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Safety and Modulation of Adaptive Immunity by Iscador® Qu Viscum Album Extract in Patients With Advanced, Recurrent or Metastatic Cancers Treated With Immune Checkpoint Inhibitors

Phase 4
Recruiting
Conditions
Advanced Solid Tumor
Interventions
Drug: Immune Checkpoint Inhibitors
Drug: Immune checkpoint inhibitors plus Iscador® Qu.
Registration Number
NCT06408688
Lead Sponsor
University Hospital, Basel, Switzerland
Brief Summary

The main objective of this study is to test if adding the mistletoe extract Iscador® Qu to regular cancer treatment with immune checkpoint inhibitors affects:

* The immune system's ability to fight cancer

* Safety of the treatment

* How well the treatment performs against cancer

* How the patient feels during treatment

Researchers will compare patients treated with immune checkpoint inhibitors plus Iscador® Qu with patients treated with imune checkpoint inhibitors only.

Detailed Description

The impact of mistletoe preparations - that are claimed to have immunostimulatory properties - on cancer treatment with immune checkpoint inhibitors remains unclear. To address this knowledge gap, the current study aims to investigate the modulation of adaptive immunity through the combination of Iscador (a specific mistletoe preparation) and immune checkpoint inhibitors. Additionally, researchers will evaluate the safety profile of this combination therapy in patients with locally advanced non-operable or metastatic cancers except for skin cancers. By examining the modulation of adaptive immunity and safety of this treatment approach, researchers aim to provide valuable insights for clinicians and patients in the context of advanced cancer care.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Locally advanced non-operable or metastatic solid tumor, except for skin cancer
  • Eligible for routine (standard) treatment with immune checkpoint inhibitor (+/- chemo/targeted therapy) as per the discretion of the local investigator
  • Subjects must be eligible for treatment with mistletoe preparations (controlled brain metastases, prednisolone equivalent below 10mg, no known hypersensitivity)
  • ECOG (Eastern Cooperative Oncology Group) performance status score of 0-2
  • Males and Females at least 18 years of age; no subjects under tutelage
  • No previous mistletoe treatment
Exclusion Criteria
  • Contraindications to Iscador® Qu or immune checkpoint inhibitors, e.g. hypersensitivity, active autoimmune disorder
  • Patients with skin cancer
  • Participation in another study with investigational drug within 30 days prior to enrolment (participation in observational studies or diagnostic studies without a particular drug intervention are allowed)
  • Enrolment of the investigator, his/her family members, employees and other dependent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm B: Immune checkpoint inhibitorsImmune Checkpoint InhibitorsPatients randomized to Arm B will be treated with Immune checkpoint inhibitors only.
Arm A: Immune checkpoint inhibitors plus Iscador® QuImmune checkpoint inhibitors plus Iscador® Qu.Patients randomized to Arm A will be treated with Immune checkpoint inhibitors plus Iscador® Qu.
Primary Outcome Measures
NameTimeMethod
Percentage of patients with a relative increase in T cell richness or diversity of 20% or morebaseline and 12 weeks (+/- 2 weeks)

Percentage of patients with a relative increase in T cell richness or diversity of 20% or more as measured by peripheral blood T cell receptor Next-generation sequencing.

Percentage of patients with a relative decrease in T cell clonality of 20% or morebaseline and 12 weeks (+/- 2 weeks)

Percentage of patients with a relative decrease in T cell clonality of 20% or more as measured by peripheral blood T cell receptor Next-generation sequencing.

Level of T cell richnessbaseline and 12 weeks (+/- 2 weeks)

Level of T cell richness as measured by peripheral blood T cell receptor Next-generation sequencing.

Level of T cell diversitybaseline and 12 weeks (+/- 2 weeks)

Level of T cell diversity as measured by peripheral blood T cell receptor Next-generation sequencing.

Level of T cell clonalitybaseline and 12 weeks (+/- 2 weeks)

Level of T cell clonality as measured by peripheral blood T cell receptor Next-generation sequencing.

Secondary Outcome Measures
NameTimeMethod
Safety and tolerability according to the NCI CTC AE v5up to 18 weeks

Safety and tolerability according to the NCI CTC AE v5 (National Cancer Institute Common Terminology Criteria for Adverse Events)

Rate of early immune checkpoint inhibitor-based treatment terminationup to 24 months

Rate of early immune checkpoint inhibitor-based treatment termination

Best tumor responseup to 24 months

Best tumor response as per investigators assessment

Progression-free survivalup to 24 months

Investigator-assessed progression-free survival

Overall survivalup to 24 months

Overall survival

EORTC QLQ C30up to 24 months

Quality of life as measured by EORTC QLQ C30 (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire). Calculation of the scores follows the validated formulas as issued by the EORTC. Scores range from 0% to 100% for all questionnaire domains with higher values representing better outcome.

Trial Locations

Locations (4)

Kantosspital Baden AG

🇨🇭

Baden, Switzerland

Universitätsspital Basel

🇨🇭

Basel, Switzerland

Kantonsspital Baselland

🇨🇭

Liestal, Switzerland

Tumor- und Brustzentrum Ostschweiz

🇨🇭

Saint Gallen, Switzerland

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