Phase Ib Trial of Pembrolizumab (MK-3475) in Combination With Dinaciclib (MK-7965) in Subjects With Hematologic Malignancies (KEYNOTE-155).

This is a non-randomized, open-label study evaluating the safety and efficacy of pembrolizumab (MK-3475) used in combination with dinaciclib (MK-7965) in the treatment of relapsed or refractory chronic lymphocytic leukemia (rrCLL), multiple myeloma (rrMM), or diffuse large B-cell lymphoma (rrDLBCL) in up to 138 participants from multiple sites.

During an initial Dose Evaluation phase (first 2 cycles) to determine Dose Limiting Toxicities (DLTs), dose combinations of pembrolizumab 200 mg + dinaciclib 7 mg/m^2, pembrolizumab 200 mg + dinaciclib 10 mg/m^2, and pembrolizumab 200 mg + dinaciclib 14 mg/m^2 will be evaluated. Following safety review of the Dose Evaluation Phase, approximately 30 participants each will be enrolled in rrCLL, rrMM, or DLBCL cohorts during the Signal Detection phase. For each disease type objective response rate (ORR) will be determined by disease specific criteria.

Cancer (Oncology) - Leukemia, Cancer (Oncology) - Lymphoma, Cancer (Oncology) - Multiple Myeloma, Cancer (Oncology)
John Pagel, MD, PhD
Swedish Cancer Institute
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Females must not be pregnant (negative urine or serum human chorionic gonadotropin test within 72 hours of study start)
  • Women of childbearing potential and male participants must agree to use adequate contraception up to 120 days after study therapy
  • Eastern Cooperative Oncology Group (ECOG) performance status 0-1
  • Must be able to provide biopsy specimens obtained ≤3 months for biomarker analysis

CLL Participants:

  • Must have a confirmed diagnosis of CLL defined by 2008 International Workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria
  • Must have received one prior therapy for CLL
  • Must meet one or more of the consensus criteria for initiating treatment

MM Participants:

  • Must have a confirmed diagnosis of active MM
  • Must have undergone prior treatment with ≥2 treatment lines of anti-myeloma therapy and failed last line of treatment (disease progression ≤60 days of completion of last therapy)
  • Must have failed prior anti-myeloma treatments that have included an immunomodulatory drug (IMiD) (pomalidomide, lenalidomide, or thalidomide) AND proteasome inhibitor (bortezomib or carfilzomib) alone or in combination.

DLBCL Participants:

  • Must have a confirmed diagnosis of DLBCL and have progressed following ≥2 lines of previous therapy, after autologous stem cell transplant, or not a candidate for autologous stem cell transplant
  • Must have measurable disease (≥1 lesion that is >15 mm in the longest diameter and by >10 mm in the short axis)

Exclusion Criteria:

  • Has been treated with a cytochrome P450 3A4 (CYP3A4) strong inhibitor or inducer within 7 days of enrollment
  • Has been treated with anti-cancer therapy or thoracic radiation therapy within 14 days
  • Has known clinically active CNS involvement
  • Has a known history of immunosuppression or is receiving systemic steroid therapy or any other form of systemic immunosuppressive therapy within 7 days
  • Has had prior anti-cancer monoclonal antibody within 4 weeks of Study Day 1or who has not recovered from adverse events due to agents administered >4 weeks earlier
  • Has undergone prior allogeneic hematopoetic stem cell transplantation within the last 5 years
  • Has a known additional malignancy that is progressing or requires active treatment
  • Has active autoimmune disease that has required systemic treatment in past 2 years
  • Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137, or anti-Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody
  • Has been previously treated with a CDK inhibitor
  • Has known Human Immunodeficiency Virus (HIV), or active Hepatitis B (HBV), or C (HCV) infection
  • Has received a live vaccine within 30 days prior to the first dose of trial treatment
  • Participants with non-secretory or oligo-secretory myeloma, plasma cell leukemia or Waldenström's macroglobulinemia
  • History of primary amyloidosis, hyperviscosity or POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, and skin changes)
  • Participants with primary mediastinal B-cell lymphoma (PMBCL)
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