A Study of Investigational Agents in Participants With Previously Treated Stage IV Nonsquamous Non-small Cell Lung Cancer (NSCLC) (MK-3475-01H/KEYMAKER-U01)
5-hydroxytryptamine subtype 3 receptor antagonist: Administered as a rescue medication per approved product label before R-DXd or I-DXd infusion
Neurokinin-1 receptor antagonist: Administered as a rescue medication per approved product label before R-DXd or I-DXd infusion
Corticosteroid: Administered as a rescue medication per approved product label before R-DXd or I-DXd infusion, and for 3 days starting 1 day prior to docetaxel administration
Study summary
Researchers are looking for new ways to treat metastatic nonsquamous non-small cell lung cancer (NSCLC) that has been treated before. Metastatic means the cancer has spread to other parts of the body. Nonsquamous means the cancer did not start in squamous cells, which are flat cells that line the inside of the lungs.
Standard treatment (usual treatment) for NSCLC is surgery, then immunotherapy with or without chemotherapy after surgery. Immunotherapy is a treatment that helps the immune system fight cancer. Chemotherapy is a medicine that works to destroy cancer cells or stop them from growing.
However, standard treatment may not work or may stop working for some people. Researchers want to know if 2 antibody drug conjugates (ADCs) can help treat metastatic nonsquamous NSCLC that did not respond (get smaller or go away) to treatment. An ADC attaches to specific targets on cancers cells and delivers treatment to destroy those cells.
Researchers will compare 2 different ADCs (the study treatments) to chemotherapy in this study. The goals of this study are to learn:
* About the safety of the study treatments and if people tolerate them
* How many people have the cancer respond to the study treatments
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
The main inclusion criteria include but are not limited to the following:
* Histologically or cytologically confirmed diagnosis of Stage IV nonsquamous non-small cell lung cancer (NSCLC)
* Documented disease progression per RECIST 1.1 after receiving an anti-programmed cell death 1 protein (PD-1)/programmed cell death ligand 1 (PD-L1) treatment and platinum-based chemotherapy
* Confirmation per local test report that epidermal growth factor receptor negative (EGFR-), anaplastic lymphoma kinase negative (ALK-), c ros oncogene 1 negative (ROS1-), or other directed therapy is not indicated as primary therapy
* Measurable disease per RECIST 1.1 as assessed by investigator and verified by BICR
* Life expectancy of at least 3 months
* An Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 assessed within 7 days before randomization
* Is an individual of any sex/gender who is at least 18 years of age at the time of providing the informed consent
* Has adequate organ function
* If capable of producing sperm refrains from donating sperm plus either abstains from penile-vaginal intercourse or uses a penile/external condom, with contraceptive use consistent with local regulations
* Participant/participants of childbearing potential (POCBP) is not pregnant and has a negative highly sensitive pregnancy test; and is not breastfeeding and uses a highly effective contraceptive method
* Archival tumor tissue sample of a tumor lesion not previously irradiated has been provided
* Has provided tissue prior to treatment randomization from a newly obtained formalin-fixed sample from a new biopsy
* Human Immunodeficiency Virus (HIV)-infected participants must have well controlled HIV on antiretroviral therapy (ART)
* Participants who are hepatitis B surface antigen (HBsAg) positive have received hepatitis B virus (HBV) antiviral therapy for at least 4 weeks and have undetectable HBV viral load prior to randomization
* Participants with history of hepatitis C virus (HCV) infection are eligible if HCV viral load is undetectable at screening
Exclusion Criteria:
The main exclusion criteria include but are not limited to the following:
* Diagnosis of small cell lung cancer or, for mixed tumors, presence of small cell elements
* Received radiation therapy to the lung
* Has uncontrolled or significant cardiovascular disorder prior to randomization
* Has clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses
* Participants who have adverse events (AEs) (other than alopecia) due to previous anticancer therapies must have recovered to ≤Grade 1 or baseline
* Has known severe hypersensitivity (≥Grade 3) to study intervention and/or any of its excipients
* Has clinically significant corneal disease
* Has received prior radiotherapy within 2 weeks of start of study intervention, or radiation related toxicities, requiring corticosteroids
* Has inadequate washout period prior to randomization
* Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention
* Has diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy
* Has previously received docetaxel as monotherapy or in combination with other therapies
* Has received an investigational agent or has used an investigational device within 4 weeks prior to study intervention administration
* Has known additional malignancy that is progressing or has required active treatment within the past 3 years
* Has known untreated central nervous system (CNS) metastases and/or carcinomatous meningitis
* Has evidence of any leptomeningeal disease
* Has history of interstitial lung disease (ILD)/pneumonitis, current diagnosis of ILD, and/or suspected ILD
* Has active autoimmune disease that has required systemic treatment in the past 2 years
* Has active infection requiring systemic therapy
* HIV-infected participants with a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease
* Has active inflammatory bowel disease requiring immunosuppressive medication or previous clear history of inflammatory bowel disease
* Has known history of, or active, neurologic paraneoplastic syndrome
* Has history of allogeneic tissue/solid organ transplant
* Have not adequately recovered from major surgery or have ongoing surgical complications
Primary outcome measure(s)
Objective Response Rate (ORR) — Up to approximately 81 months ORR is defined as the percentage of participants with Complete Response (CR: Disappearance of all target lesions) or a Partial Response (PR: At least a 30% decrease in the sum of diameters of target lesions) per Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1). The percentage of participants who experience CR or PR as assessed by Blinded Independent Central Review (BICR) will be presented.
Percentage of Participants with at Least One Adverse Event (AE) — Up to approximately 81 months An AE is defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment. The percentage of participants who experience an AE will be reported.
Percentage of Participants Who Discontinued Medication Due to an AE — Up to approximately 24 months An AE is defined as any unfavorable and unintended sign, symptom, disease, or worsening of preexisting condition temporally associated with study treatment and irrespective of causality to study treatment. The percentage of participants who discontinue study intervention due to an AE will be reported.
Trial sites (34)
Facility
City
Region
Status
University of Kentucky Chandler Medical Center ( Site 0019)
Lexington
Kentucky
Recruiting
MedStar Franklin Square Medical Center ( Site 0033)
Baltimore
Maryland
Recruiting
AHN Cancer Institute - Allegheny General ( Site 9501)
Pittsburgh
Pennsylvania
Recruiting
Centro de Estudios Clínicos SAGA ( Site 0161)
Santiago
Region M. de Santiago
Recruiting
FALP ( Site 0160)
Santiago
Region M. de Santiago
Recruiting
Bradfordhill ( Site 0162)
Santiago
Region M. de Santiago
Recruiting
Universitaetsklinik Tuebingen ( Site 0192)
Tübingen
Baden-Wurttemberg
Recruiting
Charite-Universitaetsmedizin Berlin ( Site 0191)
Berlin
Germany
Recruiting
THORACIC GENERAL HOSPITAL OF ATHENS "I SOTIRIA"-3rd Dept of Internal Medicine and Laboratory, Oncol ( Site 0204)
Athens
Attica
Recruiting
European Interbalkan Medical Center ( Site 0205)
Thessaloniki
Greece
Recruiting
Bacs-Kiskun Varmegyei Oktatokorhaz ( Site 0063)
Kecskemét
Bács-Kiskun county
Recruiting
Petz Aladar Egyetemi Oktato Korhaz ( Site 0062)
Győr
Győr-Moson-Sopron
Recruiting
Jasz-Nagykun-Szolnok Varmegyei Hetenyi Geza Korhaz-Rendelointezet ( Site 0061)
Szolnok
Jász-Nagykun-Szolnok
Recruiting
Rambam Health Care Campus ( Site 0076)
Haifa
Israel
Recruiting
Shaare Zedek Medical Center ( Site 0075)
Jerusalem
Israel
Recruiting
Meir Medical Center ( Site 0071)
Kfar Saba
Israel
Recruiting
Rabin Medical Center ( Site 0074)
Petah Tikva
Israel
Recruiting
Sheba Medical Center ( Site 0070)
Ramat Gan
Israel
Recruiting
Sourasky Medical Center ( Site 0077)
Tel Aviv
Israel
Recruiting
Fondazione IRCCS Istituto Nazionale dei Tumori ( Site 0175)
Milan
Lombardy
Recruiting
Azienda Ospedaliera Universitaria Careggi ( Site 0173)
Florence
Italy
Recruiting
Ospedale San Raffaele. ( Site 0171)
Milan
Italy
Recruiting
Fondazione Policlinico Universitario Agostino Gemelli IRCCS - Università Cattolica del Sacro Cuore ( Site 0174)
Roma
Italy
Recruiting
Wielkopolskie Centrum Pulmonologii i Torakochirurgii ( Site 0153)
Poznan
Greater Poland Voivodeship
Recruiting
Narodowy Instytut Onkologii im. Marii Sklodowskiej-Curie - Panstwowy Instytut Badawczy w Warszawie ( Site 0151)
Warsaw
Masovian Voivodeship
Recruiting
Uniwersyteckie Centrum Kliniczne-Early Clinical Trials Unit ( Site 0150)
Gdansk
Pomeranian Voivodeship
Recruiting
Szpital Wojewódzki im. Mikoaja Kopernika w Koszalinie ( Site 0152)
Koszalin
West Pomeranian Voivodeship
Active Not Recruiting
Institut Català d'Oncologia - L'Hospitalet ( Site 0090)
L'Hospitalet de Llobregat
Barcelona
Recruiting
Hospital Universitario Quiron Madrid ( Site 0091)
Madrid
Spain
Recruiting
Baskent University Dr. Turgut Noyan Research and Training Center-ONCOLOGY ( Site 0141)
Adana
Turkey (Türkiye)
Recruiting
Hacettepe Universitesi Tip Fakultesi Hastanesi ( Site 0140)
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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