Adjuvant/Neoadjuvant Immunotherapy in Melanoma Based on Serial Plasma ctDNA Monitoring
The purpose of the study is to see if periodic (serial) blood-based testing of ctDNA (circulating tumor DNA) while receiving study treatment with study drug therapy for advanced melanoma (skin cancer) can be used to decide the best plan for care during and after initial study drug treatment.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Anjana Menon
- Telefonnummer: 813-745-5537
- E-mail: Anjana.Menon@moffitt.org
Studiesteder
-
-
Florida
-
Tampa, Florida, Forenede Stater, 33612
- Rekruttering
- Moffitt Cancer Center
-
Underforsker:
- Ahmad Tarhini, MD
-
Underforsker:
- Nikhil Khushalani, MD
-
Underforsker:
- Andrew Brohl, MD
-
Ledende efterforsker:
- Zeynep Eroglu, MD
-
Underforsker:
- Edith Abraham, MD
-
Underforsker:
- Lilit Karapetyan, MD
-
Underforsker:
- Joseph Markowitz, MD
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Age ≥18 years
- Histologically confirmed melanoma (excluding uveal melanoma)
- Neoadjuvant Cohort: Surgically resectable AJCC 8th edition Stage III or Stage IV melanoma
- Adjuvant Cohort: Completely resected AJCC 8th edition Stage IIB, IIC, III, or IV melanoma
- ECOG Performance Status ≤2
- Adequate organ function: AST and ALT ≤5 × upper limit of normal (ULN) and Creatinine ≤2 × ULN.
- Baseline imaging obtained within 28 days prior to treatment initiation
- Negative pregnancy test for women of childbearing potential
- Ability to understand and sign informed consent
Exclusion Criteria:
- Prior anti-PD-1, anti-PD-L1, anti-PD-L2, or anti-CTLA-4 therapy within 1 year before enrollment
- Contraindication to nivolumab and/or ipilimumab
- Active autoimmune disease requiring systemic immunosuppressive therapy
- Concurrent malignancy requiring active treatment that could interfere with study treatment or assessments
- Unresectable disease
- Uveal melanoma
- Any medical, psychiatric, or social condition that would interfere with protocol compliance or study participation
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Ikke-randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Neoadjuvant cohort
Patients with resectable stage III/IV melanoma eligible for neoadjuvant treatment will be enrolled. Patient cases will be reviewed with the surgery team to confirm surgical resectability prior to enrollment and CT imaging will be obtained at baseline, as per standard of care. |
Administered intravenously as neoadjuvant and/or adjuvant therapy for melanoma according to protocol-defined dosing schedules. Administered intravenously in combination with nivolumab in participants meeting ctDNA-defined criteria for treatment escalation. Tumor-informed circulating tumor DNA assay performed on serial plasma samples to evaluate molecular residual disease and guide treatment adaptation. |
|
Eksperimentel: Adjuvant cohort
Patients who already underwent complete surgical resection of stage IIB/IIC/III/IV melanoma (and did not receive prior neoadjuvant treatment.) All patients in this cohort must be within 10 weeks of surgery and have CT scans post-surgery prior to study enrollment to confirm they are radiographically disease-free. Following study enrollment, all patients will have the first ctDNA analyses done within 12 weeks of date of surgery. |
Administered intravenously as neoadjuvant and/or adjuvant therapy for melanoma according to protocol-defined dosing schedules. Administered intravenously in combination with nivolumab in participants meeting ctDNA-defined criteria for treatment escalation. Tumor-informed circulating tumor DNA assay performed on serial plasma samples to evaluate molecular residual disease and guide treatment adaptation. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Event-Free Survival (EFS) in the Neoadjuvant Cohort
Tidsramme: Up to 5 Years
|
Defined as the time from initiation of study treatment to disease progression precluding surgery, melanoma recurrence, progression, or death from any cause. |
Up to 5 Years
|
|
Relapse-Free Survival (RFS) in the Adjuvant Cohort
Tidsramme: Up to 5 years
|
Defined as the time from initiation of adjuvant treatment to melanoma recurrence or death from any cause. |
Up to 5 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Pathologic Response Rate (Neoadjuvant Cohort)
Tidsramme: Up to 12 weeks
|
Proportion of participants achieving pathologic response in the surgical specimen following neoadjuvant treatment, including pathologic complete response (pCR) and major pathologic response (MPR). |
Up to 12 weeks
|
|
Objective Response Rate (ORR) by RECIST v1.1 (Neoadjuvant Cohort)
Tidsramme: Up to 12 weeks
|
Proportion of participants achieving a complete response or partial response according to RECIST version 1.1 based on radiographic assessments performed during neoadjuvant treatment. |
Up to 12 weeks
|
|
Relapse With Undetectable ctDNA
Tidsramme: Up to 5 years
|
Frequency of participants who maintain undetectable circulating tumor DNA (ctDNA) during serial monitoring and subsequently experience clinical and/or radiographic melanoma relapse. |
Up to 5 years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Zeynep Eroglu, MD, Moffitt Cancer Center
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Neoplasmer efter sted
- Neoplasmer
- Neoplasmer efter histologisk type
- Hudsygdomme
- Neuroektodermale tumorer
- Neoplasmer, kimceller og embryonale
- Neoplasmer, nervevæv
- Neuroendokrine tumorer
- Nevi og melanomer
- Neoplasmer i huden
- Hud- og bindevævssygdomme
- Melanom
- Aminosyrer, peptider og proteiner
- Proteiner
- Antistoffer, monoklonal, humaniseret
- Antistoffer, monoklonal
- Antistoffer
- Immunoglobuliner
- Immunoproteiner
- Blodproteiner
- Serum globuliner
- Globuliner
- Nivolumab
- Ipilimumab
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- MCC-23763
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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