiaMetabolism and nutrition disorders
MyalgiaMusculoskeletal and connective tissue disorders
Non-cardiac chest painGeneral disorders
Dry mouthGastrointestinal disorders
HypothyroidismEndocrine disorders
Urinary tract infectionInfections and infestations
AnxietyPsychiatric disorders
Productive coughRespiratory, thoracic and mediastinal disorders

Most-reported serious reactions: Malignant neoplasm progression, Pneumonia, Abdominal pain, Nausea, Pleural effusion, Dyspnoea, Small intestinal obstruction, Disease progression.

Data from ClinicalTrials.gov NCT02178722 adverse events section.

Sponsor's own description

The purpose of this study was to assess the safety, tolerability, and efficacy when combining MK-3475 and INCB024360 in participants with certain cancers. This study was conducted in 2 phases, Phase 1 and Phase 2.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Molecular therapies and precision medicine for hepatocellular carcinoma.
    Llovet JM, Montal R, Sia D, Finn RS. · · 2018 · cited 1481× · PMID 30061739 · DOI 10.1038/s41571-018-0073-4
  2. IDO in the Tumor Microenvironment: Inflammation, Counter-Regulation, and Tolerance.
    Munn DH, Mellor AL. · · 2016 · cited 799× · PMID 26839260 · DOI 10.1016/j.it.2016.01.002
  3. Next generation of immune checkpoint therapy in cancer: new developments and challenges.
    Marin-Acevedo JA, Dholaria B, Soyano AE, Knutson KL, et al · · 2018 · cited 582× · PMID 29544515 · DOI 10.1186/s13045-018-0582-8
  4. Targeting the IDO1 pathway in cancer: from bench to bedside.
    Liu M, Wang X, Wang L, Ma X, et al · · 2018 · cited 339× · PMID 30068361 · DOI 10.1186/s13045-018-0644-y
  5. IDO1 in cancer: a Gemini of immune checkpoints.
    Zhai L, Ladomersky E, Lenzen A, Nguyen B, et al · · 2018 · cited 319× · PMID 29375124 · DOI 10.1038/cmi.2017.143
  6. Epacadostat Plus Pembrolizumab in Patients With Advanced Solid Tumors: Phase I Results From a Multicenter, Open-Label Phase I/II Trial (ECHO-202/KEYNOTE-037).
    Mitchell TC, Hamid O, Smith DC, Bauer TM, et al · · 2018 · cited 307× · PMID 30265610 · DOI 10.1200/jco.2018.78.9602
  7. Molecular Pathways: Targeting IDO1 and Other Tryptophan Dioxygenases for Cancer Immunotherapy.
    Zhai L, Spranger S, Binder DC, Gritsina G, et al · · 2015 · cited 262× · PMID 26519060 · DOI 10.1158/1078-0432.ccr-15-0420
  8. Targeting the indoleamine 2,3-dioxygenase pathway in cancer.
    Moon YW, Hajjar J, Hwu P, Naing A. · · 2015 · cited 255× · PMID 26674411 · DOI 10.1186/s40425-015-0094-9

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