Multiple Class I Peptides & Montanide ISA 51 VG w Escalating Doses of Anti-PD-1 ab BMS936558

This study is currently recruiting participants. (see Contacts and Locations)
Verified July 2014 by H. Lee Moffitt Cancer Center and Research Institute
Sponsor:
Collaborators:
Bristol-Myers Squibb
Medarex
Information provided by (Responsible Party):
H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov Identifier:
NCT01176461
First received: August 5, 2010
Last updated: July 10, 2014
Last verified: July 2014
  Purpose

This is a pilot phase 1, open-label, single center, multi-dose, dose-escalation study of BMS-936558 in combination with or without a peptide vaccine.

The purpose of this study is to test the side effects of an investigational vaccine with an immune booster. Investigators also wish to find out its effects on the patient's immune system and whether it will shrink their melanoma.


Condition Intervention Phase
Melanoma (Skin)
Biological: MART-1
Biological: NY-ESO-1
Biological: gp100:209-217(210M)
Biological: gp100:280-288(288V)
Drug: Montanide ISA 51 VG
Biological: BMS-936558
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Pilot Trial of a Vaccine Combining Multiple Class I Peptides and Montanide ISA 51 VG With Escalating Doses of Anti-PD-1 Antibody BMS-936558 for Patients With Unresectable Stages III/IV Melanoma

Resource links provided by NLM:


Further study details as provided by H. Lee Moffitt Cancer Center and Research Institute:

Primary Outcome Measures:
  • Best Overall Response Rate (BORR) [ Time Frame: 2 years, 6 months ] [ Designated as safety issue: No ]
    The primary analysis is the BORR as determined using irRC. The BORR will be summarized using descriptive statistics.


Secondary Outcome Measures:
  • Time to Response [ Time Frame: 2 years, 6 months ] [ Designated as safety issue: No ]
    Time to response for participants with confirmed responses. Response categories: Complete Response (CR), Partial Response (PR) Stable Disease (SD), Progressive Disease (PD); disease control rate (sum of response rate for CR+PR+SD).

  • Duration of Response [ Time Frame: 2 years, 6 months ] [ Designated as safety issue: No ]
    Duration of response for participants with confirmed responses. Response categories: Complete Response (CR), Partial Response (PR) Stable Disease (SD), Progressive Disease (PD); disease control rate (sum of response rate for CR+PR+SD).


Estimated Enrollment: 150
Study Start Date: August 2010
Estimated Study Completion Date: February 2015
Estimated Primary Completion Date: February 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: A1 - Phase I Dose Escalation
Cohorts 1 through 5. Each treatment cycle is comprised of 6 doses of BMS-936558 and 6 peptide vaccines administered every 2 weeks for 12 weeks (cohort 6 has no peptides) (Cycle 1: Weeks 1, 3, 5, 7, 9, and 11; Cycle 2: Weeks 13, 15, 17, 19, 21, and 23) with tumor response assessments at the end of each cycle (during Weeks 12 and 24).
Biological: MART-1
THIS PEPTIDE REMOVED FROM STUDY ON 1/1/2013. MART-1:26-35(27L) peptide vaccine
Other Names:
  • NSC 709401
  • peptide vaccine
Biological: NY-ESO-1
NY-ESO-1 peptide vaccine
Other Names:
  • NSC 717388
  • peptide vaccine
Biological: gp100:209-217(210M)
THIS PEPTIDE REMOVED FROM STUDY ON 1/1/2013. gp100:209-217(210M) peptide vaccine
Other Names:
  • NSC 683472
  • peptide vaccine
Biological: gp100:280-288(288V)
gp100:280-288(288V) peptide vaccine
Other Names:
  • NSC 683473
  • peptide vaccine
Drug: Montanide ISA 51 VG
Administer peptide vaccine emulsions prepared with Montanide® ISA 51 VG by deep subcutaneous injection.
Other Name: NSC 737063
Biological: BMS-936558
BMS-936558 is a fully human monoclonal antibody (HuMAb) against programmed death-1 (PD-1). Level 1: 1 mg/kg cohort; Level 2: 3 mg/kg cohort; Level 3: 10 mg/kg cohort; Level 4: 3 mg/kg prior ipi gr 0/1/2 cohort; Level 5: 3 mg/kg prior ipi gr 3 cohort; Level 6: 3 mg/kg BMS-936558 (no peptide vaccine; human leukocyte antigen [HLA] unrestricted)
Other Names:
  • NSC 748726
  • Anti PD-1
  • antibody
  • MDX-1106
  • Immunotherapy
Active Comparator: A2 - BMS-936558 Without Peptide Vaccine
Cohort 6. Each treatment cycle is comprised of 6 doses of BMS-936558 administered every 2 weeks for 12 weeks (cohort 6 has no peptides) (Cycle 1: Weeks 1, 3, 5, 7, 9, and 11; Cycle 2: Weeks 13, 15, 17, 19, 21, and 23) with tumor response assessments at the end of each cycle (during Weeks 12 and 24).
Biological: BMS-936558
BMS-936558 is a fully human monoclonal antibody (HuMAb) against programmed death-1 (PD-1). Level 1: 1 mg/kg cohort; Level 2: 3 mg/kg cohort; Level 3: 10 mg/kg cohort; Level 4: 3 mg/kg prior ipi gr 0/1/2 cohort; Level 5: 3 mg/kg prior ipi gr 3 cohort; Level 6: 3 mg/kg BMS-936558 (no peptide vaccine; human leukocyte antigen [HLA] unrestricted)
Other Names:
  • NSC 748726
  • Anti PD-1
  • antibody
  • MDX-1106
  • Immunotherapy

Detailed Description:

BMS-936558 will be administered as an i.v. infusion, using a volumetric pump with a 0.2 micron in-line filter at the protocol-specified dose(s) and rate.

The vaccine consists of the following peptides: gp100280-288 (288V), and NY-ESO-1157-165 (165V).

NOTE: *Patients in cohorts 1-5 will receive the peptide vaccine, but not those in cohort 6.

Blood samples are collected for pharmacokinetic and immunologic analysis.

After completion of study therapy, patients are followed up periodically for 2 years.

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologic diagnosis of unresectable Stage III or IV melanoma. All melanomas regardless of primary site of disease will be allowed
  • Measurable unresectable melanoma at least 1 measurable lesion based on Immune-related Response Criteria (irRC)
  • Have failed at least 1 chemotherapy regimen for metastatic disease, and have been treated with up to 2 prior chemotherapy regimens
  • HLA-A*0201 positive as determined by deoxyribonucleic (DNA) allele-specific polymerase chain reaction (PCR) assay; for cohort 5 after amendment 9 and cohort 6, there is no HLA restriction
  • Positive staining of tumor tissue with antibodies to 1 or more of the following: human melanoma black 45 (HMB 45) for gp100, NY-ESO-1, and/or MART-1
  • Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
  • Prior chemotherapy or immunotherapy must have been completed at least 4 weeks before study drug administration, and all adverse events have either returned to baseline or stabilized
  • Prior treated brain or meningeal metastases must be without magnetic resonance imaging (MRI) evidence of progression for at least 8 weeks and off immunosuppressive doses of systemic steroids (> 10 mg/day prednisone or equivalent) for at least 2 weeks before study drug administration
  • Prior systemic radiation therapy must have been completed at least 4 weeks before study drug administration. Prior focal radiotherapy completed at least 2 weeks before study drug administration. No radiopharmaceuticals (strontium, samarium) within 8 weeks before study drug administration
  • Immunosuppressive doses of systemic medications, such as steroids or absorbed topical steroids (doses > 10 mg/day prednisone or equivalent) must be discontinued at least 2 weeks before study drug administration
  • Completed nitrosourea treatment at least 6 weeks before administration of any study drug
  • Prior surgery that required general anesthesia must be completed at least 2 weeks before study drug administration. Surgery requiring local/epidural anesthesia must be completed at least 72 hours before study drug administration and patients should be recovered.
  • Screening laboratory values must meet the following criteria:

    • white blood cells (WBCs) ≥ 2000 cells/ µL
    • neutrophils ≥ 1500 cells/ µL
    • platelets ≥ 100 x 10^3/ µL
    • hemoglobin ≥ 9.0 g/dL
    • serum creatinine ≤ 2 mg/dL
    • aspartic transaminase (AST) ≤ 2.5 x upper limit of normal (ULN) without, and ≤ 5 x ULN with hepatic metastasis
    • alanine transaminase (ALT) ≤ 2.5 x ULN without, and ≤ 5 x ULN with hepatic metastasis
    • bilirubin ≤ 2 x ULN (except patients with Gilbert's syndrome, who must have total bilirubin < 3.0 mg/dL)
  • Females of childbearing potential must: Agree to use using a reliable form of contraception (eg, oral contraceptives, intrauterine device, double barrier method of condom and spermicidal) for at least 28 days prior to the first dose of any study drug, during the Treatment Period (and Treatment/Follow-up if receiving study drug), and for at least 70 days after the last dose of any study drug; have a negative serum β-human chorionic gonadotropin (β-HCG) at Screening.
  • Males must agree to the use of male contraception during the Treatment Period and for at least 180 days after the last dose of any study drug.
  • Must have read, understood, and provided written informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization after the nature of the study has been fully explained
  • Willing to adhere to the study visit schedule and the prohibitions and restrictions specified in this protocol

Exclusion Criteria:

  • History of severe hypersensitivity reactions to other monoclonal antibodies (mAbs)
  • Systemic hypersensitivity to Montanide ISA 51 VG or any vaccine component
  • Prior malignancy active within the previous 2 years except for locally curable cancers that have been apparently cured, such as basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the prostate, cervix or breast
  • Patients with any active autoimmune disease or a documented history of autoimmune disease, or history of syndrome that required systemic steroids or immunosuppressive medications, except for patients with vitiligo or resolved childhood asthma/atopy
  • Known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
  • Positive tests for hepatitis B virus surface antigen (HBV SAg) or hepatitis C virus ribonucleic acid (HCV RNA) indicating active or chronic infection
  • Prior therapy with an anti-PD-1, anti-PD-L1, anti-programmed death-ligand-2 (PDL-2), or anti-cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) antibody (or any other antibody targeting T cell co-stimulation pathways)
  • Concurrent medical condition requiring the use of immunosuppressive medications, or immunosuppressive doses of systemic or absorbable topical corticosteroids
  • Underlying medical condition (eg, a condition associated with diarrhea) that, in the Investigator's opinion, would make the administration of either study drug or both study drugs hazardous to the patient or obscure the interpretation of toxicity determination or adverse events
  • Pregnant or nursing
  • Current participation in another clinical study involving treatment with medications, radiation or surgery, or prior participation in this study
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01176461

Locations
United States, Florida
H. Lee Moffitt Cancer Center and Research Institute Recruiting
Tampa, Florida, United States, 33612-9497
Contact: Donna Gallenstein    813-745-4960    donna.gallenstein@moffitt.org   
Principal Investigator: Jeffrey S. Weber, M.D., Ph.D.         
Sub-Investigator: Ronadl DeConti, M.D.         
Sub-Investigator: Geoffrey Gibney, M.D.         
Principal Investigator: Ragini Kudchadkar, M.D.         
Sub-Investigator: James Mule`, Ph.D.         
Sub-Investigator: Amod Sarnaik, M.D.         
Sub-Investigator: Shilpa Gupta, M.D.         
Sub-Investigator: Jingsong Zhang, M.D., Ph.D.         
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Bristol-Myers Squibb
Medarex
Investigators
Principal Investigator: Jeffrey S. Weber, M.D., Ph.D. H. Lee Moffitt Cancer Center and Research Institute
  More Information

Additional Information:
No publications provided by H. Lee Moffitt Cancer Center and Research Institute

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: H. Lee Moffitt Cancer Center and Research Institute
ClinicalTrials.gov Identifier: NCT01176461     History of Changes
Other Study ID Numbers: MCC-15400, NCI-P-7997, CA209-006/007, 10-15526-99-01
Study First Received: August 5, 2010
Last Updated: July 10, 2014
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board

Keywords provided by H. Lee Moffitt Cancer Center and Research Institute:
recurrent melanoma
stage IIIA melanoma
stage IIIB melanoma
stage IIIC melanoma
stage IV melanoma

Additional relevant MeSH terms:
Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas
Antibodies
Freund's Adjuvant
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Adjuvants, Immunologic

ClinicalTrials.gov processed this record on July 26, 2014