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Phase II, 2-cohort, single arm trial treated with the combination of the following two agents:
Eligible patients will be divided into two cohorts.
Cohort 1: salivary gland tumors without SOC treatment option Cohort 2: 'aggressive' thyroid cancer without SOC treatment option
Both cohorts will undergo a biopsy and will begin immunotherapy plus chemotherapy. Pembrolizumab and steroid sparing taxane: docetaxel will be given every three weeks for 3 to 6 cycles. For accessible tumors only, at week three patients will receive an on-treatment biopsy.
Patients will move on to immunotherapy maintenance after completing their cycles. Pembrolizumab will be given every three weeks until disease progression or up to 35 cycles (about 2 years).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1: salivary gland tumors without SOC treatment option | Experimental | All patients will receive pembrolizumab and docetaxel. First pembrolizumab and docetaxel will be given together. After which patients will receive pembrolizumab alone until disease progression or up to 35 cycles (about 2 years). |
|
| Cohort 2: 'aggressive' thyroid cancer without SOC treatment op | Experimental | All patients will receive pembrolizumab and docetaxel. First pembrolizumab and docetaxel will be given together. After which patients will receive pembrolizumab alone until disease progression or up to 35 cycles (about 2 years). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pembrolizumab | Drug | Pembrolizumab will be administered via IV at 200mg every three weeks. Patients will receive pembrolizumab for about 2 years. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rate of response | From the start of treatment until the first documented record of response, up to 100 months, whichever comes first. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of adverse events | Up to 24 months. | |
| Overall rate of survival | From the start of treatment until the first record of death by any cause, up to 100 months, whichever comes first. | |
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Inclusion Criteria:
Patients must have histologically confirmed disease that is unresectable and not amenable to curative intent therapy:
ECOG performance status 0 or 1.
Consent to undergo on treatment biopsy if tumor is accessible and safe to biopsy
Measurable disease per RECIST 1.1, bone only metastatic disease may be allowed on approval from study PI.
Life expectancy of greater than 12 weeks.
Available tissue for PD-L1 staining (archival or new core needle biopsy at baseline if no archival tissue available). A minimum of 10 slides are required (unless approval from the PI is obtained)
Age greater than or equal to 18 years on day of signing informed consent.
Demonstrate reasonable organ function as defined in Table 1, all screening labs should be performed within 10 days of treatment initiation.
System Laboratory Value Hematological Absolute neutrophil count (ANC) ≥1,500 /mcL Platelets ≥100,000 / mcL Hemoglobin ≥9 g/dL or ≥5.6 mmol/L without transfusion or EPO dependency (within 7 days of assessment) Renal Serum creatinine OR ≤1.5 X upper limit of normal (ULN) OR Measured or calculateda creatinine clearance ≥40 mL/min for subject with creatinine levels > 2.0 X (GFR can also be used in place of creatinine or CrCl) institutional ULN
Hepatic Serum total bilirubin ≤ 1.2 X ULN OR in case of Gilbert's disease an elevated total Bilirubin is allowed if direct Bilirubin is ≤40% of total AST (SGOT) and ALT (SGPT) ≤ 2.5 X ULN
Coagulation International Normalized Ratio (INR) or ≤1.5 X ULN unless subject is receiving anticoagulant therapy Prothrombin Time (PT) as long as PT or PTT is within therapeutic range of intended use of anticoagulants
Activated Partial Thromboplastin Time (aPTT) ≤1.5 X ULN unless subject is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants
aCreatinine clearance should be calculated per institutional standard.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alexander Pearson | University of Chicago | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Chicago Comprehensive Cancer Center | Chicago | Illinois | 60637 | United States |
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| ID | Term |
|---|---|
| D013964 | Thyroid Neoplasms |
| D012468 | Salivary Gland Neoplasms |
| ID | Term |
|---|---|
| D004701 | Endocrine Gland Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D006258 | Head and Neck Neoplasms |
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| ID | Term |
|---|---|
| C582435 | pembrolizumab |
| D000077143 | Docetaxel |
| ID | Term |
|---|---|
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
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|
| Docetaxel | Drug | Docetaxel will be administered via IV at 75mg/m2 every three weeks for 3 to 6 cycles. |
|
|
| Rate of progression free survival |
| From the start of treatment to the first record of disease progression or death by any cause, up to 100 months, whichever comes first. |
| D004700 |
| Endocrine System Diseases |
| D013959 | Thyroid Diseases |
| D009062 | Mouth Neoplasms |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D012466 | Salivary Gland Diseases |
| D006844 |
| Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D004224 | Diterpenes |
| D013729 | Terpenes |