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Testa Nivolumab och Ipilimumab immunterapi med eller utan det riktade läkemedlet Cabozantinib vid återkommande, metastaserande eller obotlig nasofarynxcancer

30 oktober 2026 uppdaterad av: National Cancer Institute (NCI)

Randomiserad fas 2-studie av Nivolumab och Ipilimumab med eller utan Cabozantinib hos patienter med avancerad nasofaryngeal karcinom som har utvecklats efter platinabehandling och immunterapi

This phase II trial tests how well nivolumab and ipilimumab immunotherapy with or without cabozantinib works in treating patients with nasopharyngeal cancer that has come back (after a period of improvement) (recurrent), has spread from where it first started (primary site) to other places in the body (metastatic), or for which no treatment is currently available (incurable). Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Cabozantinib is in a class of medications called kinase inhibitors. It works by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells. Giving immunotherapy with nivolumab and ipilimumab and targeted therapy with cabozantinib may help shrink and stabilize nasopharyngeal cancer.

Studieöversikt

Status

Upphängd

Betingelser

Intervention / Behandling

Detaljerad beskrivning

PRIMARY OBJECTIVE:

I. To determine if the progression-free survival (PFS) of the triplet combination (cabozantinib S-malate, nivolumab, and ipilimumab [CaboNivoIpi]) is more favorable than the doublet (nivolumab and ipilimumab [NivoIpi]).

SECONDARY OBJECTIVES:

I. To compare safety and tolerability between the two arms (Common Terminology Criteria for Adverse Events [CTCAE] version [v]5.0.).

II. To compare overall response rate (ORR) between the two arms via both Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 and immune-modified Response Evaluation Criteria in Solid Tumors (iRECIST) criteria.

III. To compare overall survival (OS) between the two arms. IV. To assess response by primary or acquired PD-1/L1 inhibitor resistance in the prior line of therapy.

EXPLORATORY OBJECTIVE:

I. To evaluate molecular and immunologic predictors of response (Epstein-Barr virus [EBV] viral load; PD-L1 score) between arms.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM A: Patients receive nivolumab intravenously (IV) over 30 minutes and ipilimumab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo computed tomography (CT) or magnetic resonance imaging (MRI) and collection of blood samples throughout the trial.

ARM B: Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1 and cabozantinib S-malate orally (PO) daily on days 1-28 of each cycle. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients may continue with cabozantinib S-malate after 2 years per treating investigator. Patients undergo CT or MRI and collection of blood samples throughout the trial.

After completion of study treatment, patients are followed up every 8-12 weeks until progression of disease occurs or a new non-protocol anti-cancer therapy is initiated and then every 6 months for up to 2 years.

Studietyp

Interventionell

Inskrivning (Beräknad)

50

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • California
      • Irvine, California, Förenta staterna, 92612
        • UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
      • Los Angeles, California, Förenta staterna, 90033
        • USC / Norris Comprehensive Cancer Center
      • Los Angeles, California, Förenta staterna, 90020
        • Keck Medicine of USC Koreatown
      • Los Angeles, California, Förenta staterna, 90033
        • Los Angeles General Medical Center
      • Newport Beach, California, Förenta staterna, 92663
        • USC Norris Oncology/Hematology-Newport Beach
      • Orange, California, Förenta staterna, 92868
        • UC Irvine Health/Chao Family Comprehensive Cancer Center
      • Palo Alto, California, Förenta staterna, 94304
        • Stanford Cancer Institute Palo Alto
    • Georgia
      • Atlanta, Georgia, Förenta staterna, 30308
        • Emory University Hospital Midtown
    • Idaho
      • Boise, Idaho, Förenta staterna, 83706
        • Saint Alphonsus Cancer Care Center-Boise
      • Caldwell, Idaho, Förenta staterna, 83605
        • Saint Alphonsus Cancer Care Center-Caldwell
      • Coeur d'Alene, Idaho, Förenta staterna, 83814
        • Kootenai Health - Coeur d'Alene
      • Nampa, Idaho, Förenta staterna, 83687
        • Saint Alphonsus Cancer Care Center-Nampa
      • Post Falls, Idaho, Förenta staterna, 83854
        • Kootenai Clinic Cancer Services - Post Falls
      • Sandpoint, Idaho, Förenta staterna, 83864
        • Kootenai Clinic Cancer Services - Sandpoint
    • Illinois
      • Chicago, Illinois, Förenta staterna, 60611
        • Northwestern University
      • Chicago, Illinois, Förenta staterna, 60637
        • University of Chicago Comprehensive Cancer Center
      • Chicago, Illinois, Förenta staterna, 60612
        • University of Illinois
      • Danville, Illinois, Förenta staterna, 61832
        • Carle at The Riverfront
      • DeKalb, Illinois, Förenta staterna, 60115
        • Northwestern Medicine Cancer Center Kishwaukee
      • Effingham, Illinois, Förenta staterna, 62401
        • Carle Physician Group-Effingham
      • Evanston, Illinois, Förenta staterna, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Geneva, Illinois, Förenta staterna, 60134
        • Northwestern Medicine Cancer Center Delnor
      • Glenview, Illinois, Förenta staterna, 60026
        • NorthShore University HealthSystem-Glenbrook Hospital
      • Glenview, Illinois, Förenta staterna, 60026
        • Northwestern Medicine Glenview Outpatient Center
      • Grayslake, Illinois, Förenta staterna, 60030
        • Northwestern Medicine Grayslake Outpatient Center
      • Harvey, Illinois, Förenta staterna, 60426
        • Ingalls Memorial Hospital
      • Highland Park, Illinois, Förenta staterna, 60035
        • NorthShore University HealthSystem-Highland Park Hospital
      • Lake Forest, Illinois, Förenta staterna, 60045
        • Northwestern Medicine Lake Forest Hospital
      • Mattoon, Illinois, Förenta staterna, 61938
        • Carle Physician Group-Mattoon/Charleston
      • New Lenox, Illinois, Förenta staterna, 60451
        • UC Comprehensive Cancer Center at Silver Cross
      • Orland Park, Illinois, Förenta staterna, 60462
        • University of Chicago Medicine-Orland Park
      • Orland Park, Illinois, Förenta staterna, 60462
        • Northwestern Medicine Orland Park
      • Urbana, Illinois, Förenta staterna, 61801
        • Carle Cancer Center
      • Warrenville, Illinois, Förenta staterna, 60555
        • Northwestern Medicine Cancer Center Warrenville
    • Iowa
      • Ankeny, Iowa, Förenta staterna, 50023
        • UI Health Care Mission Cancer and Blood - Ankeny Clinic
      • Clive, Iowa, Förenta staterna, 50325
        • Mercy Cancer Center-West Lakes
      • Clive, Iowa, Förenta staterna, 50325
        • UI Health Care Mission Cancer and Blood - West Des Moines Clinic
      • Council Bluffs, Iowa, Förenta staterna, 51503
        • Heartland Oncology and Hematology LLP
      • Council Bluffs, Iowa, Förenta staterna, 51503
        • Methodist Jennie Edmundson Hospital
      • Council Bluffs, Iowa, Förenta staterna, 51503
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MEJ
      • Des Moines, Iowa, Förenta staterna, 50309
        • Iowa Methodist Medical Center
      • Des Moines, Iowa, Förenta staterna, 50314
        • Mercy Medical Center - Des Moines
      • Des Moines, Iowa, Förenta staterna, 50309
        • UI Health Care Mission Cancer and Blood - Des Moines Clinic
      • Des Moines, Iowa, Förenta staterna, 50314
        • UI Health Care Mission Cancer and Blood - Laurel Clinic
      • Waukee, Iowa, Förenta staterna, 50263
        • UI Health Care Mission Cancer and Blood - Waukee Clinic
    • Massachusetts
      • Boston, Massachusetts, Förenta staterna, 02111
        • Tufts Medical Center
    • Minnesota
      • Bemidji, Minnesota, Förenta staterna, 56601
        • Sanford Joe Lueken Cancer Center
    • Missouri
      • St Louis, Missouri, Förenta staterna, 63128
        • Mercy Hospital South
    • Montana
      • Anaconda, Montana, Förenta staterna, 59711
        • Community Hospital of Anaconda
      • Billings, Montana, Förenta staterna, 59101
        • Billings Clinic Cancer Center
      • Bozeman, Montana, Förenta staterna, 59715
        • Bozeman Health Deaconess Hospital
      • Great Falls, Montana, Förenta staterna, 59405
        • Benefis Sletten Cancer Institute
      • Kalispell, Montana, Förenta staterna, 59901
        • Logan Health Medical Center
      • Missoula, Montana, Förenta staterna, 59804
        • Community Medical Center
    • Nebraska
      • Omaha, Nebraska, Förenta staterna, 68114
        • Nebraska Methodist Hospital
      • Omaha, Nebraska, Förenta staterna, 68114
        • Oncology Associates PC
      • Omaha, Nebraska, Förenta staterna, 68114
        • Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
    • New Jersey
      • Basking Ridge, New Jersey, Förenta staterna, 07920
        • Memorial Sloan Kettering Basking Ridge
      • Middletown, New Jersey, Förenta staterna, 07748
        • Memorial Sloan Kettering Monmouth
      • Montvale, New Jersey, Förenta staterna, 07645
        • Memorial Sloan Kettering Bergen
    • New York
      • Commack, New York, Förenta staterna, 11725
        • Memorial Sloan Kettering Commack
      • Harrison, New York, Förenta staterna, 10604
        • Memorial Sloan Kettering Westchester
      • New York, New York, Förenta staterna, 10065
        • Memorial Sloan Kettering Cancer Center
      • Uniondale, New York, Förenta staterna, 11553
        • Memorial Sloan Kettering Nassau
    • North Carolina
      • Chapel Hill, North Carolina, Förenta staterna, 27599
        • UNC Lineberger Comprehensive Cancer Center
      • Charlotte, North Carolina, Förenta staterna, 28204
        • Novant Health Presbyterian Medical Center
      • Huntersville, North Carolina, Förenta staterna, 28078
        • Novant Health Cancer Institute - Huntersville
      • Matthews, North Carolina, Förenta staterna, 28105
        • Novant Health Cancer Institute - Matthews
      • Mooresville, North Carolina, Förenta staterna, 28117
        • Novant Health Cancer Institute - Mooresville
    • North Dakota
      • Bismarck, North Dakota, Förenta staterna, 58501
        • Sanford Bismarck Medical Center
      • Fargo, North Dakota, Förenta staterna, 58122
        • Sanford Roger Maris Cancer Center
      • Fargo, North Dakota, Förenta staterna, 58122
        • Sanford Broadway Medical Center
    • Ohio
      • Cincinnati, Ohio, Förenta staterna, 45220
        • Good Samaritan Hospital - Cincinnati
    • Oklahoma
      • Lawton, Oklahoma, Förenta staterna, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Förenta staterna, 73104
        • University of Oklahoma Health Sciences Center
      • Tulsa, Oklahoma, Förenta staterna, 74146
        • Oklahoma Cancer Specialists and Research Institute-Tulsa
    • Oregon
      • Ontario, Oregon, Förenta staterna, 97914
        • Saint Alphonsus Cancer Care Center-Ontario
      • Portland, Oregon, Förenta staterna, 97239
        • Oregon Health and Science University
    • South Carolina
      • Charleston, South Carolina, Förenta staterna, 29425
        • Medical University of South Carolina
    • South Dakota
      • Sioux Falls, South Dakota, Förenta staterna, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Förenta staterna, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Nashville, Tennessee, Förenta staterna, 37232
        • Vanderbilt University/Ingram Cancer Center
    • Virginia
      • Richmond, Virginia, Förenta staterna, 23235
        • VCU Massey Cancer Center at Stony Point
      • Richmond, Virginia, Förenta staterna, 23298
        • VCU Massey Comprehensive Cancer Center
    • West Virginia
      • Morgantown, West Virginia, Förenta staterna, 26506
        • West Virginia University Healthcare
      • Parkersburg, West Virginia, Förenta staterna, 26101
        • Camden Clark Medical Center
    • Wisconsin
      • Eau Claire, Wisconsin, Förenta staterna, 54701
        • Marshfield Medical Center-EC Cancer Center
      • Marshfield, Wisconsin, Förenta staterna, 54449
        • Marshfield Medical Center-Marshfield
      • Minocqua, Wisconsin, Förenta staterna, 54548
        • Marshfield Medical Center - Minocqua
      • Rice Lake, Wisconsin, Förenta staterna, 54868
        • Marshfield Medical Center-Rice Lake
      • Stevens Point, Wisconsin, Förenta staterna, 54482
        • Marshfield Medical Center-River Region at Stevens Point
      • Weston, Wisconsin, Förenta staterna, 54476
        • Marshfield Medical Center - Weston

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Patients must have histologically documented nasopharyngeal carcinoma (NPC) regardless of World Health Organization (WHO) classification (keratinizing squamous cell carcinoma, non-keratinizing, or basaloid squamous cell carcinoma) and regardless of association with Epstein-Barr virus (EBV) and/or human papillomavirus (HPV)

  • Recurrent, metastatic and incurable disease treated with platinum-gemcitabine and prior PD-1/L1 blockade (as first or second-line therapy)

  • Patients are eligible regardless of prior smoking history, p16 immunohistochemistry (IHC) status, PD-L1 expression status, EBV tumor status, EBV viral load at baseline, or tumor genomic alteration status

  • Patients must have at least one measurable lesion (by RECIST v1.1) which has not been previously irradiated that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions as >= 10 mm (>= 1 cm) (and short axis for nodal lesions, LN >= 15 mm) with CT scan, MRI, or calipers by clinical exam

  • Patients may have had no more than 2 prior lines of prior systemic therapy for recurrent, metastatic NPC

  • No prior VEGFR targeted therapy permitted

  • Age >= 18 years

  • Eastern Cooperative Oncology Group Performance (ECOG) performance status 0-2

  • Absolute neutrophil count (ANC) >= 1,000/mm^3

  • Hemoglobin >= 9 g/dL

  • Platelet count >= 100,000/mm^3

  • Creatinine or creatinine clearance =< 1.5 mg/dL or >= 30 Modification of Diet in Renal Disease (MDRD)

  • Total bilirubin =< 1.5 x institutional upper limit of normal (ULN); except subjects with Gilbert syndrome who can have a total bilirubin < 3 mg/dL

  • Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGT]) =< 3 x upper limit of normal (ULN)

    • Up to =< 5 allowed with liver metastases

  • Not pregnant and not nursing, because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown. Therefore, for women of childbearing potential only, a negative urine or serum pregnancy test, per institution standard, done =< 7 days prior to registration is required.

    • Pregnant women are excluded from this study because nivolumab, ipilimumab, and cabozantinib are all Class C or D agents with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants, secondary to treatment of the mother with any of the study agents, breastfeeding should be discontinued if the mother is treated with as part of this study (in either arm)

  • No active tumor bleeding: or radiographic evidence of major blood vessel infiltration as judged by the treating investigator

  • Prior -anti-cancer therapy is allowed: Patients need to be recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities > grade 1), with the exception of alopecia. Any life-threatening events clearly attributable to prior immunotherapy exposure that have a high possibility of recurring should warrant exclusion: including severe pneumonitis, grade 4 bullous dermatitis/drug reaction with eosinophilia and systemic symptoms (DRESS), neurologic events such as autoimmune encephalitis transverse myelitis, and/or myocarditis. Maintenance hormonal replacement or long-term hormonal therapy exposure is permitted.

    • No chemotherapy or radiotherapy within 3 weeks (6 weeks for nitrosoureas or mitomycin C) prior to registration. Palliative (limited-field) radiation therapy is permitted, if all of the following criteria are met:

      • Repeat imaging demonstrates no new sites of bone metastases.
      • The lesion being considered for palliative radiation is not a target lesion

  • No patients with a prior malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen

  • Brain metastases allowed: Patients with treated brain metastases are eligible if follow-up brain imaging 3 weeks after central nervous system (CNS)-directed therapy shows no evidence of progression. Patients with new or progressive brain metastases (active brain metastases) or leptomeningeal disease are eligible if the treating physician determines that immediate CNS specific treatment is not required and is unlikely to be required during the first cycle of therapy

  • Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months prior to registration are eligible for this trial

  • For patients with evidence of chronic hepatitis B (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated

    • Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently receiving treatment, they are eligible if they have an undetectable HCV viral load

  • Solid organ or tissue transplant is allowed: - subsequent therapy with nivolumab increases the risk of organ/tissue rejection. Patients must be instructed that it is crucial they stay in touch with their transplant team during treatment

  • No active autoimmune disease: or history of autoimmune disease that might recur, and which may affect vital organ function or require immune suppressive treatment including systemic corticosteroids. These include but are not limited to patients with a history of

    • Immune related neurologic disease,
    • Multiple sclerosis,
    • Autoimmune (demyelinating) neuropathy,
    • Guillain-Barre syndrome (GBS),
    • Myasthenia gravis;
    • Systemic autoimmune disease such as SLE,
    • Connective tissue diseases,
    • Scleroderma, inflammatory bowel disease (IBD),
    • Crohn's, ulcerative colitis,
    • Patients with a history of toxic epidermal necrolysis (TEN),
    • Stevens-Johnson syndrome, or phospholipid syndrome should be excluded because of the risk of recurrence or exacerbation of disease

  • Patients with vitiligo, endocrine deficiencies including thyroiditis managed with replacement hormones including physiologic corticosteroids are eligible

  • Patients with rheumatoid arthritis and other arthropathies, Sjogren's syndrome, and psoriasis controlled with topical medication and patients with only positive serology, such as antinuclear antibodies (ANA) or anti-thyroid antibodies, should be evaluated for the presence of target organ involvement and potential need for systemic treatment but should otherwise be eligible

  • Pneumonitis should be evaluated for the nature of the disease process, need for treatment prior study treatment, and the risk of exacerbation with study treatment

  • Able to swallow oral medication: No known medical condition causing an inability to swallow oral formulations of agents

  • No condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalent) or other immunosuppressive medications within 14 days of study registration. Patients are permitted the use of topical, ocular, intra-articular, intranasal, and inhalational corticosteroids (with minimal systemic absorption). Adrenal replacement steroid doses > 10 mg daily prednisone are permitted. A brief (less than 3 weeks) course of corticosteroids for prophylaxis (e.g., contrast dye allergy) or for treatment of non-autoimmune conditions (e.g., delayed-type hypersensitivity reaction caused by a contact allergen) is permitted

  • Concomitant anticoagulation with coumarin agents (e.g., warfarin), direct thrombin inhibitors (e.g., dabigatran), direct factor Xa inhibitor betrixaban, or platelet inhibitors (e.g., clopidogrel) is prohibited. Allowed anticoagulants are the following:

    • Prophylactic use of low-dose aspirin for cardio-protection (per local applicable guidelines) and low-dose low molecular weight heparins (LMWH).
    • Therapeutic doses of LMWH or anticoagulation with direct factor Xa inhibitors rivaroxaban, edoxaban, or apixaban in subjects without known brain metastases who are on a stable dose of the anticoagulant for at least 1 week before first dose of study treatment without clinically significant hemorrhagic complications from the anticoagulation regimen or the tumor

  • Concomitant use of any medications or substances that are strong inhibitors or inducers of CYP3A4 is discouraged; if unavoidable, the dose of cabozantinib on study should be adjusted accordingly. Any complementary medications (e.g., herbal supplements or traditional Chinese medicines) intended to treat the disease under study are prohibited

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: Arm A (nivolumab, ipilimumab)

Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1 of each cycle. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients undergo CT or MRI and collection of blood samples throughout the trial.
Biologisk: Ipilimumab

Given IV

Andra namn:
  • Anti-cytotoxisk T-lymfocyt-associerad antigen-4 monoklonal antikropp
  • BMS-734016
  • Ipilimumab Biosimilar CS1002
  • MDX-010
  • MDX-CTLA4
  • Yervoy
  • MDX010
  • BMS734016
  • BMS 734016
  • MDX 010
Procedur: Magnetic Resonance Imaging

Undergo MRI

Andra namn:
  • MRI
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medicinsk bildbehandling, magnetisk resonans / kärnmagnetisk resonans
  • HERR
  • MR-avbildning
  • MRI-skanning
  • NMR-avbildning
  • NMRI
  • Kärnmagnetisk resonanstomografi
  • Magnetisk resonanstomografi (MRT)
  • sMRI
  • Magnetisk resonanstomografi (förfarande)
  • Strukturell MRI
Biologisk: Nivolumab

Given IV

Andra namn:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Procedur: Biospecimen Collection

Undergo collection of blood samples

Andra namn:
  • Biologisk provsamling
  • Bioprov insamlat
  • Provsamling
  • Provuppsamling
Procedur: Computed Tomography

Undergo CT scan

Andra namn:
  • CT
  • KATT
  • Datortomografi
  • Beräknad axiell tomografi
  • Datoriserad axialtomografi
  • tomografi
  • Datoriserad axiell tomografi (förfarande)
  • Datortomografi (CT) skanning
  • Diagnostisk kattskanning
  • Diagnostisk kattskanningstjänsttyp
Experimentell: Arm B (nivolumab, ipilimumab, cabozantinib)

Patients receive nivolumab IV over 30 minutes and ipilimumab IV over 30 minutes on day 1 and cabozantinib S-malate PO daily on days 1-28 of each cycle. Cycles repeat every 28 days for up to 2 years in the absence of disease progression or unacceptable toxicity. Patients may continue with cabozantinib S-malate after 2 years per treating investigator. Patients undergo CT or MRI and collection of blood samples throughout the trial.
Biologisk: Ipilimumab

Given IV

Andra namn:
  • Anti-cytotoxisk T-lymfocyt-associerad antigen-4 monoklonal antikropp
  • BMS-734016
  • Ipilimumab Biosimilar CS1002
  • MDX-010
  • MDX-CTLA4
  • Yervoy
  • MDX010
  • BMS734016
  • BMS 734016
  • MDX 010
Procedur: Magnetic Resonance Imaging

Undergo MRI

Andra namn:
  • MRI
  • Magnetisk resonans
  • Magnetic Resonance Imaging Scan
  • Medicinsk bildbehandling, magnetisk resonans / kärnmagnetisk resonans
  • HERR
  • MR-avbildning
  • MRI-skanning
  • NMR-avbildning
  • NMRI
  • Kärnmagnetisk resonanstomografi
  • Magnetisk resonanstomografi (MRT)
  • sMRI
  • Magnetisk resonanstomografi (förfarande)
  • Strukturell MRI
Läkemedel: Cabozantinib S-malate

Given PO

Andra namn:
  • BMS-907351
  • Cabometyx
  • Cometriq
  • XL-184
  • XL184
  • XL 184
Biologisk: Nivolumab

Given IV

Andra namn:
  • BMS-936558
  • MDX-1106
  • NIVO
  • ONO-4538
  • Opdivo
  • CMAB819
  • Nivolumab Biosimilar CMAB819
  • MDX 1106
  • MDX1106
  • BMS 936558
  • ABP 206
  • Nivolumab Biosimilar ABP 206
  • BCD-263
  • Nivolumab Biosimilar BCD-263
  • BMS936558
  • ONO 4538
  • ONO4538
Procedur: Biospecimen Collection

Undergo collection of blood samples

Andra namn:
  • Biologisk provsamling
  • Bioprov insamlat
  • Provsamling
  • Provuppsamling
Procedur: Computed Tomography

Undergo CT scan

Andra namn:
  • CT
  • KATT
  • Datortomografi
  • Beräknad axiell tomografi
  • Datoriserad axialtomografi
  • tomografi
  • Datoriserad axiell tomografi (förfarande)
  • Datortomografi (CT) skanning
  • Diagnostisk kattskanning
  • Diagnostisk kattskanningstjänsttyp

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Progression-free survival (PFS)
Tidsram: From randomization to the first of either progression or death from any cause, or censored at last known tumor assessment date, assessed up to 2 years

PFS will be estimated using the Kaplan-Meier method, where the log-rank test will be used to compare the 2 treatment arms.
From randomization to the first of either progression or death from any cause, or censored at last known tumor assessment date, assessed up to 2 years

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Overall survival (OS)
Tidsram: From randomization to death from any cause, or censored at last known follow-up, assessed up to 2 years

OS will be estimated using the Kaplan-Meier method, where the log-rank test will be used to compare the 2 treatment arms.
From randomization to death from any cause, or censored at last known follow-up, assessed up to 2 years
Incidence of adverse events
Tidsram: Up to 2 years

The maximum grade for each type of adverse event will be summarized using Common Terminology Criteria for Adverse Events version 5.0. The frequency and percentage of grade 3+ adverse events will be compared between the 2 treatment arms. Comparisons between arms will be made by using either the chi-square or Fisher's exact test.
Up to 2 years
Response by subgroups of interest
Tidsram: Up to 2 years

Will also report and compare the overall response rate (ORR) between different subgroups of interest (primary or acquired PD-1/L1 inhibitor resistance in the prior line of therapy (further defined below), etc.). These comparisons will be done via chi-square or Fisher's exact tests. We'll also assess primary versus acquired resistance to prior PD-1 inhibition in each arm as well. While not a formal stratification, in the interim and final analysis we'll also descriptively assess these subgroups between arms as well.
Up to 2 years
ORR
Tidsram: Up to 2 years

The response rate will be compared via chi-square or Fisher's exact tests between the 2 treatment arms using both the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria and also separately for the immune-modified RECIST criteria.
Up to 2 years
Predictors of response
Tidsram: Up to 2 years

Will correlate the baseline data (Epstein-Barr virus viral load, p16 immunohistochemistry status, smoking history, and PD-L1 score) with ORR data. For this analysis, logistic regression models will be assessed using the baseline data to predict binary response data. Odds ratios and 95% confidence intervals will be reported. Will also summarize the data using descriptive statistics and graphical methods.
Up to 2 years

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

National Cancer Institute (NCI)

Utredare

  • Huvudutredare: Ari J Rosenberg, Alliance for Clinical Trials in Oncology

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

19 februari 2024

Primärt slutförande (Beräknad)

6 december 2028

Avslutad studie (Beräknad)

6 december 2028

Studieregistreringsdatum

Först inskickad

13 juni 2023

Först inskickad som uppfyllde QC-kriterierna

13 juni 2023

Första postat (Faktisk)

15 juni 2023

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

2 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

30 oktober 2026

Senast verifierad

1 oktober 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • NCI-2023-04469
  • U10CA180821 (U.S.S. NIH-anslag/kontrakt)
  • NCI-2023-04469 (Registeridentifierare: CTRP (Clinical Trial Reporting Program))
  • A092105 (Annan identifierare: CTEP)
  • A092105 (Annan identifierare: Alliance for Clinical Trials in Oncology)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

NCI is committed to sharing data in accordance with NIH policy. For more details on how clinical trial data is shared, access the link to the NIH data sharing policy page.

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Ja

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

produkt tillverkad i och exporterad från U.S.A.

Nej

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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