A Phase I Trial of Ipilimumab (Immunotherapy) and MGN1703 (TLR Agonist) in Patients With Advanced Solid Malignancies
试验速览
- 阶段
- 1 期
- 状态
- 进行中（未招募）
- 入组人数
- 28
- 试验地点
- 1
- 主要终点
- Maximum Tolerated Dose (MTD) of MGN1703 with Ipilimumab
研究概览
简要总结
The goal of this clinical research study is to find the highest tolerable dose of MGN1703 that can be given in combination with ipilimumab to patients with advanced tumors. The safety of this drug combination will also be studied.
This is an investigational study. MGN1703 is not FDA approved or commercially available. It is currently being used for research purposes only. Ipilimumab is FDA approved and commercially available for the treatment of unresectable (cannot be removed with surgery) or metastatic (has spread) melanoma.
Up to 60 participants will be enrolled in this study. All will take part at MD Anderson.
详细描述
Study Groups:
If you are found to be eligible to take part in this study, you will be assigned to a dose level of MGN1703 based on when you joined this study. Up to 4 dose levels of MGN1703 will be tested. Up to 6 participants will be enrolled at each dose level. The first group of participants will receive the lowest dose level of MGN1703. Each new group will receive a higher dose of MGN1703 than the group before it, if no intolerable side effects were seen. This will continue until the highest tolerable dose of MGN1703 is found. This is called dose escalation.
In another part of the study (called dose expansion) up to 3 groups of up to 12 additional participants will be enrolled. Two (2) groups will receive MGN1703 at the highest tolerable dose that was found in dose escalation. One (1) group will receive the first dose level of MGN1703 (if it is found to be tolerable). The study doctor will tell you which dose of MGN1703 you will receive.
All participants will receive the same dose level of ipilimumab. You will receive ipilimumab at standard doses.
Study Drug Administration:
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients must have a histologically-confirmed metastatic or locally advanced solid tumor that has failed to respond to standard therapy, progressed despite standard therapy, or for which standard therapy does not exist.
- •There is no limit on the number of prior treatment regimens.
- •Patients must be off prior chemotherapy, hormonal therapy, or biological therapy for at least 4 weeks or >3 half-lives whichever comes first. Patients with prostate cancer may continue to receive LHRH agonist (unless orchiectomy has been performed).
- •ECOG performance status </= 2 (Karnofsky >60%).
- •Patients must have adequate organ and marrow function as defined below within 7 days: WBC >/= 2500/mm^
- •Absolute neutrophil count (ANC) >/= 1,500/mm^
- •Absolute lymphocyte count (ALC) >/= 500/mm^
- •Hemoglobin >/= 9g/dl. Platelets >/= 75,000/mm^
- •Creatinine </= 2.0 x ULN or measured CrCl of >/= 50ml/m^2/1.73 m^
- •Total bilirubin </= 2.0 mg/dL (unless previously diagnosed with Gilbert's Syndrome). AST(SGOT)/ALT(SGPT) </= 3 times the institutional upper limit of normal (patients with liver involvement will be allowed </= 5.0 X institutional upper normal limit).
- •Patients must have recovered from toxicity related to prior therapy to at least grade 1 (defined by CTCAE 4.0) or baseline level. Chronic stable grade 2 peripheral neuropathy secondary to neurotoxicity from prior therapies may be considered on a case by case basis by the Principal Investigator.
- •As the effect of these drugs on the developing human fetus is not known, women of child-bearing potential and men must agree to use adequate contraception (abstinence; hormonal or barrier method of birth control) for the study and at least 2 months after completion.
- •Female patient of childbearing potential has a negative serum pregnancy test within 7 days of study enrollment.
- •Patients must be willing and able to review, understand, and provide written consent before study enrollment.
- •Measurable disease as defined by irRC or RECIST 1.1 criteria
- •Age >/= 18 years.
排除标准
- •Severe autoimmune disease: Patients with a history of inflammatory bowel disease (including Crohn's disease and ulcerative colitis) and autoimmune disorders such as rheumatoid arthritis, systemic progressive sclerosis [scleroderma], Systemic Lupus Erythematosus or autoimmune vasculitis [e.g., Wegener's Granulomatosis] are excluded from this study. Patients with history of mild autoimmune disorders - including but not limited to mild psoriasis or Hashimoto's hyperthyroidism may be included at the discretion of the principle investigator.
- •History of acute diverticulitis, intra-abdominal abscess, GI obstruction, abdominal carcinomatosis or other known risk factors for bowel perforation.
- •Any underlying medical or psychiatric condition, which in the opinion of the Investigator, will make the administration of study drug hazardous or obscure the interpretation of AEs: e.g. a condition associated with frequent diarrhea or chronic skin conditions, recent surgery or colonic biopsy from which the patient has not recovered, or partial endocrine organ deficiencies.
- •Current evidence of active and uncontrolled infection, NYHA Class III-IV CHF, documented Child's class B-C cirrhosis, active pancreatitis or uncontrolled medical disease which in the opinion of the investigator could compromise assessment of efficacy.
- •Known human immunodeficiency virus (HIV)-positive and on highly active antiretroviral therapy (HAART), and/or Hepatitis B or C on treatment. Drug interactions between those agents and these experimental agents are wholly unknown (screening not required).
- •Major surgical procedure, open biopsy, or significant traumatic injury within 28 days of day 1 of therapy.
- •Known hypersensitivity to the components of study drugs, its analogs, or drugs of similar chemical or biologic composition.
- •Any non-oncology vaccine therapy used for prevention of infectious diseases (for up to one month prior to or after any dose of ipilimumab).
- •Concomitant therapy with any of the following: IL-2, interferon or other non-study immunotherapy regimens; cytotoxic chemotherapy; immunosuppressive agents; other investigational therapies; or chronic use of systemic corticosteroids (when used in the management of cancers other than intracranial glioblastoma, gliosarcoma or anaplastic astrocytoma, or when used to treat non-cancer-related illnesses).
- •Radiation therapy within 4 weeks of study enrollment (exception is radiotherapy expansion arm which requires radiation treatment within 2 week period).
- •Pregnant and breastfeeding women are excluded from this study. Women of child-bearing potential and men must agree to use contraception prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician.
- •Use of any other concurrent investigational agents or anticancer agents including hormonal therapy, except in the case of prostate cancer patients who are being treated with LHRH agonist at the time of trial entry.
- •Previous exposure to TLR agonist therapy.
- •Known history of plasma cortisol and adrenocorticotropic hormone (ACTH) levels consistent with adrenal failure.
研究组 & 干预措施
Dose Escalation Group: MGN1703 + Ipilimumab
Participants receive MGN1703 on Days 1, 8, and 15 of all cycles as an injection under the skin. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long. Participants receive a total of 4 treatment cycles for a total of 12 weeks on treatment.
干预措施: MGN1703 (Drug)
Dose Escalation Group: MGN1703 + Ipilimumab
Participants receive MGN1703 on Days 1, 8, and 15 of all cycles as an injection under the skin. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long. Participants receive a total of 4 treatment cycles for a total of 12 weeks on treatment.
干预措施: Ipilimumab (Drug)
MTD Group: MGN1703 (subcutaneously) + Ipilimumab
Dose expansion group consists of participants with advanced malignancy and cutaneous or subcutaneous manifestations.
MGN1703 given subcutaneously at MTD from the Dose Escalation Group. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long.
干预措施: MGN1703 (Drug)
MTD Group: MGN1703 (subcutaneously) + Ipilimumab
Dose expansion group consists of participants with advanced malignancy and cutaneous or subcutaneous manifestations.
MGN1703 given subcutaneously at MTD from the Dose Escalation Group. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long.
干预措施: Ipilimumab (Drug)
MTD Group: MGN1703 (intratumoral injection) + Ipilimumab
Dose expansion group consists of participants with advanced malignancy and cutaneous or or subcutaneous manifestations.
MGN1703 given by intratumoral injection at MTD from the Dose Escalation Group. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long.
干预措施: MGN1703 (Drug)
MTD Group: MGN1703 (intratumoral injection) + Ipilimumab
Dose expansion group consists of participants with advanced malignancy and cutaneous or or subcutaneous manifestations.
MGN1703 given by intratumoral injection at MTD from the Dose Escalation Group. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long.
干预措施: Ipilimumab (Drug)
MTD Post XRT Group: MGN1703 (subcutaneously) + Ipilimumab
Dose expansion group consists of participants with advanced malignancy treated with radiation (XRT) within the past 2 weeks.
MGN1703 given subcutaneously at MTD from the Dose Escalation Group. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long.
干预措施: MGN1703 (Drug)
MTD Post XRT Group: MGN1703 (subcutaneously) + Ipilimumab
Dose expansion group consists of participants with advanced malignancy treated with radiation (XRT) within the past 2 weeks.
MGN1703 given subcutaneously at MTD from the Dose Escalation Group. Ipilimumab dosed at 3 mg/kg once per cycle on Day 8 following MGN1703 administration.
Each cycle is 21 days long.
干预措施: Ipilimumab (Drug)
结局指标
主要结局
Maximum Tolerated Dose (MTD) of MGN1703 with Ipilimumab
时间窗: 84 days
If more than or equal to one third of the participants at a dose level experience dose limiting toxicity (DLT), the MTD reassessed and the next lowest dose level for the combination therapy considered the MTD.
次要结局
- Tumor Response(84 days)