A study to compare the safety of three different combination schemes of immunotherapy drugs (ipilimumab + nivolumab) given to patients who are recently diagnosed with melanoma, before they undergo surgery.
- Conditions
- Resectable stage III melanoma patients with one or more measurable lymph node metastases that can be biopsied, no history of in-transit metastases within the last 6 months, naïve for CTLA-4/PD-1/PD-L1 immunotherapy.Therapeutic area: Diseases [C] - Cancer [C04]
- Registration Number
- EUCTR2016-001984-35-GB
- Lead Sponsor
- Antoni van Leeuwenhoek Hospital
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Authorised-recruitment may be ongoing or finished
- Sex
- Not specified
- Target Recruitment
- 90
1. Adults at least 18 years of age
2. World Health Organization (WHO) Performance Status 0 or 1
3.Cytologically or histologically confirmed resectable stage III melanoma with one or more macroscopic lymph node metastases (measurable according to RECIST 1.1), that can be biopsied, and no history of in-transit metastases within the last 6 months
4. No other malignancies, except adequately treated and a cancer-related life-expectancy of more than 5 years
5. Patient willing to undergo triple tumor biopsies and extra blood withdrawal during screening and in case of relapse
6. No prior immunotherapy targeting CTLA-4, PD-1 or PD-L1
7. No immunosuppressive medications within 6 months prior study inclusion
8. Screening laboratory values must meet the following criteria: WBC 2.0x109/L, Neutrophils 1.5x109/L, Platelets 100 x109/L, Hemoglobin 5.5 mmol/L, Creatinine 1.5x ULN, AST 1.5 x ULN, ALT 1.5 x ULN, Bilirubin 1.5 X ULN
9. Normal LDH
10. Women of childbearing potential (WOCBP) must use appropriate method(s) of contraception. WOCBP should use an adequate method to avoid pregnancy for 23 weeks (30 days plus the time required for nivolumab to undergo five half-lives) after the last dose of investigational drug
11. 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 start of ipilimumab + nivolumab
12. Men who are sexually active with WOCBP must use any contraceptive method with a failure rate of less than 1% per year. Men receiving nivolumab and who are sexually active with WOCBP will be instructed to adhere to contraception for a period of 31 weeks after the last dose of investigational product
13. Women who are not of childbearing potential (i.e., who are postmenopausal), or surgically sterile as well as azoospermic men do not require contraception
14. Patient is capable of understanding and complying with the protocol requirements and has signed the Informed Consent document.
Are the trial subjects under 18? no
Number of subjects for this age range: 0
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 10
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 5
1. Distantly metastasized melanoma
2. History of in-transit metastases within the last 6 months
3. No measurable lesion according to RECIST 1.1
4. Subjects with any active autoimmune disease or a documented history of autoimmune disease, or history of syndrome that required systemic steroids or immunosuppressive medications, except for subjects with vitiligo or resolved childhood asthma/atopy
5. Prior CTLA-4 or PD-1/PD-L1 targeting immunotherapy
6. Radiotherapy prior or post-surgery
7. Patients will be excluded if they test positive for hepatitis B virus surface antigen (HBV sAg) or hepatitis C virus ribonucleic acid (HCV antibody), indicating acute or chronic infection
8. Patients will be excluded if they have known history of testing positive for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS)
9. Allergies and Adverse Drug Reaction
History of allergy to study drug components
History of severe hypersensitivity reaction to any monoclonal antibody
10. Underlying medical conditions that, in the Investigator's opinion, will make the administration of study drug hazardous or obscure the interpretation of toxicity determination or adverse events;
11. Concurrent medical condition requiring the use of immunosuppressive medications, or immunosuppressive doses of systemic or absorbable topical corticosteroids;
12. Use of other investigational drugs before study drug administration 30 days and 5 half-times before study inclusion
13. Pregnant or nursing
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method