Patient case: 51-year-old female with papillary thyroid carcinoma; genetic feature: BRAF (V600E)

Clinical trial: Low-dose Interleukin-2 and Pembrolizumab in Melanoma and Renal Cell Cancer

Summary: This study will evaluate the safety and disease control rate of the combination of pembrolizumab plus low-dose interleukin-2 in patients who have either advanced melanoma or renal cell cancer.


Eligibility: Main Inclusion Criteria
  -  Stage IV or unresectable stage III malignant melanoma or renal cell carcinoma.
  -  Melanoma
  -  Patients must have failed anti-PD-1/PD-L1 antibody therapy.
  -  Patients must have failed ipilimumab or be intolerant of ipilimumab and therefore unable to receive ipilimumab.
  -  Patients may, but are not obligated, to have failed high- dose IL2.
  -  BRAF status must be known or unable to be performed. If the melanoma expresses a BRAF mutation of V600E, V600K, or V600R patient must have received and progressed through a BRAF inhibitor or have failed that therapy due to toxicity.
  -  Renal Cell Carcinoma
  -  Patients must have failed anti-PD-1/PD-L1 antibody therapy.
  -  Patients must have failed a VEGF pathway inhibitor and a second tyrosine kinase inhibitor.
  -  Patients may, but are not obligated, to have failed high- dose IL2.
  -  Measurable disease based upon RECIST 1.1.
  -  Subjects with brain metastases will be eligible if the following are true:
  -  Subjects with ≤ 3 brain metastases
  -  All metastases are ≤ 3 cm
  -  All metastases have been treated and are asymptomatic
  -  Steroids are not required for management of the brain metastases
  -  All metastases have been stable for 1 month following treatment
  -  Subjects with > 3 brain metastases
  -  All metastases are ≤ 3 cm
  -  All metastases have been treated and are asymptomatic
  -  Steroids are not required for management of the brain metastases
  -  All metastases have been stable for 6 months following treatment
  -  Performance status: ECOG 0-1.
  -  Adequate organ function.
  -  Ability to provide informed consent.
  Main Exclusion Criteria:
  -  Pregnancy
  -  Currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment.
  -  Has a diagnosis of primary or secondary immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 3 weeks prior to the first dose of trial treatment. Replacement doses of steroids are permitted.
  -  Known history of active TB (Bacillus Tuberculosis)
  -  Hypersensitivity to pembrolizumab or any of its excipients.
  -  Known additional malignancies (exceptions DCIS or LCIS, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy).
  -  Prior anti-cancer monoclonal antibody (mAb) within 3 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 3 weeks earlier.
  -  Prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent.
  -  Known carcinomatous meningitis.
  -  Active autoimmune disease that has required systemic treatment in the past 2 years. Patients may be eligible if they have the following autoimmune diseases: thyroiditis or hypothyroidism, mild arthritis, diabetes, resolved hypophysitis, ulcerative colitis after total abdominal colectomy.
  -  Active infection requiring systemic therapy.
  -  Known psychiatric or substance abuse disorders.
  -  Known history of Human Immunodeficiency Virus (HIV).
  -  Known active Hepatitis B virus (HBV) or Hepatitis C virus (HCV).
  -  Has received a live vaccine within 30 days of planned start of study therapy.
  -  Severe chronic pulmonary disease.
  -  Congestive heart failure, angina, or symptomatic cardiac arrhythmia or is classified according to the New York Heart Association classification as having Class III or IV heart disease.
  -  History of (non-infectious) pneumonitis that required steroids or current pneumonitis.

Relevance to patient case: not relevant