Now Available: Final Rule for FDAAA 801 and NIH Policy on Clinical Trial Reporting

Continuous Infusion of rhIL-15 for Adults With Advanced Cancer

This study is currently recruiting participants. (see Contacts and Locations)
Verified October 2016 by National Institutes of Health Clinical Center (CC)
Sponsor:
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Cancer Institute (NCI) )
ClinicalTrials.gov Identifier:
NCT01572493
First received: April 5, 2012
Last updated: November 17, 2016
Last verified: October 2016
  Purpose

Background:

- People with cancer can have a weak immune system as a result of the cancer itself, or from prior treatments. . Still, treatments that stimulate the immune system have been shown to be effective against a number of different cancers. Recombinant human interleukin-15 (rhIL-15) is a drug that is designed to boost the immune system. Researchers are interested in seeing if rhIL-15 can strengthen the immune system's response against cancer. The drug will be given through a vein without a break for 10 days (240 hours).

Objectives:

  • To see rhIL-15 given as a continuous infusion over 10 days can be used to treat advanced cancer
  • Identify the side effects associated with this treatment.

Eligibility:

- Individuals at least 18 years of age with advanced cancer for which there are no effective treatments.

Design:

  • Participants screening procedures will include a physical exam and medical history, laboratory (blood) tests and x-rays (Imaging studies) to determine suitability for the protocol. --Appropriate participants with easily accessible tumor deposits may also be asked to have one pretreatment and one post (cycle 1) treatment tumor biopsy. .
  • Eligible participants will be admitted to the hospital for the rhIL-15 treatment and will spend about 12 days in the hospital. .
  • Participants will receive one 10 day infusion each cycle (about every 42 days) for as long as there are no serious side effects and the disease does not progress.
  • Participants will continue treatment as long as imaging studies show that the tumor continues to shrink or for two additional cycles after it has disappeared from the x-rays to make that the cancer is completely gone.
  • Participants who stop treatment for side effects or because their tumor did not shrink or stopped responding to the treatment will continue to have follow-up visits to monitor the outcome of the rhIL-15 treatment until there is evidence their cancer has progress or they begin another treatment.

Condition Intervention Phase
Lymphoma
Carcinoma
Biological: rh IL-15
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase I Study of a Continuous Intravenous Infusion of Recombinant Human Interleukin IL-15 (rhIL-15) in Adults With Metastatic Cancers

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • MTD and DLT [ Time Frame: After one cycle ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 52
Study Start Date: April 2012
Estimated Study Completion Date: April 2020
Estimated Primary Completion Date: April 2018 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
IL-15 IV for first 10 days of each cycle
Biological: rh IL-15
IL-15 IV for first 10 days of each cycle

Detailed Description:

BACKGROUND:

  • Interleukin-15 (IL-15) is a stimulatory cytokine with a number of desirable immunotherapeutic features, and clinical trials evaluating recombinant human (rh) IL-15 are underway.
  • In contrast to IL-2, IL-15 treatment does not stimulate activation-induced cell death of Tcells; potentially inhibits immunosuppressive CD4+CD25+ T regulatory cells, contributes to the proliferation, differentiation and activation of CD8+ T-cells and NK-cells and the maintenance of long-term CD8+ memory T-cells.
  • IL-15 is active in a number of syngeneic mouse preclinical tumor models, and vacciniabased constructs expressing IL-15 induced long-lasting, high-avidity cytotoxic CD8+ Tlymphocyte response that appears to be more effective than similar IL-2 expressing vaccines.
  • Pharmacology/toxicology (pharm/tox) experiments in non-human primate (NHP) rhesus macaques and preliminary results from the first-in-human phase I trial examining rhIL-15 given as an IV bolus (IVB) for 12 consecutive days indicate significant stimulation and expansion of NK-cells and CD8+ T-cells.
  • rhIL-15 given as an IVB at 1 mcg/kg dose level appears to be well tolerated despite the presence of some common cytokine-related side effects indicating that 0.1 mcg/kg/day is an appropriate initial dose level for a phase I safety trial of continuous intravenous infusion (CIV) of rhIL-15.
  • Comparison of the pharmacokinetic and immunologic assessments from the IVB phase I trial with the data from both sets of NHP pharm/tox experiments suggest that CIV of rhIL-15 may have greater potential for stimulating an anticancer cellular immune response with a more manageable safety profile.

OBJECTIVES:

Primary Objective:

- Determine the safety, toxicity profile, dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of rhIL-15 administered as a CIV for 10 consecutive days (240 hours) in subjects with metastatic unresectable cancers for which curative or palliative measures either do not exist or are not associated with a survival advantage.

ELIGIBILITY CRITERIA:

  • Patients greater than or equal to18 years-old, ECOG PS less than or equal to 1, with pathologically confirmed metastatic unresectable cancers for which curative or palliative measures either do not exist or are not associated with a survival advantage.
  • Patients with measurable or evaluable disease, normal organ and bone marrow function.

DESIGN:

  • This is a single-institution, open-label, non-randomized 3 + 3 design phase I dose escalation study.
  • Groups of 3 to 6 subjects will receive CIV rhIL-15 at doses of 0.1, 0.25, 0.5 1, 2, 4, 6 and 8 mcg/kg/day for 10 days provided that DLT has not been observed.
  • After assessments of the 10-day dosing cohorts have been completed, new groups of 3 to 6 subjects will receive CIVrhIL-15 at doses of 3, 4 and 5 mcg/kg/day for 5 days provided that a DLT has not been observed.
  • Patients with evidence of response and the absence of significant toxicities will be eligible for repeat cycles of treatment.
  • Samples for correlative studies will be obtained prior to treatment and at specific times points during and after treatment to assess pharmacokinetics of rhIL-15, the effect of rhIL-15 on immune cell subset populations and pro-inflammatory cytokine levels in the peripheral blood and for the development of neutralizing anti-rhIL-15 antibodies.
  Eligibility

Ages Eligible for Study:   18 Years to 99 Years   (Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria
  • INCLUSION CRITERIA
  • Age greater than or equal to 18 years.
  • Patients must have histologically confirmed (by the NCI Pathology Department) solid tumor malignancy or lymphoma that is metastatic or unresectable and for which standard curative or palliative measures do not exist or are associated with minimal patient survival benefit (as defined the Metabolism Branch physicians or if the patient refuses standard of care treatment ). Enrollment of patients with tumors that can be safely biopsied is encouraged.
  • Patients must have evaluable or measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded for non-nodal lesions and short axis for nodal lesions) as greater than or equal to 20 mm with conventional techniques or as greater than or equal to 10 mm with spiral CT scan.
  • Patients must have recovered to < grade 1 CTCAEv4 from toxicity of prior chemotherapy or biologic therapy and must not have had prior chemotherapy or biologic therapy within 4 weeks (6 weeks for nitrosoureas or mitomycin C, 8 weeks for UCN-01).
  • Patients must be at least 1 month since any prior radiation or major surgery.
  • Patients on bisphosphonates for any cancer or on hormone therapy for prostate cancer will not need to discontinue this therapy to be eligible. However, patients with prostate cancer will need to have metastatic prostate cancer that has progressed despite hormonal therapy. Castrate testosterone levels occur within hours after castration and within 2 to 3 weeks of a luteinizing hormone-releasing hormone agonist. The current standard is to continue androgen suppression despite progressive disease.
  • DLCO/VA and FEV-1.0 > 60% of predicted on pulmonary function tests.
  • Serum creatinine of less than or equal to 1.5 X the upper limit of normal.
  • AST and ALT < 2.5 x the upper limit of normal.
  • Absolute neutrophil count greater than or equal to 1,500/mm(3) and platelets greater than or equal to 100,000/mm(3).
  • Karnofsky performance status greater than or equal to 70% or ECOG less than or equal to 1
  • Subjects with inactive central nervous system (CNS) metastasis are eligible. Inactive CNS metastasis is defined as: no signs of cerebral edema after successful definitive treatment of brain metastases (surgical resection, whole brain irradiation, stereotactic radiation therapy, or a combination of these) with stable or improved radiographic appearance on MRI scan at least 1 month after completion of treatment.

EXCLUSION CRITERIA:

  • Patients who have received any systemic corticosteroid therapy within 3 weeks prior to the start of therapy with the exception of physiological replacement doses of cortisone acetate or equivalent.
  • Patients who have received any cytotoxic therapy, immunotherapy, antitumor vaccines, monoclonal antibodies or major surgery in the 4 weeks prior to the start of the study.
  • Life expectancy of less than 3 months.
  • Patients with more than 30% replacement of hepatic parenchyma by tumor or any history of drug related hepatic encephalopathy.
  • History of complex ventricular or supraventricular arrhythmias
  • Documented HIV, active bacterial infections, active or chronic hepatitis B, or hepatitis C infection.
  • A positive hepatitis B serology indicative of previous immunization (i.e., HBsAb positive and HBc Ab negative), or a fully resolved acute hepatitis B infection is not an exclusion criterion.
  • A positive hepatitis C serology is an exclusion criterion.
  • Concurrent anticancer therapy (including other investigational agents), with the exception of hormone therapy for prostate cancer.
  • Active CNS metastases (inactive CNS metastases are defined).
  • History of severe asthma or presently on chronic inhaled corticosteroid medications (patients with a history of mild asthma controlled with inhaled bronchodilators are eligible).
  • History of autoimmune disease, with the exception of an autoimmune event associated with prior ipilimumab (anti-CTLA-4) therapy that has been completely resolved for more than 4 weeks.
  • Inability or refusal to practice effective contraception during therapy or the presence of pregnancy or active breastfeeding (men and women of childbearing potential must use an effective method of birth control or abstinence during treatment and for 4 months after completion of treatment).
  • Cognitive impairment, history of medical or psychiatric disease, other uncontrolled intercurrent illness, active substance abuse, or social circumstances, which in the view of the Principal Investigator (PI), would preclude safe treatment or the ability to give informed consent.
  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: NCT01572493

Contacts
Contact: Maureen E Edgerly, R.N. (301) 451-5433 edgerlym@pbmac.nci.nih.gov
Contact: Kevin C Conlon, M.D. (301) 402-2913 conlonkc@mail.nih.gov

Locations
United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike Recruiting
Bethesda, Maryland, United States, 20892
Contact: For more information at the NIH Clinical Center contact National Cancer Institute Referral Office    (888) NCI-1937      
Sponsors and Collaborators
National Cancer Institute (NCI)
Investigators
Principal Investigator: Kevin C Conlon, M.D. National Cancer Institute (NCI)
  More Information

Additional Information:
Publications:
Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01572493     History of Changes
Other Study ID Numbers: 120113  12-C-0113 
Study First Received: April 5, 2012
Last Updated: November 17, 2016
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Pharmacokinetics of lL-15
Cytokine Therapy
Effects of rhlL-15 on T-cells and NK cells
Immunotherapy

ClinicalTrials.gov processed this record on December 07, 2016