- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT03743766
Nivolumab, BMS-936558 i kombinasjon med Relatlimab, BMS-986016 hos pasienter med metastatisk melanom som er naive for tidligere immunterapi i metastatisk setting
En fase II-studie av anti-PD1 monoklonalt antistoff (Nivolumab, BMS-936558) administrert i kombinasjon med anti-LAG3 monoklonalt antistoff (Relatlimab, BMS-986016) hos pasienter med metastatisk melanom som er naive til tidligere immunterapi i metastatisk setting
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
Studietype
Registrering (Faktiske)
Fase
- Fase 2
Kontakter og plasseringer
Studiesteder
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, Forente stater, 15232
- UPMC Hillman Cancer Center
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Beskrivelse
Inklusjonskriterier:
• Menn eller kvinner 18 år eller eldre som oppfyller kriteriene i AJCC 8. utgave for ikke-opererbart stadium IIIB, stadium IIIC, stadium IIID eller stadium IV melanom som ikke har mottatt behandling med immunterapi i metastatisk setting
Ekskluderingskriterier:
Kjente eller mistenkte CNS-metastaser, med følgende unntak:
- Personer med kontrollerte hjernemetastaser vil få lov til å melde seg på. Kontrollerte hjernemetastaser er definert som ingen radiografisk progresjon i minst 4 uker etter stråling og/eller kirurgisk behandling på tidspunktet for samtykke. Forsøkspersonene må være fri for steroider i minst 2 uker før randomisering.
- Personer med tegn eller symptomer på hjernemetastaser er ikke kvalifisert med mindre hjernemetastaser er utelukket ved computertomografi eller magnetisk resonansavbildning.
- Aktiv autoimmun sykdom som krever behandling, med unntak av type 1 diabetes mellitus, vitiligo, løst astma/atopi hos barn, kontrollert hyper/hypotyreose, hypoadrenalisme eller hypopituitarisme.
- Tidligere systemisk behandling i metastatisk setting, inkludert anti-PD1, anti-PDL1, anti-PDL2, anti-CTLA-4 antistoff, eller et hvilket som helst annet antistoff eller medikament som er spesifikt målrettet mot T-celle-kostimulering eller immunsjekkpunktveier; eller kjemoterapi.
- Tidligere adjuvant behandling med anti-PD1, anti-PDL1 og/eller anti-LAG3 antistoff. Vær oppmerksom på at tidligere adjuvant behandling med målrettet terapi (f.eks. BRAF/MEK-hemming), anti-CTLA4 eller behandling som ikke er spesifisert på annen måte ovenfor, er tillatt.
- Okulært melanom
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Relatlimab
Syklus 1: Relatlimab (BMS-986016) leveres som en steril 10 mg/ml formulering som skal administreres som en intravenøs (IV) infusjon med 160 mg IV de første 4 ukene (syklus 1). Syklus 2+: Kombinasjonsterapi vil bli administrert ved sekvensiell infusjon. Nivolumab administrert ved 480 mg IV etterfulgt av infusjon av relatlimab ved 160 mg IV en gang hver 4. uke. |
Relatlimab (BMS-986016) - 10 mg/ml formulering som skal administreres som en intravenøs (IV) infusjon ved 160 mg IV.
Andre navn:
|
|
Eksperimentell: Nivolumab
Syklus 1: Nivolumab (BMS-936558) leveres som en steril 10 mg/ml formulering som skal administreres som en IV-infusjon ved 480 mg IV de første 4 ukene. Syklus 2+: Kombinasjonsterapi vil bli administrert ved sekvensiell infusjon. Nivolumab administrert ved 480 mg IV etterfulgt av infusjon av relatlimab ved 160 mg IV en gang hver 4. uke. |
Nivolumab (BMS-936558) - 10 mg/ml formulering som skal administreres som en IV-infusjon ved 480 mg IV.
Andre navn:
|
|
Eksperimentell: Relatlimab + Nivolumab
Syklus 1+: Kombinasjonsterapi vil bli administrert ved sekvensiell infusjon.
Nivolumab administrert ved 480 mg IV etterfulgt av infusjon av relatlimab ved 160 mg IV de første 4 ukene (syklus 1), deretter en gang hver 4. uke etterpå.
|
Kombinasjonsbehandling (Relatlimab + Nivolumab) vil bli administrert ved sekvensiell infusjon.
Nivolumab administrert ved 480 mg IV etterfulgt av infusjon av relatlimab ved 160 mg IV.
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
LAG3 Gene Expression From scRNAseq
Tidsramme: 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
Tidsramme: At Week 4
|
Percent Lymphocyte-activation gene 3 (LAG3) level (cell surface molecule expressed on activated T cells) expression from scRNAseq
|
At Week 4
|
|
PD1 Expression
Tidsramme: At baseline (Week 0)
|
Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
|
At baseline (Week 0)
|
|
PD1 Expression
Tidsramme: At Week 4
|
Percent PD1 (programmed cell death protein 1) expression after completion of lead-in phase.
|
At Week 4
|
|
Change in Tumor Size
Tidsramme: 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:
|
At baseline and at 4 weeks
|
|
Overall Response Rate (ORR)
Tidsramme: 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.
|
Beginning at 12 weeks post initial treatment, up to 4 years
|
|
Overall Response Rate (ORR) - ITT (Intent-to-treat) Population
Tidsramme: 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.
|
Beginning at 12 weeks post initial treatment, up to 4 years
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Varighet av svar
Tidsramme: 12 uker etter førstegangsbehandling, opptil 4 år
|
Tid fra første dokumenterte fullstendig respons (CR) eller delvis respons (PR) til første dato progredierende sykdom er objektivt dokumentert.
Per RECIST v1.1, CR: Forsvinning av alle mållesjoner.
Eventuelle patologiske lymfeknuter (enten mål eller ikke-mål) må ha reduksjon i kort akse til
|
12 uker etter førstegangsbehandling, opptil 4 år
|
|
Progresjonsfri overlevelse (PFS)
Tidsramme: Inntil 4 år
|
Progresjonsfri overlevelse er definert som tiden mellom datoen for randomisering og den første datoen for dokumentert progresjon eller død på grunn av en hvilken som helst årsak, avhengig av hva som inntreffer først.
I henhold til RECIST v1.1, progressiv sykdom (PD): Minst 20 % økning i summen av diametre av mållesjoner, med den minste summen i studien som referanse (dette inkluderer grunnlinjesummen hvis den er den minste i studien).
I tillegg til den relative økningen på 20 %, skal summen også vise en absolutt økning på minst 5 mm.
|
Inntil 4 år
|
|
Total overlevelse (OS)
Tidsramme: Inntil 4 år
|
Total overlevelse er definert som tiden mellom datoen for randomisering og datoen for død på grunn av en hvilken som helst årsak.
|
Inntil 4 år
|
|
Secondary Outcome: Clinical Benefit Rate
Tidsramme: 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.
|
12 weeks post initial treatment, up to 4 years
|
|
Clinical Benefit Rate - ITT (Intent-to-treat) Population
Tidsramme: 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.
|
12 weeks post initial treatment, up to 4 years
|
|
Progression-free Survival (PFS) by Lead-in Arm
Tidsramme: 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.
|
Up to 4 years
|
|
CD8+ Tumor Infiltrating Lymphocytes
Tidsramme: At Baseline
|
Number of CD8+ tumor infiltrating lymphocytes present.
|
At Baseline
|
|
CD8+ Tumor Infiltrating Lymphocytes
Tidsramme: At Week 4
|
Number of CD8+ tumor infiltrating lymphocytes present.
|
At Week 4
|
|
CD4+ Tumor Infiltrating Lymphocytes
Tidsramme: At Week 4
|
Number of CD4+ tumor infiltrating lymphocytes present.
|
At Week 4
|
|
CD4+ Tumor Infiltrating Lymphocytes
Tidsramme: At Baseline
|
Number of CD4+ tumor infiltrating lymphocytes present.
|
At Baseline
|
|
LAG3 Levels - PBMC
Tidsramme: 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
|
|
LAG3 Levels - PBMC
Tidsramme: 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.
|
At Week 4
|
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LAG3 Levels - TIL
Tidsramme: 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.
|
At Baseline
|
|
LAG3 Levels - PBMC
Tidsramme: At Week 16
|
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
Tidsramme: 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
|
|
PD-1 Expression in PBMC
Tidsramme: At Baseline
|
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
|
|
PD-1 Expression in PBMC
Tidsramme: 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
|
|
PD-1 Expression in PBMC
Tidsramme: 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
|
|
PD-1 Expression in TIL
Tidsramme: 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
Tidsramme: 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.
|
At Week 4
|
|
Cell Effector/Memory Status - TIL
Tidsramme: At Baseline
|
Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
|
At Baseline
|
|
Cell Effector/Memory Status - TIL
Tidsramme: At Week 4
|
Measure of cells that have previously encountered and responded to their cognate antigen in TIL.
|
At Week 4
|
|
Cell Effector/Memory Status - PBMCs
Tidsramme: At Baseline
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Baseline
|
|
Cell Effector/Memory Status - PBMC
Tidsramme: 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
Tidsramme: At Week 16
|
Measure of cells that have previously encountered and responded to their cognate antigen in PBMCs.
|
At Week 16
|
|
Regulatory T Cell (Treg) Marker Levels - PMBCs
Tidsramme: At Baseline
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Baseline
|
|
Regulatory T Cell (Treg) Marker Levels - PMBCs
Tidsramme: 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
Tidsramme: At Week 16
|
Amount of Regulatory T cell (Treg) markers present in PBMCs in treated patients.
|
At Week 16
|
|
Regulatory T Cell (Treg) Marker Levels - TIL
Tidsramme: At Baseline
|
Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
|
At Baseline
|
|
Regulatory T Cell (Treg) Marker Levels - TIL
Tidsramme: At Week 4
|
Amount of Regulatory T cell (Treg) markers present in TILs in treated patients.
|
At Week 4
|
|
Activation and Maturation of Dendritic Cells - PBMC
Tidsramme: At Baseline
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Baseline
|
|
Activation and Maturation of Dendritic Cells - PBMC
Tidsramme: 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
Tidsramme: At Week 16
|
Measure of expression of activation and maturation of dendritic cells in PBMCs.
|
At Week 16
|
|
Activation and Maturation of Dendritic Cells - TIL
Tidsramme: At Baseline
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Baseline
|
|
Activation and Maturation of Dendritic Cells - TIL
Tidsramme: At Week 4
|
Measure of expression of activation and maturation of dendritic cells in tumor (TIL).
|
At Week 4
|
|
Soluble LAG3 Levels - PBMC
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: At 4 weeks
|
Number of T cells present in TIL or PBMC.
|
At 4 weeks
|
|
T Cell Count
Tidsramme: At 12 weeks
|
Number of T cells present in TIL or PBMC.
|
At 12 weeks
|
|
T Cell Count
Tidsramme: 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
|
Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Single Cell RNA Sequencing
Tidsramme: 2 weeks
|
The presence and quantity of RNA in in blood and tumor tissue.
|
2 weeks
|
|
Single Cell RNA Sequencing
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
|
Samarbeidspartnere og etterforskere
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: John Kirkwood, MD, University of Pittsburgh
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
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
- Aminosyrer, peptider og proteiner
- Proteiner
- Antistoffer, monoklonalt, humanisert
- Antistoffer, monoklonalt
- Antistoffer
- Immunoglobuliner
- Immunoproteiner
- Blodproteiner
- Serumglobuliner
- Globuliner
- Nivolumab
- Relatlimab
Andre studie-ID-numre
- 18-071
Plan for individuelle deltakerdata (IPD)
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