Circadian-Optimized Light Therapy for the Treatment of Patients With Advanced Melanoma Receiving Tumor-Infiltrating Lymphocyte Therapy
A Single-Center, Prospective Pilot Trial of Circadian-Optimized Light Therapy (COLT) in Patients Undergoing Tumor-Infiltrating Lymphocyte (TIL) Therapy for Metastatic Melanoma
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Detaljert beskrivelse
PRIMARY OBJECTIVE:
I. Evaluate the feasibility of COLT with TIL therapy.
SECONDARY OBJECTIVES:
I. Evaluate the safety of COLT with TIL therapy. II. Evaluate the acceptability of COLT intervention to patients. III. Evaluate the effect of COLT on patient-reported quality of life metrics.
EXPLORATORY OBJECTIVES:
I. Evaluate changes that occur in patient circadian clocks with COLT during TIL therapy using actigraphy and circadian clock gene analysis.
II. Evaluate the alterations and time course that occur in tumor immune cell subsets and phenotype with COLT during TIL therapy.
III. Evaluate the toxicities related to TIL therapy (i.e., cytopenia, interleukin 2 [IL-2] toxicity) that occur with COLT during TIL therapy.
OUTLINE:
Starting on day -14, patients receive access to the Circadian OS application and within the first hour of waking up undergo light therapy sessions over 1 hour daily between 8:00 and 10:00 am for up to 28 days after TIL in the absence of disease progression or unacceptable toxicity. Patients also receive standard of care TIL infusion on day 0. Patients may optionally continue COLT for up to 90 days post TIL infusion. Patients also wear wrist actigraphy continuously to monitor sleep-wake cycles, light exposure, and circadian rhythms during TIL therapy. Additionally, patients undergo blood sample collection throughout the study.
After completion of study intervention, patients are followed up at 30 days.
Studietype
Studietype
Registrering (Antatt)
Registrering
Fase
Fase
- Fase 1
Kontakter og plasseringer
Studiesteder
-
-
California
-
Duarte, California, Forente stater, 91010
- City of Hope Medical Center
-
Hovedetterforsker:
- Kelly Mahuron
-
Ta kontakt med:
- Kelly Mahuron
- E-post: kmahuron@coh.org
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Beskrivelse
Inclusion Criteria:
- Documented informed consent of the participant and/or legally authorized representative
- Age: ≥ 18 years
- Ability to read and understand English for questionnaires
- Progression on or after immune checkpoint inhibitor therapy
- Deemed eligible and consented for standard-of-care TIL therapy (lifileucel/Amtagvi)
- Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (typically required for TIL therapy; confirm with clinical standards of practice [SOP])
Exclusion Criteria:
- Explicit Munich Chronotype Questionnaire (MCTQ) cutoffs (< 2:00, > 5:00)
- Use of melatonin or pharmacologic sleep aids (e.g., zolpidem, trazodone, benzodiazepines) within 14 days prior to enrollment
- Night shift work within the past 30 days or expected during the intervention
- Travel across ≥ 2 time zones within the past 14 days
- Diagnosed or suspected untreated moderate to severe obstructive sleep apnea
- History of mania, hypomania, bipolar disorder, migraine (with or without photophobia), or active seizure disorder
- Active psychosis, suicidal ideation, or recent psychiatric hospitalization (< 3 months)
- Ocular conditions exacerbated by bright light exposure
- Any other condition that would, in the investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns with clinical study procedures
- Prospective participants who, in the opinion of the investigator, may not be able to comply with all study procedures (including compliance issues related to feasibility/logistics)
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
|
Eksperimentell: Treatment (COLT, TIL)
Starting on day -14, patients receive access to the Circadian OS application and within the first hour of waking up undergo light therapy sessions over 1 hour daily between 8:00 and 10:00 am for up to 28 days after TIL in the absence of disease progression or unacceptable toxicity.
Patients also receive standard of care TIL infusion on day 0. Patients may optionally continue COLT for up to 90 days post TIL infusion.
Patients also wear wrist actigraphy continuously to monitor sleep-wake cycles, light exposure, and circadian rhythms during TIL therapy.
Additionally, patients undergo blood sample collection throughout the study.
|
Hjelpestudier
Gjennomgå blodprøvetaking
Andre navn:
Receive access to Circadian OS application
Wear wrist actigraphy
Undergo light therapy sessions
Andre navn:
Given infusion
Andre navn:
|
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Adherence
Tidsramme: From the start of intervention through the end of the intervention period, assessed up to day 90
|
Will be measured as the proportion of prescribed daily Circadian-Optimized Light Therapy (COLT) sessions attempted by each participant.
Session initiation, duration, and completion will be automatically recorded by the Circadian OS application and verified at scheduled study visits.
Participants who attempt at least 50% of sessions will be considered adherent.
Adherence data will be summarized descriptively, including the median and range of completion rates across participants.
Will be reported with a two-sided 95% exact (Clopper-Pearson) confidence interval.
|
From the start of intervention through the end of the intervention period, assessed up to day 90
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence, severity, and attribution of COLT-related treatment-emergent adverse events
Tidsramme: From the first day of COLT administration through 30 days after completion of intervention
|
Will be graded by Common Terminology Criteria for Adverse Events version 5.0.
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From the first day of COLT administration through 30 days after completion of intervention
|
|
Patient-reported acceptability and usability of COLT
Tidsramme: Up to day 90
|
Will be assessed using the Acceptability of Intervention Measure questionnaire.
Responses will be summarized as total and subscale scores with means, standard deviations, medians, and ranges.
The proportion of participants meeting a predefined threshold for acceptability or usability on the instrument's scale will also be reported with exact 95 percent confidence intervals.
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Up to day 90
|
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Patient scores for quality of life and symptom burden
Tidsramme: Up to day 90
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Will be assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care.
Data will be evaluated for functional scale, global health status, and symptoms.
Scores will be summarized descriptively and compared across study phases.
|
Up to day 90
|
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Patient scores for fatigue
Tidsramme: Up to day 28
|
Will be assessed using the Patient Reported Outcomes Measurement Information System (PROMIS) Fatigue questionnaire.
Data will be evaluated for functional scale, global health status, and symptoms.
Scores will be summarized descriptively and compared across study phases.
|
Up to day 28
|
|
Patient scores for depression
Tidsramme: Up to day 90
|
Will be evaluated using PROMIS Depression questionnaire.
Data will be evaluated for functional scale, global health status, and symptoms.
Scores will be summarized descriptively and compared across study phases.
|
Up to day 90
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Samarbeidspartnere
Samarbeidspartnere
Etterforskere
Etterforskere
- Hovedetterforsker: Kelly Mahuron, City of Hope Medical Center
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Neoplasmer etter nettsted
- Neoplasmer
- Neoplasmer etter histologisk type
- Hudsykdommer
- Nevroektodermale svulster
- Neoplasmer, kjønnsceller og embryonale
- Neoplasmer, nervevev
- Nevroendokrine svulster
- Nevi og melanomer
- Neoplasmer i huden
- Hud- og bindevevssykdommer
- Melanom
- Undersøkelsesteknikker
- Terapeutikk
- Kliniske laboratorieteknikker
- Diagnostiske teknikker og prosedyrer
- Diagnose
- Prøvehåndtering
- Fototerapi
- Ultraviolett terapi
Andre studie-ID-numre
Andre studie-ID-numre
- 25102 (Annen identifikator: City of Hope Medical Center)
- P30CA033572 (U.S. NIH-stipend/kontrakt)
- NCI-2026-03733 (Registeridentifikator: CTRP (Clinical Trial Reporting Program))
Legemiddel- og utstyrsinformasjon, studiedokumenter
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