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A Dose Escalation Phase I Study of Radiotherapy Administered in Combination With Anti-CTLA4 Monoclonal Antibody (Ipilimumab) in Patients With Unresectable Stage III or Stage IV Advanced Malignant Melanoma


Phase 1
18 Years
N/A
Open (Enrolling)
Both
Malignant Melanoma

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Trial Information

A Dose Escalation Phase I Study of Radiotherapy Administered in Combination With Anti-CTLA4 Monoclonal Antibody (Ipilimumab) in Patients With Unresectable Stage III or Stage IV Advanced Malignant Melanoma


OBJECTIVES:

Primary: To determine the Maximum Tolerated Dose (MTD), Dose Limiting Toxicity (DLT) and
recommended Phase 2 dose of radiation therapy administered in combination with ipilimumab.

Secondary:

Adverse event profiles Preliminary anti-tumor activity following escalating doses of
radiation combined to ipilimumab using the immune related response criteria irRC overall
survival in patients treated with this combination systemic immunologic anti tumor response
intratumoral immune response pharmacodynamic effects of ipilimumab and radiotherapy in
combination on Absolute Lymphocyte Count (ALC) associations between ALC and anti-tumor
activity of ipilimumab and radiotherapy in combination


Inclusion Criteria:



- Willing and able to give written informed consent.

- Histologic diagnosis of melanoma.

- Unresectable locally advanced or metastatic melanoma with at least one melanoma
metastasis accessible to radiation therapy.

- Measurable disease according to immune related Response Criteria

- Required values for initial laboratory tests:

WBC >= 2000/uL ANC >= 1000/uL Platelets >= 75 x 103/uL Hemoglobin >= 8 g/dL Creatinine <=
2,5 x ULN AST/ALT <= 2.5 x ULN for patients without liver metastasis or <= 5 x ULN for
patients with liver metastasis Total Bilirubin <= 1,5.x ULN, (except patients with
Gilbert's Syndrome, who must have a total bilirubin less than 3.0 mg/dL)

- No active or chronic infection with HIV, Hepatitis B, or Hepatitis C.

- ECOG Performance status of 0 or 1.

- Men and women, >= 18 years of age.

- Women of childbearing potential (WOCBP) must be using an adequate method of
contraception to avoid pregnancy throughout the study and for up to 8 weeks after the
last dose of investigational product, in such a manner that the risk of pregnancy is
minimized.

Exclusion Criteria:

- Suspected or known CNS tumors including brain metastasis.

- Any other malignancy form 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.

- Autoimmune disease: Patients with a history of inflammatory bowel disease are
excluded from this study, as are patients with a history of symptomatic disease
(e.g., rheumatoid arthritis, systemic progressive sclerosis [scleroderma], systemic
lupus erythematosus, autoimmune vasculitis [e.g., Wegener's Granulomatosis]); motor
neuropathy considered of autoimmune origin (e.g. Guillain-Barre Syndrome).

- Any underlying medical or psychiatric condition, which in the opinion of the
investigator will make the administration of ipilimumab hazardous or obscure the
interpretation of AEs, such as a condition associated with frequent diarrhea.

- Any non-oncology vaccine therapy used for prevention of infectious diseases (for up
to 1 month before or after any dose of ipilimumab).

- A history of prior treatment with ipilimumab or prior CD137 agonist or CTLA‑4
inhibitor or agonist.

- Concomitant hormonal treatment, chemotherapy or immunotherapy.

- Other investigational therapy.

- Prior radiotherapy within the same body area.

- Prior radiotherapy targeting fields containing flat bones.

- Women of childbearing potential (WOCBP), defined above

- Prisoners or subjects who are compulsorily detained (involuntarily incarcerated) for
treatment of either a psychiatric or physical (e.g., infectious) illness.

- Persons of reproductive potential must agree to use an adequate method of
contraception throughout treatment and for at least 8 weeks after ipilimumab is
stopped.

Type of Study:

Interventional

Study Design:

Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Maximum Tolerated Dose of radiation therapy administered in combination with ipilimumab

Outcome Description:

To determine the Maximum Tolerated Dose (MTD), Dose Limiting Toxicity (DLT) andrecommended Phase 2 dose of radiation therapy administered in combination with ipilimumab.

Outcome Time Frame:

between week 4 and week 10

Safety Issue:

Yes

Authority:

France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Study ID:

CSET 2010/1663 -Mel-Ipi-Rx

NCT ID:

NCT01557114

Start Date:

March 2011

Completion Date:

March 2014

Related Keywords:

  • Malignant Melanoma
  • unresectable Stage III or stage IV advanced malignant melanoma
  • Melanoma

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