Study on Combination Therapies for Esophageal Cancer (Substudy 06E)

Sponsor: Merck Sharp & Dohme LLC

Sponsor score: 40

ClinicalTrials ID:NCT06780111

This clinical trial is exploring new treatment combinations for esophageal squamous cell carcinoma (ESCC), a type of cancer affecting the esophagus. The study focuses on cases where the cancer cannot be fully removed by surgery or has spread to other parts of the body.

Patient Parameters

Program Overview

Researchers are investigating new ways to treat esophageal squamous cell carcinoma (ESCC), a cancer that starts in the lining of the esophagus, the tube connecting the throat to the stomach. This study focuses on ESCC that is either locally advanced and cannot be completely removed by surgery, or has spread to other parts of the body (metastatic). Current treatments include pembrolizumab, an immunotherapy that helps the immune system fight cancer, and chemotherapy, which destroys or stops the growth of cancer cells. The study aims to learn about the safety and effectiveness of combining pembrolizumab with new investigational drugs, with or without chemotherapy. One of these investigational drugs is ifinatamab deruxtecan (I-DXd), which targets cancer cells to deliver treatment directly to them. The main goal is to understand how safe these treatments are and how well patients tolerate them, as well as how the cancer responds to these treatments.

Description

The main protocol for this study is identified as MK-3475-U06. Researchers are testing new combinations of treatments for esophageal squamous cell carcinoma (ESCC), a cancer that affects the esophagus. This study is for cases where the cancer cannot be fully removed by surgery or has spread to other parts of the body. The treatments being studied include pembrolizumab, an immunotherapy that boosts the immune system to fight cancer, and chemotherapy, which kills or stops the growth of cancer cells. The study is also testing new investigational drugs, including ifinatamab deruxtecan (I-DXd), which is designed to target and destroy cancer cells. The main goals are to determine the safety of these treatments, how well patients can tolerate them, and how effectively they reduce or eliminate the cancer.

Eligibility Criteria

Inclusion Criteria

The main inclusion criteria include but are not limited to the following:

  • Has histologically or cytologically confirmed diagnosis of locally advanced unresectable or metastatic squamous cell carcinoma of the esophagus in first-line (1L) setting.
  • Has measurable disease per RECIST 1.1 as assessed by the local site. investigator or designee/radiology assessment and verified by BICR. Lesions situated in a previously irradiated area are considered measurable if progression has been shown in such lesions.
  • Has AEs due to previous anticancer therapies of ≤Grade 1 or baseline (except alopecia and vitiligo). Endocrine-related AEs adequately treated with hormone replacement are acceptable.
  • Human immunodeficiency virus (HIV)-infected participants must have well controlled HIV on antiretroviral therapy (ART).
  • Has Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1.
  • Has adequate organ function.

Exclusion Criteria

The main exclusion criteria include but are not limited to the following:

  • Has had systemic anticancer therapy for locally advanced unresectable or metastatic esophageal cancer.
  • Has tumor invasion into organs located adjacent to the esophageal disease site (eg, aorta or respiratory tract) at an increased risk of fistula.
  • Has uncontrollable pleural effusion, pericardial effusion, or ascites requiring frequent drainage or medical intervention.
  • Has clinically significant corneal disease, history of documented severe dry eye syndrome, severe Meibomian gland disease and/or blepharitis, or severe corneal disease that prevents/delays corneal healing.
  • HIV-infected participants with a history of Kaposi's sarcoma and/or Multicentric Castleman's Disease.
  • Has received prior therapy with an anti-programmed cell death 1 protein (PD-1), anti-programmed cell death ligand 1 (PD-L1), or anti-programmed cell death ligand 2 (PD-L2) agent, or with an agent directed to another stimulatory or coinhibitory T-cell receptor.
  • Has received prior systemic anticancer therapy including investigational agents within 4 weeks before the first dose of study intervention.
  • Has received prior radiotherapy within 2 weeks of start of study intervention, or has radiation-related toxicities, requiring corticosteroids.
  • Has received a live or live-attenuated vaccine within 30 days before the first dose of study intervention. Administration of killed vaccines is allowed.
  • Has inadequate cardiac function assessed as: - corrected QT interval by Fredericia (QTcF) value >470 msec.
  • Has clinically significant cardiovascular disease within 6 months from first dose of study intervention, including New York Heart Association Class III or IV congestive heart failure, unstable angina, myocardial infarction, cerebral vascular accident, or cardiac arrhythmia associated with hemodynamic instability.
  • Has peripheral neuropathy ≥ Grade 2.
  • Has diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy (in dosing exceeding 10 mg daily of prednisone equivalent) or any other form of immunosuppressive therapy within 7 days prior to the first dose of study intervention.
  • Has known additional malignancy that is progressing or has required active treatment within the past 3 years.
  • Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis.
  • Has active autoimmune disease that has required systemic treatment in the past 2 years.
  • Has had (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease, and/or suspected interstitial lung disease (ILD)/pneumonitis that cannot be ruled out by imaging at Screening.
  • Has active infection requiring systemic therapy.
  • Has clinically severe pulmonary compromise resulting from intercurrent pulmonary illnesses, including, but not limited to, any underlying pulmonary disorder.

Locations

FACILITYZIPCITYSTATE
UPMC Hillman Cancer Center ( Site 1904)15232PittsburghPennsylvania

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