Ipilimumab and Nivolumab With Immunoembolization in Treating Participants With Metastatic Uveal Melanoma in the Liver
Ipilimumab and Nivolumab in Combination With Immunoembolization for the Treatment of Metastatic Uveal Melanoma
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. Determine the clinical benefit of treatment with immunoembolization (IEMBO) in combination with ipilimumab and nivolumab.
SECONDARY OBJECTIVES:
I. Determine all treatment and immune related toxicities. II. Determine progression free survival. III. Determine overall survival.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19107
- Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Histologically confirmed metastatic uveal melanoma in the liver; patients must have at least one measurable liver metastasis that is >= 10 mm in longest diameter by computed tomography (CT) scan or magnetic resonance imaging (MRI)
- The total volume of the tumors must be less than 50% of the liver volume
- Willingness and ability to give informed consent
- Agreement to access archival tissue or agreement for tumor biopsy prior to treatment
- Eastern Cooperative Oncology Group (ECOG) performance status of 0, or 1
- Serum creatinine =< 2.0 mg/dl
- Granulocyte count >= 1000/mm^3
- Platelet count >= 100,000/mm^3
- Bilirubin =< 2.0 mg/ml
- Albumin >= 3.0 g/dl
- Prothrombin time (PT)/partial thromboplastin time (PTT) less than 1.5 times normal
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than 3 x upper limit of normal (ULN)
- Alkaline phosphatase less than 1.5 times ULN (grade 1)
- Women must not be pregnant or breast-feeding
- Women of child-bearing potential must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 23 weeks after the last dose of nivolumab and/or ipilimumab and sexually active males must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 31 weeks after the last dose of nivolumab and/or ipilimumab
Exclusion Criteria:
- Failure to meet any of the criteria set forth in the inclusion criteria section
- Previous systemic exposure to anti-CTLA-4 antibody or anti-PD1 antibody
- Previous liver-directed treatments including chemoembolization, radiosphere, hepatic arterial perfusion, or drug-eluting beads; liver resection and focal ablation are permitted
- Presence of symptomatic liver failure including ascites and hepatic encephalopathy
- Presence of untreated brain metastases; if patients have had previous treatment for the brain metastasis, an MRI or CT scan of the brain must confirm the stabilization of the brain metastasis for more than 2 months
- Presence of uncontrolled hypertension or congestive heart failure, or acute myocardial infarction within 6 months of entry
- Presence of any other medical complication that implies survival of less than six months
- Uncontrolled severe bleeding tendency or active gastrointestinal (GI) bleeding
- Significant allergic reaction to contrast dye or granulocyte-macrophage colony-stimulating (GM-CSF)
- Immunosuppressive treatments within 4 weeks prior to embolization, unless prednisone =< 5 mg or equivalent
- Pregnancy or breast-feeding women
- Patients with active hepatitis with serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) equal or greater than 5 times normal
- Biliary obstruction, biliary stent or prior biliary surgery except cholecystectomy
- Positive for known human immunodeficiency virus (HIV) Infection
- Uncontrolled chronic obstructive pulmonary disease or previous known pulmonary fibrosis
- Active infection
- Auto-immune disease including inflammatory bowel disease, lupus, rheumatoid arthritis, but not including hypothyroidism or psoriasis if condition has been stable for 2 months or greater
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Treatment (ipilimumab, nivolumab, immunoembolization)
Patients receive ipilimumab IV over 30 minutes and nivolumab IV over 30 minutes on day 1.
Patients also undergo immunoembolization on day 2. Cycles repeat every 3 weeks for 12 weeks in the absence of disease progression or unacceptable toxicity.
Patients with complete response, partial response, or stable disease may receive nivolumab IV on day 1 and undergo immunoembolization on day 2. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
The interval between treatments may be extended up to every 6 weeks at the discretion of the treating physician.
|
Given IV
Other Names:
Given IV
Other Names:
Undergo immunoembolization
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Hepatic Metastasis Stabilization Rate by Response Criteria (Response Evaluation Criteria in Solid Tumors [RECIST] 1.1)
Time Frame: At the end of 4th treatment cycle (Day 84 +/- 3 days). Cycles are 21 days.
|
Defined as complete response + partial response + stable disease.
Rated by Response Evaluation Criteria in Solid Tumors version 1.1.
The estimate of the hepatic metastasis stabilization rate will be presented with corresponding 95% confidence intervals.
The method of Atkinson and Brown will be used to adjust for the two-stage design.
|
At the end of 4th treatment cycle (Day 84 +/- 3 days). Cycles are 21 days.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Adverse Events
Time Frame: Up to 1 year
|
Graded by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0.
Toxicity rates will be estimated with corresponding 95% confidence intervals.
|
Up to 1 year
|
|
Progression Free Survival (PFS)
Time Frame: From the start of the treatment to confirmation of progression of disease, assessed up to 1 year
|
Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Will be estimated using the Kaplan-Meier method.
|
From the start of the treatment to confirmation of progression of disease, assessed up to 1 year
|
|
Overall Survival
Time Frame: up to 2 years
|
Will be estimated using the Kaplan-Meier method.
|
up to 2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Marlana Orloff, MD, Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Neoplasms by Histologic Type
- Eye Diseases
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Neuroendocrine Tumors
- Nevi and Melanomas
- Eye Neoplasms
- Uveal Diseases
- Melanoma
- Uveal Neoplasms
- Uveal Melanoma
- Amino Acids, Peptides, and Proteins
- Proteins
- Therapeutics
- Biological Factors
- Antibodies, Monoclonal, Humanized
- Antibodies, Monoclonal
- Antibodies
- Immunoglobulins
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Receptors, Cell Surface
- Membrane Proteins
- Hemostatic Techniques
- Therapeutic Occlusion
- Antigens
- Antigens, Surface
- Biomarkers
- Receptors, Immunologic
- Antigens, Differentiation, T-Lymphocyte
- Antigens, Differentiation
- Immune Checkpoint Proteins
- Costimulatory and Inhibitory T-Cell Receptors
- Nivolumab
- Ipilimumab
- Embolization, Therapeutic
- CTLA-4 Antigen
Other Study ID Numbers
Other Study ID Numbers
- 18P.042
- JT 10364 (Other Identifier: JeffTrial Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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