ENGOT-EN9/LEAP-001: a phase 3, randomized, open-label study of pembrolizumab plus lenvatinib versus chemotherapy for first-line treatment of advanc...

Date 29 September 2019
Event ESMO 2019 Congress
Session Poster Display session 2
Topics Endometrial Cancer
Presenter Christian Marth
Citation Annals of Oncology (2019) 30 (suppl_5): v403-v434. 10.1093/annonc/mdz250
Authors C. Marth1, C. Vulsteke2, M.J. Rubio3, V. Makker4, E.I. Braicu5, I.A. McNeish6, M. Radoslaw7, A. Ayhan8, K. Hasegawa9, X. Wu10, L. Dutta11, C. Xu12, S.M. Keefe13, J. Lee14, S. Pignata15
  • 1Medical University Of Innsbruck, University Hospital Innsbruck, 6020 - Innsbruck/AT
  • 2Integrated Cancer Center Ghent, AZ Maria Middelares AZMMSJ, 9051 - Gent/BE
  • 3Medical Oncology, H. Reina Sofía de Córdoba, Córdoba/ES
  • 4Medical Oncology, Memorial Sloan-Kettering Cancer Center, 10065 - New York City/US
  • 5Department Of Gynecology, Universitätsklinik Charité, Campus Virchow Klinikum, 13353 - Berlin/DE
  • 6Department Of Surgery And Cancer, Imperial College London, London/GB
  • 7Oddział Ginekologii Onkologicznej Katedry I Kliniki Onkologii, Uniwersytet Medyczny im K. Marcinkowskiego w Poznaniu, Poznań/PL
  • 8Medical Oncology, Ankara Baskent University Hospital, Ankara/TR
  • 9Gynecologic Oncology, Saitama Medical University International Medical Center, 350-1298 - Hidaka, Saitama/JP
  • 10Department Of Gynecologic Oncology, Fudan University Shanghai Cancer Center, 200032 - Shanghai/CN
  • 11Clinical Research, Eisai Inc., Woodcliff Lake/US
  • 12Biostatistics, Merck & Co., Inc., Kenilworth/US
  • 13Oncology Clinical Development, Merck & Co., Inc., Kenilworth/US
  • 14Clinical Research, Merck & Co., Inc., Kenilworth/US
  • 15Urology And Gynecology, Istituto Nazionale Tumori – I.R.C.C.S - Fondazione Pascale, 80131 - Napoli/IT

Abstract

Background

While early stage endometrial cancer (EC) is associated with a favorable prognosis, prognosis for advanced or recurrent EC is poor. Paclitaxel and carboplatin chemotherapy (CT) is often used as first-line treatment for these patients; however, there exists an imperative need for more effective and tolerable therapies. In KEYNOTE-146, combination therapy with the PD-1 inhibitor pembrolizumab (pembro) and the tyrosine kinase inhibitor lenvatinib resulted in an ORR of 39% in patients with EC (Makker et al. ASCO 2018). Based on these promising data, the ENGOT-EN9/LEAP-001 study was initiated to assess this combination therapy in women with recurrent or advanced EC.

Trial design

The ENGOT-EN9/LEAP-001 study (NCT03884101) is a phase 3, randomized, open-label, active-controlled trial comparing combination therapy with pembro and lenvatinib to paclitaxel and carboplatin CT in patients with newly diagnosed stage III-IV or recurrent EC (NCT03884101). Approximately 720 patients not previously treated with systemic chemotherapy (except as part of a chemoradiation regimen), antiangiogenic agents, PD-1 or PD-L1 inhibitors, or other T-cell receptor–targeted agents will be randomized 1:1 to pembro (200 mg Q3W) plus lenvatinib (20 mg daily) or paclitaxel and carboplatin CT (pac 175 mg/m2 plus carb AUC 6 Q3W). Patients will first be stratified by proficient vs deficient mismatch repair status (pMMR vs dMMR), and pMMR patients will be further stratified by ECOG performance status (0 vs 1), measurable disease (yes vs no), and prior chemoradiation (yes vs no). Treatment will continue until disease progression, initiation of new anticancer treatment, unacceptable adverse events, or withdrawal of consent for up to 35 cycles for pembro or 7 cycles of paclitaxel and carboplatin CT. Primary endpoints are PFS per RECIST v1.1, assessed by blinded independent central review, and OS. Secondary endpoints are ORR, health-related quality of life, safety and tolerability, and pharmacokinetics of lenvatinib. Exploratory endpoints include duration of response, disease control rate, and clinical benefit rate. Enrollment is ongoing.

Clinical trial identification

NCT03884101; 21, 2019.

Editorial acknowledgement

Nathan Rodeberg, PhD, and Diane Neer, ELS, of MedThink SciCom, funded by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and Eisai Inc.

Legal entity responsible for the study

Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and Eisai Inc., Woodcliff Lake, NJ, USA, are responsible for the governance, coordination and running of the study.

Funding

Funding for this study was provided by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, and Eisai Inc., Woodcliff Lake, NJ, USA.

Disclosure

C. Vulsteke: Honoraria (self), Research grant / Funding (self): Roche; Honoraria (self): Janssen; Honoraria (self): Novartis; Honoraria (self): Leo-Pharma; Honoraria (self): Merck MSD; Honoraria (self): AstraZeneca; Honoraria (self): Astellas. V. Makker: Advisory / Consultancy: Eisai; Advisory / Consultancy: Merck; Research grant / Funding (institution): Takeda; Honoraria (self), Advisory / Consultancy: ArQule; Research grant / Funding (self): Karyopharm; Research grant / Funding (self): AstraZeneca. I.A. McNeish: Honoraria (self): Clovis Oncology; Honoraria (self), Research grant / Funding (institution): AstraZeneca; Honoraria (self): Takeda; Honoraria (self): Tesaro. L. Dutta: Full / Part-time employment: Eisai. C. Xu: Shareholder / Stockholder / Stock options, Full / Part-time employment: Merck. S.M. Keefe: Travel / Accommodation / Expenses, Shareholder / Stockholder / Stock options, Full / Part-time employment: Merck. J. Lee: Shareholder / Stockholder / Stock options, Full / Part-time employment: Merck. S. Pignata: Honoraria (self), Research grant / Funding (institution): MSD; Honoraria (self), Research grant / Funding (institution): Roche; Research grant / Funding (institution): AstraZeneca; Honoraria (self): Clovis Oncology; Honoraria (self): Tesaro; Honoraria (self): Inctre. All other authors have declared no conflicts of interest.