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Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 1 |
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Life expectancy >12 weeks, as assessed by the investigator |
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TAK-676 SA |
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With histologically confirmed (cytological diagnosis is acceptable) advanced or metastatic solid tumors that have no standard therapeutic options or are intolerant to these therapies |
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TAK-676 in combination with pembrolizumab |
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With histologically confirmed (cytological diagnosis is acceptable) advanced or metastatic solid tumors, including |
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Tumors that have relapsed or are refractory to anti-programmed cell death protein 1 (anti-PD-1)/anti-programmed cell death ligand 1 (anti-PD-L1) therapy |
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Tumors that are naive to anti-PD-1/ anti-PD-L1 therapy |
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Adequate bone marrow, renal, hepatic and cardiac functions |
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Left ventricular ejection fraction (LVEF) >50%, as measured by echocardiogram or multiple-gated acquisition (MUGA) scan within 4 weeks before receiving the first dose of study drug |
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Clinically significant toxic effects of previous therapy have recovered to Grade 1 (per NCI CTCAE Version 5.0) or baseline, except for alopecia, Grade 2 peripheral neuropathy, and/or autoimmune endocrinopathies with stable endocrine replacement therapy |
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Once peripheral evidence of TAK-676 pharmacodynamic stimulation of the innate and/or adaptive immune system is observed in the blood and/or clinical response (CR/PR) is observed in at least 1 participant, subsequent participants must |
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Have at least 1 lesion amenable for biopsy |
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Agree to have 2 tumor biopsies: 1 during the screening period and 1 while on TAK-676 treatment |
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Must have at least 1 RECIST v.1.1-evaluable (measurable or nonmeasurable) lesion |
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PK/pharmacodynamic blood must be drawn on a peripherally-inserted catheter. TAK-676 is preferentially administered through a central line, but peripheral infusion is acceptable. If a peripheral line is used for TAK-676 and/or pembrolizumab infusion, it must be separate than the one used for PK/ pharmacodynamic collection |
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Corrected QT interval by Fredericia (QTcF) greater than (>) 450 milliseconds (men) or >475 milliseconds (women) on a 12-lead ECG during the screening period
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Grade greater than or equal to (>=) 2 hypotension (that is, hypotension for which nonurgent intervention is required) at screening or during C1D1 predose assessment
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Oxygen saturation less than (<) 92 percent (%) on room air at screening or during C1D1 predose assessment
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Treated with other STING agonists/antagonist and TLR agonists within the past 6 months
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Active vaping within 90 days of C1D1 of study drug(s)
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Active smoking
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Current history of pneumonitis, interstitial lung disease, severe chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, other restrictive lung diseases, acute pulmonary embolism, or Grade >=2 pleural effusion or ascites not controlled by tap or requiring indwelling catheters
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History of brain metastasis unless
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Clinically stable (that is, >=6 weeks) following prior surgery, whole-brain radiation, or stereotactic radiosurgery, AND
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Off corticosteroids
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Ongoing Grade >= 2 infection or participants with Grade >=2 fever of malignant origin
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Chronic, active hepatitis (example: participants with known hepatitis B surface antigen seropositive and/or detectable hepatitis C virus [HCV]-RNA)
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For participants in the SA arm only: refusal of standard therapeutic options
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For participants in the combination arm only: contraindication and/or intolerance to the administration of pembrolizumab
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Concurrent chemotherapy, immunotherapy (except for pembrolizumab in the combination arm), biologic, or hormonal therapy (except for adjuvant endocrine therapy for a history of breast cancer). Concurrent use of hormones for noncancer-related conditions is acceptable (except for corticosteroid hormones)
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Radiation therapy within 14 days (42 days for radiation to the lungs) and/or systemic treatment with radionuclides within 42 days before C1D1 of study drug(s). Participants with clinically relevant ongoing pulmonary complications from prior radiation therapy are not eligible
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Use of systemic corticosteroids or other immunosuppressive therapy, concurrently or within days of C1D1 of study drug(s), with the following exceptions
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Topical, intranasal, inhaled, ocular, and/or intra-articular corticosteroids
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Physiological doses of replacement steroid therapy (example: for adrenal insufficiency)
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Use of medications that are known clinical OATP1B1 and/or OATP1B3 inhibitors, concurrently or within 14 days of C1D1 of study drug(s)
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Receipt of live attenuated vaccine within 28 days of C1D1 of study drug(s)
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Recipients of allogeneic or autologous stem cell transplantation or organ transplantation
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