66 Participants Needed

Tazemetostat + PD-1 Blockade for Non-Small Cell Lung Cancer

Recruiting at 1 trial location
DS
SM
DS
QH
Overseen ByQuillan Huang, MD
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Breakthrough TherapyThis drug has been fast-tracked for approval by the FDA given its high promise

What You Need to Know Before You Apply

What is the purpose of this trial?

This is an open label, single arm, phase Ib/II clinical trial of checkpoint blockade, pembrolizumab and EZH2 inhibitor, tulmimetostat combination therapy for patients with advanced non-small cell lung cancer who have progressed from front or second-line treatment. Patients will be enrolled at multiple Veterans Affairs Medical Centers.

Do I need to stop my current medications to join the trial?

The trial does not specify if you need to stop taking your current medications. However, you cannot take medications that strongly affect the liver enzyme CYP3A4, like certain antibiotics or herbal supplements such as St. John's wort. It's best to discuss your current medications with the trial team.

Is the combination of Tazemetostat and Pembrolizumab safe for humans?

Pembrolizumab, a PD-1 inhibitor, has been used in various cancer treatments and is generally considered safe, but it can cause immune-related side effects like type 1 diabetes, thyroid issues, and inflammation of organs such as the lungs and liver. Tazemetostat's safety profile is not detailed here, but Pembrolizumab's known side effects should be considered when evaluating the combination's safety.12345

What makes the drug combination of Tazemetostat and Pembrolizumab unique for treating non-small cell lung cancer?

The combination of Tazemetostat and Pembrolizumab is unique because it combines a PD-1 inhibitor (Pembrolizumab) that helps the immune system attack cancer cells with Tazemetostat, which targets specific enzymes involved in cancer cell growth. This dual approach may offer a novel way to enhance the effectiveness of treatment for non-small cell lung cancer.34567

What data supports the effectiveness of the drug Tazemetostat + PD-1 Blockade for Non-Small Cell Lung Cancer?

Pembrolizumab, a part of this treatment, has shown promising results in treating non-small cell lung cancer, especially in patients with PD-L1-positive tumors. It is already approved for use in certain lung cancers and has demonstrated clinical activity in various solid tumors.348910

Who Is on the Research Team?

DS

Daniel S Shin, MD PhD

Principal Investigator

Michael E. DeBakey VA Medical Center, Houston, TX

Are You a Good Fit for This Trial?

This trial is for adults with advanced non-small cell lung cancer who've seen their disease progress after anti-PD-1/L1 therapy. They must have good performance status (ECOG 0-1), provide a tumor tissue sample, and have measurable disease. Adequate organ function and agreement to use contraception are required. Those with certain infections, recent major surgery, active pneumonitis or autoimmune diseases, other cancers within 3 years, or severe hypersensitivity to pembrolizumab can't participate.

Inclusion Criteria

I am not pregnant and will use birth control during the trial.
I am fully active or can carry out light work.
My cancer has worsened despite treatment with an anti-PD-1/L1 drug.
See 7 more

Exclusion Criteria

I have not needed treatment for an autoimmune disease in the last 2 years.
You are pregnant at the time of the study treatment.
My lung cancer is a low to intermediate grade neuroendocrine type.
See 18 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Safety Lead-in Phase Ib

Safety lead-in phase using BOIN with 2 dose levels of tulmimetostat to determine recommended dose for phase II

Duration not specified
Multiple visits for dose administration and monitoring

Treatment Phase II

Combination treatment with tulmimetostat and pembrolizumab for up to 2 years

2 years
Pembrolizumab every 3 weeks, tulmimetostat daily

Follow-up

Participants are monitored for safety and effectiveness after treatment

1 year

What Are the Treatments Tested in This Trial?

Interventions

  • Pembrolizumab
  • Tazemetostat
Trial Overview The study tests the combination of Tazemetostat (an EZH2 inhibitor) and Pembrolizumab (a checkpoint blockade therapy) in patients with advanced non-small cell lung cancer at multiple Veterans Affairs Medical Centers. It's an open-label phase Ib/II trial where all participants receive the same treatment without a comparison group.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: combination of tulmimetostat and pembrolizumabExperimental Treatment1 Intervention

Pembrolizumab is already approved in United States, European Union, United Kingdom for the following indications:

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Approved in United States as KEYTRUDA for:
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Approved in European Union as KEYTRUDA for:
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Approved in United Kingdom as KEYTRUDA for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+

VA Greater Los Angeles Healthcare System

Collaborator

Trials
53
Recruited
8,700+

Published Research Related to This Trial

In a phase II trial involving 15 patients with resectable non-small cell lung cancer (NSCLC), neoadjuvant treatment with pembrolizumab showed a major pathologic response in 27% of patients, indicating promising antitumor activity before surgery.
The treatment was found to be feasible and safe, with only 33% of patients experiencing moderate adverse events, and no postoperative mortality, suggesting that pembrolizumab does not compromise surgical outcomes.
Neoadjuvant anti-programmed death-1 immunotherapy by pembrolizumab in resectable non-small cell lung cancer: First clinical experience.Eichhorn, F., Klotz, LV., Kriegsmann, M., et al.[2022]
Pembrolizumab, a PD-1 inhibitor, has demonstrated clinical effectiveness in treating various solid tumors, particularly in patients with PD-L1-positive non-small-cell lung cancer and unresectable/metastatic melanoma.
Early-phase trials and ongoing studies are focused on further confirming the clinical benefits of pembrolizumab in thoracic malignancies, highlighting its potential as a significant treatment option in cancer therapy.
Pembrolizumab for the treatment of thoracic malignancies: current landscape and future directions.Karim, S., Leighl, N.[2017]
A 68-year-old patient with stage IV lung adenocarcinoma showed an unexpected positive response to paclitaxel after failing treatment with pembrolizumab, an anti-PD-1 immunotherapy.
The patient experienced a response duration of over fourteen months with paclitaxel, suggesting that combining or sequencing chemotherapy with immunotherapy may enhance treatment effectiveness in certain cases.
[Prolonged response with paclitaxel after immunotherapy by pembrolizumab in lung cancer].Zapata, E., Mennecier, B., Leduc, C., et al.[2017]

Citations

Neoadjuvant anti-programmed death-1 immunotherapy by pembrolizumab in resectable non-small cell lung cancer: First clinical experience. [2022]
Pembrolizumab for the treatment of thoracic malignancies: current landscape and future directions. [2017]
[Prolonged response with paclitaxel after immunotherapy by pembrolizumab in lung cancer]. [2017]
Tiragolumab plus atezolizumab versus placebo plus atezolizumab as a first-line treatment for PD-L1-selected non-small-cell lung cancer (CITYSCAPE): primary and follow-up analyses of a randomised, double-blind, phase 2 study. [2022]
Perioperative outcomes of pulmonary resection after neoadjuvant pembrolizumab in patients with non-small cell lung cancer. [2022]
Programmed Cell Death-1 Inhibitor-Induced Type 1 Diabetes Mellitus. [2022]
Multiple autoimmune side effects of immune checkpoint inhibitors in a patient with metastatic melanoma receiving pembrolizumab. [2021]
FDA Approval Summary: Pembrolizumab for Treatment of Metastatic Non-Small Cell Lung Cancer: First-Line Therapy and Beyond. [2022]
Comparative efficacy and safety of immunotherapies targeting the PD-1/PD-L1 pathway for previously treated advanced non-small cell lung cancer: A Bayesian network meta-analysis. [2019]
Pembrolizumab monotherapy for non-small cell lung cancer (NSCLC): can patient stratification be improved in the UK Tayside population? A retrospective cohort study. [2023]
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