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Nivolumab in Patients With Recurrent Malignant Mesothelioma (NivoMes)

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: NCT02497508
Recruitment Status : Completed
First Posted : July 14, 2015
Last Update Posted : September 14, 2017
Bristol-Myers Squibb
Information provided by (Responsible Party):
The Netherlands Cancer Institute

Brief Summary:

This is a prospective, single arm, phase II trial in previously treated patients with MPM who are considered candidates for immunotherapy and repeat thoracoscopies/transthoracic biopsies. Nivolumab will be administered 3 mg/kg q2 weeks by intravenous injection.

The administration of nivolumab as monotherapy will improve DCR form 20% to 40% at 12 weeks when compared to DCR of patients treated with best supportive care based on historical controls.

Condition or disease Intervention/treatment Phase
Malignant Pleural Mesothelioma Drug: nivolumab Phase 2

Detailed Description:
Patients will undergo pre- and post-treatment thoracoscopies/biopsies.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 33 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Single Arm Phase II Study of Nivolumab in Patients With Recurrent Malignant Pleural Mesothelioma: Interim Biopsy Analysis to Determine Efficacy. Acronym: NivoMes Study
Study Start Date : July 2015
Actual Primary Completion Date : July 2017
Actual Study Completion Date : July 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Mesothelioma
Drug Information available for: Nivolumab

Arm Intervention/treatment
Experimental: Nivolumab
Nivolumab will be administered 2 weekly by intravenous infusion in a dose of 3 mg/kg
Drug: nivolumab
Other Name: BMS-936558

Primary Outcome Measures :
  1. DCR [ Time Frame: at 12 weeks ]
    The number of patients that have CR or PR plus the number of patients that have SD, as a percentage of the total number of patients in the study.

Secondary Outcome Measures :
  1. PFS [ Time Frame: Until progression, every 6 weeks up to 24 weeks. ]
    The time from the date of start of treatment to the date of the first documented tumor progression as determined by modified RECIST, or death due to any cause.

  2. OS [ Time Frame: every 8 weeks until death ]
    The time from date of start of treatment to the date of death

  3. TTP [ Time Frame: Until progression, every 6 weeks up to 24 weeks. ]
    The time from the date of start of treatment to the time of disease progression.

  4. ORR [ Time Frame: Every 6 weeks up to 24 weeks. ]
    The number of subjects whose best confirmed objective response is a CR or PR, divided by the number of treated subjects.

  5. Safety and tolerability (The incidence of (serious) adverse events) [ Time Frame: Participants will be followed fot the duration of the trial, an expected average of 6 weeks ]
    The incidence of (serious) adverse events

  6. DCR [ Time Frame: At 6 months ]
    The number of patients that have CR or PR plus the number of patients that have SD, as a percentage of the total number of patients in the study.

Other Outcome Measures:
  1. Exploratory [ Time Frame: At screening and after cycle 3 (day 35-50) ]
    The effects of nivolumab on tissue samples with respect to influx of immuno-modulating cells and the PD-L1 status of tumors and other possible biomarkers and explore correlations between biomarkers and anti-tumor activity.

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

Inclusion Criteria:

  • Patients with histological or cytological diagnosed malignant pleural mesothelioma and age >18 years.
  • Progressive disease after at least one course of chemotherapy.
  • Previous chemotherapy or experimental therapy ≥ 4 weeks ago.
  • Medically suitable for limited surgical intervention (pleural biopsies up to limited pleurectomy).
  • Not considered candidates for trimodality treatment (as part of a study).
  • Measurable or evaluable disease (see tumor response assessment).
  • Ability to understand the study and give signed informed consent prior to beginning of protocol specific procedures including the approval of a second thoracoscopy or transthoracic pleural biopsy after the third course.
  • Radiotherapy is allowed when this is given for palliation, the interval is > 12 weeks and not all tumor is within the irradiation field.
  • WHO performance status 0 or 1 (see appendix 1).
  • Adequate organ function as evidenced by the following peripheral blood counts or serum chemistries at study entry:

    • Hematology: Neutrophil count >= 1.5 x 109/l, Platelets >= 150 x 109/l, Hemoglobin >= 6,0 mmol/l.
    • Chemistry: Total serum bilirubin ≤ 1.5 times within the upper limits of normal (ULN); ASAT and ALAT <= 2.5x ULN, AP (alkaline phosphatases) < 5x ULN (unless bone metastases are present in the absence of any liver disease).

Age and Reproductive Status

  • Women of childbearing potential (WOCBP) must use appropriate method(s) of contraception to avoid pregnancy during treatment and for 23 weeks after the last dose of investigational drug.
  • Women of childbearing potential must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours prior to the first dose of nivolumab.
  • Men who are sexually active with WOCBP must use any contraceptive method with a failure rate of less than 1% per year during treatment and for a period of 31 weeks after the last dose of investigational drug.
  • Women who are not of childbearing potential (ie, who are postmenopausal or surgically sterile) as well as azoospermic men do not require contraception.

Exclusion Criteria:

  • Active uncontrolled infection, severe cardiac dysfunction or uncorrectable bleeding tendency.
  • Inability to perform biopsies of the pleural lesions.
  • Symptomatic peripheral neuropathy >= grade 2 according to NCI CTC, version 4.0.
  • Presence of symptomatic CNS metastases.
  • Unstable peptic ulcer, unstable diabetes mellitus or other serious disabling condition.
  • Impaired renal function: creatinine clearance less than 50ml/min.
  • Concomitant administration to any other experimental drugs under investigation.
  • Patients are excluded if they have an active, known or suspected autoimmune disease. Subjects are permitted to enroll if they have vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger
  • Patients are excluded if they have a condition requiring systemic treatment with either corticosteroids (> 10 mg daily prednisone equivalents) or other immuno-suppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses < 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.
  • Patients are excluded if they have had prior treatment with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways

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): NCT02497508

Sponsors and Collaborators
The Netherlands Cancer Institute
Bristol-Myers Squibb
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Principal Investigator: Paul Baas, MD, PhD The Netherlands Cancer Institute
Principal Investigator: Josine Quispel-Janssen, MD The Netherlands Cancer Institute
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Responsible Party: The Netherlands Cancer Institute
ClinicalTrials.gov Identifier: NCT02497508    
Other Study ID Numbers: N14MPN
First Posted: July 14, 2015    Key Record Dates
Last Update Posted: September 14, 2017
Last Verified: September 2017
Keywords provided by The Netherlands Cancer Institute:
progressive disease after at least 1 course of chemotherapy
Additional relevant MeSH terms:
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Mesothelioma, Malignant
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms, Mesothelial
Lung Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Pleural Neoplasms
Lung Diseases
Respiratory Tract Diseases
Antineoplastic Agents, Immunological
Antineoplastic Agents
Immune Checkpoint Inhibitors
Molecular Mechanisms of Pharmacological Action