E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Renal cell carcinoma (clear cell & non-clear cell), or kidney cancer |
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E.1.1.1 | Medical condition in easily understood language |
Renal cell carcinoma (clear cell & non-clear cell), or kidney cancer |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10023400 |
E.1.2 | Term | Kidney cancer |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
1. To estimate the objective response rate (ORR) per RECIST 1.1 as assessed by BICR in subjects with clear cell RCC.
2. To estimate the ORR per RECIST 1.1 as assessed by BICR in subjects with non-clear cell RCC. |
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E.2.2 | Secondary objectives of the trial |
1. To estimate the duration of response (DOR), disease control rate (DCR), and the progression-free survival (PFS) per RECIST 1.1 as assessed by BICR and overall survival (OS) in subjects with clear cell or non-clear cell RCC by cohort.
2. To determine the safety and tolerability of pembrolizumab in subjects with clear cell or non-clear cell RCC by cohort.
3. To describe the patient population using the International Metastatic RCC Database Consortium (IMDC) risk group : favorable versus intermediate versus poor risk groups in subjects with clear cell or non-clear cell RCC by cohort [1,2,3]. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Merck will conduct Future Biomedical Research on DNA (blood and tissue) specimens collected during this clinical trial. Such research is for biomarker testing to address emergent questions not described elsewhere in the protocol (as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The objective of collecting specimens for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is to use such information to develop safer, more effective drugs, and/or to ensure that subjects receive the correct dose of the correct drug at the correct time. |
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E.3 | Principal inclusion criteria |
- Provide written informed consent/assent for the trial
- Be > or = 18 years of age on day of signing informed consent
- Cohort A (clear cell cohort) must have histologically confirmed diagnosis of clear cell RCC or RCC with clear cell component (with or without sarcomatoid features)
- Cohort B (non-clear cell cohort) must have histologically confirmed diagnosis of non-clear cell RCC (with or without sarcomatoid features). Confirmation of the diagnosis of non-clear cell RCC by central histology review during the screening phase is required prior to allocation to Cohort B
- Have locally advanced/metastatic disease, i.e., Stage IV RCC per American Joint Committee on Cancer (AJCC) or have recurrent disease
- Have measurable disease per RECIST 1.1 as assessed by BICR. Target lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions
- Have received no prior systemic therapy for advanced RCC
- Provide adequate tissue for biomarker analysis for cohorts A and B
- Demonstrate adequate organ function
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E.4 | Principal exclusion criteria |
- Is currently participating in or has participated in a study of an investigational agent or using an investigational device within 4 weeks prior to allocation, has had major surgery within 4 weeks prior to allocation or radiation therapy within 2 weeks prior to allocation, or who has not recovered (i.e., < or = Grade 1 or at baseline) from adverse events due to prior treatment
- Had prior treatment with any anti-PD-1, or PD-L1, or PD-L2 agent or an antibody targeting any other immune-regulatory receptors or mechanisms. Examples of such antibodies include (but are not limited to) antibodies against IDO, PD-L1, IL-2R, GITR
- 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, except in the case of central nervous system (CNS) metastases
- Has an active autoimmune disease requiring systemic treatment within the past 3 months or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic or immunosuppressive agents
- Has a known additional malignancy that has had progression or has required active treatment in the last 3 years. Note: Subjects with basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has undergone potentially curative therapy or carcinoma in situ are not excluded
- Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis
- Has a history of (non-infectious) pneumonitis that required steroids or current pneumonitis
- Has had a prior solid organ transplant |
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E.5 End points |
E.5.1 | Primary end point(s) |
Objective response rate (ORR) per RECIST 1.1 by BCIR |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
At Interim & Final Analyses. Interim Analysis to be conducted on the non clear cell RCC cohort and is to be performed at the time when 30th subject in this cohort has the opportunity to complete the 3rd scan |
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E.5.2 | Secondary end point(s) |
- Duration of response (DOR) per RECIST 1.1 by BCIR
- Disease control rate (DCR) per RECIST 1.1 by BCIR
- Progression-free survival (PFS) per RECIST 1.1 by BCIR; overall survival (OS) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
At Interim & Final Analyses |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 28 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Canada |
Czech Republic |
Denmark |
Germany |
Korea, Republic of |
Poland |
Russian Federation |
Spain |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 5 |