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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04976634
Registration number
NCT04976634
Ethics application status
Date submitted
16/07/2021
Date registered
26/07/2021
Titles & IDs
Public title
Pembrolizumab Plus Lenvatinib in Combination With Belzutifan in Solid Tumors (MK-6482-016)
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Scientific title
An Open-label, Multicenter, Phase 2 Study to Evaluate the Efficacy and Safety of Pembrolizumab Plus Lenvatinib in Combination With Belzutifan in Multiple Solid Tumors
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Secondary ID [1]
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MK-6482-016
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Secondary ID [2]
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6482-016
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Carcinoma, Hepatocellular
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Colorectal Neoplasms
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Pancreatic Ductal Adenocarcinoma
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Biliary Tract Neoplasms
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Endometrial Neoplasms
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Esophageal Neoplasms
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Condition category
Condition code
Cancer
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Bowel - Back passage (rectum) or large bowel (colon)
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Cancer
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Liver
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Cancer
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Oesophageal (gullet)
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Cancer
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Womb (Uterine or endometrial cancer)
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Cancer
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Biliary tree (gall bladder and bile duct)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Pembrolizumab
Treatment: Drugs - Belzutifan
Treatment: Drugs - Lenvatinib
Experimental: Arm 1: Pembrolizumab + Belzutifan + Lenvatinib - Participants will receive pembrolizumab 400 mg PLUS belzutifan 120 mg PLUS lenvatinib 20 mg (For HCC: 8 mg \[body weight \<60kg\] or 12 mg \[body weight = 60 kg\]). Pembrolizumab will be administered via intravenous (IV) infusion once every 6 weeks (Q6W) for a maximum of 18 doses (approximately 2 years). Belzutifan and lenvatinib will be administered orally once daily (QD) until progressive disease or discontinuation.
Experimental: Arm 2: Pembrolizumab + Lenvatinib - Participants with IO resistant ESCC will receive pembrolizumab 400 mg PLUS lenvatinib 20 mg. Pembrolizumab will be administered via intravenous (IV) infusion once every 6 weeks (Q6W) for a maximum of 18 doses (approximately 2 years). Lenvatinib will be administered orally once daily (QD) until progressive disease or discontinuation.
Treatment: Drugs: Pembrolizumab
Pembrolizumab 400 mg administered Q6W via IV infusion
Treatment: Drugs: Belzutifan
Belzutifan 120 mg administered QD via oral tablet
Treatment: Drugs: Lenvatinib
Lenvantinib dose for HCC is 8 mg QD for body weight \<60 kg and 12 mg QD for body weight = 60 kg administered via oral capsule. For all other tumors, the lenvatinib dose is 20 mg QD administered via oral capsule
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Arm 1: Number of Participants Who Experience at Least One Dose-limiting Toxicity (DLT)
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Assessment method [1]
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Occurrence of any of the following will be considered a DLT if possibly, probably, or definitely related to study treatment administration: Grade 4 nonhematologic toxicity; Grade 4 hematologic toxicity lasting \>7 days; Grade 4 thrombocytopenia-any duration; Grade 3 thrombocytopenia if associated with clinically significant hemorrhage; Febrile neutropenia Grade 3 or Grade 4; Grade 3 nonhematologic toxicity lasting \>5 days despite optimal supportive care; Grade 3 hypertension not controlled by antihypertensive medication(s); Grade 3 or Grade 4 nonhematologic laboratory abnormality (if medical intervention is required, or leads to hospitalization, or persists for \>1 week) ; Elevated bilirubin if persists \>4 weeks (for HCC and BTC participants only); Designated alanine aminotransferase (ALT) or aspartate aminotransferase (AST) liver test abnormalities; Treatment-related toxicity resulting in participant discontinuation of study intervention during the DLT window; Grade 5 toxicity.
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Timepoint [1]
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Up to approximately 21 days
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Primary outcome [2]
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Arm 1: Number of Participants Who Experience at Least One Adverse Event (AE)
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Assessment method [2]
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An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experience one or more AEs will be presented.
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Timepoint [2]
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Up to approximately 60 months
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Primary outcome [3]
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Arm 1: Number of Participants Who Discontinue Study Treatment Due to an AE
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Assessment method [3]
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An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinue study treatment due to an AE will be presented separately for the safety lead-in phase (up to 21 days) and the main study.
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Timepoint [3]
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Up to approximately 59 months
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Primary outcome [4]
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Confirmed Objective Response Rate (ORR) Per Response Criteria in Solid Tumors Version 1.1 (RECIST 1.1) as Assessed by Blinded Independent Central Review (BICR)
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Assessment method [4]
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ORR is defined as the percentage of participants who have a Complete Response (CR) or a Partial Response (PR) per RECIST 1.1, as assessed by blinded independent central review (BICR).
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Timepoint [4]
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Up to approximately 60 months
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Secondary outcome [1]
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Duration of Response (DOR) Per RECIST 1.1 as Assessed by BICR
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Assessment method [1]
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DOR is defined as the time from first documented evidence of CR or PR until progressive disease (PD) or death due to any cause, whichever occurs first. The DOR per RECIST 1.1 will be assessed by BICR.
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Timepoint [1]
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Up to approximately 60 months
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Secondary outcome [2]
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Disease Control Rate (DCR) Per RECIST 1.1 as Assessed by BICR
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Assessment method [2]
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DCR is defined as the percentage of participants who have a CR, PR, or Stable Disease (SD). The best overall response of CR, PR, or SD after = 6 weeks will be assessed per RECIST 1.1 by BICR.
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Timepoint [2]
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Up to approximately 60 months
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Secondary outcome [3]
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Progression-Free Survival (PFS) Per RECIST 1.1 as Assessed by BICR
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Assessment method [3]
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PFS is defined as the time from first day of study intervention to the first documented progressive disease (PD) per RECIST1.1 as assessed by BICR, or death due to any cause, whichever occurs first.
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Timepoint [3]
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Up to approximately 60 months
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Secondary outcome [4]
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Overall Survival (OS)
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Assessment method [4]
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OS is defined as the time from the first day of study intervention to death due to any cause.
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Timepoint [4]
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Up to approximately 60 months
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Secondary outcome [5]
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ORR Per Modified Response Criteria in Solid Tumors Version 1.1 (mRECIST 1.1) for Hepatocellular Carcinoma (HCC) as Assessed by BICR
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Assessment method [5]
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ORR is defined as the percentage of participants who have a CR or a PR per mRECIST 1.1 for HCC, as assessed by BICR.
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Timepoint [5]
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Up to approximately 60 months
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Secondary outcome [6]
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DOR Per mRECIST 1.1 for HCC as Assessed by BICR
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Assessment method [6]
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DOR is defined as the time from the first documented evidence of CR or PR until either progressive disease (PD) or death due to any cause, whichever occurs first. The DOR per mRECISIT 1.1 for HCC willl be assessed by BICR.
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Timepoint [6]
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Up to approximately 60 months
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Secondary outcome [7]
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DCR Per mRECIST 1.1 for HCC as Assessed by BICR
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Assessment method [7]
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DCR is defined as the percentage of participants who have a CR or PR or SD. The best overall response of CR, PR, or SD after = 6 weeks per mRECIST 1.1 for HCC will be assessed by BICR.
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Timepoint [7]
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Up to approximately 60 months
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Secondary outcome [8]
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PFS Per mRECIST 1.1 for HCC as Assessed by BICR
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Assessment method [8]
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PFS is defined as the time from first day of study intervention to the first documented PD per mRECIST 1.1 for HCC as assessed by BICR, or death due to any cause, whichever occurs first.
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Timepoint [8]
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Up to approximately 60 months
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Secondary outcome [9]
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Arm 2: Number of Participants Who Experienced an Adverse Event (AE)
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Assessment method [9]
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An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who experience an AE after administration of pembrolizumab plus lenvatinib will be presented.
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Timepoint [9]
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Up to approximately 60 months
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Secondary outcome [10]
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Arm 2: Number of Participants Who Discontinued Study Treatment Due to an AE
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Assessment method [10]
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An AE is defined as any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinue study treatment of pembrolizumab plus lenvatinib after an AE will be presented.
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Timepoint [10]
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Up to approximately 59 months
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Eligibility
Key inclusion criteria
* Diagnosis of one of the following advanced (unresectable and/or metastatic) solid tumors, documented by histopathology or cytopathology:
* Hepatocellular carcinoma (HCC)
* Colorectal cancer (CRC) (non-microsatellite instability-high [non-MSI-H]/deficient mismatch repair [dMMR])
* Pancreatic ductal adenocarcinoma (PDAC).
* Biliary tract cancer (BTC) (includes intrahepatic, extrahepatic cholangiocarcinoma [CCA] and gall bladder cancer)
* Endometrial cancer (EC)
* Esophageal squamous cell carcinoma (ESCC)
* Disease progression on or since the most recent treatment (does not apply to newly diagnosed unresectable or metastatic HCC or EC).
* Measurable disease per RECIST v1.1 as assessed locally (by investigator) and verified by BICR
* Submission of an archival tumor tissue sample or newly obtained core or excisional biopsy of a tumor lesion not previously irradiated
* Male participants are abstinent from heterosexual intercourse or agree to follow contraceptive guidance during and for at least 7 days after last dose of study intervention with belzutifan and lenvatinib
* Female participants are not pregnant or breastfeeding, not a woman of child-bearing potential (WOCBP), or is a WOCBP and agrees to follow contraceptive guidance during the intervention period and and for at least 120 days after the last dose of pembrolizumab or for at least 30 days after last dose of lenvatinib or belzutifan, whichever occurs last
* Adequate organ function
* Adequately controlled blood pressure with or without antihypertensive medications
* HCC Specific No prior systemic chemotherapy, including anti-VEGF therapy, anti-programmed cell-death (PD-1)/PD-L1 or any systemic investigational anticancer agents for advanced/unresectable HCC (1L)
* CRC ([non-MSI-H/dMMR) Specific Received at least 2 prior lines of systemic therapy for unresectable or metastatic disease which includes fluoropyrimidine, irinotecan and oxaliplatin
* PDAC Specific Prior therapy with at least 1 (platinum or gemcitabine containing regimen) but no more than 2 prior systemic therapies for unresectable or metastatic pancreatic cancer
* BTC Specific Received at least 1 prior line of systemic therapy (containing gemcitabine or fluoropyrimidine) for unresectable or metastatic disease
* EC Specific Study treatment is for 1L therapy of EC and participants should not have received prior systemic chemotherapy. Exception: May have received 1 prior line of line of systemic platinum-based adjuvant and/or neoadjuvant chemotherapy in the setting of a curative-intent resection, if the recurrence occurred =6 months after the last dose of chemotherapy or may have received prior radiation with or without chemotherapy
* ESCC Specific Have experienced radiographic or clinical progression on one prior line of standard systemic therapy (immune oncology (IO) naïve participants) or an anti-PD-1/PD-L1 (IO resistant participants)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Unable to swallow orally administered medication or presence of a gastrointestinal (GI) disorder that may affect study intervention absorption
* History of a second malignancy that is progressing or has required active treatment within 3 years
* A pulse oximeter reading <92% at rest, or requirement of intermittent supplemental oxygen/ chronic supplemental oxygen
* Presence of central nervous system (CNS) metastases and/or carcinomatous meningitis
* Clinically significant cardiovascular disease within 6 months of first dose of study intervention
* Symptomatic pleural effusion, unless clinically stable after treatment
* Preexisting = Grade 3 gastrointestinal (GI) or non-GI fistula
* Moderate to severe hepatic impairment
* Clinically significant history of bleeding within 3 months before screening
* Presence of serious active nonhealing wound/ulcer/bone fracture
* Requirement for hemodialysis or peritoneal dialysis
* History of human immunodeficiency virus (HIV) infection
* History of Hepatitis B or active Hepatis C virus infections. with exceptions for HCC and BTC
* Prior therapy with a PD-1, anti-PD-L1, anti-PD-L2 agent, vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor (TKI) or hypoxia-inducible factor 2a (HIF-2a)
* Radiographic evidence of intratumoral cavitation, or invasion/infiltration of a major blood vessel
* EC specific exclusion criteria: History of carcinosarcoma, endometrial leiomyosarcoma or other high-grade sarcomas, or endometrial stromal sarcomas
* ESCC specific exclusion criteria: Has clinically apparent ascites or pleural effusion or experienced weight loss >20% over approximately 3 months before first dose of study therapy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
18/08/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
22/03/2027
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Actual
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Sample size
Target
730
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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Gosford Hospital-Oncology Trials ( Site 4004) - Gosford
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Recruitment hospital [2]
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Westmead Hospital-Department of Medical Oncology ( Site 4001) - Westmead
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Recruitment hospital [3]
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Northern Hospital-Department of Medical Oncology ( Site 4003) - Epping
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Recruitment hospital [4]
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Cabrini Hospital - Malvern-Cabrini Institute ( Site 4000) - Malvern
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Recruitment postcode(s) [1]
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2250 - Gosford
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Recruitment postcode(s) [2]
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2145 - Westmead
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Recruitment postcode(s) [3]
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3076 - Epping
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Recruitment postcode(s) [4]
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3144 - Malvern
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Recruitment outside Australia
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United States of America
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Arizona
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United States of America
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California
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United States of America
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Connecticut
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United States of America
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District of Columbia
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United States of America
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Florida
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United States of America
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Maryland
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United States of America
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Michigan
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United States of America
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New York
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North Carolina
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Texas
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Virginia
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Washington
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Wisconsin
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Belgium
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Antwerpen
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Belgium
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Bruxelles-Capitale, Region De
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Belgium
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Vlaams-Brabant
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Belgium
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West-Vlaanderen
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Belgium
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Namur
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Chile
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Araucania
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Chile
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Los Lagos
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Chile
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Region M. De Santiago
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France
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Bretagne
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France
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Doubs
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France
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Finistere
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France
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Herault
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France
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Ile-de-France
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France
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Isere
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France
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Vaucluse
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Israel
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Haifa
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Israel
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Jerusalem
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Israel
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Ramat Gan
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Israel
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Tel Aviv
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Korea, Republic of
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Jeonranamdo
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Korea, Republic of
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Taegu-Kwangyokshi
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Korea, Republic of
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Seoul
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Netherlands
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Limburg
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Netherlands
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Zuid-Holland
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Utrecht
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New Zealand
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Auckland
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Spain
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Asturias
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Spain
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Barcelona
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Spain
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La Coruna
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Spain
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Madrid, Comunidad De
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Merck Sharp & Dohme LLC
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to determine the safety and efficacy of belzutifan in combination with pembrolizumab and lenvatinib in multiple solid tumors including hepatocellular carcinoma (HCC), colorectal cancer (CRC), pancreatic ductal adenocarcinoma (PDAC), biliary tract cancer (BTC), endometrial cancer (EC),and esophageal squamous cell carcinoma (ESCC). There is no formal hypothesis testing in this study.
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Trial website
https://clinicaltrials.gov/study/NCT04976634
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Medical Director
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Address
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Merck Sharp & Dohme LLC
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Toll Free Number
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Address
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Phone
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1-888-577-8839
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf
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When will data be available (start and end dates)?
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Available to whom?
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: http://engagezone.msd.com/ds_documentation.php
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04976634