Non-Small Cell Lung CancerPhase 2KEAPSAKENCT04265534
KEAPSAKE: A Study of Telaglenastat (CB-839) With Standard-of-Care Chemoimmunotherapy in 1L KEAP1/NRF2-Mutated, Nonsquamous NSCLC
A Phase 2 study testing Telaglenastat, Carboplatin Chemotherapy and Pemetrexed Chemotherapy in people with Non-Small Cell Lung Cancer and Non-squamous Non-small-cell Lung Cancer, run by Calithera Biosciences, Inc at 102 sites in United States.
Trial summary
This is a Phase 2, randomized, multicenter, double-blind study of the glutaminase inhibitor telaglenastat with standard-of-care pembrolizumab and chemotherapy versus placebo with standard-of-care pembrolizumab and chemotherapy for first line treatment of metastatic disease in patients with KEAP1/NRF2-mutated, stage… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non-Small Cell Lung Cancer, Non-squamous Non-small-cell Lung Cancer, Non-Squamous Non-Small Cell Neoplasm of Lung
- What is being tested?
- Telaglenastat, Carboplatin Chemotherapy and Pemetrexed Chemotherapy
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 40 participants
- Where
- 102 sitesUnited States
- Study dates
- 24 Jul 2020to 9 Feb 2022
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Histologically or cytologically documented non-squamous NSCLC
- Stage IV (M1a-c, AJCC 8th Edition, Amin 2017) disease not previously treated with systemic therapy for metastatic NSCLC
- Patients who received adjuvant or neo-adjuvant therapy (with or without immunotherapy) for localized NSCLC are eligible if all adjuvant/neo-adjuvant therapy (including immunotherapy) was completed at least 6 months prior to the development of metastatic disease.
- No known actionable mutation in EGFR, ALK, ROS1, BRAF, NTRK or other known actionable mutation for which there is approved therapy in the first-line lung cancer setting
- Must have at least one radiographically measurable lesion per RECIST v1.1 defined as a lesion that is ≥ 10 mm in longest diameter or lymph node that is ≥ 15 mm in short axis imaged by computed tomography (CT) scan or magnetic resonance imaging (MRI)
- Target lesions situated in a previously irradiated area may be considered measurable if progression has been demonstrated subsequent to radiation therapy
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- Age ≥ 18 years on the day of signing informed consent
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
- Estimated life expectancy of at least 3 months
- Recovery to baseline or ≤ grade 1 National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) v5.0 from toxicities related to the prior treatment, unless after discussion with the medical monitor, the AE(s) are deemed clinically non-significant and/or stable on supportive therapy
- Has sponsor-approved eligible mutation in KEAP1 or NRF2 documented by NGS from a CAP-accredited and/or CLIA-certified laboratory (study-provided NGS or other NGS) and STK11 mutation status is known for the purpose of stratification.
- Adequate organ function laboratory findings (defined per protocol)
- Reproductive status:
- A female patient of childbearing potential must: i. Have a negative serum pregnancy test within 7 days prior to randomization ii. Agree to use methods of contraception outlined in Section 8.1.2 during the study through 120 days following the last dose of telaglenastat or pembrolizumab, or through 180 days following the last dose of chemotherapeutic drugs iii. Postmenopausal females (no menses for > 1 year without an alternate medical cause) and surgically sterilized females are exempt from these requirements b. Male patients who are sexually active with heterosexual partners of childbearing potential must agree to contraceptive requirements outlined in Section 8.1.2 and refrain from donating sperm during the study through 120 days following the last dose of telaglenastat or pembrolizumab, or through 180 days following the last dose of chemotherapeutic drugs
Who cannot join
- Squamous cell histology and mixed histology tumors with any small-cell/neuroendocrine component (other mixed histology should be reviewed with the medical monitor for eligibility)
- Any other concurrent malignancy requiring local or systemic therapy. Patients with other previously treated malignancy(ies) are allowed if the specific neoplasm, in the opinion of the principal investigator and with the agreement of the medical monitor, is not expected to interfere with study-specific endpoints
- Radiation therapy to the lung > 30 Gy within 6 months prior to randomization
- Clinically active diverticulitis, intra-abdominal abscess, gastrointestinal obstruction, abdominal carcinomatosis
- Active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs)
- Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
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- Treatment with chronic systemic steroids greater than 10 mg equivalent of prednisone per day
- Unstable/inadequate cardiac function, defined as the following:
- Myocardial infarction or symptomatic ischemia within 6 months prior to randomization
- Uncontrolled or clinically significant conduction abnormalities (e.g., patients with ventricular tachycardia on anti-arrhythmics are excluded; patients with 1st degree atrioventricular [AV] block or asymptomatic left anterior fascicular block [LAFB]/right bundle branch block [RBBB] are eligible)
- Congestive heart failure (New York Heart Association class III to IV)
- Unable to swallow oral medications
- Known sensitivity to any component of the study treatment (pembrolizumab, carboplatin, pemetrexed, and/or telaglenastat) or previous severe hypersensitivity to another monoclonal antibody (mAb)
- Unable or unwilling to take folic acid or vitamin B12 supplementation (per pemetrexed label)
- Unable to interrupt aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) as specified in pemetrexed label
- Interstitial lung disease or a history of pneumonitis that required oral or intravenous glucocorticoid treatment
- Unable or unwilling to discontinue proton pump inhibitor (PPI) use ≥ 5 days prior to randomization
- Patient known to be positive for Human Immunodeficiency Virus (HIV)
- Known active Hepatitis B or C. Active Hepatitis B is defined as a known positive HBsAg result. Active Hepatitis C is defined by a known positive Hepatitis C antibody result and known quantitative Hepatitis C virus RNA results greater than the lower limits of detection of the assay. Patients receiving antiviral therapy for Hepatitis B or C also are not eligible
- Any condition including social, psychiatric or medical (including uncontrolled significant concurrent illness) that in the opinion of the Investigator could interfere with treatment or protocol-related procedures
- Regular use of illicit drugs or history (within past year) of substance abuse (including alcohol)
- Patients who are pregnant or lactating
- Major surgery < 3 weeks prior to randomization. In addition, patients with ongoing clinically relevant complications from prior surgery are not eligible and they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting study treatment
- Any radiation therapy within 2 weeks prior to randomization (with exception of SRS for brain metastases). In addition, patients with ongoing clinically relevant complications from prior radiation therapy, patients requiring corticosteroids to treat radiation toxicity and patients who developed radiation pneumonitis are not eligible.
- Symptomatic ascites or pleural effusion. Patients who are clinically stable following treatment for these conditions (including therapeutic thoraco- or paracentesis) are eligible
- Refractory nausea and vomiting, uncontrolled diarrhea, malabsorption, significant small bowel resection or gastric bypass surgery, use of feeding tubes or other situation that may preclude adequate absorption or oral study drug
- Infection requiring more than 5 days of parenteral antibiotics, antivirals, or antifungals within two weeks prior to randomization. Anti-infective therapy must be completed at least 7 days before randomization
- Patients with active and/or untreated central nervous system metastasis including carcinomatous meningitis (leptomeningeal disease) are not eligible. Patients with previously treated brain metastases are eligible if they meet the following criteria:
- Received definitive treatment with stereotactic radiosurgery (SRS) or surgery to all known central nervous system (CNS) lesions (whole brain radiotherapy is not an eligible modality)
- Be at least 4 weeks post-surgical resection of CNS disease, symptomatically stable and off steroids before randomization
- Any live-virus vaccination within 28 days prior to randomization. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster (chicken pox), yellow fever, rabies, Bacillus Calmette-Guérin (BCG), and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (e.g., FluMist ®) are live attenuated vaccines and are not allowed
- Has had an allogeneic tissue/solid organ transplant
Trial locations and contacts
102 sites in 1 country.
102 sites in 1 country
United States102 sites
New York Oncology Hematology, P.C. (400 Patoon Creek Blvd.)
Albany, New York, 12206
New York Oncology Hematology, P.C. (43 New Scotland Ave.)
Albany, New York, 12208
University of New Mexico Comprehensive Cancer Center
Albuquerque, New Mexico, 87131
University Cancer and Blood Center
Athens, Georgia, 30607
Piedmont Cancer Institute
Atlanta, Georgia, 30318
Emory University Hospital
Atlanta, Georgia, 30322
Texas Oncology - Austin Midtown
Austin, Texas, 78705
Texas Oncology - Austin Central
Austin, Texas, 78731
Texas Oncology - South Austin
Austin, Texas, 78745
Johns Hopkins Bayview Memorial Hospital
Baltimore, Maryland, 21224
Texas Oncology Beaumont - USOR
Beaumont, Texas, 77701
New Jersey Cancer Care and Blood Disorders (NJCCBD)
Belleville, New Jersey, 07109
Summit Medical Group
Berkeley Heights, New Jersey, 07932
Center for Cancer and Blood Disorders
Bethesda, Maryland, 20817
University of Alabama at Birmingham
Birmingham, Alabama, 35294
Oncology and Hematology Associates of Southwest Virginia
Blacksburg, Virginia, 24060
Boca Raton Regional Hospital Lynn Cancer Institute
Boca Raton, Florida, 33486
Central Care Cancer Center
Bolivar, Missouri, 65613
Massachusetts General Hospital
Boston, Massachusetts, 02114
Roswell Park Comprehensive Cancer Center
Buffalo, New York, 14263
Cone Health at Alamance Regional
Burlington, North Carolina, 27215
Aultman Hospital
Canton, Ohio, 44710
Tennessee Oncology - Chattanooga (SCRI)
Chattanooga, Tennessee, 37404
TriHealth Cancer Institute
Cincinnati, Ohio, 45220
New York Oncology Hematology, P.C.
Clifton Park, New York, 12065
Maryland Oncology Hematology - USOR
Columbia, Maryland, 21044
Ohio State University, James Cancer Hospital and Solove Research Institute
Columbus, Ohio, 43210
Ohio Health
Columbus, Ohio, 43214
Minnesota Oncology Hematology, P.A.
Coon Rapids, Minnesota, 55433
Pontchartrain Cancer Center
Covington, Louisiana, 70443
Texas Oncology - Denison
Denison, Texas, 75020
Henry Ford Cancer Institute
Detroit, Michigan, 48202
Minnesota Oncology Hematology, P.A.
Edina, Minnesota, 55435
Virginia Cancer Specialists
Fairfax, Virginia, 22031
Holy Cross Hospital - Bines Cancer Center
Fort Lauderdale, Florida, 33308
Florida Cancer Specialist - South (SCRI)
Fort Myers, Florida, 33901
Fort Wayne Medical Oncology and Hematology
Fort Wayne, Indiana, 46804
Texas Oncology - Fort Worth Cancer Center
Fort Worth, Texas, 76104
Compassionate Cancer Care
Fountain Valley, California, 92708
Frederick Health - James M. Stockman Cancer Institute
Frederick, Maryland, 21702
St. Joseph Heritage Healthcare
Fullerton, California, 92835
Cone Health Cancer Center
Greensboro, North Carolina, 27403
Memorial Cancer Institute at Memorial Hospital West
Hollywood, Florida, 33021
Hawaii Cancer Care
Honolulu, Hawaii, 96813
Oncology Consultants
Houston, Texas, 770390
Bronson Methodist Hospital (West Michigan Cancer Center)
Kalamazoo, Michigan, 49001
Oncology and Hematology of South Texas
Laredo, Texas, 78041
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, 89169
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03766
Loma Linda University Medical Center
Loma Linda, California, 92350
University of Southern California (USC)
Los Angeles, California, 90033
Cedars-Sinai Medical Center
Los Angeles, California, 90048
UCLA
Los Angeles, California, 90095
Oncology and Hematology Associates of Southwest Virginia
Low Moor, Virginia, 24457
University of Wisconsin Carbone Cancer Center
Madison, Wisconsin, 53705
Minnesota Oncology Hematology, P.A.
Maplewood, Minnesota, 55109
Northwest Georgia Oncology
Marietta, Georgia, 30060
University of Miami Sylvester Comprehensive Cancer Center
Miami, Florida, 33136
Froedtert Hospital and the Medical College of Wisconsin (MCW)
Milwaukee, Wisconsin, 53226
Pelmutter Cancer Center at Winthrop
Mineola, New York, 11501
Minnesota Oncology Hematology, P.A.
Minneapolis, Minnesota, 55404
University of South Alabama - Mitchell Cancer Center
Mobile, Alabama, 36604
Tennessee Oncology - Nashville (SCRI)
Nashville, Tennessee, 37203
New York University Langone (NYU)
New York, New York, 10016
Columbia University Medical Center
New York, New York, 10032
Memorial Sloan Kettering Cancer Center
New York, New York, 10065
Weill Cornell Medical College - New York Presbyterian Hospital
New York, New York, 10065
Ocala Oncology Center
Ocala, Florida, 34474
Nebraska Methodist Hospital
Omaha, Nebraska, 68114
University of California Irvine, Chao Family Comprehensive Cancer Center
Orange, California, 92868
The Valley Hospital - Luckow Pavilion
Paramus, New Jersey, 07652
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania, 15232
Providence Portland Medical Center
Portland, Oregon, 92713
Oregon Health & Science University (OHSU) Knight Cancer Institute
Portland, Oregon, 97239
Virginia Commonwealth University (VCU) Massey Cancer Center
Richmond, Virginia, 23298
Oncology and Hematology Associates of Southwest Virginia
Roanoke, Virginia, 24014
Oncology of Northshore
Rolling Meadows, Illinois, 60008
Minnesota Oncology Hematology, P.A.
Saint Paul, Minnesota, 55102
Oncology and Hematology Associates of Southwest Virginia
Salem, Virginia, 24153
Utah Cancer Specialist
Salt Lake City, Utah, 84106
University of Utah - Huntsman Cancer Institute
Salt Lake City, Utah, 84112
St. Joseph Heritage Healthcare - Santa Rosa
Santa Rosa, California, 95403
University of Washington Seattle Cancer Care Alliance (SCCA)
Seattle, Washington, 98109
Sanford Health
Sioux Falls, South Dakota, 57104
Orchard Healthcare Research Inc.
Skokie, Illinois, 60077
Beacon Health
South Bend, Indiana, 46601
Washington University
St Louis, Missouri, 63110
Florida Cancer Specialist - North (SCRI)
St. Petersburg, Florida, 33705
Pennsylvania State University Milton S. Hershey Medical Center
State College, Pennsylvania, 16801
Northwest Medical Specialities
Tacoma, Washington, 98405
Florida Cancer Specialist - Panhandle (SCRI)
Tallahassee, Florida, 32308
Moffitt Cancer Center
Tampa, Florida, 33612
Toledo Clinic Cancer Center
Toledo, Ohio, 43623
Oklahoma Cancer Specialists and Research Institute (OCSRI)
Tulsa, Oklahoma, 74146
Johns Hopkins Sibley Memorial Hospital
Washington D.C., District of Columbia, 20016
Sibley Memorial Hospital
Washington D.C., District of Columbia, 20016
Florida Cancer Specialist - East (SCRI)
West Palm Beach, Florida, 33401
University of Kansas Medical Center (KUMC)
Westwood, Kansas, 66205
Minnesota Oncology Hematology, P.A.
Woodbury, Minnesota, 55125
Oncology and Hematology Associates of Southwest Virginia
Wytheville, Virginia, 24382
St. Joseph Mercy Hospital Cancer Care Center
Ypsilanti, Michigan, 48197
Yuma Regional Medical Center
Yuma, Arizona, 85364
About this study
Official title: A Phase 2 Randomized, Multicenter, Double-Blind Study of the Glutaminase Inhibitor Telaglenastat With Pembrolizumab and Chemotherapy Versus Placebo With Pembrolizumab and Chemotherapy in First-Line, Metastatic KEAP1/NRF2-Mutated, Nonsquamous, Non-Small Cell Lung Cancer (NSCLC)
This is a Phase 2, randomized, multicenter, double-blind study of the glutaminase inhibitor telaglenastat with standard-of-care pembrolizumab and chemotherapy versus placebo with standard-of-care pembrolizumab and chemotherapy for first line treatment of metastatic disease in patients with KEAP1/NRF2-mutated, stage IV, nonsquamous, non-small cell lung cancer (NSCLC). The study primary endpoints are PFS per RECIST v. 1.1 and safety. KEAP1/NRF2 mutation status (for eligibility) and STK11/LKB1 status (for stratification) will be determined by next generation sequencing. A commercial liquid biopsy (circulating tumor DNA) NGS test will be provided to study participants free of charge.
- Conditions
- Non-Small Cell Lung Cancer, Non-squamous Non-small-cell Lung Cancer, Non-Squamous Non-Small Cell Neoplasm of Lung, KEAP1 Gene Mutation, NRF2 Gene Mutation, NFE2L2 Gene Mutation
- Being tested
- Telaglenastat, Carboplatin Chemotherapy, Pemetrexed Chemotherapy, Pembrolizumab Immunotherapy, Placebo
- Keywords
- NSCLC, KEAP1, NRF2, NFE2l2, LKB1, STK11, Next Generation Sequencing, NGS, Mutation, Pembrolizumab, Pemetrexed, Carboplatin, Randomized, Placebo, Chemotherapy, Targeted Therapy, Telaglenastat, Glutamine, Glutaminase, Glutathione
- Medical subject headings
- Carcinoma, Non-Small-Cell Lung
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TelaglenastatDrug
Also called CB-839
Oral Glutaminase Inhibitor
Carboplatin ChemotherapyDrug
Also called Paraplatin
IV infusion
Pemetrexed ChemotherapyDrug
Also called Alimta
IV infusion
Pembrolizumab ImmunotherapyBiological
Also called Keytruda
IV infusion
PlaceboDrug
Also called Oral placebo
Oral placebo
Folic acid 400 -1000 μgDietary supplement
Orally, once daily beginning 7 days prior to the first dose of pemetrexed and continue until 21 days after the last dose of pemetrexed.
Vitamin B12 1000 μgDietary supplement
Vitamin B12 1000 μg Intramuscular injection one week prior to the first dose of pemetrexed and once every 3 cycles (9 weeks) thereafter. Subsequent vitamin B12 injections may be given the same day as pemetrexed administration.
Dexamethasone 4 mgDrug
For prophylaxis, orally twice per day (or equivalent). Taken the day before, day of, and day after pemetrexed administration.
| Study group | Role | What they receive |
|---|---|---|
| Telaglenastat with Pembrolizumab and Chemotherapy | Experimental | The glutaminase inhibitor telaglenastat will be administered orally, twice daily with food, every day in combination with standard-of-care pembrolizumab plus chemotherapy by intravenous (IV) infusion every 3 weeks. Receives: Drug: Telaglenastat; Drug: Carboplatin Chemotherapy; Drug: Pemetrexed Chemotherapy; Biological: Pembrolizumab Immunotherapy; Dietary Supplement: Folic acid 400 -1000 μg; Dietary Supplement: Vitamin B12 1000 μg; Drug: Dexamethasone 4 mg |
| Placebo with Pembrolizumab and Chemotherapy | Placebo comparator | Placebo will be administered orally twice daily with food every day in combination with standard-of-care pembrolizumab plus chemotherapy by IV infusion every 3 weeks. Receives: Drug: Carboplatin Chemotherapy; Drug: Pemetrexed Chemotherapy; Biological: Pembrolizumab Immunotherapy; Drug: Placebo; Dietary Supplement: Folic acid 400 -1000 μg; Dietary Supplement: Vitamin B12 1000 μg; Drug: Dexamethasone 4 mg |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression-Free Survival (PFS), Assessed by Investigator per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
Duration of investigator-determined PFS per RECIST v1.1 in the intent-to-treat (ITT) population
Measured: Up to 24 months
Safety and Tolerability of Telaglenastat Plus Standard-of-Care Pembrolizumab and Chemotherapy Assessed by Type, Incidence, Severity, Seriousness, and Study Drug Relatedness of Adverse Events per CTCAE v5.0
Measured: Up to 55 months
Recommended Phase 2 Dose of Telaglenastat in Combination with Standard-of-Care Pembrolizumab and Chemotherapy Assessed by Incidence and Nature of Protocol Defined Dose-Limiting Toxicities (DLTs) During the Safety Run-in Period
Measured: Up to 6 months
Secondary outcomes (7)
Objective Response Rate (ORR) for Patients Treated with Telaglenastat plus Standard-of-Care Pembrolizumab and Chemotherapy versus Placebo plus Standard-of-Care Pembrolizumab and Chemotherapy
ORR is defined as the percentage of patients with complete response (CR) or partial response (PR) according to the RECIST v1.1 criteria as assessed by the investigator.
Measured: Up to 24 months
Duration of Response (DOR) for Patients Treated with Telaglenastat plus Standard-of-Care Pembrolizumab and Chemotherapy versus Placebo plus Standard-of-Care Pembrolizumab and Chemotherapy
DOR is defined as the duration of response for patients achieving a CR or PR
Measured: Up to 24 months
Overall Survival
Measured: Up to 55 months
PFS in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Measured: Up to 24 months
ORR in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Measured: Up to 24 months
DOR in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Measured: Up to 24 months
OS in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Measured: Up to 55 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Feb 2020
- Study start24 Jul 2020
- Primary completion5 Nov 2021
- Study completion9 Feb 2022
Why it stopped: Lack of Clinical Benefit
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Non-Small Cell Lung CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 40 participants (actual)
Sponsor and investigators
- Lead sponsor
- Calithera Biosciences, Inc
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Emil Kuriakose, MD, Study director, Calithera Biosciences, Inc
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04265534
- Sponsor's protocol ID
- CX-839-014
- Acronym
- KEAPSAKE
- Status last verified
- Sep 2022
- First submitted
- 7 Feb 2020
- Last updated
- 21 Sep 2022
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Aden D, Sureka N, Zaheer S, Chaurasia JK, Zaheer S. Metabolic Reprogramming in Cancer: Implications for Immunosuppressive Microenvironment. Immunology. 2025 Jan;174(1):30-72. doi: 10.1111/imm.13871. Epub 2024 Oct 27.
PubMed 39462179
Study at a glance
From the registry record, last updated by the sponsor on 21 Sep 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2 Randomized, Multicenter, Double-Blind Study of the Glutaminase Inhibitor Telaglenastat With Pembrolizumab and Chemotherapy Versus Placebo With Pembrolizumab and Chemotherapy in First-Line, Metastatic KEAP1/NRF2-Mutated, Nonsquamous, Non-Small Cell Lung Cancer (NSCLC)
- ClinicalTrials.gov ID
- NCT04265534
- Acronym / sponsor ID
- KEAPSAKE / CX-839-014
- Conditions
- Non-Small Cell Lung Cancer, Non-squamous Non-small-cell Lung Cancer, Non-Squamous Non-Small Cell Neoplasm of Lung, KEAP1 Gene Mutation, NRF2 Gene Mutation, NFE2L2 Gene Mutation
- Keywords
- NSCLC, KEAP1, NRF2, NFE2l2, LKB1, STK11, Next Generation Sequencing, NGS
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Lack of Clinical Benefit
- Enrolment
- 40 participants (actual)
- Lead sponsor
- Calithera Biosciences, IncIndustry (pharma, biotech, devices)
- Study start
- 24 Jul 2020 (actual)
- Primary completion
- 5 Nov 2021 (actual)
- Study completion
- 9 Feb 2022 (actual)
- First posted
- 11 Feb 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a Phase 2, randomized, multicenter, double-blind study of the glutaminase inhibitor telaglenastat with standard-of-care pembrolizumab and chemotherapy versus placebo with standard-of-care pembrolizumab and chemotherapy for first line treatment of metastatic disease in patients with KEAP1/NRF2-mutated, stage IV, nonsquamous, non-small cell lung cancer (NSCLC). The study primary endpoints are PFS per RECIST v. 1.1 and safety. KEAP1/NRF2 mutation status (for eligibility) and STK11/LKB1 status (for stratification) will be determined by next generation sequencing. A commercial liquid biopsy (circulating tumor DNA) NGS test will be provided to study participants free of charge.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Telaglenastat with Pembrolizumab and Chemotherapy | Experimental | Drug: Telaglenastat, Drug: Carboplatin Chemotherapy, Drug: Pemetrexed Chemotherapy, Biological: Pembrolizumab Immunotherapy, Dietary Supplement: Folic acid 400 -1000 μg, Dietary Supplement: Vitamin B12 1000 μg, Drug: Dexamethasone 4 mgThe glutaminase inhibitor telaglenastat will be administered orally, twice daily with food, every day in combination with standard-of-care pembrolizumab plus chemotherapy by intravenous (IV) infusion every 3 weeks. |
| Placebo with Pembrolizumab and Chemotherapy | Placebo comparator | Drug: Carboplatin Chemotherapy, Drug: Pemetrexed Chemotherapy, Biological: Pembrolizumab Immunotherapy, Drug: Placebo, Dietary Supplement: Folic acid 400 -1000 μg, Dietary Supplement: Vitamin B12 1000 μg, Drug: Dexamethasone 4 mgPlacebo will be administered orally twice daily with food every day in combination with standard-of-care pembrolizumab plus chemotherapy by IV infusion every 3 weeks. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (14 listed)
- Histologically or cytologically documented non-squamous NSCLC
- Stage IV (M1a-c, AJCC 8th Edition, Amin 2017) disease not previously treated with systemic therapy for metastatic NSCLC
- No known actionable mutation in EGFR, ALK, ROS1, BRAF, NTRK or other known actionable mutation for which there is approved therapy in the first-line lung cancer setting
- Must have at least one radiographically measurable lesion per RECIST v1.1 defined as a lesion that is ≥ 10 mm in longest diameter or lymph node that is ≥ 15 mm in short axis imaged by computed tomography (CT) scan or magnetic resonance imaging (MRI)
- Age ≥ 18 years on the day of signing informed consent
Key exclusion criteria (32 listed)
- Squamous cell histology and mixed histology tumors with any small-cell/neuroendocrine component (other mixed histology should be reviewed with the medical monitor for eligibility)
- Any other concurrent malignancy requiring local or systemic therapy. Patients with other previously treated malignancy(ies) are allowed if the specific neoplasm, in the opinion of the principal investigator and with the agreement of the medical monitor, is not expected to interfere with study-specific endpoints
- Radiation therapy to the lung > 30 Gy within 6 months prior to randomization
- Clinically active diverticulitis, intra-abdominal abscess, gastrointestinal obstruction, abdominal carcinomatosis
- Active autoimmune disease that has required systemic treatment in past 2 years (i.e., with use of disease modifying agents, corticosteroids or immunosuppressive drugs)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TelaglenastatAlso: CB-839Oral Glutaminase Inhibitor | Drug | Telaglenastat with Pembrolizumab and Chemotherapy |
| Carboplatin ChemotherapyAlso: ParaplatinIV infusion | Drug | Placebo with Pembrolizumab and Chemotherapy, Telaglenastat with Pembrolizumab and Chemotherapy |
| Pemetrexed ChemotherapyAlso: AlimtaIV infusion | Drug | Placebo with Pembrolizumab and Chemotherapy, Telaglenastat with Pembrolizumab and Chemotherapy |
| Pembrolizumab ImmunotherapyAlso: KeytrudaIV infusion | Biological | Placebo with Pembrolizumab and Chemotherapy, Telaglenastat with Pembrolizumab and Chemotherapy |
| PlaceboAlso: Oral placeboOral placebo | Drug | Placebo with Pembrolizumab and Chemotherapy |
| Folic acid 400 -1000 μgOrally, once daily beginning 7 days prior to the first dose of pemetrexed and continue until 21 days after the last dose of pemetrexed. | Dietary supplement | Placebo with Pembrolizumab and Chemotherapy, Telaglenastat with Pembrolizumab and Chemotherapy |
| Vitamin B12 1000 μgVitamin B12 1000 μg Intramuscular injection one week prior to the first dose of pemetrexed and once every 3 cycles (9 weeks) thereafter. Subsequent vitamin B12 injections may be given the same day as pemetrexed administration. | Dietary supplement | Placebo with Pembrolizumab and Chemotherapy, Telaglenastat with Pembrolizumab and Chemotherapy |
| Dexamethasone 4 mgFor prophylaxis, orally twice per day (or equivalent). Taken the day before, day of, and day after pemetrexed administration. | Drug | Placebo with Pembrolizumab and Chemotherapy, Telaglenastat with Pembrolizumab and Chemotherapy |
Primary outcome
Progression-Free Survival (PFS), Assessed by Investigator per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1
Time frame: Up to 24 months
Duration of investigator-determined PFS per RECIST v1.1 in the intent-to-treat (ITT) population
Safety and Tolerability of Telaglenastat Plus Standard-of-Care Pembrolizumab and Chemotherapy Assessed by Type, Incidence, Severity, Seriousness, and Study Drug Relatedness of Adverse Events per CTCAE v5.0
Time frame: Up to 55 months
Recommended Phase 2 Dose of Telaglenastat in Combination with Standard-of-Care Pembrolizumab and Chemotherapy Assessed by Incidence and Nature of Protocol Defined Dose-Limiting Toxicities (DLTs) During the Safety Run-in Period
Time frame: Up to 6 months
7 secondary outcomes
Objective Response Rate (ORR) for Patients Treated with Telaglenastat plus Standard-of-Care Pembrolizumab and Chemotherapy versus Placebo plus Standard-of-Care Pembrolizumab and Chemotherapy
Time frame: Up to 24 months
Duration of Response (DOR) for Patients Treated with Telaglenastat plus Standard-of-Care Pembrolizumab and Chemotherapy versus Placebo plus Standard-of-Care Pembrolizumab and Chemotherapy
Time frame: Up to 24 months
Overall Survival
Time frame: Up to 55 months
PFS in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Time frame: Up to 24 months
ORR in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Time frame: Up to 24 months
DOR in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Time frame: Up to 24 months
OS in the Subgroup of Patients with Biochemical Evidence of Activation of the NRF2 Pathway
Time frame: Up to 55 months
Results and safety
The study was stopped early (reason given: Lack of Clinical Benefit). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Sep 2022.
- Derived from this study: PubMed 39462179Aden D, Sureka N, Zaheer S, Chaurasia JK, Zaheer S. Metabolic Reprogramming in Cancer: Implications for Immunosuppressive Microenvironment. Immunology. 2025 Jan;174(1):30-72. doi: 10.1111/imm.13871. Epub 2024 Oct 27.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Emil Kuriakose, MD study director
Calithera Biosciences, Inc
102 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Telaglenastat, Carboplatin Chemotherapy and Pemetrexed Chemotherapy in people with Non-Small Cell Lung Cancer and Non-squamous Non-small-cell Lung Cancer, run by Calithera Biosciences, Inc at 102 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 14 inclusion and 32 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 21 Sep 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 102 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was stopped early (reason given: Lack of Clinical Benefit). Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression-Free Survival (PFS), Assessed by Investigator per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 (time frame: Up to 24 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04265534, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2022.