Solid TumorPhase 1/2NCT07843550
A Phase 1/2 Trial Of Larotrectinib And Pembrolizumab In Patients With Solid Tumors Previously Treated With Immune Checkpoint Inhibitor Monotherapy
A Phase 1/2 study testing Larotrectinib and Pembrolizumab in people with Solid Tumor, run by M.D. Anderson Cancer Center at 1 site in United States.
Trial summary
This is a single-center, open-label Phase 1/2 trial evaluating the safety and efficacy of the combination of larotrectinib and pembrolizumab in patients with advanced/metastatic lung adenocarcinoma or melanoma. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Solid Tumor
- What is being tested?
- Larotrectinib and Pembrolizumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 22 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Mar 2027to 13 Jul 2029
- Phase
- Phase 1/2
- Are there results?
- Not yet: the study is under way
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
- Patients must meet all of the following inclusion criteria to be eligible for enrollment in the study.
- Ability to understand and willingness to sign informed consent form prior to initiation of the study and any study procedures.
- Capable of and willing to comply with scheduled visits, treatment plans, laboratory tests, and other study-related tests and procedures.
- Age ≥18 years.
- Histologically documented locally advanced or metastatic lung adenocarcinoma or melanoma.
- Patients who have previously received ICI monotherapy:
Show all 34Show fewer
- Must have a minimum drug exposure of at least 1 dose of ICI and documented disease progression on the treatment.
- Patients must be willing to undergo tumor biopsy as required by the study, if safe and feasible.
- Patients who are unable or unwilling to undergo pretreatment tumor biopsy may still be eligible for the study following discussion with the principal investigator (PI).
- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 (Appendix 1) with no deterioration in performance status within 2 weeks prior to study treatment initiation.
- Measurable disease per the RECIST v1.1 (Appendix 2).
- Adequate organ function as defined below:
- Hematologic Function: hematopoietic growth factors are not allowed ≤7 days prior to screening assessment for short-acting growth factors and ≤14 days prior to screening assessment for long-acting growth factors (i.e., half-life >48 hours [e.g., peg-filgrastim]):
- Hemoglobin >9.0 g/dL (red blood cell/plasma transfusion is not allowed ≤14 days prior to screening assessment)
- Absolute neutrophil count ≥1500/mL
- Platelets ≥100,000/mL (platelet transfusion is not allowed ≤7 days prior to screening assessment)
- Hepatic Function:
- Total bilirubin <1.5 × ULN (<2.0 × ULN for patients with documented Gilbert's syndrome or <3.0 × ULN for patients for whom the indirect bilirubin level suggests an extrahepatic source of elevation)
- AST/ALT ≤2.5 × institutional ULN. Transaminases up to 5 × ULN in the presence of liver metastases.
- Serum albumin ≥2.5 g/dL.
- Renal Function:
- o Estimated glomerular filtration rate ≥60 mL/min by Modification of Diet in Renal Disease Formula or by 24-hour urine collection.
- Coagulation:
- Prothrombin time/international normalized ratio and activated partial thromboplastin time /partial thromboplastin time <1.5 × ULN, or within target range per institutional guidelines if taking anticoagulant(s), regardless of whether the anticoagulant use is prophylactic or therapeutic.
- Life expectancy ≥3 months.
- Able to swallow PO medications.
- Larotrectinib and pembrolizumab can cause fetal harm when administered to a pregnant woman. For this reason, women of childbearing potential (WOCBP) must agree to use adequate contraception ((hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of the study treatment period, and for 4 months after completion of study treatment.
- (Refer to Pregnancy Assessment Policy MD Anderson Cancer Center [MDACC] Institutional Policy # CLN1114). WOCBP includes all female patients, between the onset of menses (as early as 8 years of age) and 55 years unless the patient presents with an applicable exclusionary factor which may be one of the following:
- Postmenopausal (no menses in ≥12 consecutive months)
- History of hysterectomy or bilateral salpingo-oophorectomy
- Ovarian failure (follicle-stimulating hormone and estradiol in menopausal range and have received whole pelvic radiation therapy)
- History of bilateral tubal ligation or another surgical sterilization procedure • Approved methods of birth control are as follows: Hormonal contraception (i.e. birth control pills, injection, implant, transdermal patch, vaginal ring), intrauterine device, tubal ligation or hysterectomy, patient/partner post vasectomy, implantable or injectable contraceptives, and condoms plus spermicide. Not engaging in sexual activity for the duration of the study treatment period and the drug washout period is an acceptable practice; however, periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of birth control. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
- Male patients must agree to use adequate contraception throughout the duration of the study treatment period and for 4 months after the last dose of study treatment.
- WOCBP must have a negative blood pregnancy test within 14 days of study treatment initiation.
Who cannot join
- Documented alterations in NTRK1, NTRK2, or NTRK3 including fusions, rearrangements, deletions, and single nucleotide variants by DNA sequencing or polymerase chain reaction test on circulating tumor DNA, fresh tumor biopsy, or archival tumor tissue (obtained within 3 years of first larotrectinib dose) performed in a Clinical Laboratory Improvement Amendments-certified or equivalent laboratory.
- Patients who required dose interruption for more than 4 weeks, permanent discontinuation, or required systemic immunosuppression due to severe irAEs associated with previous ICI treatment.
- Untreated CNS or leptomeningeal metastases. Patients with treated CNS metastases are allowed if ALL of the following conditions are met:
- Radiation therapy ≥14 days prior to study treatment initiation
- Surgical resection ≥28 days prior to study treatment initiation; no evidence of clinical or radiographic progression on CNS imaging ≤28 days prior to study treatment initiation
- Residual neurological symptoms Grade ≤2 and on a stable dose of steroids and/or anticonvulsant therapy (if applicable) ≥14 days prior to study treatment initiation.
Show all 45Show fewer
- Has other malignancy(ies) diagnosed or treated within 5 years of study treatment initiation except for:
- Clinically insignificant tumors for which no systemic anticancer treatment is required (e.g., basal cell or squamous cell carcinoma of the skin, carcinoma in situ of the breast or cervix)
- Tumors that have been treated with curative intent with low risk for recurrence during trial participation. Note: Approval from the PI is required for exceptions.
- Patients with known or suspected impairment of GI function including any conditions that might hinder drug absorption, the ability to take PO medication, other malabsorption, or uncontrolled inflammatory GI disease such as Crohn's disease or ulcerative colitis.
- History of cerebrovascular stroke within 6 months of study treatment initiation.
- History of interstitial lung disease (ILD) or non-infectious pneumonitis requiring high-dose glucocorticoids or any active ILD or pneumonitis, or prior thoracic radiotherapy within 2 months of enrollment.
- Has any of the following cardiovascular abnormalities:
- Medically uncontrolled hypertension (≥160 mmHg systolic blood pressure or ≥100 mmHg diastolic blood pressure based on an average of 3 readings)
- Acute coronary syndrome (e.g., unstable angina, coronary artery stenting or angioplasty, bypass grafting) within 6 months prior to enrollment
- History of uncontrolled clinically significant unstable arrhythmias. Patients who have pacemakers to control atrial arrhythmia are eligible for the study. Patients with medically controlled atrial fibrillation >1 month prior to study treatment initiation are eligible.
- History of congenital long QT syndrome or prolonged corrected QT interval (QTc) using Fridericia's method >470 ms (unless a pacemaker is in place)
- Left ventricular ejection fraction <50%
- Symptomatic congestive heart failure (New York Heart Association Class II or higher).
- Has active systemic infection requiring systemic therapy within 72 hours prior to study treatment initiation.
- History of severe allergic reaction or known sensitivity to any of the study treatment components.
- Patients who have had a major surgical procedure(s) ≤28 days or minor procedure(s) ≤7 days prior to study treatment initiation; in all cases, the patient must be sufficiently recovered and stable before study treatment initiation.
- Has active severe acute respiratory syndrome coronavirus 2 infection. If symptomatic, the symptoms must have resolved prior to study treatment initiation.
- Has active, untreated human immunodeficiency virus (HIV) infection (CD4+ T cell count ≤350 cells/μL and presence of acquired immunodeficiency syndrome [AIDS]-defining opportunistic infections in the past 12 months). For patients with CD4+ T cell counts >350 cells/μL or in the absence of AIDS-defining opportunistic infections, enrollment will be considered, if the following conditions are met:
- Patient must be on an established antiretroviral therapy for at least 28 days prior to enrollment and treatment must not conflict with other study restrictions
- Patient must have an HIV viral load less than 400 copies/mL prior to enrollment.
- Has active/chronic hepatitis B or C virus infection (patients who are positive for hepatitis B surface antigen are excluded; patients who are positive for hepatitis B core antibody or hepatitis C antibody must have a negative hepatitis B DNA or hepatitis C RNA test result, respectively, before enrollment).
- Has an active autoimmune disease, or ongoing any grade irAE from ICIs/other immunomodulatory treatments requiring systemic treatment (i.e., with use of disease modifying agents, non-physiologic doses of corticosteroids, or immunosuppressive drugs). Patients with autoimmune or ICI inhibitor/other immunomodulatory treatment-induced endocrine disorder on hormonal supplementation may be enrolled.
- Any other unstable or clinically significant concurrent medical condition (including, but not limited to substance abuse, uncontrolled intercurrent illness including symptomatic arterial thrombosis, pulmonary embolism, etc.) that would, in the opinion of the investigator, jeopardize the safety of a patient, have an impact on their expected survival through the end of study participation, and/or affect their ability to comply with the requirements of the study.
- Patients receiving specific oncologic therapies:
- Prior therapy with any NTRK-targeted therapy
- Treatment with targeted therapy, chemotherapy, or biologics/mAbs (nonimmunotherapy) ≤21 days or 5 half-lives (whichever is shorter) prior to study treatment initiation
- Treatment with radiation therapy ≤14 days prior to study treatment initiation
- Treatment with immunotherapy (e.g., ICIs) ≤28 days prior to study treatment initiation
- Treatment with any other anticancer treatment not included in "a" through "d" ≤28 days prior to study treatment initiation
- Treatment with any other investigational drug(s) not included in "a" through "e" ≤28 days prior to study treatment initiation (with the exception of provisionally approved mAb prophylaxis).
- Patients who require treatment with systemic cyclosporin A or derivative.
- Concomitant use of medications known to prolong QTc.
- Concomitant use of medications that are sensitive or narrow therapeutic index substrates of cytochrome P450 (CYP) 3A, P-glycoprotein (P-gp), breast cancer resistance protein (BCRP), or organic anion transporting polypeptide 1B3 (OATP1B3) during study treatment.
- Concomitant use of medications known to be moderate or strong CYP3A4 or P-gp inhibitors and/or moderate or strong CYP3A4 inducers is prohibited within 7 days prior to study treatment initiation and during the study treatment period.
- Pregnant or breastfeeding.
- Patients should be excluded if they have a condition requiring systemic treatment with either corticosteroids (>10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study treatment administration. Inhaled or topical steroids and adrenal replacement doses <10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease. Patients are permitted to use topical, ocular, intraarticular, intranasal, and inhalational corticosteroids (with minimal systemic absorption).
- Patients who received a live, attenuated vaccine within 30 days prior to Cycle 1 Day 1.
- Enrolled patients should not receive live vaccine during the study. Non-live COVID vaccines will be allowed on study, but it is recommended to avoid their use during the first treatment cycle (from 3 days prior to Cycle 1 Day 1 through Cycle 2 Day 3). Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however, intranasal influenza vaccines (e.g., Flu-Mist®) are live attenuated vaccines and are not allowed.
- Unresolved toxicities from prior therapy (defined as having not resolved to Grade ≤1 or baseline) or any other toxicity that is deemed irreversible by the investigator. Exceptions include endocrinopathies from prior therapy or disease and successfully treated (such as hypothyroidism, diabetes mellitus), alopecia, vitiligo, and Grade ≤2 peripheral neuropathy.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site
UT MD Anderson
Houston, Texas, 77030
David Hong, MD, 713-563-5844, dshong@mdanderson.org
David Hong, MD
About this study
This is a single-center, open-label Phase 1/2 trial evaluating the safety and efficacy of the combination of larotrectinib and pembrolizumab in patients with advanced/metastatic lung adenocarcinoma or melanoma.
Read the detailed description
Primary Objectives:
- To determine the safety and tolerability of the larotrectinib and pembrolizumab combination in patients with advanced/metastatic lung adenocarcinoma or melanoma.
- To determine the ORR of the larotrectinib and pembrolizumab combination in patients with advanced/metastatic lung adenocarcinoma or melanoma.
Secondary Objective:
- To determine the DOR of the larotrectinib and pembrolizumab combination.
Exploratory Objective:
- To evaluate blood and tissue-based pharmacodynamic biomarkers of the larotrectinib and pembrolizumab combination.
- Conditions
- Solid Tumor
- Being tested
- Larotrectinib, Pembrolizumab
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
LarotrectinibDrug
Also called Vitrakvi
Taken twice daily
PembrolizumabDrug
Also called Keytruda
Give by IV infused over 30 minutes through an IV line containing a sterile 0.2 µm to 5 µm in-line or add-on filter.
| Study group | Role | What they receive |
|---|---|---|
| Phase 1 and Phase 2: Treatment with Larotrectinib + Pembrolizumab | Experimental | Larotrectinib and pembrolizumab will be administered on an outpatient basis in 21-day cycles until disease progression, unacceptable toxicity, death, withdrawal of consent, or discontinuation from the study treatment for any other reason. Receives: Drug: Larotrectinib; Drug: Pembrolizumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Safety and Adverse Events (AEs)
Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0
Measured: Through study completion; an average of 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Sep 2026
- Study start1 Mar 2027 (estimated)
- Primary completion13 Jul 2027 (estimated)
- Study completion13 Jul 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Solid TumorStudies of the same condition, open and under way.
- More trials run by M.D. Anderson Cancer CenterThe sponsor's other registered studies.
- 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 1/2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 22 participants (estimated)
Sponsor and investigators
- Lead sponsor
- M.D. Anderson Cancer Center
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- David Hong, MD, Principal investigator, UT MD Anderson
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07843550
- Sponsor's protocol ID
- 2026-0889
- Other IDs
- NCI-2026-07108
- Status last verified
- Sep 2026
- First submitted
- 21 Sep 2026
- Last updated
- 28 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1/2 Trial Of Larotrectinib And Pembrolizumab In Patients With Solid Tumors Previously Treated With Immune Checkpoint Inhibitor Monotherapy
- ClinicalTrials.gov ID
- NCT07843550
- Acronym / sponsor ID
- 2026-0889
- Conditions
- Solid Tumor
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 22 participants (estimated)
- Lead sponsor
- M.D. Anderson Cancer CenterUniversity, hospital or other
- Study start
- 1 Mar 2027 (estimated)
- Primary completion
- 13 Jul 2027 (estimated)
- Study completion
- 13 Jul 2029 (estimated)
- First posted
- 28 Sep 2026 (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 single-center, open-label Phase 1/2 trial evaluating the safety and efficacy of the combination of larotrectinib and pembrolizumab in patients with advanced/metastatic lung adenocarcinoma or melanoma.
Detailed description
Primary Objectives:
- To determine the safety and tolerability of the larotrectinib and pembrolizumab combination in patients with advanced/metastatic lung adenocarcinoma or melanoma.
- To determine the ORR of the larotrectinib and pembrolizumab combination in patients with advanced/metastatic lung adenocarcinoma or melanoma.
Secondary Objective:
- To determine the DOR of the larotrectinib and pembrolizumab combination.
Exploratory Objective:
- To evaluate blood and tissue-based pharmacodynamic biomarkers of the larotrectinib and pembrolizumab combination.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Phase 1 and Phase 2: Treatment with Larotrectinib + Pembrolizumab | Experimental | Drug: Larotrectinib, Drug: PembrolizumabLarotrectinib and pembrolizumab will be administered on an outpatient basis in 21-day cycles until disease progression, unacceptable toxicity, death, withdrawal of consent, or discontinuation from the study treatment for any other reason. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (34 listed)
- Patients must meet all of the following inclusion criteria to be eligible for enrollment in the study.
- Ability to understand and willingness to sign informed consent form prior to initiation of the study and any study procedures.
- Capable of and willing to comply with scheduled visits, treatment plans, laboratory tests, and other study-related tests and procedures.
- Age ≥18 years.
- Histologically documented locally advanced or metastatic lung adenocarcinoma or melanoma.
Key exclusion criteria (45 listed)
- Documented alterations in NTRK1, NTRK2, or NTRK3 including fusions, rearrangements, deletions, and single nucleotide variants by DNA sequencing or polymerase chain reaction test on circulating tumor DNA, fresh tumor biopsy, or archival tumor tissue (obtained within 3 years of first larotrectinib dose) performed in a Clinical Laboratory Improvement Amendments-certified or equivalent laboratory.
- Patients who required dose interruption for more than 4 weeks, permanent discontinuation, or required systemic immunosuppression due to severe irAEs associated with previous ICI treatment.
- Untreated CNS or leptomeningeal metastases. Patients with treated CNS metastases are allowed if ALL of the following conditions are met:
- Has other malignancy(ies) diagnosed or treated within 5 years of study treatment initiation except for:
- Patients with known or suspected impairment of GI function including any conditions that might hinder drug absorption, the ability to take PO medication, other malabsorption, or uncontrolled inflammatory GI disease such as Crohn's disease or ulcerative colitis.
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 |
|---|---|---|
| LarotrectinibAlso: VitrakviTaken twice daily | Drug | Phase 1 and Phase 2: Treatment with Larotrectinib + Pembrolizumab |
| PembrolizumabAlso: KeytrudaGive by IV infused over 30 minutes through an IV line containing a sterile 0.2 µm to 5 µm in-line or add-on filter. | Drug | Phase 1 and Phase 2: Treatment with Larotrectinib + Pembrolizumab |
Primary outcome
Safety and Adverse Events (AEs)
Time frame: Through study completion; an average of 1 year
Incidence of Adverse Events, Graded According to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version (v) 5.0
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Sep 2026.
- UT MD Anderson WebsiteLink provided by the sponsor.
Related trials for Solid Tumor
RecruitingPhase 1/2
Study of INBRX-106 and INBRX-106 in Combination With Pembrolizumab (Keytruda®) in Subjects With Locally Advanced or Metastatic Solid Tumors (Hexavalent OX40 Agonist)
Solid Tumor, Non-Small Cell Lung Cancer
Active, not recruitingPhase 1
A Study to Assess Safety, Tolerability, and Pharmacokinetics of ABSK043 in Patients With Advanced Solid Tumor
Neoplasms
Active, not recruitingPhase 3
A Safety and Efficacy Extension Study of Pertuzumab in Patients With Solid Tumors Previously Enrolled in a Hoffmann-La Roche-Sponsored Pertuzumab Clinical Trial
Solid Tumors
RecruitingPhase 1
IL-12 Genetically Engineered Myeloid Cells in Participants With Relapsed, Refractory Solid Tumors
Relapsed Solid Tumor Malignancies, Refractory Solid Tumor Malignancies
RecruitingObservational study
Immune Checkpoint Inhibitor Toxicity Risk Prediction in Solid Tumors
Malignant Solid Neoplasm
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.
David Hong, MD principal investigator
UT MD Anderson
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Larotrectinib and Pembrolizumab in people with Solid Tumor, run by M.D. Anderson Cancer Center at 1 site 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 34 inclusion and 45 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: opening soon, as of the sponsor's last update on 28 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact David Hong, MD ((713) 563-5844, dshong@mdanderson.org), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Safety and Adverse Events (AEs) (time frame: Through study completion; an average of 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 28 Sep 2026.