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Ipilimumab and Nivolumab With Immunoembolization in Treating Participants With Metastatic Uveal Melanoma in the Liver

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03472586
Recruitment Status : Active, not recruiting
First Posted : March 21, 2018
Last Update Posted : August 16, 2022
Sponsor:
Collaborator:
Bristol-Myers Squibb
Information provided by (Responsible Party):
Thomas Jefferson University ( Sidney Kimmel Cancer Center at Thomas Jefferson University )

Study Description
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Brief Summary:
This phase II trial studies ipilimumab and nivolumab with immunoembolization in treating patients with uveal melanoma that has spread to the liver. Immunotherapy with monoclonal antibodies, such as ipilimumab and nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Immunoembolization may kill tumor cells due to loss of blood supply and develop an immune response against tumor cells. Giving ipilimumab and nivolumab with immunoembolization may work better in treating patients with uveal melanoma.

Condition or disease Intervention/treatment Phase
Metastatic Malignant Neoplasm in the Liver Metastatic Uveal Melanoma Stage IV Uveal Melanoma AJCC v7 Biological: Ipilimumab Biological: Nivolumab Drug: Embolization Therapy Phase 2

Detailed Description:

PRIMARY OBJECTIVES:

I. Determine the clinical benefit of treatment with immunoembolization (IEMBO) in combination with ipilimumab and nivolumab.

SECONDARY OBJECTIVES:

I. Determine all treatment and immune related toxicities. II. Determine progression free survival. III. Determine overall survival.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 14 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Ipilimumab and Nivolumab in Combination With Immunoembolization for the Treatment of Metastatic Uveal Melanoma
Actual Study Start Date : May 2, 2018
Actual Primary Completion Date : December 14, 2020
Estimated Study Completion Date : June 30, 2023

Resource links provided by the National Library of Medicine

MedlinePlus Genetics related topics: Melanoma
MedlinePlus related topics: Melanoma

Arms and Interventions
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Arm Intervention/treatment
Experimental: Treatment (ipilimumab, nivolumab, immunoembolization)
Patients receive ipilimumab IV over 30 minutes and nivolumab IV over 30 minutes on day 1. Patients also undergo immunoembolization on day 2. Cycles repeat every 3 weeks for 12 weeks in the absence of disease progression or unacceptable toxicity. Patients with complete response, partial response, or stable disease may receive nivolumab IV on day 1 and undergo immunoembolization on day 2. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. The interval between treatments may be extended up to every 6 weeks at the discretion of the treating physician.
 Biological: Ipilimumab
Given IV
Other Names:
  • Anti-Cytotoxic T-Lymphocyte-Associated Antigen-4 Monoclonal Antibody
  • BMS-734016
  • MDX-010
  • 720801
  • 477202-00-9
  • 732442

Biological: Nivolumab
Given IV
Other Names:
  • 946414-94-4
  • BMS-936558
  • ONO-4538
  • Opdivo

Drug: Embolization Therapy
Undergo immunoembolization


Outcome Measures
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Primary Outcome Measures :
  1. Hepatic metastasis stabilization rate by response criteria (Response Evaluation Criteria in Solid Tumors [RECIST] 1.1) [ Time Frame: At the end of 4th treatment cycle; cycle is 28 days ]
    Defined as complete response + partial response + stable disease. Rated by Response Evaluation Criteria in Solid Tumors version 1.1. The estimate of the hepatic metastasis stabilization rate will be presented with corresponding 95% confidence intervals. The method of Atkinson and Brown will be used to adjust for the two-stage design.


Secondary Outcome Measures :
  1. Incidence of adverse events [ Time Frame: Up to 1 year ]
    Graded by National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Toxicity rates will be estimated with corresponding 95% confidence intervals.

  2. Progression free survival (PFS) [ Time Frame: From the start of the treatment to confirmation of progression of disease, assessed up to 1 year ]
    Will be estimated using the Kaplan-Meier method.

  3. Overall survival [ Time Frame: From the start of the treatment to confirmation of progression of disease, assessed up to 1 year ]
    Will be estimated using the Kaplan-Meier method.


Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically confirmed metastatic uveal melanoma in the liver; patients must have at least one measurable liver metastasis that is >= 10 mm in longest diameter by computed tomography (CT) scan or magnetic resonance imaging (MRI)
  • The total volume of the tumors must be less than 50% of the liver volume
  • Willingness and ability to give informed consent
  • Agreement to access archival tissue or agreement for tumor biopsy prior to treatment
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0, or 1
  • Serum creatinine =< 2.0 mg/dl
  • Granulocyte count >= 1000/mm^3
  • Platelet count >= 100,000/mm^3
  • Bilirubin =< 2.0 mg/ml
  • Albumin >= 3.0 g/dl
  • Prothrombin time (PT)/partial thromboplastin time (PTT) less than 1.5 times normal
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than 3 x upper limit of normal (ULN)
  • Alkaline phosphatase less than 1.5 times ULN (grade 1)
  • Women must not be pregnant or breast-feeding
  • Women of child-bearing potential must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 23 weeks after the last dose of nivolumab and/or ipilimumab and sexually active males must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 31 weeks after the last dose of nivolumab and/or ipilimumab

Exclusion Criteria:

  • Failure to meet any of the criteria set forth in the inclusion criteria section
  • Previous systemic exposure to anti-CTLA-4 antibody or anti-PD1 antibody
  • Previous liver-directed treatments including chemoembolization, radiosphere, hepatic arterial perfusion, or drug-eluting beads; liver resection and focal ablation are permitted
  • Presence of symptomatic liver failure including ascites and hepatic encephalopathy
  • Presence of untreated brain metastases; if patients have had previous treatment for the brain metastasis, an MRI or CT scan of the brain must confirm the stabilization of the brain metastasis for more than 2 months
  • Presence of uncontrolled hypertension or congestive heart failure, or acute myocardial infarction within 6 months of entry
  • Presence of any other medical complication that implies survival of less than six months
  • Uncontrolled severe bleeding tendency or active gastrointestinal (GI) bleeding
  • Significant allergic reaction to contrast dye or granulocyte-macrophage colony-stimulating (GM-CSF)
  • Immunosuppressive treatments within 4 weeks prior to embolization, unless prednisone =< 5 mg or equivalent
  • Pregnancy or breast-feeding women
  • Patients with active hepatitis with serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) equal or greater than 5 times normal
  • Biliary obstruction, biliary stent or prior biliary surgery except cholecystectomy
  • Positive for known human immunodeficiency virus (HIV) Infection
  • Uncontrolled chronic obstructive pulmonary disease or previous known pulmonary fibrosis
  • Active infection
  • Auto-immune disease including inflammatory bowel disease, lupus, rheumatoid arthritis, but not including hypothyroidism or psoriasis if condition has been stable for 2 months or greater
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03472586


Locations
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United States, Pennsylvania
Sidney Kimmel Cancer Center at Thomas Jefferson University
Philadelphia, Pennsylvania, United States, 19107
Sponsors and Collaborators
Sidney Kimmel Cancer Center at Thomas Jefferson University
Bristol-Myers Squibb
Investigators
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Principal Investigator: Marlana Orloff, MD Sidney Kimmel Cancer Center at Thomas Jefferson University
More Information
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Additional Information:

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Responsible Party: Sidney Kimmel Cancer Center at Thomas Jefferson University
ClinicalTrials.gov Identifier: NCT03472586    
Other Study ID Numbers: 18P.042
First Posted: March 21, 2018    Key Record Dates
Last Update Posted: August 16, 2022
Last Verified: August 2022

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Melanoma
Neoplasms
Uveal Neoplasms
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Nerve Tissue
Nevi and Melanomas
Eye Neoplasms
 Neoplasms by Site
Eye Diseases
Uveal Diseases
Nivolumab
Ipilimumab
Antineoplastic Agents, Immunological
Antineoplastic Agents
Immune Checkpoint Inhibitors
Molecular Mechanisms of Pharmacological Action