- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT03743766
Nivolumab, BMS-936558 en association avec Relatlimab, BMS-986016 chez des patients atteints de mélanome métastatique n'ayant jamais reçu d'immunothérapie antérieure dans un contexte métastatique
Une étude de phase II sur l'anticorps monoclonal anti-PD1 (Nivolumab, BMS-936558) administré en association avec l'anticorps monoclonal anti-LAG3 (Relatlimab, BMS-986016) chez des patients atteints de mélanome métastatique n'ayant jamais reçu d'immunothérapie antérieure dans le cadre métastatique
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Type d'étude
Inscription (Réel)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
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Pennsylvania
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Pittsburgh, Pennsylvania, États-Unis, 15232
- UPMC Hillman Cancer Center
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
La description
Critère d'intégration:
• Hommes ou femmes de 18 ans ou plus répondant aux critères de la 8e édition de l'AJCC pour les mélanomes non résécables de stade IIIB, de stade IIIC, de stade IIID ou de stade IV qui n'ont pas reçu de traitement par immunothérapie dans un contexte métastatique
Critère d'exclusion:
Métastases connues ou suspectées du SNC, avec les exceptions suivantes :
- Les sujets présentant des métastases cérébrales contrôlées seront autorisés à s'inscrire. Les métastases cérébrales contrôlées sont définies comme l'absence de progression radiographique pendant au moins 4 semaines après une radiothérapie et/ou un traitement chirurgical au moment du consentement. Les sujets doivent être sans stéroïdes pendant au moins 2 semaines avant la randomisation.
- Les sujets présentant des signes ou des symptômes de métastases cérébrales ne sont pas éligibles à moins que les métastases cérébrales ne soient exclues par tomodensitométrie ou imagerie par résonance magnétique.
- Maladie auto-immune active nécessitant un traitement, à l'exception du diabète sucré de type 1, du vitiligo, de l'asthme/atopie infantile résolu, de l'hyper/hypothyroïdie contrôlée, de l'hyposurrénalisme ou de l'hypopituitarisme.
- Traitement systémique antérieur dans le cadre métastatique, y compris les anticorps anti-PD1, anti-PDL1, anti-PDL2, anti-CTLA-4 ou tout autre anticorps ou médicament ciblant spécifiquement la costimulation des lymphocytes T ou les voies de contrôle immunitaire ; ou chimiothérapie.
- Traitement adjuvant antérieur par anticorps anti-PD1, anti-PDL1 et/ou anti-LAG3. Notez qu'un traitement adjuvant antérieur avec une thérapie ciblée (par ex. inhibition de BRAF/MEK), anti-CTLA4, ou un traitement non spécifié ci-dessus serait autorisé.
- Mélanome oculaire
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Relatlimab
Cycle 1 : Relatlimab (BMS-986016) est fourni sous forme de formulation stérile de 10 mg/mL à administrer en perfusion intraveineuse (IV) à 160 mg IV pendant les 4 premières semaines (cycle 1). Cycle 2+ : La thérapie combinée sera administrée par perfusion séquentielle. Nivolumab administré à 480 mg IV suivi d'une perfusion de relatlimab à 160 mg IV une fois toutes les 4 semaines. |
Relatlimab (BMS-986016) - Formulation de 10 mg/mL à administrer en perfusion intraveineuse (IV) à 160 mg IV.
Autres noms:
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Expérimental: Nivolumab
Cycle 1 : Nivolumab (BMS-936558) est fourni sous forme de formulation stérile de 10 mg/mL à administrer en perfusion IV à 480 mg IV pendant les 4 premières semaines. Cycle 2+ : La thérapie combinée sera administrée par perfusion séquentielle. Nivolumab administré à 480 mg IV suivi d'une perfusion de relatlimab à 160 mg IV une fois toutes les 4 semaines. |
Nivolumab (BMS-936558) - Formulation de 10 mg/mL à administrer en perfusion IV à 480 mg IV.
Autres noms:
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Expérimental: Relatlimab + Nivolumab
Cycle 1+ : La thérapie combinée sera administrée par perfusion séquentielle.
Nivolumab administré à 480 mg IV suivi d'une perfusion de relatlimab à 160 mg IV pendant les 4 premières semaines (cycle 1), puis une fois toutes les 4 semaines ensuite.
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La thérapie combinée (Relatlimab + Nivolumab) sera administrée par perfusion séquentielle.
Nivolumab administré à 480 mg IV suivi d'une perfusion de relatlimab à 160 mg IV.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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LAG3 Gene Expression From scRNAseq
Délai: At Baseline
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Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
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At Baseline
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LAG3 Gene Expression From scRNAseq
Délai: At Week 4
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Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
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At Week 4
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PD1 Expression
Délai: At baseline (Week 0)
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Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
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At baseline (Week 0)
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PD1 Expression
Délai: At Week 4
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Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
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At Week 4
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Change in Tumor Size
Délai: At baseline and at 4 weeks
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Percentage change in tumor size assessed per Response Evaluation Criteria in Solid Tumors. Per RECIST 1.1, Tumor lesions: Must be accurately measured in at least one dimension (longest diameter in the plane of measurement is to be recorded) with a minimum size of:
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At baseline and at 4 weeks
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Overall Response Rate (ORR)
Délai: Beginning at 12 weeks post initial treatment, up to 4 years
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Percent of participants experiencing Complete Response (CR) + Number of participants experiencing Partial Response (PR)/total patients assessed.
Per RECIST v1.1, CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
PD: At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
(Note: the appearance of one or more new lesions is also considered progression).
SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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Beginning at 12 weeks post initial treatment, up to 4 years
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Overall Response Rate (ORR) - ITT (Intent-to-treat) Population
Délai: Beginning at 12 weeks post initial treatment, up to 4 years
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Percent of participants experiencing Complete Response (CR) + Number of participants experiencing Partial Response (PR)/total patients assessed.
Per RECIST v1.1, CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.
PD: At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
(Note: the appearance of one or more new lesions is also considered progression).
SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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Beginning at 12 weeks post initial treatment, up to 4 years
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Durée de la réponse
Délai: 12 semaines après le traitement initial, jusqu'à 4 ans
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Délai entre la première réponse complète (RC) ou réponse partielle (RP) documentée et la première date à laquelle la progression de la maladie est objectivement documentée.
Selon RECIST v1.1, CR : Disparition de toutes les lésions cibles.
Tout ganglion lymphatique pathologique (qu'il soit cible ou non cible) doit avoir une réduction de l'axe court pour
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12 semaines après le traitement initial, jusqu'à 4 ans
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Survie sans progression (PFS)
Délai: Jusqu'à 4 ans
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La survie sans progression est définie comme le temps entre la date de randomisation et la première date de progression documentée ou de décès quelle qu'en soit la cause, selon la première éventualité.
Selon RECIST v1.1, maladie évolutive (MP) : augmentation d'au moins 20 % de la somme des diamètres des lésions cibles, en prenant comme référence la plus petite somme de l'étude (ceci inclut la somme de référence si c'est la plus petite de l'étude).
En plus de l'augmentation relative de 20 %, la somme doit également démontrer une augmentation absolue d'au moins 5 mm.
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Jusqu'à 4 ans
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Survie globale (OS)
Délai: Jusqu'à 4 ans
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La survie globale est définie comme le temps écoulé entre la date de randomisation et la date du décès quelle qu'en soit la cause.
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Jusqu'à 4 ans
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Secondary Outcome: Clinical Benefit Rate
Délai: 12 weeks post initial treatment, up to 4 years
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Percent of patients with Complete Response (CR) + Partial Response (PR) + Stable Disease (SD) / total patients assessed per RECIST v1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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12 weeks post initial treatment, up to 4 years
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Clinical Benefit Rate - ITT (Intent-to-treat) Population
Délai: 12 weeks post initial treatment, up to 4 years
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Percent of patients with Complete Response (CR) + Partial Response (PR) + Stable Disease (SD) / total patients assessed per RECIST v1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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12 weeks post initial treatment, up to 4 years
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Progression-free Survival (PFS) by Lead-in Arm
Délai: Up to 4 years
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Progression-free survival is defined as the time between the date of randomization and the first date of documented progression or death due to any cause, whichever occurs first.
Per RECIST v1.1, Progressive Disease (PD): At least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum on study (this includes the baseline sum if that is the smallest on study).
In addition to the relative increase of 20%, the sum must also demonstrate an absolute increase of at least 5 mm.
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Up to 4 years
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CD8+ Tumor Infiltrating Lymphocytes
Délai: At Baseline
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Number of CD8+ tumor infiltrating lymphocytes present.
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At Baseline
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CD8+ Tumor Infiltrating Lymphocytes
Délai: At Week 4
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Number of CD8+ tumor infiltrating lymphocytes present.
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At Week 4
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CD4+ Tumor Infiltrating Lymphocytes
Délai: At Week 4
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Number of CD4+ tumor infiltrating lymphocytes present.
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At Week 4
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CD4+ Tumor Infiltrating Lymphocytes
Délai: At Baseline
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Number of CD4+ tumor infiltrating lymphocytes present.
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At Baseline
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LAG3 Levels - PBMC
Délai: At Baseline
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To determine the amount of LAG3 expressed on activated T cells in the blood through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
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At Baseline
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LAG3 Levels - PBMC
Délai: At Week 4
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To determine the amount of LAG3 expressed on activated T cells in the blood through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
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At Week 4
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LAG3 Levels - TIL
Délai: At Baseline
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To determine the amount of LAG3 expressed on activated tumor infiltrating lymphocytes (TIL) through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
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At Baseline
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LAG3 Levels - PBMC
Délai: At Week 16
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To determine the amount of LAG3 expressed on activated T cells in the blood through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
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At Week 16
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LAG3 Levels - TIL
Délai: At Week 4
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To determine the amount of LAG3 expressed on activated tumor infiltrating lymphocytes (TIL) through single-cell RNA sequencing.
The LAG3 expression is reported as the natural log (ln) of the number of LAG3 transcripts divided by the number of total mapped reads plus 1.
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At Week 4
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PD-1 Expression in PBMC
Délai: At Baseline
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To determine the amount of PD-1 (programmed cell death protein 1) expressed on PBMCs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
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At Baseline
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PD-1 Expression in PBMC
Délai: At Week 4
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To determine the amount of PD-1 (programmed cell death protein 1) expressed on PBMCs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
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At Week 4
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PD-1 Expression in PBMC
Délai: At Week 16
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To determine the amount of PD-1 (programmed cell death protein 1) expressed on PBMCs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
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At Week 16
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PD-1 Expression in TIL
Délai: At Baseline
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To determine the amount of PD-1 (programmed cell death protein 1) expressed on TILs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
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At Baseline
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PD-1 Expression in TIL
Délai: At Week 4
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To determine the amount of PD-1 (programmed cell death protein 1) expressed on TILs through single-cell RNA sequencing in treated patients.
The PD-1 expression is reported as the natural log (ln) of the number of PD-1 transcripts divided by the number of total mapped reads plus 1.
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At Week 4
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Cell Effector/Memory Status - TIL
Délai: At Baseline
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Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
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At Baseline
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Cell Effector/Memory Status - TIL
Délai: At Week 4
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Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
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At Week 4
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Cell Effector/Memory Status - PBMCs
Délai: At Baseline
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Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
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At Baseline
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Cell Effector/Memory Status - PBMC
Délai: At Week 4
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Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
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At Week 4
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Cell Effector/Memory Status - PBMC
Délai: At Week 16
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Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
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At Week 16
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Regulatory T Cell (Treg) Marker Levels - PMBCs
Délai: At Baseline
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Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
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At Baseline
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Regulatory T Cell (Treg) Marker Levels - PMBCs
Délai: At Week 4
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Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
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At Week 4
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Regulatory T Cell (Treg) Marker Levels - PMBCs
Délai: At Week 16
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Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
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At Week 16
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Regulatory T Cell (Treg) Marker Levels - TIL
Délai: At Baseline
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Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
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At Baseline
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Regulatory T Cell (Treg) Marker Levels - TIL
Délai: At Week 4
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Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
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At Week 4
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Activation and Maturation of Dendritic Cells - PBMC
Délai: At Baseline
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Measure of expression of activation and maturation of dendritic cells in PBMCs.
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At Baseline
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Activation and Maturation of Dendritic Cells - PBMC
Délai: At Week 4
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Measure of expression of activation and maturation of dendritic cells in PBMCs.
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At Week 4
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Activation and Maturation of Dendritic Cells - PBMC
Délai: At Week 16
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Measure of expression of activation and maturation of dendritic cells in PBMCs.
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At Week 16
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Activation and Maturation of Dendritic Cells - TIL
Délai: At Baseline
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Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
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At Baseline
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Activation and Maturation of Dendritic Cells - TIL
Délai: At Week 4
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Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
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At Week 4
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Soluble LAG3 Levels - PBMC
Délai: At the time of disease progression - up to 4 years
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Amount of LAG3 (cell surface molecule expressed on activated T cells) protein present in blood in patients that had previously demonstrated complete response (CR), partial response (PR), or stable disease (SD) per RECIST 1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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At the time of disease progression - up to 4 years
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Soluble LAG3 Levels - TIL
Délai: At the time of disease progression - up to 4 years
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Amount of LAG3 (cell surface molecule expressed on activated T cells) protein present in tumor tissue in patients that had previously demonstrated complete response (CR), partial response (PR), or stable disease (SD) per RECIST 1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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At the time of disease progression - up to 4 years
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Granzyme B Serum Levels
Délai: At 2 weeks prior first study treatment, at 4 weeks, at 12 weeks
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Level of granzyme B (a serine protease secreted cells to mediate apoptosis in target cells) in serum.
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At 2 weeks prior first study treatment, at 4 weeks, at 12 weeks
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T Cell Count
Délai: At 4 weeks
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Number of T cells present in TIL or PBMC.
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At 4 weeks
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T Cell Count
Délai: At 12 weeks
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Number of T cells present in TIL or PBMC.
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At 12 weeks
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T Cell Count
Délai: At the time of disease progression - up to 4 years
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Number of T cells present in TIL or PBMC.
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At the time of disease progression - up to 4 years
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Single Cell RNA Sequencing
Délai: 2 weeks
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The presence and quantity of RNA in in blood and tumor tissue.
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2 weeks
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Single Cell RNA Sequencing
Délai: At 4 weeks post Cycle 1
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The presence and quantity of RNA in in blood and tumor tissue.
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At 4 weeks post Cycle 1
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Single Cell RNA Sequencing
Délai: At week 16 (12 weeks post combination treatment (3 cycles)
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The presence and quantity of RNA in in blood and tumor tissue.
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At week 16 (12 weeks post combination treatment (3 cycles)
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Single Cell RNA Sequencing
Délai: At the time of disease progression - up to 4 years
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The presence and quantity of RNA in in blood and tumor tissue in patients that had previously demonstrated complete response (CR), partial response (PR), or stable disease (SD) per RECIST 1.1.
CR: Disappearance of all target lesions.
Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to <10 mm.
PR: At least a 30% decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters; SD: Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
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At the time of disease progression - up to 4 years
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: John Kirkwood, MD, University of Pittsburgh
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Tumeurs par site
- Tumeurs
- Tumeurs par type histologique
- Maladies de la peau
- Tumeurs neuroectodermiques
- Tumeurs, cellules germinales et embryonnaires
- Tumeurs, tissu nerveux
- Tumeurs neuroendocrines
- Nevi et mélanomes
- Tumeurs cutanées
- Maladies de la peau et du tissu conjonctif
- Mélanome
- Acides aminés, peptides et protéines
- Protéines
- Anticorps, monoclonal, humanisé
- Anticorps, monoclonal
- Anticorps
- Immunoglobulines
- Immunoprotéines
- Protéines sanguines
- Globulines sériques
- Globulines
- Nivolumab
- relatif
Autres numéros d'identification d'étude
- 18-071
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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