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Low-dose Interleukin-2 and Pembrolizumab in Melanoma and Renal Cell Cancer (UVA-AM-002)

Primary Purpose

Carcinoma, Renal Cell, Melanoma

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Pembrolizumab
Interleukin-2
Sponsored by
William Grosh, MD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Carcinoma, Renal Cell focused on measuring pembrolizumab, IL-2, interleukin-2, MK-3475

Eligibility Criteria

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

Main Inclusion Criteria

  • Stage IV or unresectable stage III malignant melanoma or renal cell carcinoma.
  • Melanoma

    • Patients must have failed anti-PD-1/PD-L1 antibody therapy.
    • Patients must have failed ipilimumab or be intolerant of ipilimumab and therefore unable to receive ipilimumab.
    • Patients may, but are not obligated, to have failed high- dose IL2.
    • BRAF status must be known or unable to be performed. If the melanoma expresses a BRAF mutation of V600E, V600K, or V600R patient must have received and progressed through a BRAF inhibitor or have failed that therapy due to toxicity.
  • Renal Cell Carcinoma

    • Patients must have failed anti-PD-1/PD-L1 antibody therapy.
    • Patients must have failed a VEGF pathway inhibitor and a second tyrosine kinase inhibitor.
    • Patients may, but are not obligated, to have failed high- dose IL2.
  • Measurable disease based upon RECIST 1.1.
  • Subjects with brain metastases will be eligible if the following are true:
  • Subjects with ≤ 3 brain metastases

    • All metastases are ≤ 3 cm
    • All metastases have been treated and are asymptomatic
    • Steroids are not required for management of the brain metastases
    • All metastases have been stable for 1 month following treatment
  • Subjects with > 3 brain metastases

    • All metastases are ≤ 3 cm
    • All metastases have been treated and are asymptomatic
    • Steroids are not required for management of the brain metastases
    • All metastases have been stable for 6 months following treatment
  • Performance status: ECOG 0-1.
  • Adequate organ function.
  • Ability to provide informed consent.

Main Exclusion Criteria:

  • Pregnancy
  • Currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment.
  • Has a diagnosis of primary or secondary immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 3 weeks prior to the first dose of trial treatment. Replacement doses of steroids are permitted.
  • Known history of active TB (Bacillus Tuberculosis)
  • Hypersensitivity to pembrolizumab or any of its excipients.
  • Known additional malignancies (exceptions DCIS or LCIS, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy).
  • Prior anti-cancer monoclonal antibody (mAb) within 3 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 3 weeks earlier.
  • Prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent.
  • Known carcinomatous meningitis.
  • Active autoimmune disease that has required systemic treatment in the past 2 years. Patients may be eligible if they have the following autoimmune diseases: thyroiditis or hypothyroidism, mild arthritis, diabetes, resolved hypophysitis, ulcerative colitis after total abdominal colectomy.
  • Active infection requiring systemic therapy.
  • Known psychiatric or substance abuse disorders.
  • Known history of Human Immunodeficiency Virus (HIV).
  • Known active Hepatitis B virus (HBV) or Hepatitis C virus (HCV).
  • Has received a live vaccine within 30 days of planned start of study therapy.
  • Severe chronic pulmonary disease.
  • Congestive heart failure, angina, or symptomatic cardiac arrhythmia or is classified according to the New York Heart Association classification as having Class III or IV heart disease.
  • History of (non-infectious) pneumonitis that required steroids or current pneumonitis.

Sites / Locations

  • University of Virginia Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Level 1

Level -1

Arm Description

Pembrolizumab (200 mg) administered intravenously (day 2 of cycle 1; day 1 of cycles 2 and beyond); Low dose-interleukin 2 (LD-IL2) 12 MIU/m2 administered subcutaneously (days 1-5 and 8-12 of each cycle); each cycle is 21 days.

Pembrolizumab (200 mg) administered intravenously (day 2 of cycle 1; day 1 of cycles 2 and beyond); Low dose-interleukin 2 (LD-IL2) 5 MIU/m2 administered subcutaneously (days 1-5 and 8-12 of each cycle); each cycle is 21 days.

Outcomes

Primary Outcome Measures

Safety: adverse event profile
Obtain preliminary data on the safety of LD-IL2 with pembrolizumab
Disease control rate: melanoma
Estimate the disease control rate (CR+PR+SD by RECIST 1.1) among candidate patients with metastatic melanoma treated with pembrolizumab and LD-IL2 and to determine whether disease control is significantly improved. SD for 6 months or more will be considered SD for the purpose of this assessment.
Disease control rate: renal cell cancer
Estimate the disease control rate (CR+PR+SD by RECIST 1.1) among patients with metastatic renal cell cancer treated with pembrolizumab and LD-IL2 and to determine whether disease control is significantly improved. SD for 6 months or more will be considered SD for the purpose of this assessment.

Secondary Outcome Measures

Progression free survival: metastatic melanoma
Estimate progression-free survival defined as the duration of time from first response (SD/PR/CR) to time of recurrence/progression or death from any cause, whichever occurs first
Progression free survival: renal cell cancer
Estimate progression-free survival defined as the duration of time from first response (SD/PR/CR) to time of recurrence/progression or death from any cause, whichever occurs first

Full Information

First Posted
March 23, 2017
Last Updated
July 9, 2019
Sponsor
William Grosh, MD
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1. Study Identification

Unique Protocol Identification Number
NCT03111901
Brief Title
Low-dose Interleukin-2 and Pembrolizumab in Melanoma and Renal Cell Cancer
Acronym
UVA-AM-002
Official Title
Low-dose Interleukin-2 and Pembrolizumab Among Patients With Metastatic Melanoma and Renal Cell Carcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Withdrawn
Why Stopped
funding was withdrawn
Study Start Date
October 29, 2018 (Actual)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
October 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
William Grosh, MD

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will evaluate the safety and disease control rate of the combination of pembrolizumab plus low-dose interleukin-2 in patients who have either advanced melanoma or renal cell cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Carcinoma, Renal Cell, Melanoma
Keywords
pembrolizumab, IL-2, interleukin-2, MK-3475

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Level 1
Arm Type
Experimental
Arm Description
Pembrolizumab (200 mg) administered intravenously (day 2 of cycle 1; day 1 of cycles 2 and beyond); Low dose-interleukin 2 (LD-IL2) 12 MIU/m2 administered subcutaneously (days 1-5 and 8-12 of each cycle); each cycle is 21 days.
Arm Title
Level -1
Arm Type
Experimental
Arm Description
Pembrolizumab (200 mg) administered intravenously (day 2 of cycle 1; day 1 of cycles 2 and beyond); Low dose-interleukin 2 (LD-IL2) 5 MIU/m2 administered subcutaneously (days 1-5 and 8-12 of each cycle); each cycle is 21 days.
Intervention Type
Drug
Intervention Name(s)
Pembrolizumab
Other Intervention Name(s)
MK-3475, KEYTRUDA
Intervention Description
Pembrolizumab solution
Intervention Type
Drug
Intervention Name(s)
Interleukin-2
Other Intervention Name(s)
IL-2
Intervention Description
Interleukin-2 solution
Primary Outcome Measure Information:
Title
Safety: adverse event profile
Description
Obtain preliminary data on the safety of LD-IL2 with pembrolizumab
Time Frame
up to 90 days post-treatment
Title
Disease control rate: melanoma
Description
Estimate the disease control rate (CR+PR+SD by RECIST 1.1) among candidate patients with metastatic melanoma treated with pembrolizumab and LD-IL2 and to determine whether disease control is significantly improved. SD for 6 months or more will be considered SD for the purpose of this assessment.
Time Frame
baseline and every 9 weeks (up to week 104)
Title
Disease control rate: renal cell cancer
Description
Estimate the disease control rate (CR+PR+SD by RECIST 1.1) among patients with metastatic renal cell cancer treated with pembrolizumab and LD-IL2 and to determine whether disease control is significantly improved. SD for 6 months or more will be considered SD for the purpose of this assessment.
Time Frame
baseline and every 9 weeks (up to week 104)
Secondary Outcome Measure Information:
Title
Progression free survival: metastatic melanoma
Description
Estimate progression-free survival defined as the duration of time from first response (SD/PR/CR) to time of recurrence/progression or death from any cause, whichever occurs first
Time Frame
From first response (SD/PR/CR) to time of recurrence/progression or death from any cause, whichever occurs first, assessed for an estimated total of 120 months.
Title
Progression free survival: renal cell cancer
Description
Estimate progression-free survival defined as the duration of time from first response (SD/PR/CR) to time of recurrence/progression or death from any cause, whichever occurs first
Time Frame
From first response (SD/PR/CR) to time of recurrence/progression or death from any cause, whichever occurs first, assessed for an estimated total of 120 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria Stage IV or unresectable stage III malignant melanoma or renal cell carcinoma. Melanoma Patients must have failed anti-PD-1/PD-L1 antibody therapy. Patients must have failed ipilimumab or be intolerant of ipilimumab and therefore unable to receive ipilimumab. Patients may, but are not obligated, to have failed high- dose IL2. BRAF status must be known or unable to be performed. If the melanoma expresses a BRAF mutation of V600E, V600K, or V600R patient must have received and progressed through a BRAF inhibitor or have failed that therapy due to toxicity. Renal Cell Carcinoma Patients must have failed anti-PD-1/PD-L1 antibody therapy. Patients must have failed a VEGF pathway inhibitor and a second tyrosine kinase inhibitor. Patients may, but are not obligated, to have failed high- dose IL2. Measurable disease based upon RECIST 1.1. Subjects with brain metastases will be eligible if the following are true: Subjects with ≤ 3 brain metastases All metastases are ≤ 3 cm All metastases have been treated and are asymptomatic Steroids are not required for management of the brain metastases All metastases have been stable for 1 month following treatment Subjects with > 3 brain metastases All metastases are ≤ 3 cm All metastases have been treated and are asymptomatic Steroids are not required for management of the brain metastases All metastases have been stable for 6 months following treatment Performance status: ECOG 0-1. Adequate organ function. Ability to provide informed consent. Main Exclusion Criteria: Pregnancy Currently participating and receiving study therapy or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of treatment. Has a diagnosis of primary or secondary immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 3 weeks prior to the first dose of trial treatment. Replacement doses of steroids are permitted. Known history of active TB (Bacillus Tuberculosis) Hypersensitivity to pembrolizumab or any of its excipients. Known additional malignancies (exceptions DCIS or LCIS, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or in situ cervical cancer that has undergone potentially curative therapy). Prior anti-cancer monoclonal antibody (mAb) within 3 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to agents administered more than 3 weeks earlier. Prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., ≤ Grade 1 or at baseline) from adverse events due to a previously administered agent. Known carcinomatous meningitis. Active autoimmune disease that has required systemic treatment in the past 2 years. Patients may be eligible if they have the following autoimmune diseases: thyroiditis or hypothyroidism, mild arthritis, diabetes, resolved hypophysitis, ulcerative colitis after total abdominal colectomy. Active infection requiring systemic therapy. Known psychiatric or substance abuse disorders. Known history of Human Immunodeficiency Virus (HIV). Known active Hepatitis B virus (HBV) or Hepatitis C virus (HCV). Has received a live vaccine within 30 days of planned start of study therapy. Severe chronic pulmonary disease. Congestive heart failure, angina, or symptomatic cardiac arrhythmia or is classified according to the New York Heart Association classification as having Class III or IV heart disease. History of (non-infectious) pneumonitis that required steroids or current pneumonitis.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William W Grosh, MD
Organizational Affiliation
University of Virginia Health System
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Virginia Cancer Center
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Low-dose Interleukin-2 and Pembrolizumab in Melanoma and Renal Cell Cancer

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