- ICH GCP
- Register voor klinische proeven in de VS.
- Klinische proef NCT03743766
Nivolumab, BMS-936558 in combinatie met Relatlimab, BMS-986016 bij patiënten met gemetastaseerd melanoom die nog niet eerder immuuntherapie hebben ondergaan in de gemetastaseerde setting
Een fase II-studie van anti-PD1 monoklonaal antilichaam (Nivolumab, BMS-936558) toegediend in combinatie met anti-LAG3 monoklonaal antilichaam (Relatlimab, BMS-986016) bij patiënten met gemetastaseerd melanoom die nog niet eerder immuuntherapie hebben ondergaan in de gemetastaseerde setting
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
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Pennsylvania
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Pittsburgh, Pennsylvania, Verenigde Staten, 15232
- UPMC Hillman Cancer Center
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Beschrijving
Inclusiecriteria:
• Mannen of vrouwen van 18 jaar of ouder die voldoen aan de AJCC 8e editie criteria voor inoperabel stadium IIIB, stadium IIIC, stadium IIID of stadium IV melanoom die geen behandeling met immunotherapie hebben gekregen in de gemetastaseerde setting
Uitsluitingscriteria:
Bekende of vermoede CZS-metastasen, met de volgende uitzonderingen:
- Proefpersonen met gecontroleerde hersenmetastasen mogen zich inschrijven. Gecontroleerde hersenmetastasen worden gedefinieerd als geen radiografische progressie gedurende ten minste 4 weken na bestraling en/of chirurgische behandeling op het moment van toestemming. Proefpersonen moeten gedurende ten minste 2 weken vóór randomisatie geen steroïden meer gebruiken.
- Proefpersonen met tekenen of symptomen van hersenmetastasen komen niet in aanmerking, tenzij hersenmetastasen worden uitgesloten door computertomografie of magnetische resonantiebeeldvorming.
- Actieve auto-immuunziekte waarvoor behandeling nodig is, met uitzondering van diabetes mellitus type 1, vitiligo, verdwenen astma/atopie bij kinderen, gecontroleerde hyper-/hypothyreoïdie, hypoadrenalisme of hypopituïtarisme.
- Voorafgaande systemische behandeling in de gemetastaseerde setting, inclusief anti-PD1-, anti-PDL1-, anti-PDL2-, anti-CTLA-4-antilichaam of enig ander antilichaam of geneesmiddel dat specifiek gericht is op T-celcostimulatie of immuuncontrolepostroutes; of chemotherapie.
- Voorafgaande adjuvante behandeling met anti-PD1-, anti-PDL1- en/of anti-LAG3-antilichaam. Houd er rekening mee dat eerdere adjuvante behandeling met gerichte therapie (bijv. BRAF/MEK-remming), anti-CTLA4 of behandeling die hierboven niet anders is gespecificeerd, is toegestaan.
- Oculair melanoom
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Relatlimab
Cyclus 1: Relatlimab (BMS-986016) wordt geleverd als een steriele formulering van 10 mg/ml voor toediening als een intraveneuze (IV) infusie van 160 mg IV gedurende de eerste 4 weken (cyclus 1). Cyclus 2+: Combinatietherapie wordt toegediend door sequentiële infusie. Nivolumab toegediend in een dosis van 480 mg i.v. gevolgd door infusie van relatlimab in een dosis van 160 mg i.v. eenmaal per 4 weken. |
Relatlimab (BMS-986016) - formulering van 10 mg/ml voor toediening als een intraveneuze (IV) infusie van 160 mg IV.
Andere namen:
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Experimenteel: Nivolumab
Cyclus 1: Nivolumab (BMS-936558) wordt geleverd als een steriele formulering van 10 mg/ml voor toediening als een intraveneuze infusie van 480 mg IV gedurende de eerste 4 weken. Cyclus 2+: Combinatietherapie wordt toegediend door sequentiële infusie. Nivolumab toegediend in een dosis van 480 mg i.v. gevolgd door infusie van relatlimab in een dosis van 160 mg i.v. eenmaal per 4 weken. |
Nivolumab (BMS-936558) - formulering van 10 mg/ml voor toediening als intraveneuze infusie van 480 mg IV.
Andere namen:
|
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Experimenteel: Relatlimab + Nivolumab
Cyclus 1+: Combinatietherapie wordt toegediend door sequentiële infusie.
Nivolumab toegediend in een dosis van 480 mg i.v. gevolgd door infusie van relatlimab in een dosis van 160 mg i.v. gedurende de eerste 4 weken (cyclus 1), daarna eenmaal per 4 weken.
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Combinatietherapie (Relatlimab + Nivolumab) wordt toegediend door sequentiële infusie.
Nivolumab toegediend in een dosis van 480 mg IV, gevolgd door infusie van relatlimab in een dosis van 160 mg IV.
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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LAG3 Gene Expression From scRNAseq
Tijdsspanne: At Baseline
|
Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
|
At Baseline
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LAG3 Gene Expression From scRNAseq
Tijdsspanne: At Week 4
|
Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
|
At Week 4
|
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PD1 Expression
Tijdsspanne: At baseline (Week 0)
|
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
Tijdsspanne: 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
Tijdsspanne: 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)
Tijdsspanne: 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
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Overall Response Rate (ORR) - ITT (Intent-to-treat) Population
Tijdsspanne: 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
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Duur van de reactie
Tijdsspanne: 12 weken na de eerste behandeling, tot 4 jaar
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Tijd vanaf de eerste gedocumenteerde volledige respons (CR) of gedeeltelijke respons (PR) tot de eerste datum waarop progressieve ziekte objectief wordt gedocumenteerd.
Volgens RECIST v1.1, CR: Verdwijning van alle doellaesies.
Alle pathologische lymfeklieren (of ze nu doelwit of niet-doelwit zijn) moeten een reductie in de korte as hebben
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12 weken na de eerste behandeling, tot 4 jaar
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Progressievrije overleving (PFS)
Tijdsspanne: Tot 4 jaar
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Progressievrije overleving wordt gedefinieerd als de tijd tussen de datum van randomisatie en de eerste datum van gedocumenteerde progressie of overlijden door welke oorzaak dan ook, welke zich het eerst voordoet.
Per RECIST v1.1, Progressive Disease (PD): Ten minste 20% toename van de som van de diameters van doellaesies, waarbij de kleinste som in het onderzoek als referentie wordt genomen (dit omvat de basissom als dat de kleinste in het onderzoek is).
Naast de relatieve toename van 20% moet de som ook een absolute toename van minimaal 5 mm aantonen.
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Tot 4 jaar
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Algehele overleving (OS)
Tijdsspanne: Tot 4 jaar
|
Totale overleving wordt gedefinieerd als de tijd tussen de datum van randomisatie en de datum van overlijden door welke oorzaak dan ook.
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Tot 4 jaar
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Secondary Outcome: Clinical Benefit Rate
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: At Baseline
|
Number of CD8+ tumor infiltrating lymphocytes present.
|
At Baseline
|
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CD8+ Tumor Infiltrating Lymphocytes
Tijdsspanne: At Week 4
|
Number of CD8+ tumor infiltrating lymphocytes present.
|
At Week 4
|
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CD4+ Tumor Infiltrating Lymphocytes
Tijdsspanne: At Week 4
|
Number of CD4+ tumor infiltrating lymphocytes present.
|
At Week 4
|
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CD4+ Tumor Infiltrating Lymphocytes
Tijdsspanne: At Baseline
|
Number of CD4+ tumor infiltrating lymphocytes present.
|
At Baseline
|
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LAG3 Levels - PBMC
Tijdsspanne: 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.
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At Baseline
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LAG3 Levels - PBMC
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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.
|
At Week 16
|
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LAG3 Levels - TIL
Tijdsspanne: 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.
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At Week 4
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PD-1 Expression in PBMC
Tijdsspanne: 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.
|
At Baseline
|
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PD-1 Expression in PBMC
Tijdsspanne: 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.
|
At Week 4
|
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PD-1 Expression in PBMC
Tijdsspanne: 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
Tijdsspanne: 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
|
|
PD-1 Expression in TIL
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: At Baseline
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Baseline
|
|
Cell Effector/Memory Status - PBMC
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: At Baseline
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Baseline
|
|
Regulatory T Cell (Treg) Marker Levels - PMBCs
Tijdsspanne: At Week 4
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Week 4
|
|
Regulatory T Cell (Treg) Marker Levels - PMBCs
Tijdsspanne: At Week 16
|
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
Tijdsspanne: At Baseline
|
Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
|
At Baseline
|
|
Regulatory T Cell (Treg) Marker Levels - TIL
Tijdsspanne: 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
Tijdsspanne: At Baseline
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Baseline
|
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Activation and Maturation of Dendritic Cells - PBMC
Tijdsspanne: At Week 4
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Week 4
|
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Activation and Maturation of Dendritic Cells - PBMC
Tijdsspanne: 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
Tijdsspanne: At Baseline
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Baseline
|
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Activation and Maturation of Dendritic Cells - TIL
Tijdsspanne: At Week 4
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Week 4
|
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Soluble LAG3 Levels - PBMC
Tijdsspanne: 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
|
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Soluble LAG3 Levels - TIL
Tijdsspanne: 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.
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At the time of disease progression - up to 4 years
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Granzyme B Serum Levels
Tijdsspanne: 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.
|
At 2 weeks prior first study treatment, at 4 weeks, at 12 weeks
|
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T Cell Count
Tijdsspanne: At 4 weeks
|
Number of T cells present in TIL or PBMC.
|
At 4 weeks
|
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T Cell Count
Tijdsspanne: At 12 weeks
|
Number of T cells present in TIL or PBMC.
|
At 12 weeks
|
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T Cell Count
Tijdsspanne: 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
|
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Single Cell RNA Sequencing
Tijdsspanne: 2 weeks
|
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
Tijdsspanne: At 4 weeks post Cycle 1
|
The presence and quantity of RNA in in blood and tumor tissue.
|
At 4 weeks post Cycle 1
|
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Single Cell RNA Sequencing
Tijdsspanne: 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)
|
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Single Cell RNA Sequencing
Tijdsspanne: 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
|
Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: John Kirkwood, MD, University of Pittsburgh
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per site
- Neoplasmata
- Neoplasmata per histologisch type
- Huidziektes
- Neuro-ectodermale tumoren
- Neoplasmata, kiemcellen en embryonaal
- Neoplasmata, zenuwweefsel
- Neuro-endocriene tumoren
- Nevi en melanomen
- Huidneoplasmata
- Huid- en bindweefselaandoeningen
- Melanoma
- Aminozuren, peptiden en eiwitten
- Eiwitten
- Antilichamen, monoklonaal, gehumaniseerd
- Antilichamen, monoklonaal
- Antilichamen
- Immunoglobulinen
- Immunoproteïnen
- Bloedeiwitten
- Serum -globulines
- Globulines
- Nivolumab
- relatlimab
Andere studie-ID-nummers
- 18-071
Plan Individuele Deelnemersgegevens (IPD)
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