ニボルマブ、BMS-936558 と Relatlimab、BMS-986016 を併用した転移性悪性黒色腫患者における、転移性環境で以前に免疫療法を受けていない
転移性悪性黒色腫患者における抗 PD1 モノクローナル抗体 (Nivolumab、BMS-936558) と抗 LAG3 モノクローナル抗体 (Relatlimab、BMS-986016) の併用投与に関する第 II 相試験
調査の概要
詳細な説明
研究の種類
入学 (実際)
段階
- フェーズ2
連絡先と場所
研究場所
-
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Pennsylvania
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Pittsburgh、Pennsylvania、アメリカ、15232
- UPMC Hillman Cancer Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
説明
包含基準:
• AJCC第8版切除不能ステージIIIB、ステージIIIC、ステージIIID、またはステージIVメラノーマの基準を満たす18歳以上の男性または女性で、転移状況で免疫療法による治療を受けていない
除外基準:
-次の例外を除いて、既知または疑われるCNS転移:
- 脳転移が制御されている被験者は、登録が許可されます。 制御された脳転移は、同意時の放射線および/または外科的治療後、少なくとも 4 週間、放射線学的に進行がないことと定義されます。 被験者は無作為化の前に少なくとも 2 週間はステロイドを使用していない必要があります。
- -脳転移の徴候または症状がある被験者は、コンピューター断層撮影または磁気共鳴画像法によって脳転移が除外されない限り、適格ではありません。
- -1型真性糖尿病、白斑、解決された小児喘息/アトピー、制御された甲状腺機能亢進症/甲状腺機能低下症、副腎機能低下症または下垂体機能低下症を除く、治療を必要とする活動的な自己免疫疾患。
- -抗PD1、抗PDL1、抗PDL2、抗CTLA-4抗体、またはT細胞共刺激または免疫チェックポイント経路を特異的に標的とするその他の抗体または薬物を含む、転移状況における以前の全身治療;または化学療法。
- -抗PD1、抗PDL1、および/または抗LAG3抗体による以前のアジュバント治療。 標的療法による以前のアジュバント治療(例: BRAF/MEK 阻害)、抗 CTLA4、または上記で指定されていない治療は許可されます。
- 眼黒色腫
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的:レラトリマブ
サイクル 1: Relatlimab (BMS-986016) は、無菌の 10 mg/mL 製剤として供給され、最初の 4 週間 (サイクル 1) は 160 mg IV で静脈内 (IV) 注入として投与されます。 サイクル 2+: 併用療法は、連続注入によって投与されます。 ニボルマブを 480 mg IV で投与した後、4 週間ごとに 160 mg IV でレラトリマブを注入しました。 |
Relatlimab (BMS-986016) - 160 mg IV で静脈内 (IV) 注入として投与される 10 mg/mL 製剤。
他の名前:
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実験的:ニボルマブ
サイクル 1: ニボルマブ (BMS-936558) は、滅菌 10 mg/mL 製剤として供給され、最初の 4 週間は 480 mg IV で IV 注入として投与されます。 サイクル 2+: 併用療法は、連続注入によって投与されます。 ニボルマブを 480 mg IV で投与した後、4 週間ごとに 160 mg IV でレラトリマブを注入しました。 |
ニボルマブ (BMS-936558) - 480 mg IV で IV 注入として投与される 10 mg/mL 製剤。
他の名前:
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実験的:レラトリマブ + ニボルマブ
サイクル 1+: 併用療法は、連続注入によって投与されます。
ニボルマブを 480 mg IV で投与した後、最初の 4 週間 (サイクル 1) に 160 mg IV でレラトリマブを注入し、その後は 4 週間ごとに 1 回投与しました。
|
併用(Relatlimab + Nivolumab)療法は、連続注入によって投与されます。
ニボルマブを 480 mg IV で投与した後、レラトリマブを 160 mg IV で注入。
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
LAG3 Gene Expression From scRNAseq
時間枠:At Baseline
|
Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
|
At Baseline
|
|
LAG3 Gene Expression From scRNAseq
時間枠:At Week 4
|
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
時間枠:At baseline (Week 0)
|
Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
|
At baseline (Week 0)
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PD1 Expression
時間枠:At Week 4
|
Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
|
At Week 4
|
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Change in Tumor Size
時間枠:At baseline and at 4 weeks
|
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)
時間枠:Beginning at 12 weeks post initial treatment, up to 4 years
|
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
|
|
Overall Response Rate (ORR) - ITT (Intent-to-treat) Population
時間枠:Beginning at 12 weeks post initial treatment, up to 4 years
|
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
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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応答期間
時間枠:最初の治療後 12 週間、最大 4 年間
|
最初に記録された完全奏効(CR)または部分奏効(PR)から、進行性疾患が客観的に記録された最初の日までの時間。
RECIST v1.1 によると、CR: すべての標的病変の消失。
病理学的リンパ節 (標的か非標的かを問わず) は、短軸が縮小する必要があります。
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最初の治療後 12 週間、最大 4 年間
|
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無増悪生存期間 (PFS)
時間枠:4年まで
|
無増悪生存期間は、無作為化の日から、最初に記録された進行または何らかの原因による死亡のいずれか早い方の日までの時間として定義されます。
RECIST v1.1 によると、進行性疾患 (PD): 研究で最小の合計を参照として、標的病変の直径の合計が少なくとも 20% 増加します (これには、研究で最小の場合はベースラインの合計が含まれます)。
20% の相対的な増加に加えて、合計は少なくとも 5 mm の絶対的な増加も示さなければなりません。
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4年まで
|
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全生存期間 (OS)
時間枠:4年まで
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全生存期間は、無作為化日から何らかの原因による死亡日までの時間として定義されます。
|
4年まで
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Secondary Outcome: Clinical Benefit Rate
時間枠:12 weeks post initial treatment, up to 4 years
|
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
時間枠:12 weeks post initial treatment, up to 4 years
|
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
時間枠:Up to 4 years
|
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
|
|
CD8+ Tumor Infiltrating Lymphocytes
時間枠:At Baseline
|
Number of CD8+ tumor infiltrating lymphocytes present.
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At Baseline
|
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CD8+ Tumor Infiltrating Lymphocytes
時間枠:At Week 4
|
Number of CD8+ tumor infiltrating lymphocytes present.
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At Week 4
|
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CD4+ Tumor Infiltrating Lymphocytes
時間枠:At Week 4
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Number of CD4+ tumor infiltrating lymphocytes present.
|
At Week 4
|
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CD4+ Tumor Infiltrating Lymphocytes
時間枠:At Baseline
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Number of CD4+ tumor infiltrating lymphocytes present.
|
At Baseline
|
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LAG3 Levels - PBMC
時間枠:At Baseline
|
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.
|
At Baseline
|
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LAG3 Levels - PBMC
時間枠:At Week 4
|
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
時間枠:At Baseline
|
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
時間枠: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
時間枠:At Week 4
|
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.
|
At Week 4
|
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PD-1 Expression in PBMC
時間枠: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
|
|
PD-1 Expression in PBMC
時間枠:At Week 4
|
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
|
|
PD-1 Expression in PBMC
時間枠:At Week 16
|
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.
|
At Week 16
|
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PD-1 Expression in TIL
時間枠:At Baseline
|
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.
|
At Baseline
|
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PD-1 Expression in TIL
時間枠:At Week 4
|
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
時間枠:At Baseline
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Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
|
At Baseline
|
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Cell Effector/Memory Status - TIL
時間枠:At Week 4
|
Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
|
At Week 4
|
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Cell Effector/Memory Status - PBMCs
時間枠:At Baseline
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Baseline
|
|
Cell Effector/Memory Status - PBMC
時間枠:At Week 4
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Week 4
|
|
Cell Effector/Memory Status - PBMC
時間枠:At Week 16
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Week 16
|
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Regulatory T Cell (Treg) Marker Levels - PMBCs
時間枠:At Baseline
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Baseline
|
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Regulatory T Cell (Treg) Marker Levels - PMBCs
時間枠:At Week 4
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Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Week 4
|
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Regulatory T Cell (Treg) Marker Levels - PMBCs
時間枠:At Week 16
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Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Week 16
|
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Regulatory T Cell (Treg) Marker Levels - TIL
時間枠:At Baseline
|
Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
|
At Baseline
|
|
Regulatory T Cell (Treg) Marker Levels - TIL
時間枠:At Week 4
|
Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
|
At Week 4
|
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Activation and Maturation of Dendritic Cells - PBMC
時間枠:At Baseline
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Baseline
|
|
Activation and Maturation of Dendritic Cells - PBMC
時間枠:At Week 4
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Week 4
|
|
Activation and Maturation of Dendritic Cells - PBMC
時間枠:At Week 16
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Week 16
|
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Activation and Maturation of Dendritic Cells - TIL
時間枠:At Baseline
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Baseline
|
|
Activation and Maturation of Dendritic Cells - TIL
時間枠:At Week 4
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Week 4
|
|
Soluble LAG3 Levels - PBMC
時間枠:At the time of disease progression - up to 4 years
|
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.
|
At the time of disease progression - up to 4 years
|
|
Soluble LAG3 Levels - TIL
時間枠:At the time of disease progression - up to 4 years
|
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.
|
At the time of disease progression - up to 4 years
|
|
Granzyme B Serum Levels
時間枠:At 2 weeks prior first study treatment, at 4 weeks, at 12 weeks
|
Level of granzyme B (a serine protease secreted cells to mediate apoptosis in target cells) in serum.
|
At 2 weeks prior first study treatment, at 4 weeks, at 12 weeks
|
|
T Cell Count
時間枠:At 4 weeks
|
Number of T cells present in TIL or PBMC.
|
At 4 weeks
|
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T Cell Count
時間枠:At 12 weeks
|
Number of T cells present in TIL or PBMC.
|
At 12 weeks
|
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T Cell Count
時間枠:At the time of disease progression - up to 4 years
|
Number of T cells present in TIL or PBMC.
|
At the time of disease progression - up to 4 years
|
その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Single Cell RNA Sequencing
時間枠:2 weeks
|
The presence and quantity of RNA in in blood and tumor tissue.
|
2 weeks
|
|
Single Cell RNA Sequencing
時間枠:At 4 weeks post Cycle 1
|
The presence and quantity of RNA in in blood and tumor tissue.
|
At 4 weeks post Cycle 1
|
|
Single Cell RNA Sequencing
時間枠:At week 16 (12 weeks post combination treatment (3 cycles)
|
The presence and quantity of RNA in in blood and tumor tissue.
|
At week 16 (12 weeks post combination treatment (3 cycles)
|
|
Single Cell RNA Sequencing
時間枠:At the time of disease progression - up to 4 years
|
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.
|
At the time of disease progression - up to 4 years
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 18-071
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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