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Bevacizumab Plus Ipilimumab in Patients With Unresectable Stage III or IV Melanoma

Primary Purpose

Melanoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Bevacizumab Plus Ipilimumab Cohort 1
Bevacizumab Plus Ipilimumab Cohort 2
Bevacizumab Plus Ipilimumab Cohort 3
Bevacizumab Plus Ipilimumab Cohort 4
Sponsored by
Dana-Farber Cancer Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring bevacizumab, ipilimumab, unresectable stage III melanoma, unresectable stage IV melanoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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
  • NYHA Grade II or greater congestive heart failure
  • History of myocardial infarction or unstable angina within 6 months prior to study enrollment
  • History of stroke of transient ischemic attack within 6 months prior to study enrollment
  • Significant known vascular disease
  • Symptomatic peripheral vascular disease
  • Evidence of bleeding diathesis or coagulopathy
  • Major surgical procedure or significant traumatic injury within 28 days prior to study enrollment
  • Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to study enrollment
  • History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrollment
  • Serious, non-healing wound, ulcer or bone fracture
  • Proteinuria at screening
  • Known hypersensitivity to any component of bevacizumab
  • History of hemoptysis within 3 months prior to study enrollment
  • Current, ongoing treatment with full-dose warfarin or its equivalent
  • Current or recent (within 10 days of enrollment) use of aspirin (>325mg/day) or chronic use of other NSAIDs
  • Medications that inhibit platelet function
  • Known involvement of melanoma within gastrointestinal tract
  • Ulcerated skin lesions

Sites / Locations

  • Beth Israel Deaconess Medical Center
  • Dana-Farber Cancer Institute
  • Massachusetts General Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Bevacizumab Plus Ipilimumab Cohort 1

Bevacizumab Plus Ipilimumab Cohort 2

Bevacizumab Plus Ipilimumab Cohort 3

Bevacizumab Plus Ipilimumab Cohort 4

Arm Description

5 subjects for this cohort

17 subects for this cohort

12 subjects

12 subjects

Outcomes

Primary Outcome Measures

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

Secondary Outcome Measures

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
To perform correlative studies investigating the effects of this combination therapy on antitumor immunity and tumor vasculature

Full Information

First Posted
November 12, 2008
Last Updated
May 9, 2023
Sponsor
Dana-Farber Cancer Institute
Collaborators
Genentech, Inc., Bristol-Myers Squibb
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1. Study Identification

Unique Protocol Identification Number
NCT00790010
Brief Title
Bevacizumab Plus Ipilimumab in Patients With Unresectable Stage III or IV Melanoma
Official Title
A Phase I Trial of Bevacizumab Plus Ipilimumab in Patients With Unresectable Stage III or IV Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Completed
Study Start Date
February 26, 2009 (Actual)
Primary Completion Date
June 22, 2018 (Actual)
Study Completion Date
June 22, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dana-Farber Cancer Institute
Collaborators
Genentech, Inc., Bristol-Myers Squibb

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma
Keywords
bevacizumab, ipilimumab, unresectable stage III melanoma, unresectable stage IV melanoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bevacizumab Plus Ipilimumab Cohort 1
Arm Type
Experimental
Arm Description
5 subjects for this cohort
Arm Title
Bevacizumab Plus Ipilimumab Cohort 2
Arm Type
Experimental
Arm Description
17 subects for this cohort
Arm Title
Bevacizumab Plus Ipilimumab Cohort 3
Arm Type
Experimental
Arm Description
12 subjects
Arm Title
Bevacizumab Plus Ipilimumab Cohort 4
Arm Type
Experimental
Arm Description
12 subjects
Intervention Type
Drug
Intervention Name(s)
Bevacizumab Plus Ipilimumab Cohort 1
Other Intervention Name(s)
Bevacizumab- also known as Avastin, Ipilimumab-also known as MDX-010 or MDX-101 & marketed as Yervoy
Intervention Description
Cohort 1: Ipilimumab 10 mg/kg IV every 3 weeks x 4 doses(induction), then every 3 months (maintenance); Bevacizumab 7.5 mg/kg IV every 3 weeks (continuous)
Intervention Type
Drug
Intervention Name(s)
Bevacizumab Plus Ipilimumab Cohort 2
Other Intervention Name(s)
Bevacizumab- also known as Avastin, Ipilimumab-also known as MDX-010 or MDX-101 & marketed as Yervoy
Intervention Description
Cohort 2: Ipilimumab 10 mg/kg IV every 3 weeks x 4 doses(induction), then every 3 months (maintenance); Bevacizumab 15 mg/kg IV every 3 weeks (continuous)
Intervention Type
Drug
Intervention Name(s)
Bevacizumab Plus Ipilimumab Cohort 3
Other Intervention Name(s)
Bevacizumab- also known as Avastin, Ipilimumab-also known as MDX-010 or MDX-101 & marketed as Yervoy
Intervention Description
Cohort 3: Ipilimumab 3 mg/kg IV every 3 weeks x 4 doses (induction), then every 3 months (maintenance); Bevacizumab 7.5 mg/kg IV every 3 weeks (continuous)
Intervention Type
Drug
Intervention Name(s)
Bevacizumab Plus Ipilimumab Cohort 4
Other Intervention Name(s)
Bevacizumab- also known as Avastin, Ipilimumab-also known as MDX-010 or MDX-101 & marketed as Yervoy
Intervention Description
Cohort 4: Ipilimumab 3 mg/kg IV every 3 weeks x 4 doses (induction), then every 3 months (maintenance); Bevacizumab 15 mg/kg IV every 3 weeks (continuous)
Primary Outcome Measure Information:
Title
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 Outcome Measure Information:
Title
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
Time Frame
3 years
Title
To perform correlative studies investigating the effects of this combination therapy on antitumor immunity and tumor vasculature
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
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 NYHA Grade II or greater congestive heart failure History of myocardial infarction or unstable angina within 6 months prior to study enrollment History of stroke of transient ischemic attack within 6 months prior to study enrollment Significant known vascular disease Symptomatic peripheral vascular disease Evidence of bleeding diathesis or coagulopathy Major surgical procedure or significant traumatic injury within 28 days prior to study enrollment Core biopsy or other minor surgical procedure, excluding placement of a vascular access device, within 7 days prior to study enrollment History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrollment Serious, non-healing wound, ulcer or bone fracture Proteinuria at screening Known hypersensitivity to any component of bevacizumab History of hemoptysis within 3 months prior to study enrollment Current, ongoing treatment with full-dose warfarin or its equivalent Current or recent (within 10 days of enrollment) use of aspirin (>325mg/day) or chronic use of other NSAIDs Medications that inhibit platelet function Known involvement of melanoma within gastrointestinal tract Ulcerated skin lesions
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
F. Stephen Hodi, MD
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02214
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Bevacizumab Plus Ipilimumab in Patients With Unresectable Stage III or IV Melanoma

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