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Yervoy With Sylatron Unresectable Stage 3 or 4 Melanoma

Primary Purpose

Melanoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Sylatron
Yervoy
Sponsored by
H. Lee Moffitt Cancer Center and Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma focused on measuring unresectable, stage 3, stage 4, autoimmune, antibodies

Eligibility Criteria

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

Inclusion Criteria:

  • Must have cytologically or histologically-confirmed and unresectable melanoma, previously untreated systemically other than a BRAF inhibitor for metastatic disease, meeting one of the following American Joint Committee on Cancer (AJCC) staging criteria: AJCC Stage IV (Tany,Nany,M1); AJCC Stage IIIB/C patients with unresectable nodal/locoregional involvement; Patients with cutaneous, ocular or mucosal melanoma are eligible
  • Must have adequate hepatic, renal and bone marrow function as defined by the following parameters obtained within 4 weeks prior to initiation of study treatment. Hematologic Criteria: white blood count (WBC) >/= 3.0 x 10^9/L, Platelet > 100 x 10^9/L, Hemoglobin >/= 9 g/dL or 5.6 mmol/L; Renal and Hepatic Functional Criteria: Serum creatinine < 2.0 mg/dL or < 140 μmol/L, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) < 2 times upper normal limit of laboratory normal (ULN)
  • Must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Must give informed consent according to institutional policy
  • Must be willing to give written informed consent and must be able to adhere to dose and visit schedules
  • Female patients of childbearing potential must be using a medically accepted method of birth control prior to Screening and agree to continue its use during the study or be surgically sterilized (e.g., hysterectomy or tubal ligation). Females of childbearing potential should be counseled in the appropriate use of birth control while in this study. Females who are not currently sexually active must agree and consent to use one of the above-mentioned methods should they become sexually active while participating in the study.
  • Female patients of childbearing potential must have a negative serum pregnancy test (beta-hCG) at Screening.

Exclusion Criteria:

  • Female patients who are pregnant, intend to become pregnant, or are nursing
  • Previously treated with interferon alpha 2b, Sylatron or Yervoy therapy for melanoma
  • Patients whose disease can be completely surgically resected
  • Have not recovered from the effects of recent surgery
  • Patients with a history of prior malignancy within the past 2 years other than surgically cured squamous or basal cell carcinoma of the skin, or cervical carcinoma in situ
  • Have severe cardiovascular disease, i.e., arrhythmias requiring chronic treatment, congestive heart failure (NYHA Class III or IV) or symptomatic ischemic heart disease
  • Patients with thyroid dysfunction not responsive to therapy
  • Patients who, in the opinion of the investigator, have uncontrolled diabetes mellitus
  • Suffering from an active autoimmune disease except medically controlled hypothyroidism and vitiligo
  • An active and/or uncontrolled infection, including active hepatitis
  • Have a history of seropositivity for HIV
  • Pre-existing psychiatric condition, including but not limited to: History of severe depression (including Hospitalization for depression, Electroconvulsive therapy for depression, Depression that resulted in a prolonged absence from work and/or significant disruption of daily functions); Suicidal of homicidal ideation and/or suicidal or homicidal attempt; History of severe psychiatric disorders (e.g., psychosis, post-traumatic stress disorder or mania); Past history or current use of lithium and/or antipsychotic drugs
  • A clinical diagnosis of substance abuse of the one or more of the following drugs, within the following timeframes, (not including time spent in detoxification, hospitalization or incarceration): Alcohol, intravenous drug use (IVDU), inhalational, psychotropics, narcotics, cocaine, prescription or over-the-counter drugs: within 1 year of the Screening visit; Receiving methadone, buprenorphine hydrochloride (HCL), and/or butorphanol tartrate within 1 year of Screening visit, unless participant has drug screen negative for other (non-narcotic) drugs documented in past year and repeated negative within 2 months of Screening visit; Multi-drug abuse (2 or more substances in 17a and 17b) within 3 years of Screening visit; If the patient's historic marijuana use is deemed excessive by the principal investigator (PI), or medically qualified individual or is interfering with the patient's life, then the patient is not eligible and should not be screened. If patient's marijuana use is not deemed excessive by PI and does not interfere with life, the patient must be instructed to discontinue any current use of recreational marijuana prior to entry into study.
  • Patients with a medical condition requiring chronic systemic corticosteroids
  • Known to be allergic to the drug substance or any of the excipients in the Sylatron or Yervoy formulation
  • Patients who are in a situation or have any condition that, in the opinion of the investigator, may interfere with optimal participation in the study
  • Have used any investigational drugs within 30 days of study entry
  • Are participating in any other clinical treatment study

Sites / Locations

  • H. Lee Moffitt Cancer Center and Research Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Yervoy with Sylatron

Arm Description

Participants are given Yervoy induction every 3 weeks for four doses, for 12 weeks, and all participants simultaneously receive Sylatron induction weekly, followed by Sylatron maintenance alone for up to 144 additional weeks (total 156 weeks = 3 years).

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD) of Sylatron
MTD of peginterferon alfa-2b (Sylatron) combined with Ipilimumab (Yervoy).
Maximum Tolerated Dose (MTD) of Ipilimumab
MTD of Ipilimumab (Yervoy) combined with peginterferon alfa-2b (Sylatron). To assess the safety, toxicities and tolerability of a regimen of 3 μg/kg weekly Sylatron with concurrent induction Yervoy at 3 mg/kg, then if well tolerated, at 10 mg/kg every three weeks four times, in participants with unresectable stages IIIC/IV melanoma, and to define a well tolerated dose of Yervoy in that combination.

Secondary Outcome Measures

Number of Participants With Overall Response (OR)
Overall Response: Complete Response (CR) + Partial Response (PR) by immune-related response criteria (irRC). Immune Related CR (irCR): Complete disappearance of all lesions (whether measurable or not, and no new lesions, and confirmation by a repeat consecutive assessment no less than 4 weeks from date first documented. Immure Related PR (irPR): decrease in tumor burden >50% relative to baseline confirmed by repeat consecutive assessment at least 4 weeks later.
Progression Free Survival (PFS)
Immune Related Progressive Disease (irPD): increase in tumor burden >25% relative to nadir (minimum recorded tumor burden) confirmed by repeat consecutive assessment at least 4 weeks later.
Overall Survival (OS)
OS: The length of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive.
Treatment Related Adverse Events (AEs) - Grade 3 to 5
Percentage of participants with treatment related AEs, Grade 3 to 5. All adverse events, regardless of causality are also reported in the Serious Adverse Event/Other Adverse Event reporting area.

Full Information

First Posted
December 19, 2011
Last Updated
March 20, 2017
Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01496807
Brief Title
Yervoy With Sylatron Unresectable Stage 3 or 4 Melanoma
Official Title
A Phase Ib Study of Yervoy With Sylatron for Patients With Unresectable Stages IIIB/C/IV Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Completed
Study Start Date
February 17, 2012 (undefined)
Primary Completion Date
March 16, 2016 (Actual)
Study Completion Date
August 29, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
H. Lee Moffitt Cancer Center and Research Institute
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to see how much of the drug Yervoy can be safely tolerated when it is given to people who are also receiving a drug called Sylatron. Investigators also wish to find out whether the addition of Yervoy increases the chance that Sylatron will cause a rise in the level of antibodies in the patient's blood that recognize their own tissues, known as "autoimmune" antibodies. Investigators also want to find out how likely it is that their tumor will shrink.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma
Keywords
unresectable, stage 3, stage 4, autoimmune, antibodies

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
31 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Yervoy with Sylatron
Arm Type
Experimental
Arm Description
Participants are given Yervoy induction every 3 weeks for four doses, for 12 weeks, and all participants simultaneously receive Sylatron induction weekly, followed by Sylatron maintenance alone for up to 144 additional weeks (total 156 weeks = 3 years).
Intervention Type
Drug
Intervention Name(s)
Sylatron
Other Intervention Name(s)
PEG-Intron
Intervention Description
Sylatron - Once per week for 12 weeks, given as an injection under the skin.
Intervention Type
Drug
Intervention Name(s)
Yervoy
Other Intervention Name(s)
Ipilimumab
Intervention Description
Yervoy - Once every 3 weeks for 12 weeks (4 times total), given over a 90-minute intravenous infusion (through the vein).
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD) of Sylatron
Description
MTD of peginterferon alfa-2b (Sylatron) combined with Ipilimumab (Yervoy).
Time Frame
Up to 48 Months
Title
Maximum Tolerated Dose (MTD) of Ipilimumab
Description
MTD of Ipilimumab (Yervoy) combined with peginterferon alfa-2b (Sylatron). To assess the safety, toxicities and tolerability of a regimen of 3 μg/kg weekly Sylatron with concurrent induction Yervoy at 3 mg/kg, then if well tolerated, at 10 mg/kg every three weeks four times, in participants with unresectable stages IIIC/IV melanoma, and to define a well tolerated dose of Yervoy in that combination.
Time Frame
Up to 48 Months
Secondary Outcome Measure Information:
Title
Number of Participants With Overall Response (OR)
Description
Overall Response: Complete Response (CR) + Partial Response (PR) by immune-related response criteria (irRC). Immune Related CR (irCR): Complete disappearance of all lesions (whether measurable or not, and no new lesions, and confirmation by a repeat consecutive assessment no less than 4 weeks from date first documented. Immure Related PR (irPR): decrease in tumor burden >50% relative to baseline confirmed by repeat consecutive assessment at least 4 weeks later.
Time Frame
Up to 54 Months
Title
Progression Free Survival (PFS)
Description
Immune Related Progressive Disease (irPD): increase in tumor burden >25% relative to nadir (minimum recorded tumor burden) confirmed by repeat consecutive assessment at least 4 weeks later.
Time Frame
Up to 54 Months
Title
Overall Survival (OS)
Description
OS: The length of time from either the date of diagnosis or the start of treatment for a disease, such as cancer, that patients diagnosed with the disease are still alive.
Time Frame
Up to 54 Months
Title
Treatment Related Adverse Events (AEs) - Grade 3 to 5
Description
Percentage of participants with treatment related AEs, Grade 3 to 5. All adverse events, regardless of causality are also reported in the Serious Adverse Event/Other Adverse Event reporting area.
Time Frame
4 Years, 1 Month
Other Pre-specified Outcome Measures:
Title
Count of Participants Developing Positive Autoantibody Screen
Description
Number of participants who developed a positive result during treatment for one or more antibodies of a previously negative screen. This study was not designed to statistically test the efficacy of treatment, and no inferential analyses will be performed. Investigators planned to look for evidence of serologic and clinical autoimmunity.
Time Frame
Up to 54 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Must have cytologically or histologically-confirmed and unresectable melanoma, previously untreated systemically other than a BRAF inhibitor for metastatic disease, meeting one of the following American Joint Committee on Cancer (AJCC) staging criteria: AJCC Stage IV (Tany,Nany,M1); AJCC Stage IIIB/C patients with unresectable nodal/locoregional involvement; Patients with cutaneous, ocular or mucosal melanoma are eligible Must have adequate hepatic, renal and bone marrow function as defined by the following parameters obtained within 4 weeks prior to initiation of study treatment. Hematologic Criteria: white blood count (WBC) >/= 3.0 x 10^9/L, Platelet > 100 x 10^9/L, Hemoglobin >/= 9 g/dL or 5.6 mmol/L; Renal and Hepatic Functional Criteria: Serum creatinine < 2.0 mg/dL or < 140 μmol/L, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) < 2 times upper normal limit of laboratory normal (ULN) Must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Must give informed consent according to institutional policy Must be willing to give written informed consent and must be able to adhere to dose and visit schedules Female patients of childbearing potential must be using a medically accepted method of birth control prior to Screening and agree to continue its use during the study or be surgically sterilized (e.g., hysterectomy or tubal ligation). Females of childbearing potential should be counseled in the appropriate use of birth control while in this study. Females who are not currently sexually active must agree and consent to use one of the above-mentioned methods should they become sexually active while participating in the study. Female patients of childbearing potential must have a negative serum pregnancy test (beta-hCG) at Screening. Exclusion Criteria: Female patients who are pregnant, intend to become pregnant, or are nursing Previously treated with interferon alpha 2b, Sylatron or Yervoy therapy for melanoma Patients whose disease can be completely surgically resected Have not recovered from the effects of recent surgery Patients with a history of prior malignancy within the past 2 years other than surgically cured squamous or basal cell carcinoma of the skin, or cervical carcinoma in situ Have severe cardiovascular disease, i.e., arrhythmias requiring chronic treatment, congestive heart failure (NYHA Class III or IV) or symptomatic ischemic heart disease Patients with thyroid dysfunction not responsive to therapy Patients who, in the opinion of the investigator, have uncontrolled diabetes mellitus Suffering from an active autoimmune disease except medically controlled hypothyroidism and vitiligo An active and/or uncontrolled infection, including active hepatitis Have a history of seropositivity for HIV Pre-existing psychiatric condition, including but not limited to: History of severe depression (including Hospitalization for depression, Electroconvulsive therapy for depression, Depression that resulted in a prolonged absence from work and/or significant disruption of daily functions); Suicidal of homicidal ideation and/or suicidal or homicidal attempt; History of severe psychiatric disorders (e.g., psychosis, post-traumatic stress disorder or mania); Past history or current use of lithium and/or antipsychotic drugs A clinical diagnosis of substance abuse of the one or more of the following drugs, within the following timeframes, (not including time spent in detoxification, hospitalization or incarceration): Alcohol, intravenous drug use (IVDU), inhalational, psychotropics, narcotics, cocaine, prescription or over-the-counter drugs: within 1 year of the Screening visit; Receiving methadone, buprenorphine hydrochloride (HCL), and/or butorphanol tartrate within 1 year of Screening visit, unless participant has drug screen negative for other (non-narcotic) drugs documented in past year and repeated negative within 2 months of Screening visit; Multi-drug abuse (2 or more substances in 17a and 17b) within 3 years of Screening visit; If the patient's historic marijuana use is deemed excessive by the principal investigator (PI), or medically qualified individual or is interfering with the patient's life, then the patient is not eligible and should not be screened. If patient's marijuana use is not deemed excessive by PI and does not interfere with life, the patient must be instructed to discontinue any current use of recreational marijuana prior to entry into study. Patients with a medical condition requiring chronic systemic corticosteroids Known to be allergic to the drug substance or any of the excipients in the Sylatron or Yervoy formulation Patients who are in a situation or have any condition that, in the opinion of the investigator, may interfere with optimal participation in the study Have used any investigational drugs within 30 days of study entry Are participating in any other clinical treatment study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andrew Brohl, M.D., Ph.D.
Organizational Affiliation
H. Lee Moffitt Cancer Center and Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
H. Lee Moffitt Cancer Center and Research Institute
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
28031816
Citation
Brohl AS, Khushalani NI, Eroglu Z, Markowitz J, Thapa R, Chen YA, Kudchadkar R, Weber JS. A phase IB study of ipilimumab with peginterferon alfa-2b in patients with unresectable melanoma. J Immunother Cancer. 2016 Dec 20;4:85. doi: 10.1186/s40425-016-0194-1. eCollection 2016.
Results Reference
derived
Links:
URL
http://www.readcube.com/articles/10.1186/s40425-016-0194-1?author_access_token=q4OsayXrovStniJBXf5KJW_BpE1tBhCbnbw3BuzI2RPgg2JIGHBI3V3-ffseGUyjAuw9rUiDlEJbtg5ZLnbOf6_A1R3uJM6OsFjtrfI8OCUCx0vfNVtKTA0zp40r-hd7eg9LOaU91RAq_c6MepNx4Q%3D%3D
Description
A phase IB study of ipilimumab with peginterferon alfa-2b in patients with unresectable melanoma

Learn more about this trial

Yervoy With Sylatron Unresectable Stage 3 or 4 Melanoma

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