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Non-small Cell Lung CancerPhase 2CANOPY-NNCT03968419

This Study Will Evaluate the Effect of Canakinumab or Pembrolizumab Given as Monotherapy or in Combination as Neo-adjuvant Treatment for Subjects With Early Stages NSCLC.

A Phase 2 study testing Canakinumab and Pembrolizumab in people with Non-small Cell Lung Cancer, run by Novartis Pharmaceuticals at 29 sites in 12 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study was to evaluate the major pathological response (MPR) rate of canakinumab given as a neoadjuvant treatment, either as single agent or in combination with pembrolizumab, in addition to evaluate the MPR of pembrolizumab as a single agent and the dynamic of the tumor microenvironment changes on… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Non-small Cell Lung Cancer
What is being tested?
Canakinumab and Pembrolizumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
88 participants
Where
29 sitesin 12 countries
Study dates
5 Nov 2019to 15 Aug 2022
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 confirmed NSCLC stage IB-IIIA (per AJCC 8th edition), deemed suitable for primary resection by treating surgeon, except for N2 and T4 tumors.
  • Subject must have been eligible for surgery and with a planned surgical resection in approximately 4-6 weeks (after the first dose of study treatment).
  • A mandatory newly obtained tissue biopsy from primary site was required for study enrollment. An archival biopsy was also acceptable if obtained up to 5 months before first day of study treatment and if the subject did not go through antineoplastic systemic therapies between biopsy collection date and beginning of study treatment.
  • Eastern Cooperative oncology group (ECOG) performance status of 0 or 1.

Who cannot join

  • Subjects with unresectable or metastatic disease.
  • History of severe hypersensitivity reactions to monoclonal antibodies, which in the opinion of the investigator may pose an increased risk of serious infusion reaction
  • Subjects who received prior systemic therapy (including chemotherapy, other anti-cancer therapies and any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways) in the past 3 years before screening
  • Active autoimmune disease that has required systemic treatment in the past 2 years prior to randomization. Control of the disorder with replacement therapy was permitted
  • Subject with suspected or proven immunocompromised state or infections

Trial locations and contacts

29 sites in 12 countries.

29 sites in 12 countries

United States4 sites
  • Methodist Hospital / Methodist Cancer Center

    Houston, Texas, 77030

  • University of Kansas Medical Center Neurology Dept.

    Kansas City, Kansas, 66160

  • UCLA Oncology Hematology

    La Jolla, California, 92037

  • SUNY - Upstate Medical University

    Syracuse, New York, 13210

Other trials in United States

Germany4 sites
  • Novartis Investigative Site

    Bad Berka, 99437

  • Novartis Investigative Site

    Cologne, 51109

  • Novartis Investigative Site

    Giessen, 35392

  • Novartis Investigative Site

    Halle, 06120

Other trials in Germany

France3 sites
  • Novartis Investigative Site

    Bron, 69677

  • Novartis Investigative Site

    Montpellier, Herault, 34059

  • Novartis Investigative Site

    Paris, 75679

Other trials in France

Netherlands3 sites
  • Novartis Investigative Site

    's-Hertogenbosch, 5200

  • Novartis Investigative Site

    Breda, 4819 EV

  • Novartis Investigative Site

    Maastricht, 6229 HX

Other trials in Netherlands

Russia3 sites
  • Novartis Investigative Site

    Omsk, 644013

  • Novartis Investigative Site

    Saint Petersburg, 195271

  • Novartis Investigative Site

    Saint Petersburg, 197022

Other trials in Russia

Spain3 sites
  • Novartis Investigative Site

    Jaén, Andalusia, 23007

  • Novartis Investigative Site

    Madrid, 28034

  • Novartis Investigative Site

    Oviedo, Principality of Asturias, 33011

Other trials in Spain

Turkey (Türkiye)3 sites
  • Novartis Investigative Site

    Izmir

  • Novartis Investigative Site

    Sakarya, 54290

  • Novartis Investigative Site

    Sihhiye / Ankara, 06100

Other trials in Turkey (Türkiye)

Taiwan2 sites
  • Novartis Investigative Site

    Taipei, 103616

  • Novartis Investigative Site

    Taipei, 110

Other trials in Taiwan

Belgium1 site
  • Novartis Investigative Site

    Brussels, 1000

Other trials in Belgium

Canada1 site
  • Novartis Investigative Site

    Montreal, Quebec, H2W 1T8

Other trials in Canada

Greece1 site
  • Novartis Investigative Site

    Thessaloniki, 57001

Other trials in Greece

Japan1 site
  • Novartis Investigative Site

    Kashiwa, Chiba, 277 8577

Other trials in Japan

About this study

Official title: A Randomized, Open-label, Phase II Study of Canakinumab or Pembrolizumab as Monotherapy or in Combination as Neoadjuvant Therapy in Subjects With Resectable Non-small Cell Lung Cancer (CANOPY-N)

The purpose of this study was to evaluate the major pathological response (MPR) rate of canakinumab given as a neoadjuvant treatment, either as single agent or in combination with pembrolizumab, in addition to evaluate the MPR of pembrolizumab as a single agent and the dynamic of the tumor microenvironment changes on treatment.

Read the detailed description

This was a randomized, phase II, open-label study evaluating canakinumab, an anti-IL-1β monoclonal antibody, or pembrolizumab, a monoclonal antibody designed to block the PD-1 receptor, as monotherapy or in combination as neoadjuvant therapy. The study population included adult subjects with resectable non-small cell lung cancer (NSCLC) planned for surgery in approximately 4-6 weeks. Subjects were treated for a maximum duration of 6 weeks (2 cycles) until surgery, progression, unacceptable toxicity or discontinuation from the study treatment for any other reason.

Subjects were randomized in a 2:2:1 ratio to one of the 3 treatment arms (canakinumab alone or canakinumab in combination with pembrolizumab or pembrolizumab alone). Surgery was performed between 4 to 6 weeks after the first dose of study treatment.

All randomized subjects were followed for safety for up to 130 days following the last dose of study treatment (safety follow-up period).

Being tested
Canakinumab, Pembrolizumab
Keywords
ACZ885, canakinumab, pembrolizumab, NSCLC, non-small cell lung cancer, non small cell lung cancer, early stage NSCLC, squamous, non-squamous,, MPR, major pathological response, hs-CRP, PD-L1, hsCRP, surgery, neo-adjuvant, neo adjuvant, CD8, hs-IL-6, CANOPY
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.

  • CanakinumabDrug

    Also called ACZ885

    200 mg of canakinumab administered via subcutaneous injections once every 3 weeks for a maximum duration of 6 weeks

  • PembrolizumabDrug

    200 mg of pembrolizumab administered via infusion once every 3 weeks for a maximum duration of 6 weeks

Study groups in NCT03968419
Study groupRoleWhat they receive
Canakinumab monotherapyExperimentalParticipants received 200 mg of canakinumab once every 3 weeks for a maximum duration of 6 weeks prior to surgery
Receives: Drug: Canakinumab
Canakinumab + pembrolizumabExperimentalParticipants received 200 mg of canakinumab in combination with 200 mg of pembrolizumab once every 3 weeks for a maximum duration of 6 weeks prior to surgery
Receives: Drug: Canakinumab; Drug: Pembrolizumab
Pembrolizumab monotherapyExperimentalParticipants received 200 mg of pembrolizumab every 3 weeks for a maximum duration of 6 weeks prior to surgery
Receives: Drug: Pembrolizumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Major Pathological Response (MPR) Rate at the Time of Surgery in Subjects Randomized to Canakinumab Monotherapy and in Combination With Pembrolizumab Based on Central Review

    MPR was defined as the percentage of participants with major pathological response (defined as ≤10% residual viable tumor cells on surgical samples). Any participant who had >10% residual viable cancer cells, or started new antineoplastic therapy prior to surgery, or did not have the surgery performed, or had the surgery performed but with unevaluable MPR result, was considered as a non-responder.

    MPR was assessed at the time of surgery in all subjects randomized to canakinumab monotherapy and in combination with pembrolizumab based on central review.

    Measured: At time of surgery (up to 6 weeks after first dose of study treatment)

Secondary outcomes (12)
  1. Canakinumab Antidrug Antibodies (ADA) Prevalence

    Canakinumab ADA prevalence at baseline was calculated as the percentage of participants who had a canakinumab ADA positive result at baseline

    Measured: Predose (0 hour) on Day 1 of Cycle 1 (Cycle=21 days)

  2. Canakinumab ADA Incidence

    Canakinumab ADA incidence on treatment was calculated as the percentage of participants who were canakinumab treatment-induced ADA positive (post-baseline ADA positive with ADA-negative sample at baseline) and canakinumab treatment-boosted ADA positive (post-baseline ADA positive with titer that is at least the fold titer change greater than the ADA-positive baseline titer)

    Measured: From baseline (Predose on Day 1 of Cycle 1) up to 130 days after last dose of study treatment (assessed up to 24.6 weeks). Cycle = 21 days

  3. Pembrolizumab ADA Prevalence

    Pembrolizumab ADA prevalence at baseline was calculated as the percentage of participants who had a pembrolizumab ADA positive result at baseline

    Measured: Predose (0 hour) on Day 1 of Cycle 1 (Cycle = 21 days)

  4. Pembrolizumab ADA Incidence

    Pembrolizumab ADA incidence on treatment was calculated as the percentage of participants who were pembrolizumab treatment-induced ADA positive (post-baseline ADA positive with ADA-negative sample at baseline) and pembrolizumab treatment-boosted ADA positive (post-baseline ADA positive with titer that is at least the fold titer change greater than the ADA-positive baseline titer)

    Measured: From baseline (Predose on Day 1 of Cycle 1) up to 26 days after last dose of study treatment (assessed up to 10.7 weeks). Cycle = 21 days

  5. Overall Response Rate (ORR) Based on Local Investigator Assessment Using RECIST v1.1

    ORR is defined as the percentage of subjects with confirmed best overall response of complete response (CR) or partial response (PR), as per local investigator's assessment by RECIST 1.1.

    CR: Disappearance of all non-nodal target lesions. In addition, any pathological lymph nodes assigned as target lesions must have a reduction in short axis to < 10 mm.

    PR: At least a 30% decrease in the sum of diameter of all target lesions, taking as reference the baseline sum of diameters

    Measured: From date of randomization to date of surgery, assessed up to 6 weeks

  6. Serum Canakinumab Concentration

    Canakinumab serum concentrations were determined at the specified time points.

    Measured: Predose (0 hour) on Day 1 of Cycles 1 and 2 (Cycle =21 days)

  7. Serum Pembrolizumab Concentration

    Pembrolizumab serum concentrations were determined at the specified time points.

    Measured: Predose (0 hour) and 0.5 hours post dose on Day 1 of Cycle 1 and predose on Cycle 2 (Cycle =21 days)

  8. Surgical Feasibility Rate

    Surgical feasibility rate was defined as the percentage of subjects who underwent surgery following study treatment.

    Measured: Up to 6 weeks after first dose

  9. Major Pathological Response (MPR) Rate at the Time of Surgery in Subjects Randomized to Pembrolizumab Monotherapy Based on Central Review

    MPR was defined as the percentage of participants with major pathological response (defined as ≤10% residual viable tumor cells on surgical samples). Any participant who had >10% residual viable cancer cells, or started new antineoplastic therapy prior to surgery, or did not have the surgery performed, or had the surgery performed but with unevaluable MPR result, was considered as a non-responder.

    MPR was assessed at the time of surgery in all subjects randomized to pembrolizumab monotherapy arm based on central review.

    Measured: At time of surgery (up to 6 weeks after first dose)

  10. Difference in Major Pathological Response (MPR) Rate Between the Canakinumab Plus Pembrolizumab Arm and the Pembrolizumab Arm Based on Central Review

    MPR was defined as the percentage of participants with ≤10% residual viable tumor cells on surgical samples. MPR was assessed at the time of surgery based on central review. The difference in MPR rate between the canakinumab plus pembrolizumab arm and the pembrolizumab arm based on central review along with the Chang and Zhang confidence interval was assessed.

    Measured: At time of surgery (up to 6 weeks after first dose of study treatment)

  11. Major Pathological Response (MPR) Rate at the Time of Surgery in All Subjects Based on Local Review

    MPR was defined as the percentage of participants with major pathological response (defined as ≤10% residual viable tumor cells on surgical samples). Any participant who had >10% residual viable cancer cells, or started new antineoplastic therapy prior to surgery, or did not have the surgery performed, or had the surgery performed but with unevaluable MPR result, was considered as a non-responder.

    MPR was assessed at the time of surgery in all subjects based on local review.

    Measured: At time of surgery (up to 6 weeks after first dose)

  12. Major Pathological Response (MPR) Rate Based on the Levels of Biomarkers

    MPR was defined as the percentage of participants with major pathological response (defined as ≤10% residual viable tumor cells on surgical samples). Any participant who had >10% residual viable cancer cells, or started new antineoplastic therapy prior to surgery, or did not have the surgery performed, or had the surgery performed but with unevaluable MPR result, was considered as a non-responder.

    MPR rate was analyzed by the biomarker subgroups at baseline. Biomarkers included PD-L1, CD8, hs-CRP and hs-IL-6.

    Measured: From date of randomization up to 6 weeks after first dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 May 2019
  2. Study start5 Nov 2019
  3. Primary completion20 Apr 2022
  4. Study completion15 Aug 2022

Why it stopped: Study early terminated due to low enrollment compared to the anticipated figures.

Resources

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
None (open label)
Enrolment
88 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03968419
Sponsor's protocol ID
CACZ885V2201C
Other IDs
2018-004813-42, 2018
Acronym
CANOPY-N
Status last verified
Jun 2024
First submitted
15 May 2019
Last updated
20 Jun 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent expert panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data is currently available according to the process described on www.clinicalstudydatarequest.com.

Publications

  • Garrido P, Pujol JL, Kim ES, Lee JM, Tsuboi M, Gomez-Rueda A, Benito A, Moreno N, Gorospe L, Dong T, Blin C, Rodrik-Outmezguine V, Passos VQ, Mok TS. Canakinumab with and without pembrolizumab in patients with resectable non-small-cell lung cancer: CANOPY-N study design. Future Oncol. 2021 Apr;17(12):1459-1472. doi: 10.2217/fon-2020-1098. Epub 2021 Mar 2.

    PubMed 33648347

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Canakinumab and Pembrolizumab in people with Non-small Cell Lung Cancer, run by Novartis Pharmaceuticals at 29 sites in 12 countries.

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 4 inclusion and 5 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 20 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 sites in United States, Germany, France, Netherlands, Russia and 7 more countries. 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. 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?

Yes. Results are posted in the registry (first posted 3 Jul 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Major Pathological Response (MPR) Rate at the Time of Surgery in Subjects Randomized to Canakinumab Monotherapy and in Combination With Pembrolizumab Based on Central Review (time frame: At time of surgery (up to 6 weeks after first dose of study treatment)). 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 NCT03968419, 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 20 Jun 2024.

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