ClinicalTrials.gg
RecruitingNCT05182164PEMBROCABOSARCUpdated Oct 7, 2025

Combination of Pembrolizumab and Cabozantinib in Patients With Advanced Sarcomas

A Phase 2 interventional study of Association of pembrolizumab + cabozantinib in Soft Tissue Sarcoma Adult, Advanced Soft-tissue Sarcoma and Ewing Sarcoma, sponsored by Institut Bergonié. Recruiting at 10 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-10-07.

Sponsored by Institut Bergonié · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2022; still recruiting 4 years 6 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
119
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

Phase II trial with three independent strata to independently assess the effects of the association of pembrolizumab and cabozantinib in advanced sarcomas.

Read the detailed description

3 independent, multicenter, prospective, signel-arm phase II trial, based on 2-stage Simon's optimal design, will be conducted in parallel to assess the efficacy of pembrolizumab + cabozantinib, in distinct populations of sarcomas:

  • stratum 1: advanced undiffenrentiated pleomorphic sarcoma
  • stratum 2: advanced osteosarcoma
  • stratum 3: advanced ewing sarcoma
02

Conditions studied

  • Soft Tissue Sarcoma Adult
  • Advanced Soft-tissue Sarcoma
  • Ewing Sarcoma
  • Osteosarcoma
  • Undifferentiated Pleomorphic Sarcoma

Keywords

  • soft-tissue sarcoma
  • immune checkpoint inhibitor
03

In context

Sarcoma, Ewing

250 studies on the registry are indexed under Sarcoma, Ewing; 69 are open to participants now.

This study's planned enrollment of 119 is above the median of 36 across 204 interventional studies indexed under Sarcoma, Ewing.

Browse Sarcoma, Ewing studies →

Lead sponsor

Institut Bergonié is the lead sponsor of 119 studies on the registry; 16 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Histology: undifferentiated pleomorphic sarcoma (stratum 1), bone osteosarcoma (stratum 2), bone or extraskeletal or Ewing sarcoma (stratum 3),
  2. Advanced non resectable / disease,
  3. Recurrent disease or progression after standard therapy,
  4. Documented progression according to criteria.
  5. Have provided tissue of a tumor lesion from \< 3 months old sample obtained on locally advanced disease, or metastatis with no subsequent treatment since or from a newly obtained core or excisional biopsy,
  6. No more of three for advanced disease,
  7. Age ≥ 18 years,
  8. ≤ 1,
  9. according to RECIST v1.1 outside any previously irradiated field. At least one site of disease must be uni-dimensionally ≥ 10 mm,
  10. > 3 months,
  11. Participant must have advanced disease and must not be a candidate for other approved therapeutic regimen known to provide significant clinical benefit based on investigator judgement,
  12. No symptomatic central nervous system disease,
  13. No chronic use of .
  14. Adequate hematological, renal, metabolic and hepatic function,
  15. No prior or concurrent malignant disease diagnosed or treated in the last 2 years except for adequately treated in situ carcinoma of the cervix, basal or squamous skin cell carcinoma, or in situ transitional bladder cell carcinoma,
  16. At least three weeks since last chemotherapy, immunotherapy and two weeks for any other pharmacological treatment and/or radiotherapy,
  17. Recovery to grade ≤ 1 from any adverse event (AE) derived from previous treatment (excluding alopecia of any grade, non-painful peripheral neuropathy grade ≤ 2 and endocrine-related grade ≤ 2 requiring treatment or hormone replacement) (according to , version 5.0). For patients previously treated by radiotherapy, they must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis,
  18. Women of must have a negative serum pregnancy test within 72 hours prior to receiving the first dose of study medication. Both women and men must agree to use 2 medically acceptable methods of throughout the treatment period and for 6 months after discontinuation of treatment. Subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for ≥ 1 year,
  19. Voluntary signed and dated written informed consents prior to any specific study procedure,
  20. Patients with a social security in compliance with the French Law.

Exclusion criteria

Exclusion Criteria:

  1. Previous treatment with Pembrolizumab or Cabozantinib,
  2. Has received prior therapy with an , anti-PD-L1, anti-PD-L2, anti-CD137, or anti-Cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) antibody (including ipilimumabor any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways),
  3. Evidence of progressive or symptomatic central nervous system or ,
  4. Men or women of who are not using an effective method of ; women who are pregnant or breast feeding, men or women who are planning to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment,
  5. Participation to a study involving a medical or therapeutic intervention in the last 21 days,
  6. Previous enrolment in the present study,
  7. Patient unable to follow and comply with the study procedures because of any geographical, familial, social or psychological reasons,
  8. Patient unable to swallow,
  9. Known to any involved study drug or of its formulation components,
  10. Has an active disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, or drugs). Replacement therapy is not considered a form of systemic treatment and is allowed.
  11. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment,
  12. History of idiopathic pulmonary fibrosis, history of non-infectious pneumonitis that required steroids, current pneumonitis/interstitial lung disease, drug-induced pneumonitis, organizing pneumonia, or evidence of active pneumonitis on screening chest CT scan. History of radiation pneumonitis in the radiation field (fibrosis) is permitted,
  13. Has a known history of (defined as Hepatitis B surface antigen [HBsAg] reactive) or known active virus (defined as HCV RNA [qualitative] is detected) infection.
  14. Has a known history of infection and/or of active TB (Bacillus Tuberculosis),
  15. Treatment with anticoagulants such as anti-Vitamin K, thrombin or Factor Xa inhibitors, or antiplatelet agents (e.g., clopidogrel),
  16. Previous allogenic bone marrow transplant or solid organ transplantation,
  17. Has an active infection requiring systemic treatment at study entry,
  18. The subject has a interval calculated by the Fridericia formula (QTcF) > 500 ms within 28 days before treatment. Note: if initial QTcF is found to be > 500 ms, two additional ECGs separated by at least 3 minutes should be performed. If the average of these three consecutive results for QTcF is ≤ 500 ms, the subject meets eligibility in this regard,
  19. The subject requires chronic concomitant treatment of strong inducers
  20. The subject has experienced any of the following: Clinically-significant gastrointestinal bleeding within 6 months before the first dose of study treatment, Hemoptysis of ≥ 2.5 mL of red blood within 3 months before the first dose of study treatment, Any other signs indicative of pulmonary hemorrhage within 3 months before the first dose of study treatment, The subject has radiographic evidence of cavitating pulmonary lesion(s), The subject has tumor in contact with, invading or encasing any major blood vessels, or The subject has evidence of tumor invading the GI tract, or any evidence of endotracheal or endobronchial tumor within 28 days before the first dose of cabozantinib.
  21. The subject has uncontrolled, significant intercurrent or recent illness including, but not limited to, the following conditions which are fully described in the study protocol: Cardiovascular disorders, Gastrointestinal disorders particularly those associated with a high risk of perforation or fistula formation, Other disorders associated with a high risk of fistula formation including PEG tube placement within 3 months before the first dose of study therapy,
  22. Has received a within 30 days prior to the first dose of study drug. 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. Note: Seasonal influenza vaccines for injection are generally killed virus vaccines and are allowed; however, intranasal influenza vaccines (eg, FluMist®) are live attenuated vaccines and are not allowed.
  23. Has an history or current evidence of any condition, therapy, or laboratory abnormality that might counfound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
  24. The subject is planning to have oral surgery/invasive dental procedure within the projected duration of the study, starting with the screening visit through 3 months after the last dose of study treatment or had such a procedure within 3 months of first dose of study treatment.
Terms in these criteria, in plain language(22)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

CTCAE grade

The US National Cancer Institute’s scale of how severe an adverse event is — any unwanted medical event during a study, such as a symptom, an illness or an abnormal test result, whether or not a treatment caused it. Whether it did is judged separately.

1
Mild.
2
Moderate.
3
Severe.
4
Life-threatening.
5
Death due to the event.

“Side effects of earlier treatment resolved to grade 1 or less” means they have settled to mild or gone.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
119 participants (estimated)

Study arms

  • Experimental
    Stratum 1: advanced undifferentiated pleomorphic sarcoma

    Patients with advanced undifferentiated pleomorphic sarcoma will be treated by the combination of pembrolizumab + cabozantinib

    Drug: Association of pembrolizumab + cabozantinib

  • Experimental
    Stratum 2: advanced osteosarcoma

    Patients with advanced osteosarcoma will be treated by the combination of pembrolizumab + cabozantinib

    Drug: Association of pembrolizumab + cabozantinib

  • Experimental
    Stratum 3: advanced Ewing sarcoma

    Patients with advanced Ewing sarcoma will be treated by the combination of pembrolizumab + cabozantinib

    Drug: Association of pembrolizumab + cabozantinib

Interventions

  • DrugAssociation of pembrolizumab + cabozantinib

    A treatment cycle consists of 3 weeks. Pembrolizumab will be administered intraveinously on day 1 every 3 weeks (200 mg). Cabozantinib will be administered per os, once daily (40 mg), and given on a continuous basis.

This study also gives Pembrolizumab, Cabozantinib. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. Assessment of the efficacy of pembrolizumab and cabozantinib (independently for each stratum)

    Efficacy will be assessed in terms of non-progression rate at 6 months and is defined as the proportion of patients with complete response (CR), or partial response (PR), or stable disease (SD) at 6 months from the start of the treatment, based on RECIST 1.1 criteria.

    Time frame: 6 months

Secondary outcomes

  1. Best overall response, independently for each stratum

    Best overall response is defined as the best response across all time points (RECIST 1.1). The best overall response is determined once all the data for the patient is known (RECIST 1.1).

    Time frame: Throughout the treatment period, an expected average of 6 months

  2. 1-year progression-free survival, independently for each stratum

    Progression-free survival is defined as the delay between the start date of treatment and the date of progression (as per RECIST 1.1) or death (from any cause), whichever occurs first.

    Time frame: 1 year

  3. 1-year overall survival, independently for each stratum

    Overall survival is defined as the delay between the start date of treatment and the date of death (of any cause).

    Time frame: 1 year

  4. Safety profile, independently for each stratum: Common Terminology Criteria for Adverse Events version 5

    Toxicity graded using the Common Terminology Criteria for Adverse Events version 5.

    Time frame: Throughout the treatment period, an expected average of 6 months

  5. 6-months non-progression rate according to iRECIST

    Efficacy will be assessed in terms of non-progression rate at 6 months and is defined as the proportion of patients with complete response (CR), or partial response (PR), or stable disease (SD) at 6 months from the start of the treatment, based on iRECIST criteria (Seymour, 2017).

    Time frame: 6 months

  6. Blood cytokines levels

    Levels of cytokines in blood will be measured by ELISA.

    Time frame: baseline, cycle 2 day 1, cycle 2 day 8, cycle 3 day 1, cycle 4 day 1, cycle 6 day 1 and at progression (each cycle is 21 days)

  7. Blood lymphocytes levels

    Levels of lymphocytes in blood will be measured by flow cytometry.

    Time frame: baseline, cycle 2 day 1, cycle 2 day 8, cycle 3 day 1, cycle 4 day 1, cycle 6 day 1 and at progression (each cycle is 21 days)

  8. Blood kynurenine levels

    Levels of kynurenine in blood will be measured by ELISA.

    Time frame: baseline, cycle 2 day 1, cycle 2 day 8, cycle 3 day 1, cycle 4 day 1, cycle 6 day 1 and at progression (each cycle is 21 days)

  9. Tumor immune cells levels

    Levels of immune cells in tumor will be measured by immunohistochemistry.

    Time frame: before treatment onset and cycle 2 day 8 (each cycle is 21 days)

07

Study locations

6 of 10 sites recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 7, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05182164
Lead sponsor
Institut Bergonié
Collaborators
Ipsen, MSD France
Responsible party
Sponsor
First posted
Jan 10, 2022
Start date
Apr 25, 2022
Primary completion
Dec 2026 (estimated)
Completion
Dec 2027 (estimated)
Last update
Oct 7, 2025

Study contacts

Maud TOULMONDE, MD
Contact
m.toulmonde@bordeaux.unicancer.fr
+33556333333
Simone MATHOULIN-PELISSIER, MD, PhD
Contact
s.mathoulin@bordeaux.unicancer.fr

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drugs tested here: Pembrolizumab · Cabozantinib

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