Study of Epacadostat (INCB024360) Alone and In Combination With Pembrolizumab (MK-3475) With Chemotherapy and Pembrolizumab Without Chemotherapy in Participants With Advanced Solid Tumors (MK-3475-434)
Condition: Neoplasms; Carcinoma, Non-Small-Cell Lung
MeSH terms: Carcinoma, Non-Small-Cell Lung
Intervention: Epacadostat 25 mg; Epacadostat 100 mg; pembrolizumab 200 mg; Cisplatin 75 mg/m^2; Carboplatin Area Under the Curve (AUC) 5; Pemetrexed 500 mg/m^2; Paclitaxel 200 mg/m^2; Carboplatin AUC 6
Intervention description: Oral administration; Oral administration; Intravenous (IV) infusion; IV infusion; IV infusion; IV infusion; IV infusion; IV infusion
Intervention MeSH terms: Paclitaxel; Cisplatin; Carboplatin; Pembrolizumab; Pemetrexed
Phase: Phase 1
Study type: Interventional
Primary purpose: Treatment
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 34.0
Sex: All
Minimum age: 20 Years
Healthy volunteers: No
Keywords: Advanced Solid Tumors; PD-1; PD1; Programmed Cell Death-1; Programmed Cell Death 1; Programmed Cell Death-Ligand 1 (PD-L1); Programmed Cell Death-Ligand 2 (PD-L2); PDL1; PDL2

Summary:

      This is an open-label, non-randomized, Phase I study of epacadostat (INCB024360) alone and in
      combination with pembrolizumab with chemotherapy and pembrolizumab without chemotherapy in
      participants with advanced solid tumors. The primary objective of the trial is to evaluate
      the safety and tolerability of epacadostat administered alone and in combination with
      pembrolizumab with and without chemotherapy.

      With protocol amendment 02 (26-April-2019), treatment with epacadostat was stopped in the
      "Epacad+Pembro+Cisplatin+Pemetrexed", "Epacad+Pembro+Carboplatin+Pemetrexed", and
      "Epacad+Pembro+Carboplatin+Paclitaxel" study arms.
    

Eligibility criteria:

        Inclusion Criteria:

          -  For Part A: Has a histologically-confirmed metastatic or locally advanced solid tumor
             that has failed to respond to standard therapy, progressed despite standard therapy,
             or for which standard therapy does not exist.

          -  For Part B: Has a histologically-confirmed or cytologically confirmed diagnosis of
             non-small cell lung carcinoma (NSCLC) stage IIIB/IV, be naïve to systemic therapy, and
             have confirmation that epidermal growth factor receptor (EGFR) or anaplastic lymphoma
             kinase (ALK)-directed therapy is not indicated. Cohort 1 and 2 must have a
             histological or cytological diagnosis of non-squamous cancer.

          -  Has at least one measurable lesion by computed tomography or magnetic resonance
             imaging per Response Evaluation Criteria In Solid Tumors (RECIST) 1.1

          -  Has Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1

          -  Has a life expectancy of ≥3 months

          -  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 during the study through 120 days after the last dose of study
             medication

          -  For Part A: Has provided tissue for programmed cell death ligand 1 (PD-L1)/
             Indoleamine 2,3-dioxygenase 1 (IDO1) expression evaluation from an archival tissue
             sample or newly obtained core or excisional biopsy of a tumor lesion not previously
             irradiated. For Part B submission of tissue is optional.

        Exclusion Criteria:

          -  Has received prior therapy with an anti-Programmed cell death protein (PD)-1,
             anti-PD-L1, anti-PD-L2, anti-CD137, anti-Cytotoxic T-lymphocyte-associated antigen-4
             (CTLA-4) agents (including ipilimumab or any other antibody/drug specifically
             targeting T-cell co-stimulation or checkpoint pathways), or IDO1 inhibitor

          -  Is currently participating or has participated in a study with an investigational
             compound or device within 4 weeks, or 5 times half-life of the investigational
             compound, whichever is longer, of initial dosing on this study

          -  For Part A: Has had chemotherapy, targeted small molecule therapy, radiotherapy, major
             surgery, or biological cancer therapy (including monoclonal antibodies) within 4 weeks
             (6 weeks for nitrosoureas or mitomycin C) prior to the first dose of study medication,
             or who has not recovered (≤ Grade 1 or baseline) from adverse events due to a
             previously administered treatment

          -  For Part B: Has received radiotherapy within 7 days of the first dose of trial
             treatment or radiation therapy to the lung that is >30 Gray (Gy) within 6 months of
             the first dose of study medication

          -  Is expected to require any other form of systemic or localized anti-neoplastic therapy
             while in study

          -  Has active central nervous system (CNS) metastases and/or carcinomatous meningitis

          -  Has symptomatic ascites or pleural effusion

          -  Has an active autoimmune disease that has required systemic treatment

          -  Is receiving systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone
             equivalent) or any other form of immunosuppressive therapy within 1 week prior to the
             first dose of study medication

          -  Has an active infection requiring systemic therapy

          -  Has history of (noninfectious) pneumonitis that required systemic steroids or current
             pneumonitis/interstitial lung disease

          -  Has received a live vaccine within 4 weeks prior to the first dose of study medication

          -  Has a known hypersensitivity to the components of the trial treatment or another
             monoclonal antibody

          -  For Part B: Has a known sensitivity to any component of cisplatin, carboplatin,
             paclitaxel, or pemetrexed.

          -  For Part B: Is on chronic systemic steroids with the exception of use of
             bronchodilators, inhaled steroids, or local steroid injections

          -  For Part B cohort 1 and 2: Is unable to interrupt aspirin or other nonsteroidal
             ant-inflammatory drugs (NSAIDs), other than an aspirin dose ≤1.3 g per day, for a
             5-day period (8-day period for long-acting agents, such as piroxicam).

          -  For Part B cohort 1 and 2: Is unable or unwilling to take folic acid or vitamin B12
             supplementation

          -  Is Human Immunodeficiency Virus (HIV)-positive (HIV 1/2 antibodies)

          -  Has known history of or is positive for active Hepatitis B (Hepatitis B surface
             antigen reactive) or has active Hepatitis C (Hepatitis C virus ribonucleic acid)

          -  Has known psychiatric or substance abuse disorders that would interfere with
             cooperation with the requirements of the trial

          -  Is pregnant or breastfeeding, or expecting to conceive or father children during the
             study through 120 days after the last dose of study medication

          -  Has received monoamine oxidase inhibitors (MAOIs) within the 3 weeks before the first
             dose of study medication

          -  Has any history of Serotonin Syndrome after receiving serotonergic drugs

          -  Has presence of a gastrointestinal condition that may affect drug absorption