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NCT03072160

Pembrolizumab in Recurrent or Metastatic Medullary Thyroid Cancer

Completed Phase 2 Results posted Last updated 11 February 2021
What this trial tests

Phase 2 trial testing Pembrolizumab in Medullary Thyroid Cancer (MTC) in 17 participants. Completed in 22 November 2019.

Timeline
16 June 2017
Primary endpoint
22 November 2019
22 November 2019

Quick facts

Lead sponsorNational Cancer Institute (NCI)
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment17
Start date16 June 2017
Primary completion22 November 2019
Estimated completion22 November 2019
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

National Cancer Institute (NCI)

Who can join

18 and older, any sex, with Medullary Thyroid Cancer (MTC). 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.

Clinical Response Primary · 2 years

Participants with medullary thyroid cancer were administered a programmed cell death protein 1 (PD1) inhibitor to determine if any experienced a 50% or greater decline in calcitonin levels. A calcitonin response is defined as participants with a ≥50% decline from baseline that is then confirmed on a subsequent calcitonin assessment at least one week later.

GroupValue95% CI
Cohort 1: Cancer Vaccine0
Cohort 2: Participants That Have Had No Vaccine0
Percentage of Participants With a Partial Response and Complete Response by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) Primary · 2 years

Participants were imaged by CT or MRI and followed for response using the Immune-Related Response Criteria (irRC). Partial Response is a ≥30% decrease in the sum of the largest diameter (SLD) compared with baseline confirmed by a consecutive assessment at least 4 weeks after the first documentation. Complete Response is a 100% disappearance of all lesions, whether measurable or not, and no new lesions, in two consecutive observations not less than 4 weeks from the date first documented.

GroupValue95% CI
Cohort 1: Cancer Vaccine0
Cohort 2: Participants That Have Had No Vaccine0
Percentage Change in (Cluster of Differentiation 4 (CD4), CD8, Tregs, and Natural Killer (NK) Cells at Day 1 and 84 Days in All Participants Secondary · Day 1 and 84 days

Regulatory T-Cells (CD4, CD8, Tregs, and NK cells) in peripheral blood mononuclear cell (PBMC)s were measured by 7-color flow cytometry.

CD4
GroupValue95% CI
All Participants at Day 134.7312.5 – 53.5
All Participants at Day 8433.959.7 – 46.5
CD8
GroupValue95% CI
All Participants at Day 113.706.17 – 26.3
All Participants at Day 8412.506.5 – 24.22
Tregs
GroupValue95% CI
All Participants at Day 10.700.0 – 1.2
All Participants at Day 840.770.46 – 1.8
NK
GroupValue95% CI
All Participants at Day 110.476.6 – 17.7
All Participants at Day 8410.264.6 – 19.5
Number of Participants With a Sustained Decline in Carcinoembryonic Antigen (CEA) Secondary · every 3 weeks while on treatment and post treatment, up to 2 years

A sustained 50% decline in CEA. A large magnitude decline in CEA may be associated with tumor responses.

GroupValue95% CI
Cohort 1: Cancer Vaccine0
Cohort 2: Participants That Have Had No Vaccine0
Number of Participants With a Sustained Decline in Calcitonin Secondary · every 3 weeks while on treatment and post treatment, up to 2 years

A sustained 50% decline in calcitonin. A large magnitude decline in calcitonin may be associated with tumor responses.

GroupValue95% CI
Cohort 1: Cancer Vaccine0
Cohort 2: Participants That Have Had No Vaccine0
Progression-free Survival (PFS) Secondary · 3 weeks for up to 2 years while on treatment than 2 weeks after last treatment

PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first. Progression, assessed by the Immune-Related Response Criteria (irRC), is defined as at least 20% increase in the sum of the largest diameter (SLD) compared with nadir (minimum recorded tumor burden) and an increase of at least 5mm over the nadir, confirmed by a repeat,consecutive observations at least 4 weeks from the date first documented.

GroupValue95% CI
Cohort 1: Cancer Vaccine210
Cohort 2: Participants That Have Had No Vaccine55
Overall Survival at 2 Years Secondary · 2 years

Percentage of participants who are alive at 2 years.

GroupValue95% CI
Cohort 1: Cancer Vaccine100
Cohort 2: Participants That Have Had No Vaccine50
Number of Participants With Grade ≥1 Adverse Events Possibly, Probably, or Definitely Related to Pembrolizumab Secondary · Date treatment consent signed to date off study, approximately 25 months and 28 days for cohort 1 and 18 months and 12 days for cohort 2.

Adverse events were assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0). Grade 1 is mild. Grade 2 is moderate. Grade 3 is severe or medically significant but not immediately life-threatening. Grade 4 is life-threatening; urgent intervention indicated. Grade 5 is death related to adverse event.

Acute kidney injury
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related1
Cohort 1: Grade 1 Probably Related0
Cohort 1: Grade 1 Definitely Related0
Cohort 1: Grade 2 Possibly Related1
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related1
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related0
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Alanine aminotransferase
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related0
Cohort 1: Grade 1 Probably Related0
Cohort 1: Grade 1 Definitely Related0
Cohort 1: Grade 2 Possibly Related1
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related0
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related0
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Allergic rhinitis
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related1
Cohort 1: Grade 1 Probably Related0
Cohort 1: Grade 1 Definitely Related0
Cohort 1: Grade 2 Possibly Related0
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related0
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related0
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Anemia
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related0
Cohort 1: Grade 1 Probably Related0
Cohort 1: Grade 1 Definitely Related0
Cohort 1: Grade 2 Possibly Related0
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related0
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related1
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Anorexia
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related1
Cohort 1: Grade 1 Probably Related0
Cohort 1: Grade 1 Definitely Related1
Cohort 1: Grade 2 Possibly Related0
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related0
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related0
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Arthralgia
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related1
Cohort 1: Grade 1 Probably Related0
Cohort 1: Grade 1 Definitely Related0
Cohort 1: Grade 2 Possibly Related0
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related0
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related0
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Aspartate aminotransferase
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related2
Cohort 1: Grade 1 Probably Related0
Cohort 1: Grade 1 Definitely Related0
Cohort 1: Grade 2 Possibly Related0
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related0
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related0
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Diarrhea
GroupValue95% CI
Cohort 1: Grade 1 Possibly Related2
Cohort 1: Grade 1 Probably Related1
Cohort 1: Grade 1 Definitely Related0
Cohort 1: Grade 2 Possibly Related0
Cohort 1: Grade 2 Probably Related0
Cohort 1: Grade 2 Definitely Related0
Cohort 1: Grade 3 Possibly Related0
Cohort 1: Grade 3 Probably Related0
Cohort 1: Grade 3 Definitely Related0
Cohort 2: Grade 1 Possibly Related1
Cohort 2: Grade 1 Probably Related0
Cohort 2: Grade 1 Definitely Related0
Number of Participants With Grade ≥1 Adverse Events Unlikely or Unrelated to Pembrolizumab Secondary · Date treatment consent signed to date off study, approximately 25 months and 28 days for cohort 1 and 18 months and 12 days for cohort 2.

Adverse events were assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0). Grade 1 is mild. Grade 2 is moderate. Grade 3 is severe or medically significant but not immediately life-threatening. Grade 4 is life-threatening; urgent intervention indicated. Grade 5 is death related to adverse event.

Abdominal pain
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related0
Cohort 1: Grade 1 Unrelated2
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated0
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related1
Cohort 2: Grade 1 Unrelated1
Cohort 2: Grade 2 Unlikely Related0
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated0
Alanine aminotransferase increased
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related0
Cohort 1: Grade 1 Unrelated2
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated0
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related0
Cohort 2: Grade 1 Unrelated1
Cohort 2: Grade 2 Unlikely Related0
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated0
Allergic rhinitis
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related0
Cohort 1: Grade 1 Unrelated1
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated1
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related0
Cohort 2: Grade 1 Unrelated0
Cohort 2: Grade 2 Unlikely Related0
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated0
Anemia
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related0
Cohort 1: Grade 1 Unrelated2
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated0
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related0
Cohort 2: Grade 1 Unrelated0
Cohort 2: Grade 2 Unlikely Related1
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated0
Anorexia
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related0
Cohort 1: Grade 1 Unrelated0
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated0
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related0
Cohort 2: Grade 1 Unrelated0
Cohort 2: Grade 2 Unlikely Related0
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated1
Aspartate aminotransferase increased
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related1
Cohort 1: Grade 1 Unrelated2
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated0
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related0
Cohort 2: Grade 1 Unrelated0
Cohort 2: Grade 2 Unlikely Related0
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated0
Back pain
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related0
Cohort 1: Grade 1 Unrelated2
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated0
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related0
Cohort 2: Grade 1 Unrelated0
Cohort 2: Grade 2 Unlikely Related0
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated0
Blood bilirubin increased
GroupValue95% CI
Cohort 1: Grade 1 Unlikely Related0
Cohort 1: Grade 1 Unrelated1
Cohort 1: Grade 2 Unlikely Related0
Cohort 1: Grade 2 Unrelated1
Cohort 1: Grade 3 Unlikely Related0
Cohort 1: Grade 3 Unrelated0
Cohort 2: Grade 1 Unlikely Related0
Cohort 2: Grade 1 Unrelated1
Cohort 2: Grade 2 Unlikely Related0
Cohort 2: Grade 2 Unrelated0
Cohort 2: Grade 3 Unlikely Related0
Cohort 2: Grade 3 Unrelated0
Number of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0) Secondary · Date treatment consent signed to date off study, approximately 25 months and 28 days for cohort 1 and 18 months and 12 days for cohort 2.

Here is the number of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one

GroupValue95% CI
Cohort 1: Cancer Vaccine13
Cohort 2: Participants That Have Had No Vaccine4

Adverse events — posted to ClinicalTrials.gov

Time frame: Date treatment consent signed to date off study, approximately 25 months and 28 days for cohort 1 and 18 months and 12 days for cohort 2.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Cohort 1: Cancer Vaccine
Serious: 2/13 (15%)
Deaths: 0/13
Cohort 2: Participants That Have Had No Vaccine
Serious: 2/4 (50%)
Deaths: 2/4

Serious adverse events (6 terms)

ReactionSystemCohort 1: Cancer VaccineCohort 2: Participants Tha…
Acute kidney injuryRenal and urinary disorders
HeadacheNervous system disorders
Renal and urinary disorders - Other, Acute interstitial nephritisRenal and urinary disorders
Upper respiratory infectionInfections and infestations
DehydrationMetabolism and nutrition disorders
Hearing impairedEar and labyrinth disorders
Other adverse events (83 terms — click to expand)

ReactionSystemCohort 1: Cancer VaccineCohort 2: Participants Tha…
HypocalcemiaMetabolism and nutrition disorders
FatigueGeneral disorders
PainGeneral disorders
Rash acneiformSkin and subcutaneous tissue disorders
CoughRespiratory, thoracic and mediastinal disorders
Lymphocyte count decreasedInvestigations
DiarrheaGastrointestinal disorders
HyponatremiaMetabolism and nutrition disorders
Pain in extremityGeneral disorders
Rash maculo-papularSkin and subcutaneous tissue disorders
Abdominal painGastrointestinal disorders
Alanine aminotransferase increasedInvestigations
Aspartate aminotransferase increasedInvestigations
Dry skinSkin and subcutaneous tissue disorders
HeadacheNervous system disorders
HyperuricemiaMetabolism and nutrition disorders
HypokalemiaMetabolism and nutrition disorders
Neck painMusculoskeletal and connective tissue disorders
Upper respiratory infectionInfections and infestations
Allergic rhinitisRespiratory, thoracic and mediastinal disorders
AnemiaBlood and lymphatic system disorders
Back painMusculoskeletal and connective tissue disorders
CPK increasedInvestigations
Creatinine increasedInvestigations
DizzinessNervous system disorders
Dry eyeEye disorders
Edema limbsGeneral disorders
Eye painEye disorders
Generalized muscle weaknessMusculoskeletal and connective tissue disorders
HyperglycemiaMetabolism and nutrition disorders
Nasal congestionRespiratory, thoracic and mediastinal disorders
NauseaGastrointestinal disorders
Neutrophil count decreasedInvestigations
White blood cell decreasedInvestigations
Acute kidney injuryRenal and urinary disorders
AnorexiaMetabolism and nutrition disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Blood bilirubin increasedInvestigations
Buttock painMusculoskeletal and connective tissue disorders
CataractEye disorders

Most-reported serious reactions: Acute kidney injury, Headache, Renal and urinary disorders - Other, Acute interstitial nephritis, Upper respiratory infection, Dehydration, Hearing impaired.

Data from ClinicalTrials.gov NCT03072160 adverse events section.

Sponsor's own description

Background: Medullary thyroid cancer (MTC) is a tumor of the thyroid gland. Surgery is the only current treatment to cure it. The drug pembrolizumab (MK-3475) is a new type of cancer therapy. It works by allowing the immune system to detect and kill tumor cells. Objective: To test how pembrolizumab affects people with MTC and if it can offer them clinical benefit. Eligibility: People ages 18 and older with MTC Patients who have recurrent or metastatic MTC, for whom surgery is not a curative option Patients with some imaging evidence of MTC Patients with minimal symptoms related to MTC Design: Participants will be screened with: * Medical history * Physical exam * Blood, urine, and heart tests * Computed tomography (CT) scan or magnetic resonance imaging (MRI): They lie in a machine that takes pictures of the body. * Bone scan Participants will be put in a group based on their treatment history: * Group 1 if they have had an immune stimulating cancer vaccine * Group 2 if they have had no vaccine Participants will receive the study drug as a 30-minute intravenous (IV) infusion every 3 weeks. Treatment will continue for up to 2 years as long as they tolerate it and their disease does not get worse. Participants will have physical exams and blood tests on the day of each infusion. They will have CT and bone scans every 3 months. Participants may save biopsies before treatment and after starting treatment. Participants will have a final visit 3-4 weeks after stopping treatment. This will include a physical exam and blood and heart tests. After this study, participants can join a long-term follow-up study.

Publications & conference data

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

  1. The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of squamous cell carcinoma of the head and neck (HNSCC).
    Cohen EEW, Bell RB, Bifulco CB, Burtness B, et al · · 2019 · cited 528× · PMID 31307547 · DOI 10.1186/s40425-019-0662-5
  2. Targeted Therapy for Advanced Thyroid Cancer: Kinase Inhibitors and Beyond.
    Cabanillas ME, Ryder M, Jimenez C. · · 2019 · cited 247× · PMID 31322645 · DOI 10.1210/er.2019-00007
  3. Updates on the Management of Thyroid Cancer.
    Araque KA, Gubbi S, Klubo-Gwiezdzinska J. · · 2020 · cited 115× · PMID 32040962 · DOI 10.1055/a-1089-7870
  4. The Immune Landscape of Thyroid Cancer in the Context of Immune Checkpoint Inhibition.
    Varricchi G, Loffredo S, Marone G, Modestino L, et al · · 2019 · cited 78× · PMID 31412566 · DOI 10.3390/ijms20163934
  5. Molecular Alterations in Thyroid Cancer: From Bench to Clinical Practice.
    Tirrò E, Martorana F, Romano C, Vitale SR, et al · · 2019 · cited 63× · PMID 31540307 · DOI 10.3390/genes10090709
  6. Medullary Thyroid Cancer: Updates and Challenges.
    Gild ML, Clifton-Bligh RJ, Wirth LJ, Robinson BG. · · 2023 · cited 59× · PMID 37204852 · DOI 10.1210/endrev/bnad013
  7. Current Guidelines for Management of Medullary Thyroid Carcinoma.
    Kim M, Kim BH. · · 2021 · cited 55× · PMID 34154310 · DOI 10.3803/enm.2021.1082
  8. Thyroid Cancers: From Surgery to Current and Future Systemic Therapies through Their Molecular Identities.
    Lorusso L, Cappagli V, Valerio L, Giani C, et al · · 2021 · cited 51× · PMID 33803747 · DOI 10.3390/ijms22063117

Verify or expand the search:

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Trials by the same sponsor.

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03072160.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing