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Clinical Study Phase II of L19IL2 in Combination With Dacarbazine in Patients With Metastatic Melanoma

Primary Purpose

Metastatic Melanoma

Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Arm 1: L19IL2 + Dacarbazine
Arm 3: Dacarbazine
ARM 2: L19IL2 + Dacarbazine
Sponsored by
Philogen S.p.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Melanoma focused on measuring Interleukin, IL2, monoclonal, antibody, cytokine, Dacarbazine, metastatic, melanoma, tumor targeting, Dose definition, , L19

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically or cytologically confirmed unresectable metastatic (stage IV) non-uveal melanoma
  • Age > 18 years
  • Measurable disease defined as at least one lesion that can be accurately and serially measured per the modified RECIST criteria. Cutaneous lesions measuring at least 1 cm will be considered measurable.
  • Prior therapy for metastatic melanoma:

    • Phase IIa - Dose definition: prior therapy allowed, including prior chemotherapy; previous treatment with DTIC: patients should be treated > 6 months prior to study entry
    • Phase IIb -Activity Evaluation: no prior therapy except radiation. However, if radiation has been administered to a lesion, there must be radiographic evidence of progression of that lesion in order for that lesion to constitute measurable disease or to be included in the measured target lesions
  • Fewer than 3 organs involved or cutaneous and/or subcutaneous metastasis only, for PhaseIIb patients
  • ECOG performance status < 2
  • Life expectancy of at least 12 weeks
  • Absolute neutrophil count > 1.5 x 109/L, hemoglobin > 9.0 g/dL and platelets > 100 x 109/L
  • Total bilirubin ≤ 30 µmol/L (or ≤ 2.0 mg/Dl)
  • ALT and AST ≤ 2.5 x the upper limit of normal (5.0 x ULN for patients with hepatic involvement with tumor
  • LDH < 2.0 x ULN for Phase IIa patients and normal LDH for the Phase IIb ones.
  • Serum creatinine < 1.5 x ULN
  • All toxic effects of prior therapy must have resolved to ≤ Grade 1 unless otherwise specified above
  • Negative serum pregnancy test (for women of child-bearing potential only) at screening

Exclusion criteria:

  • Primary ocular melanoma
  • Evidence of brain metastases, negative CT scan within two months before study commence
  • Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study except cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors (TA, Tis & Ti) or any cancer curatively treated < 5 years prior to study entry
  • History of HIV infection or chronic hepatitis B or C
  • Presence of active infections (e.g. requiring antimicrobial therapy) or other severe concurrent disease, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study.
  • Inadequately controlled cardiac arrhythmias including atrial fibrillation
  • History within the last year of acute or subacute coronary syndromes including myocardial infarction, unstable or severe stable angina pectoris.
  • Heart insufficiency (> Grade II, New York Heart Association (NYHA) criteria).
  • Uncontrolled hypertension.
  • Ischemic peripheral vascular disease (Grade Iib-IV).
  • Severe diabetic retinopathy.
  • Active autoimmune disease
  • History of organ allograft or stem cell transplantation.
  • Recovery from major trauma including surgery within 4 weeks prior to administration of study treatment.
  • Known history of allergy to IL2, dacarbazine, or other intravenously administered human proteins/peptides/antibodies.
  • Breast feeding female.
  • Anti-tumor therapy within 4 weeks of the administration of study treatment.
  • Previous in vivo exposure to monoclonal antibodies for biological therapy in the 6 weeks before administration of study treatment.
  • Previous DTIC treatment in the last 6 months prior to study entry
  • Growth factors or immunomodulatory agents within 7 days of the administration of study treatment.
  • Patient requires or is taking corticosteroids or other immunosuppressant drugs on a long-term basis. Limited use of corticosteroids to treat or prevent acute hypersensitivity reactions is not considered an exclusion criterion.
  • Any conditions that in the opinion of the investigator could hamper compliance with the study protocol.

Sites / Locations

  • Universitätsklinik Graz
  • Charité- Universitätsmedizin Berlin
  • Universitätsklinikum Schleswig-Holstein-Campus Kiel
  • University Hospital
  • University Hospital Pisa
  • A.O. UNIVERSITARIA OSPEDALI RIUNITI - OSPEDALE UMBERTO I DI ANCONA - ANCONA (AN) (Italy)
  • European Institute of Oncology
  • Istituto Nazionale Per Lo Studio E La Cura Dei Tumori Fondazione Giovanni Pascale Di Napoli
  • Azienda Ospedaliera Universitaria Senese
  • Universitäts Spital Zürich

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

ARM 1: L19IL2 + Dacarbazin

ARM 2: L19IL2 + Dacarbazin

ARM 3: Dacarbazin

Arm Description

DTIC every three weeks until disease progression, unacceptable toxicity, withdrawal of consent, or for a maximum of 8 cycles, whichever occurs first

Outcomes

Primary Outcome Measures

To establish the recommended dose (RD) of L19IL2 when administered in combination with a fixed dose of Dacarbazine
To evaluate Objective response rate (ORR) by CT or MRI

Secondary Outcome Measures

To investigate the Pharmacokinetics of L19IL2, dacarbazine and 5-aminoimidazole -4 carboxamide (AIC).
To investigate the induction of human anti-fusion protein antibodies (HAFA)
To investigate Antitumor activity of L19IL2 with dacarbazine in patients with metastatic melanoma by TC or MRI
Evaluation of the immunological activity of study treatment
To estimate progression -free survival (PFS)
To estimate overall survival (OS)
To assess safety and tolerability

Full Information

First Posted
January 22, 2010
Last Updated
February 24, 2014
Sponsor
Philogen S.p.A.
Collaborators
Eudax S.r.l.
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1. Study Identification

Unique Protocol Identification Number
NCT01055522
Brief Title
Clinical Study Phase II of L19IL2 in Combination With Dacarbazine in Patients With Metastatic Melanoma
Official Title
Dose Definition and Activity Evaluation Study of the Tumor-Targeting Human L19IL2 Monoclonal Antibody-Cytokine Fusion Protein in Combination With Dacarbazine in Patients With Metastatic Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
October 2012
Overall Recruitment Status
Terminated
Study Start Date
June 2008 (undefined)
Primary Completion Date
February 2013 (Actual)
Study Completion Date
February 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Philogen S.p.A.
Collaborators
Eudax S.r.l.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This Phase II clinical study is an open-label, multicenter study of L19IL2 in combination with Dacarbazine in patients with metastatic melanoma. The study is divided in two parts: a phase IIa part, designed to establish the recommended dose (RD) of L19IL2 when administered in combination with a fixed dose of Dacarbazine, as well as to determine the preliminary tolerability profile; the second phase IIb part evaluates the objective response rate (ORR) including a randomized study with a fixed dose of Dacarbazine with or without L19IL2, dosed at the RD determined in phase IIa.
Detailed Description
Dose limiting toxicity will be assessed during the dose-escalation part of Phase IIa from day 1 through day 21 of the first cycle. Response will be measured using RECIST criteria every 6 weeks (after every 2 cycles of treatment). Patients with stable or responding disease at each assessment may receive additional treatment for a maximum of 6 cycles of induction. Patients with stable or responding disease after induction may receive L19IL2 (without dacarbazine) every 2 weeks as maintenance therapy. Tumor expression of ED-B FN and tumor uptake of L19IL2 and of Dacarbazine will be assessed via immunohistochemistry and/or other methods deemed appropriate on tumor tissue biopsies. Tumor biopsy will be performed on superficial accessible cutaneous and/or subcutaneous lesions only. Tumor biopsy will be considered optional and will not preclude patient entry on to study should the patient refuse. Pharmacokinetics of L19IL2, Dacarbazine and AIC will be assessed from serial blood samples using standard methods. Overall response rate, PFS, survival rate at 6 and 12 months, and overall survival time for all patients and separately for the patients in the Phase IIb part will be assessed using standard methods.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metastatic Melanoma
Keywords
Interleukin, IL2, monoclonal, antibody, cytokine, Dacarbazine, metastatic, melanoma, tumor targeting, Dose definition, , L19

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
102 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ARM 1: L19IL2 + Dacarbazin
Arm Type
Experimental
Arm Title
ARM 2: L19IL2 + Dacarbazin
Arm Type
Experimental
Arm Title
ARM 3: Dacarbazin
Arm Type
Active Comparator
Arm Description
DTIC every three weeks until disease progression, unacceptable toxicity, withdrawal of consent, or for a maximum of 8 cycles, whichever occurs first
Intervention Type
Drug
Intervention Name(s)
Arm 1: L19IL2 + Dacarbazine
Intervention Description
RD of L19IL2 determined in phase IIa. Induction Phase A: Intravenous (IV) infusion of L19IL2 on days 1, 3 and 5 of each 21-day cycle over 60 minutes via automated device (perfusor), for four consecutive 21-day cycles. Induction Phase B: Intravenous (IV) infusion of L19IL2 on days 1, 8 and 15 of each 21-day cycle over 60 minutes via automated device (perfusor), for four consecutive 21-day cycles. Maintenance: Intravenous (IV) infusion of L19IL2 on days 1, 8 and 15 of each 21-day cycle over 60 minutes via automated device (perfusor), for a maximum of 1 year after start of treatment. DTIC 1,000mg/m2 every three weeks until disease progression, unacceptable toxicity, withdrawal of consent, or one year from initiation of therapy, whichever occurs first
Intervention Type
Drug
Intervention Name(s)
Arm 3: Dacarbazine
Other Intervention Name(s)
DETICENE®
Intervention Description
Dacarbazine Dosage: 1,000 mg/m2 DTIC every three weeks until disease progression, unacceptable toxicity, withdrawal of consent, or for a maximum of 8 cycles, whichever occurs first.
Intervention Type
Drug
Intervention Name(s)
ARM 2: L19IL2 + Dacarbazine
Intervention Description
RD of L19IL2 determined in phase IIa. Intravenous (IV) infusion of L19IL2 on days 1, 8 and 15 of each 21-day cycle over 60 minutes via automated device (perfusor), for for a maximum of 1 year after start of treatment. DTIC 1,000mg/m2 every three weeks until disease progression, unacceptable toxicity, withdrawal of consent, or one year from initiation of therapy, whichever occurs first
Primary Outcome Measure Information:
Title
To establish the recommended dose (RD) of L19IL2 when administered in combination with a fixed dose of Dacarbazine
Time Frame
21 days
Title
To evaluate Objective response rate (ORR) by CT or MRI
Time Frame
18 weeks
Secondary Outcome Measure Information:
Title
To investigate the Pharmacokinetics of L19IL2, dacarbazine and 5-aminoimidazole -4 carboxamide (AIC).
Time Frame
42 days
Title
To investigate the induction of human anti-fusion protein antibodies (HAFA)
Time Frame
1 year
Title
To investigate Antitumor activity of L19IL2 with dacarbazine in patients with metastatic melanoma by TC or MRI
Time Frame
18 weeks
Title
Evaluation of the immunological activity of study treatment
Time Frame
1 year
Title
To estimate progression -free survival (PFS)
Time Frame
1 year
Title
To estimate overall survival (OS)
Time Frame
1 year
Title
To assess safety and tolerability
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically or cytologically confirmed unresectable metastatic (stage IV) non-uveal melanoma Age > 18 years Measurable disease defined as at least one lesion that can be accurately and serially measured per the modified RECIST criteria. Cutaneous lesions measuring at least 1 cm will be considered measurable. Prior therapy for metastatic melanoma: Phase IIa - Dose definition: prior therapy allowed, including prior chemotherapy; previous treatment with DTIC: patients should be treated > 6 months prior to study entry Phase IIb -Activity Evaluation: no prior therapy except radiation. However, if radiation has been administered to a lesion, there must be radiographic evidence of progression of that lesion in order for that lesion to constitute measurable disease or to be included in the measured target lesions Fewer than 3 organs involved or cutaneous and/or subcutaneous metastasis only, for PhaseIIb patients ECOG performance status < 2 Life expectancy of at least 12 weeks Absolute neutrophil count > 1.5 x 109/L, hemoglobin > 9.0 g/dL and platelets > 100 x 109/L Total bilirubin ≤ 30 µmol/L (or ≤ 2.0 mg/Dl) ALT and AST ≤ 2.5 x the upper limit of normal (5.0 x ULN for patients with hepatic involvement with tumor LDH < 2.0 x ULN for Phase IIa patients and normal LDH for the Phase IIb ones. Serum creatinine < 1.5 x ULN All toxic effects of prior therapy must have resolved to ≤ Grade 1 unless otherwise specified above Negative serum pregnancy test (for women of child-bearing potential only) at screening Exclusion criteria: Primary ocular melanoma Evidence of brain metastases, negative CT scan within two months before study commence Previous or concurrent cancer that is distinct in primary site or histology from the cancer being evaluated in this study except cervical carcinoma in situ, treated basal cell carcinoma, superficial bladder tumors (TA, Tis & Ti) or any cancer curatively treated < 5 years prior to study entry History of HIV infection or chronic hepatitis B or C Presence of active infections (e.g. requiring antimicrobial therapy) or other severe concurrent disease, which, in the opinion of the investigator, would place the patient at undue risk or interfere with the study. Inadequately controlled cardiac arrhythmias including atrial fibrillation History within the last year of acute or subacute coronary syndromes including myocardial infarction, unstable or severe stable angina pectoris. Heart insufficiency (> Grade II, New York Heart Association (NYHA) criteria). Uncontrolled hypertension. Ischemic peripheral vascular disease (Grade Iib-IV). Severe diabetic retinopathy. Active autoimmune disease History of organ allograft or stem cell transplantation. Recovery from major trauma including surgery within 4 weeks prior to administration of study treatment. Known history of allergy to IL2, dacarbazine, or other intravenously administered human proteins/peptides/antibodies. Breast feeding female. Anti-tumor therapy within 4 weeks of the administration of study treatment. Previous in vivo exposure to monoclonal antibodies for biological therapy in the 6 weeks before administration of study treatment. Previous DTIC treatment in the last 6 months prior to study entry Growth factors or immunomodulatory agents within 7 days of the administration of study treatment. Patient requires or is taking corticosteroids or other immunosuppressant drugs on a long-term basis. Limited use of corticosteroids to treat or prevent acute hypersensitivity reactions is not considered an exclusion criterion. Any conditions that in the opinion of the investigator could hamper compliance with the study protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Chiara Matilde Catania, Dr
Organizational Affiliation
European Istitute of Oncology Milan (Italy)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Claus Garbe, Prof. M.D.
Organizational Affiliation
University Hospital Tuebingen (Germany)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsklinik Graz
City
Graz
Country
Austria
Facility Name
Charité- Universitätsmedizin Berlin
City
Berlin
Country
Germany
Facility Name
Universitätsklinikum Schleswig-Holstein-Campus Kiel
City
Kiel
Country
Germany
Facility Name
University Hospital
City
Tuebingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
University Hospital Pisa
City
Pisa
State/Province
Tuscany
ZIP/Postal Code
56126
Country
Italy
Facility Name
A.O. UNIVERSITARIA OSPEDALI RIUNITI - OSPEDALE UMBERTO I DI ANCONA - ANCONA (AN) (Italy)
City
Ancona
Country
Italy
Facility Name
European Institute of Oncology
City
Milan
ZIP/Postal Code
20141
Country
Italy
Facility Name
Istituto Nazionale Per Lo Studio E La Cura Dei Tumori Fondazione Giovanni Pascale Di Napoli
City
Napoli
Country
Italy
Facility Name
Azienda Ospedaliera Universitaria Senese
City
Siena
Country
Italy
Facility Name
Universitäts Spital Zürich
City
Zürich
Country
Switzerland

12. IPD Sharing Statement

Citations:
PubMed Identifier
22028492
Citation
Eigentler TK, Weide B, de Braud F, Spitaleri G, Romanini A, Pflugfelder A, Gonzalez-Iglesias R, Tasciotti A, Giovannoni L, Schwager K, Lovato V, Kaspar M, Trachsel E, Menssen HD, Neri D, Garbe C. A dose-escalation and signal-generating study of the immunocytokine L19-IL2 in combination with dacarbazine for the therapy of patients with metastatic melanoma. Clin Cancer Res. 2011 Dec 15;17(24):7732-42. doi: 10.1158/1078-0432.CCR-11-1203. Epub 2011 Oct 25.
Results Reference
derived

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Clinical Study Phase II of L19IL2 in Combination With Dacarbazine in Patients With Metastatic Melanoma

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