企業治験 | ||
主たる治験 | ||
平成30年1月15日 | ||
令和6年6月21日 | ||
令和3年5月26日 | ||
進行性胃腺癌又は食道胃接合部腺癌患者を対象とした1次治療としてのMK-3475、TS-1及びオキサリプラチンの併用療法とMK-3475、TS-1及びシスプラチンの併用療法の第II相試験(KEYNOTE-659) | ||
進行性胃腺癌又は食道胃接合部腺癌患者を対象としたPembrolizumab(MK-3475)、TS-1及びオキサリプラチン併用療法と、Pembrolizumab(MK-3475)、TS-1及びシスプラチン併用療法の第II相試験 | ||
大鵬薬品工業株式会社 | ||
本治験は、プログラム細胞死リガンド1(PD-L1)発現陽性及びヒト上皮成長因子受容体2(HER-2)/neu陰性の進行性胃腺癌又は食道胃接合部腺癌の患者を対象に、胃がんの1次治療としてのPembrolizumab(MK-3475)+オキサリプラチン+TS-1の併用療法と、Pembrolizumab(MK-3475)+シスプラチン+TS-1の併用療法の奏効率(ORR)を推定する。 | ||
2 | ||
胃癌 | ||
参加募集終了 | ||
Pembrolizumab + オキサリプラチン + TS-1(tegafur + gimeracil + oteracil potassium)、Pembrolizumab + シスプラチン + TS-1(tegafur + gimeracil + oteracil potassium)、- | ||
国立研究開発法人国立がん研究センター治験審査委員会 | ||
2024年06月20日 |
2021年05月26日 | ||
100 | ||
/ | 100名の患者が登録された.そのうち,54名がPembrolizumab + Oxaliplatin +TS-1 (Cohort 1),46名がPembrolizumab + Cisplatin +TS-1 (Cohort 2)に登録された. 患者集団の平均年齢は62.1歳(Cohort 1:61.5歳,Cohort 2:62.9歳)で,約7割が男性(Cohort 1:79.6%,Cohort 2:60.9%)であった. |
A total of 100 patients were enrolled. 54 of them were enrolled in Pembrolizumab + Oxaliplatin + TS-1 (Cohort 1) and 46 patients were enrolled in Pembrolizumab + Cisplatin +TS-1 (Cohort 2). The mean age of the population was 62.1 years (61.5 years in Cohort 1, 62.9 years in Cohort 2), and approximately 70% of the patients were male (79.6% in Cohort 1, 60.9% in Cohort 2). |
/ | 登録例:100名 (Cohort 1:54名, Cohort 2:46名) 投与例:100名 (Cohort 1:54名, Cohort 2:46名) 完了例:0名 (Cohort 1:0名, Cohort 2:0名) 治験中止理由: ・有害事象:6名 (Cohort 1: 3名, Cohort 2:3名) ・臨床的疾患進行:6名 (Cohort 1:2名, Cohort 2:4名) ・放射線学的疾患進行:71名 (Cohort 1:40名, Cohort 2:31名) ・同意撤回:1名 (Cohort 1:0名, Cohort 2:1名) ・その他:16名 (Cohort 1:9名, Cohort 2:7名) |
Enrolled: 100 (Cohort 1:54, Cohort 2:46) Treated: 100 (Cohort 1:54, Cohort 2:46) Completed: 0 (Cohort 1:0, Cohort 2:0) Reasons for treatment discontinuation: - Adverse events: 6 (Cohort 1: 3, Cohort 2:3) - Clinical disease progression: 6 (Cohort 1:2, Cohort 2:4) - Radiological progression: 71 (Cohort 1:40, Cohort 2:31) - Withdrawal by patient: 1(Cohort 1:0, Cohort 2:1) - Other: 16 (Cohort 1:9, Cohort 2:7) |
/ | 解析対象集団:All Subjects as Treated(治験薬を1回以上投与されたすべての患者) 100名 (内訳はCohort 1が54名,Cohort 2が46名) すべての患者に有害事象及び副作用が発現した.また,重篤な有害事象は49名(Cohort 1:27名,Cohort 2:22名)の患者に発現し,重篤な副作用は35名(Cohort 1:18名,Cohort 2:17名)の患者に発現した. 【発現割合30%以上の有害事象】 ・Cohort 1 末梢性感覚ニューロパチー(94.4%), 食欲減退(70.4%),悪心(63.0%),血小板数減少(53.7%),便秘(44.4%),下痢(44.4%),好中球数減少(44.4%),倦怠感(40.7%),味覚不全(35.2%) ・Cohort 2 好中球数減少(69.6%),食欲減退(67.4%),便秘(65.2%),悪心(60.9%),下痢(47.8%),貧血(39.1%),口内炎(37.0%),疲労(32.6%),倦怠感(32.6%),味覚不全(32.6%),末梢性感覚ニューロパチー(30.4%) 【重篤な有害事象】 死亡:3名(Cohort 1) 【発現割合5%以上の重篤な有害事象】 ・Cohort 1 副腎機能不全(5.6%) ・Cohort 2 副腎機能不全,肺炎(各6.5%) |
Analysis Population: All Subjects as Treated (all patients who received at least one dose of study drug) 100 patients (Breakdown is 54 patients in Cohort 1 and 46 patients in Cohort 2) All patients experienced Treatment-emergent adverse events (TEAEs) and treatment-related adverse events (TRAEs). Serious TEAEs and serious TRAEs were reported in 49 patients (27 patients in Cohort 1 and 22 patients in Cohort 2) and 35 patients (18 patients in Cohort 1 and 17 patients in Cohort 2) respectively. Most common (Expression ratio 30% or more) TEAEs: - In Cohort 1 peripheral sensory neuropathy (94.4%), decreased appetite (70.4%), nausea (63.0%), platelet count decreased (53.7%), constipation (44.4%), diarrhoea (44.4%), neutrophil count decreased (44.4%), malaise (40.7%), and dysgeusia (35.2%) - In Cohort 2 neutrophil count decreased (69.6%), decreased appetite (67.4%), constipation (65.2%), nausea (60.9%), diarrhoea (47.8%), anaemia (39.1%), stomatitis (37.0%), fatigue (32.6%), malaise (32.6%), dysgeusia (32.6%), and peripheral sensory neuropathy (30.4%) Serious TEAEs: Deaths Due to Adverse Events: 3 patients (Cohort 1) Most common (Expression ratio 5% or more) SAEs: - In Cohort 1 adrenal insufficiency (5.6%) - In Cohort 2 adrenal insufficiency and pneumonia (6.5% each) |
/ | 解析対象集団:All Subjects as Treated 100名 中央画像判定機関がRECIST 1.1に基づき評価した抗腫瘍効果を基に算出した奏効率(ORR):Cohort 1で72.2%(95%CI:58.4 - 83.5),Cohort 2で80.4%(95%CI:66.1 - 90.6) |
Analysis Ppopulation: All Subjects as Treated 100 patients Objective Response Rate (ORR) According to Response Evaluation Criteria In Solid Tumors Version 1.1 (RECIST 1.1) Assessed by Blinded Independent Central Review (BICR): The ORR was 72.2% (95% CI: 58.4 - 83.5) in Cohort 1 and 80.4% (95% CI: 66.1 - 90.6) in Cohort 2 |
副次的評価項目の解析結果 / Secondary Outcome Measures | 解析対象集団:All Subjects as Treated 100名 *奏効期間(DOR)の解析対象集団は,All Subjects as Treatedのうち,最良総合効果がCR又はPRであった奏効例76名(Cohort 1が39名,Cohort 2が37名) ・中央画像判定機関がiRECIST に基づき評価した抗腫瘍評価を基に算出したORR:Cohort 1で72.2%(95%CI:58.4 - 83.5),Cohort 2で80.4%(95%CI:66.1 - 90.6) ・中央画像判定機関がRECIST 1.1に基づき評価した抗腫瘍効果を基に算出したDOR:Cohort 1では中央値で10.6ヶ月(95%CI:5.6 - NA),Cohort 2では中央値で9.5ヶ月(95%CI:4.7 - 15.3) ・中央画像判定機関がiRECISTに基づき評価した抗腫瘍効果を基に算出したDOR:Cohort 1では中央値で10.6ヶ月(95%CI:5.6 - NAヶ月),Cohort 2では中央値で9.5ヶ月(95%CI:4.7 - NAヶ月) ・中央画像判定機関がRECIST 1.1及びiRECISTに基づき評価した抗腫瘍効果を基に算出した病態制御率(DCR):Cohort 1で96.3% (95% CI: 87.3 - 99.5),Cohort 2で97.8% (95% CI: 88.5 - 99.9) ・中央画像判定機関がRECIST 1.1及びiRECISTに基づき評価した抗腫瘍効果を基に算出したTime to response(TTR):両Cohortとも中央値で1.5ヶ月 ・中央画像判定機関がRECIST 1.1に基づき評価した抗腫瘍効果を基に算出した無増悪生存期間(PFS):Cohort 1では中央値で9.4ヶ月(95% CI: 6.6 - 12.6ヶ月),Cohort 2では中央値で8.3ヶ月 (95% CI: 5.8 - 15.3ヶ月) ・中央画像判定機関がiRECISTに基づき評価した抗腫瘍効果を基に算出したPFS:Cohort 1では中央値で9.4ヶ月(95% CI: 6.6 - 12.6ヶ月),Cohort 2では中央値で10.9ヶ月 (95% CI: 6.7 - NAヶ月) ・全生存期間(OS):Cohort 1では中央値で16.9ヶ月(95% CI: 13.4 - 20.0ヶ月),Cohort 2では中央値で17.1ヶ月 (95% CI: 12.6 - 23.1) ・安全性 有害事象は「有害事象に関するまとめ」に記載した. | Analysis Ppopulation: All Subjects as Treated 100 patients *The analyzed population for duration of response (DOR) consists of 76 patients with the best response of complete response (CR) or partial response (PR) in the All Subjects as Treated (39 patients in Cohort 1 and 37 patients in Cohort 2) - ORR According to Immune-related Response Evaluation Criteria In Solid Tumors (iRECIST) Assessed by BICR: The ORR was 72.2% (95% CI: 58.4 - 83.5) in Cohort 1 and 80.4% (95% CI: 66.1 - 90.6) in Cohort 2. - DOR According to RECIST 1.1 Assessed by BICR: The mediam DOR was 10.6 months (95% CI: 5.6 - NA) in Cohort 1 and 9.5 months (95% CI: 4.7 - 15.3) in Cohort 2. - DOR According to iRECIST Assessed by BICR: The mediam DOR was 10.6 months (95% CI: 5.6 - NA) in Cohort 1 and 9.5 months (95% CI: 4.7 - NA) in Cohort 2. - Disease Control Rate (DCR) According to RECIST 1.1 and iRECIST Assessed by BICR: The DCR was 96.3% (95% CI: 87.3 - 99.5) in Cohort 1 and 97.8% (95% CI: 88.5 - 99.9) in Cohort 2. - Time to Response (TTR) According to RECIST 1.1 and iRECIST Assessed by BICR: The mediam TTR was 1.5 months in both Cohorts. - Progression-free Survival (PFS) According to RECIST 1.1 Assessed by BICR: The mediam PFS was 9.4 months (95% CI: 6.6 - 12.6) in Cohort 1 and 8.3 months (95% CI: 5.8 - 15.3) in Cohort 2. - PFS According to iRECIST 1.1 Assessed by BICR: The mediam PFS was 9.4 months (95% CI: 6.6 - 12.6) in Cohort 1 and 10.9 months (95% CI: 6.7 - NA) in Cohort 2. - Overall Survival (OS): The mediam OS was 16.9 months (95% CI: 13.4 - 20.0) in Cohort 1 and 17.1 months (95% CI: 12.6 - 23.1) in Cohort 2. Safety The incidence of adverse events is described in the Adverse events section. |
/ | PembrolizumabとOxaliplatin +TS-1またはCisplatin +TS-1併用療法は,PD-L1陽性,HER2陰性の進行性胃腺癌又は食道胃接合部腺癌の日本人患者に対して,有望な有効性と管理可能な安全性を示した. | The combination of pembrolizumab with Oxaliplatin +TS-1 or Cisplatin +TS-1 demonstrated promising efficacy and manageable safety in Japanese patients with PD-L1-positive, HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma. |
出版物の掲載 / Posting of iournal publication | 有 | presence |
2020年03月04日 | ||
https://pubmed.ncbi.nlm.nih.gov/35701865/ |
/ | 有 | Yes |
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/ | http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf http://engagezone.msd.com/ds_documentation.php |
http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf http://engagezone.msd.com/ds_documentation.php |
試験等の種別 | 企業治験 |
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主たる治験 | |
登録日 | 2024年06月20日 |
jRCT番号 | jRCT2080223773 |
進行性胃腺癌又は食道胃接合部腺癌患者を対象とした1次治療としてのMK-3475、TS-1及びオキサリプラチンの併用療法とMK-3475、TS-1及びシスプラチンの併用療法の第II相試験(KEYNOTE-659) | A phase IIb, clinical trial to study the safety and efficacy of Pembrolizumab (MK-3475) in combination with TS-1+Cisplatin or TS-1+Oxaliplatin as a First Line Chemotherapy in participants with Advanced or Recurrent Gastric Cancer (KEYNOTE-659) | ||
進行性胃腺癌又は食道胃接合部腺癌患者を対象としたPembrolizumab(MK-3475)、TS-1及びオキサリプラチン併用療法と、Pembrolizumab(MK-3475)、TS-1及びシスプラチン併用療法の第II相試験 | Phase IIb study of Pembrolizumab in combination with TS-1+Cisplatin or TS-1+Oxaliplatin in GC |
大鵬薬品工業株式会社 | Taiho Pharmaceutical Co., Ltd. | ||
臨床開発部門 | Clinical Development Dept. | ||
- | - | ||
03-3293-2113 | |||
toiawaseCD1@taiho.co.jp |
大鵬薬品工業株式会社 | Taiho Pharmaceutical Co., Ltd. | ||
臨床試験登録窓口 | Clinical Trial Registration Contact. | ||
- | - | ||
03-3293-2113 | |||
toiawase@taiho.co.jp |
2018年03月20日 |
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本治験は、プログラム細胞死リガンド1(PD-L1)発現陽性及びヒト上皮成長因子受容体2(HER-2)/neu陰性の進行性胃腺癌又は食道胃接合部腺癌の患者を対象に、胃がんの1次治療としてのPembrolizumab(MK-3475)+オキサリプラチン+TS-1の併用療法と、Pembrolizumab(MK-3475)+シスプラチン+TS-1の併用療法の奏効率(ORR)を推定する。 | This study estimates overall response rates (ORRs) of pembrolizumab + oxaliplatin + TS-1 and pembrolizumab + cisplatin + TS-1, as first-line treatment for gastric cancer in programmed death-ligand 1 (PD-L1) positive, human epidermal growth factor receptor 2 (HER2/neu) negative subjects with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma. | ||
2 | 2 | ||
2018年04月20日 | |||
2018年02月01日 | |||
2020年12月31日 | |||
90 | |||
介入研究 | Interventional | ||
非盲検 |
Unblinded Open-label |
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治療 |
treatment purpose |
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/ | 日本 | Japan | |
/ | ・登録時のEastern Cooperative Oncology Group (ECOG) Performance Statusが0又は1の患者 |
- Have a performance status of 0 or 1 on the Eastern Cooperative Oncology Group (ECOG) Performance Scale at the timing of enrollment. |
|
/ | ・扁平上皮又は未分化胃癌を有する患者 |
- Has squamous cell or undifferentiated gastric cancer. |
|
/ | 18歳以上 |
18age old over |
|
/ | 75歳以下 |
75age old under |
|
/ | 男性・女性 |
Both |
|
/ | 胃癌 | Gastric Adenocarcinoma | |
/ | |||
/ | 試験対象薬剤等 一般的名称等:Pembrolizumab + オキサリプラチン + TS-1(tegafur + gimeracil + oteracil potassium) 薬剤・試験薬剤:pembrolizumab, oxaliplatin, TS-1:tegafur, gimeracil, oteracil potassium 薬効分類コード:42- 腫瘍用薬 用法・用量、使用方法:Cohort 1:Pembrolizumab 200 mg 固定用量 3週毎投与法(Q3W)+オキサリプラチン130 mg/m2 Q3Wの静脈内投与+TS-1の1日2回14日間連続経口投与後7日間休薬 一般的名称等:Pembrolizumab + シスプラチン + TS-1(tegafur + gimeracil + oteracil potassium) 薬剤・試験薬剤:pembrolizumab, cisplatin, TS-1:tegafur, gimeracil, oteracil potassium 薬効分類コード:42- 腫瘍用薬 用法・用量、使用方法:Cohort 2:Pembrolizumab 200 mg 固定用量Q3W+シスプラチン60 mg/m2 Q3Wの静脈内投与+TS-1の1日2回14日間連続経口投与後7日間休薬 対象薬剤等 一般的名称等:- 薬剤・試験薬剤:- 薬効分類コード: 用法・用量、使用方法:- |
investigational material(s) Generic name etc : Pembrolizumab + oxaliplatin + TS-1 (tegafur + gimeracil + oteracil potassium) INN of investigational material : pembrolizumab, oxaliplatin, TS-1:tegafur, gimeracil, oteracil potassium Therapeutic category code : 42- Antineoplastic agents Dosage and Administration for Investigational material : Cohort 1: Pembrolizumab 200 mg fixed dose administered every 3 weeks (Q3W) + oxaliplatin 130 mg/m2 IVinfusion Q3W + TS-1 continuous oral administration twice daily (BID) for 14 days followed by a recovery period of 7 days Generic name etc : Pembrolizumab + cisplatin + TS-1 (tegafur + gimeracil + oteracil potassium) INN of investigational material : pembrolizumab, cisplatin, TS-1:tegafur, gimeracil, oteracil potassium Therapeutic category code : 42- Antineoplastic agents Dosage and Administration for Investigational material : Cohort 2: Pembrolizumab 200 mg fixed dose administered Q3W + cisplatin 60 mg/m2 IV infusion Q3W + TS-1 continuous oral administration BID for 14 days followed by a recovery period of 7 days control material(s) Generic name etc : - INN of investigational material : - Therapeutic category code : Dosage and Administration for Investigational material : - |
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/ | |||
/ | 有効性 奏効率(ORR) 中央画像判定機関が独立にRECIST 1.1に基づき評価した抗腫瘍効果を基に算出した奏効率(ORR)を評価する。 |
efficacy Overall Response Rate (ORR) To evaluate Overall Response Rate (ORR) per RECIST 1.1 as assessed by Blinded Independent Central Review (BICR). |
|
/ | 有効性 奏効期間(DOR) 中央画像判定機関がRECIST 1.1及びiRECISTに基づき評価した抗腫瘍効果を基に算出した奏効期間(DOR)を評価する。 |
efficacy Duration of Response (DOR) To evaluate the Duration of Response (DOR) per RECIST 1.1 and per iRECIST as assessed by BICR. |
医薬品 | medicine | |||
Pembrolizumab + オキサリプラチン + TS-1(tegafur + gimeracil + oteracil potassium) | Pembrolizumab + oxaliplatin + TS-1 (tegafur + gimeracil + oteracil potassium) | |||
pembrolizumab, oxaliplatin, TS-1:tegafur, gimeracil, oteracil potassium | pembrolizumab, oxaliplatin, TS-1:tegafur, gimeracil, oteracil potassium | |||
42- 腫瘍用薬 | 42- Antineoplastic agents | |||
Cohort 1:Pembrolizumab 200 mg 固定用量 3週毎投与法(Q3W)+オキサリプラチン130 mg/m2 Q3Wの静脈内投与+TS-1の1日2回14日間連続経口投与後7日間休薬 | Cohort 1: Pembrolizumab 200 mg fixed dose administered every 3 weeks (Q3W) + oxaliplatin 130 mg/m2 IVinfusion Q3W + TS-1 continuous oral administration twice daily (BID) for 14 days followed by a recovery period of 7 days | |||
Pembrolizumab + シスプラチン + TS-1(tegafur + gimeracil + oteracil potassium) | Pembrolizumab + cisplatin + TS-1 (tegafur + gimeracil + oteracil potassium) | |||
pembrolizumab, cisplatin, TS-1:tegafur, gimeracil, oteracil potassium | pembrolizumab, cisplatin, TS-1:tegafur, gimeracil, oteracil potassium | |||
42- 腫瘍用薬 | 42- Antineoplastic agents | |||
Cohort 2:Pembrolizumab 200 mg 固定用量Q3W+シスプラチン60 mg/m2 Q3Wの静脈内投与+TS-1の1日2回14日間連続経口投与後7日間休薬 | Cohort 2: Pembrolizumab 200 mg fixed dose administered Q3W + cisplatin 60 mg/m2 IV infusion Q3W + TS-1 continuous oral administration BID for 14 days followed by a recovery period of 7 days | |||
- | - | |||
- | - | |||
- | - |
参加募集終了 | completed | |
/ | 実施中 |
progressing |
MSD株式会社 | ||
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. |
大鵬薬品工業株式会社 | ||
Taiho Pharmaceutical Co., Ltd. | ||
MSD株式会社 | Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. | |
MSDの企業治験 | Clinical Trial of MSD |
国立研究開発法人国立がん研究センター治験審査委員会 | National Cancer Ctr IRB #2 - J | |
東京都中央区築地5-1-1 | 5-1-1, Tsukiji, Chuo-ku, Tokyo | |
- | ||
- | ||
承認 | approved |
有 | presence | |
NCT03382600 | ||
ClinicalTrials.gov | ClinicalTrials.gov | |
JapicCTI-183829 | ||
医薬品医療機器情報提供ホームページ | Pharmaceuticals and Medical Devices Agency | ||
http://www.info.pmda.go.jp/go/pack/4291435A1029_1_18/ | |||
キイトルーダ添付文書情報 | KEYTRUDA Package insert (in Japanese) |
設定されていません |
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設定されていません |
Prot_000.pdf |
設定されていません |
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2017年11月27日 | |||
設定されていません |
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設定されていません |