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A Phase II Trial of Stereotactic Body Radiotherapy With Concurrent Anti-PD1 Treatment in Metastatic Melanoma.

Primary Purpose

Melanoma

Status
Completed
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
stereotactic body radiotherapy
Sponsored by
University Hospital, Ghent
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma

Eligibility Criteria

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

Inclusion Criteria:

  • Before patient registration, written informed consent must be given according to ICH/GCP, and national/local regulations.
  • Histologically confirmed diagnosis of melanoma
  • At least 3 extracranial measurable metastatic lesions per RECIST v1.1. All radiology studies must be performed within 28 days prior to registration
  • First line anti-PD1 treatment.
  • Karnofsky Performance status > 60
  • Age 18 years or older
  • Female participants of childbearing potential must be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study treatment
  • Female participants who are breastfeeding or plan to breastfeed should be instructed to discontinue nursing during treatment.
  • Male participants must agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study treatment
  • Demonstrate adequate organ function defined as the following:

    • AST and ALT ≤2.5 X ULN or ≤5 X ULN with liver metastases
    • Serum total bilirubin ≤1.5 X ULN or direct bilirubin ≤ULN for patient with total bilirubin level >1.5 ULN
    • Serum creatinine ≤1.5 X ULN
    • Absolute neutrophil count >1,000 /mcL
    • Platelets >75,000 /mcL
    • Hemoglobin >9 g/dL or > 5.6 mmol/L
  • No history of active autoimmune disease requiring systemic treatment within the past 3 months or documented history of clinically severe autoimmune disease, or syndrome that requires systemic steroids or immunosuppressive agents
  • Prior malignancy: Subjects who have had another malignancy should be disease-free for 5 years, or should have a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma
  • No evidence of interstitial lung disease
  • No uncontrolled central nervous metastases and/or carcinomatous meningitis.
  • No prior radiotherapy interfering with SBRT.
  • No concomitant therapy with IL-2, interferon, other immunotherapy regimens, chemotherapy, immunosuppressive agent or chronic use of systemic corticosteroids.
  • No active infection requiring systemic therapy
  • No known history of human immunodeficiency virus (HIV)
  • No known active Hepatitis B or Hepatitis C
  • Did not receive a live vaccine within 30 days prior to start of study treatment
  • No mental condition rendering the patient unable to understand the nature, scope and possible consequences of the study
  • Patient not unlikely to comply with the protocol; i.e. uncooperative attitude, inability to return for follow-up visits, and unlikely to complete the study

Sites / Locations

  • University Hospital Ghent

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Anti-PD1 treatment in combination with SBRT

Arm Description

Patients receiving anti-PD1 treatment will be treated with high-dose radiotherapy to one lesion in 3 fractions prior to the second cycle of systemic therapy.

Outcomes

Primary Outcome Measures

Efficacy
Objective responses will be measured using RECIST v1.1. Objective responses will be defined as the number of patients with complete or partial responses as best response during follow-up.

Secondary Outcome Measures

Immunologic responses
Immunologic responses will be assessed using peripheral blood samples, analyzed with FACS phenotyping, functional testing and ELISA. Changes in immunological parameters in tissue will be analyzed using immunohistochemistry.

Full Information

First Posted
June 24, 2016
Last Updated
December 28, 2022
Sponsor
University Hospital, Ghent
Collaborators
GZA Ziekenhuizen Campus Sint-Augustinus
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1. Study Identification

Unique Protocol Identification Number
NCT02821182
Brief Title
A Phase II Trial of Stereotactic Body Radiotherapy With Concurrent Anti-PD1 Treatment in Metastatic Melanoma.
Official Title
A Phase II Trial of Stereotactic Body Radiotherapy With Concurrent Anti-PD1 Treatment in Metastatic Melanoma.
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
September 1, 2016 (Actual)
Primary Completion Date
September 9, 2018 (Actual)
Study Completion Date
December 31, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Hospital, Ghent
Collaborators
GZA Ziekenhuizen Campus Sint-Augustinus

4. Oversight

5. Study Description

Brief Summary
We hypothesize that combining anti-PD1 treatment with radiotherapy might result in improved clinical response rates and PFS compared to anti-PD1 treatment in monotherapy. The current phase II trial aims at exploring the suggested benefits of the combination and aims to improve local and distant tumour responses by exploiting the pro-immunogenic effects of radiotherapy in addition to anti-PD1 treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Anti-PD1 treatment in combination with SBRT
Arm Type
Experimental
Arm Description
Patients receiving anti-PD1 treatment will be treated with high-dose radiotherapy to one lesion in 3 fractions prior to the second cycle of systemic therapy.
Intervention Type
Radiation
Intervention Name(s)
stereotactic body radiotherapy
Intervention Description
In patients with metastatic melanoma, anti-PD-1 treatment will be combined with stereotactic body radiotherapy (SBRT). A total dose of 24 Gy SBRT will be delivered in 3 fractions to one measurable lesion and fractions will be separated >48h and <96h.
Primary Outcome Measure Information:
Title
Efficacy
Description
Objective responses will be measured using RECIST v1.1. Objective responses will be defined as the number of patients with complete or partial responses as best response during follow-up.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Immunologic responses
Description
Immunologic responses will be assessed using peripheral blood samples, analyzed with FACS phenotyping, functional testing and ELISA. Changes in immunological parameters in tissue will be analyzed using immunohistochemistry.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Before patient registration, written informed consent must be given according to ICH/GCP, and national/local regulations. Histologically confirmed diagnosis of melanoma At least 3 extracranial measurable metastatic lesions per RECIST v1.1. All radiology studies must be performed within 28 days prior to registration First line anti-PD1 treatment. Karnofsky Performance status > 60 Age 18 years or older Female participants of childbearing potential must be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study treatment Female participants who are breastfeeding or plan to breastfeed should be instructed to discontinue nursing during treatment. Male participants must agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study treatment Demonstrate adequate organ function defined as the following: AST and ALT ≤2.5 X ULN or ≤5 X ULN with liver metastases Serum total bilirubin ≤1.5 X ULN or direct bilirubin ≤ULN for patient with total bilirubin level >1.5 ULN Serum creatinine ≤1.5 X ULN Absolute neutrophil count >1,000 /mcL Platelets >75,000 /mcL Hemoglobin >9 g/dL or > 5.6 mmol/L No history of active autoimmune disease requiring systemic treatment within the past 3 months or documented history of clinically severe autoimmune disease, or syndrome that requires systemic steroids or immunosuppressive agents Prior malignancy: Subjects who have had another malignancy should be disease-free for 5 years, or should have a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma No evidence of interstitial lung disease No uncontrolled central nervous metastases and/or carcinomatous meningitis. No prior radiotherapy interfering with SBRT. No concomitant therapy with IL-2, interferon, other immunotherapy regimens, chemotherapy, immunosuppressive agent or chronic use of systemic corticosteroids. No active infection requiring systemic therapy No known history of human immunodeficiency virus (HIV) No known active Hepatitis B or Hepatitis C Did not receive a live vaccine within 30 days prior to start of study treatment No mental condition rendering the patient unable to understand the nature, scope and possible consequences of the study Patient not unlikely to comply with the protocol; i.e. uncooperative attitude, inability to return for follow-up visits, and unlikely to complete the study
Facility Information:
Facility Name
University Hospital Ghent
City
Gent
State/Province
West Vlaanderen
ZIP/Postal Code
9000
Country
Belgium

12. IPD Sharing Statement

Citations:
PubMed Identifier
28137295
Citation
De Wolf K, Kruse V, Sundahl N, van Gele M, Chevolet I, Speeckaert R, Brochez L, Ost P. A phase II trial of stereotactic body radiotherapy with concurrent anti-PD1 treatment in metastatic melanoma: evaluation of clinical and immunologic response. J Transl Med. 2017 Jan 31;15(1):21. doi: 10.1186/s12967-017-1123-x.
Results Reference
derived

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A Phase II Trial of Stereotactic Body Radiotherapy With Concurrent Anti-PD1 Treatment in Metastatic Melanoma.

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