A Phase I Trial of Bevacizumab Plus Ipilimumab in Patients With Unresectable Stage III or IV Melanoma
Overview
- Phase
- Phase 1
- Intervention
- Bevacizumab Plus Ipilimumab Cohort 1
- Conditions
- Melanoma
- Sponsor
- Dana-Farber Cancer Institute
- Enrollment
- 46
- Locations
- 3
- Primary Endpoint
- To determine the safety, tolerability and maximum tolerated dosing for the combination of bevacizumab plus ipilimumab in patients with unresectable stage III or stage IV melanoma
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The purpose of this research study is to determine the safety of using the study drugs bevacizumab and ipilimumab together, and the doses in combination which can be given to people safely. This study also seeks to investigate whether using both study drugs lengthens the amount of time before the participants melanoma worsens.
Detailed Description
* There are two phases to this research study, Induction Phase and Maintenance Phase. * Induction Phase: Participants will receive ipilimumab by an infusion into a vein or central line at weeks 1, 4, 7 and 10 for a total of 4 infusions. Bevacizumab is also given as an infusion into a vein or central line at weeks 1, 4, 7 and 10 along with ipilimumab and then every 3 weeks by itself. During all cycles of study therapy, the participant will have a physical exam on the first day and undergo blood tests at every study visit. At weeks 1, 4, 7, 10 and 12 a urine sample will be obtained for analysis. * Chest, abdomen and pelvic CT scans will be performed at week 12. If the scans at week 12 show that the participants cancer has remained stable or decreased, they will be asked to have repeat CT scans in three months. * Positron Emission Tomography (PET) scans will be done at week 8 and week 16. * Maintenance Phase: If the scans performed at week 12 show the cancer has improved or stayed the same, then the participant will continue to receive bevacizumab every three weeks and undergo a CT scan every 3 months. Also, every 3 months the participant may be eligible to receive additional doses of ipilimumab in addition to the bevacizumab.
Investigators
F. Stephen Hodi, MD
Melanoma Disease Center Director
Dana-Farber Cancer Institute
Eligibility Criteria
Inclusion Criteria
- •Measurable unresectable Stage III or Stage IV melanoma
- •ECOG Performance Status 0 or 1
- •4 weeks or greater since treatment
- •Must have recovered from any acute toxicity associated with prior therapy
- •Life expectancy of greater than 12 weeks
- •18 years of age or older
- •Laboratory values as outlined in protocol
- •Negative screening tests for HIV, active Hepatitis B and Hepatitis C
- •Patients who received prior therapy with anthracyclines should have a baseline MUGA or echo with a normal ejection fraction
Exclusion Criteria
- •CNS metastases
- •Pregnant or nursing women
- •Prior therapy with bevacizumab or ipilimumab
- •Active infection
- •Autoimmune disease: Patients with a history of inflammatory bowel disease are excluded from this study as are patients with a history of symptomatic autoimmune disease
- •Any other malignancy from which the patient has been disease-free for less than 5 years, with the exception of adequately treated and cured basal or squamous cell skin cancer, superficial bladder cancer or carcinoma in situ of the cervix
- •Any underlying medical condition which, in the principal investigator's opinion, will make the administration of study drug hazardous or obscure the interpretation of adverse events
- •Any concurrent medical condition requiring the use of systemic steroids
- •Inadequately controlled hypertension
- •Any prior history of hypertensive crisis or hypertensive encephalopathy
Arms & Interventions
Bevacizumab Plus Ipilimumab Cohort 1
5 subjects for this cohort
Intervention: Bevacizumab Plus Ipilimumab Cohort 1
Bevacizumab Plus Ipilimumab Cohort 2
17 subects for this cohort
Intervention: Bevacizumab Plus Ipilimumab Cohort 2
Bevacizumab Plus Ipilimumab Cohort 3
12 subjects
Intervention: Bevacizumab Plus Ipilimumab Cohort 3
Bevacizumab Plus Ipilimumab Cohort 4
12 subjects
Intervention: Bevacizumab Plus Ipilimumab Cohort 4
Outcomes
Primary Outcomes
To determine the safety, tolerability and maximum tolerated dosing for the combination of bevacizumab plus ipilimumab in patients with unresectable stage III or stage IV melanoma
Time Frame: 3 years
Secondary Outcomes
- To determine the best overall response rate by standard solid tumor response criteria, disease control rate, time to tumor progression, and duration of response for the combination of bevacizumab plus ipilimumab in this patient population(3 years)
- To perform correlative studies investigating the effects of this combination therapy on antitumor immunity and tumor vasculature(3 years)