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Monoclonal Antibody Therapy and Interleukin-2 in Treating Patients With Metastatic Melanoma

Primary Purpose

Intraocular Melanoma, Melanoma (Skin)

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
aldesleukin
ipilimumab
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intraocular Melanoma focused on measuring stage IV melanoma, extraocular extension melanoma, recurrent melanoma, iris melanoma, ciliary body and choroid melanoma, medium/large size, ciliary body and choroid melanoma, small size, recurrent intraocular melanoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed stage IV melanoma Mucosal or ocular melanoma also eligible Clinically evaluable disease At least 1 site of measurable disease PATIENT CHARACTERISTICS: Age 16 and over Performance status ECOG 0-1 Life expectancy At least 3 months Hematopoietic WBC at least 2,500/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10 g/dL Hematocrit at least 30% Hepatic Bilirubin no greater than upper limit of normal (ULN)* (less than 3.0 mg/dL in patients with Gilbert's syndrome) AST no greater than 3 times ULN* Hepatitis B surface antigen negative Hepatitis C antibody nonreactive No evidence or history of significant hepatic disease that would preclude safe administration of high-dose IL-2 NOTE: *Unless attributable to disease Renal Creatinine no greater than 2.0 mg/dL No evidence or history of significant renal disease that would preclude safe administration of high-dose IL-2 Cardiovascular No evidence or history of significant cardiac disease that would preclude safe administration of high-dose IL-2 Thallium stress test normal (for patients over 50 years of age or with a history of cardiovascular disease) Pulmonary No evidence or history of significant pulmonary disease that would preclude safe administration of high-dose IL-2 Immunologic HIV negative No autoimmune disease (including uveitis and autoimmune inflammatory eye disease) No active infection Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix No evidence or history of significant gastrointestinal disease that would preclude safe administration of high-dose IL-2 No evidence or history of psychiatric disease that would preclude safe administration of high-dose IL-2 No other underlying medical condition that would make the administration of the study drug hazardous or obscure the interpretation of adverse events No other concurrent medical condition that would preclude study entry PRIOR CONCURRENT THERAPY: Biologic therapy At least 3 weeks since prior immunotherapy for melanoma and recovered No prior anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4) No prior high-dose (at least 600,000 IU/kg every 8 hours) interleukin-2 (IL-2) Chemotherapy At least 3 weeks since prior chemotherapy for melanoma and recovered No concurrent chemotherapy Endocrine therapy At least 3 weeks since prior hormonal therapy for melanoma and recovered At least 4 weeks since prior corticosteroids No concurrent systemic or topical corticosteroids Radiotherapy At least 3 weeks since prior radiotherapy for melanoma and recovered Surgery Not specified Other No concurrent immunosuppressive agents (e.g., cyclosporine or its analog)

Sites / Locations

  • Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support

Outcomes

Primary Outcome Measures

Secondary Outcome Measures

Full Information

First Posted
April 7, 2003
Last Updated
June 18, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00058279
Brief Title
Monoclonal Antibody Therapy and Interleukin-2 in Treating Patients With Metastatic Melanoma
Official Title
MDX-CTLA4 Combined With IL-2 for Patients With Metastatic Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
August 2006
Overall Recruitment Status
Completed
Study Start Date
February 2003 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
August 2006 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Biological therapies, such as MDX-010, work in different ways to stimulate the immune system and stop tumor cells from growing. Interleukin-2 may stimulate a person's white blood cells to kill tumor cells. Combining monoclonal antibody therapy with interleukin-2 may kill more tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of combining monoclonal antibody therapy with interleukin-2 in treating patients who have metastatic melanoma.
Detailed Description
OBJECTIVES: Determine the maximum tolerated dose (MTD) of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4) in combination with high-dose interleukin-2 (IL-2) in patients with metastatic melanoma. (Phase I is closed to accrual as of 4/13/2004). Determine the activity of MDX-CTLA4 administered at the MTD with high-dose IL-2 in these patients. Determine whether the administration of IL-2 alters the pharmacokinetics of MDX-CTLA4 in these patients. Determine the safety and adverse event profile of this regimen in these patients. OUTLINE: This is an open-label, dose-escalation study of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4). Phase I: Patients receive MDX-CTLA4 IV on days 0, 21, and 42. Patients also receive high-dose interleukin-2 (IL-2) IV over 15 minutes every 8 hours for up to 15 doses beginning on days 22 and 43. Treatment repeats every 63 days for up to 3 courses in the absence of disease progression or unacceptable toxicity. Patients with an ongoing partial response and no greater than grade 1 toxicity may receive additional courses of therapy. Patients who require discontinuation of MDX-CTLA4 due to toxicity may continue receiving IL-2 at the discretion of the investigator. Cohorts of 3-6 patients receive escalating doses of MDX-CTLA4 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. (Phase I is closed to accrual as of 4/13/2004). Phase II: Patients receive treatment as in phase I at the MTD of MDX-CTLA4. Patients who achieve a partial or complete response and later develop recurrent or progressive disease may be retreated at the same dose. Patients are followed at 3 weeks, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter. PROJECTED ACCRUAL: A total of 3-51 patients (3-18 for phase I and 19-33 for phase II) will be accrued for this study within 1 year. (Phase I is closed to accrual as of 4/13/2004).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intraocular Melanoma, Melanoma (Skin)
Keywords
stage IV melanoma, extraocular extension melanoma, recurrent melanoma, iris melanoma, ciliary body and choroid melanoma, medium/large size, ciliary body and choroid melanoma, small size, recurrent intraocular melanoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Masking
None (Open Label)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
aldesleukin
Intervention Type
Biological
Intervention Name(s)
ipilimumab

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed stage IV melanoma Mucosal or ocular melanoma also eligible Clinically evaluable disease At least 1 site of measurable disease PATIENT CHARACTERISTICS: Age 16 and over Performance status ECOG 0-1 Life expectancy At least 3 months Hematopoietic WBC at least 2,500/mm^3 Absolute neutrophil count at least 1,500/mm^3 Platelet count at least 100,000/mm^3 Hemoglobin at least 10 g/dL Hematocrit at least 30% Hepatic Bilirubin no greater than upper limit of normal (ULN)* (less than 3.0 mg/dL in patients with Gilbert's syndrome) AST no greater than 3 times ULN* Hepatitis B surface antigen negative Hepatitis C antibody nonreactive No evidence or history of significant hepatic disease that would preclude safe administration of high-dose IL-2 NOTE: *Unless attributable to disease Renal Creatinine no greater than 2.0 mg/dL No evidence or history of significant renal disease that would preclude safe administration of high-dose IL-2 Cardiovascular No evidence or history of significant cardiac disease that would preclude safe administration of high-dose IL-2 Thallium stress test normal (for patients over 50 years of age or with a history of cardiovascular disease) Pulmonary No evidence or history of significant pulmonary disease that would preclude safe administration of high-dose IL-2 Immunologic HIV negative No autoimmune disease (including uveitis and autoimmune inflammatory eye disease) No active infection Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix No evidence or history of significant gastrointestinal disease that would preclude safe administration of high-dose IL-2 No evidence or history of psychiatric disease that would preclude safe administration of high-dose IL-2 No other underlying medical condition that would make the administration of the study drug hazardous or obscure the interpretation of adverse events No other concurrent medical condition that would preclude study entry PRIOR CONCURRENT THERAPY: Biologic therapy At least 3 weeks since prior immunotherapy for melanoma and recovered No prior anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4) No prior high-dose (at least 600,000 IU/kg every 8 hours) interleukin-2 (IL-2) Chemotherapy At least 3 weeks since prior chemotherapy for melanoma and recovered No concurrent chemotherapy Endocrine therapy At least 3 weeks since prior hormonal therapy for melanoma and recovered At least 4 weeks since prior corticosteroids No concurrent systemic or topical corticosteroids Radiotherapy At least 3 weeks since prior radiotherapy for melanoma and recovered Surgery Not specified Other No concurrent immunosuppressive agents (e.g., cyclosporine or its analog)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven A. Rosenberg, MD, PhD
Organizational Affiliation
NCI - Surgery Branch
Official's Role
Study Chair
Facility Information:
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
16283570
Citation
Maker AV, Phan GQ, Attia P, Yang JC, Sherry RM, Topalian SL, Kammula US, Royal RE, Haworth LR, Levy C, Kleiner D, Mavroukakis SA, Yellin M, Rosenberg SA. Tumor regression and autoimmunity in patients treated with cytotoxic T lymphocyte-associated antigen 4 blockade and interleukin 2: a phase I/II study. Ann Surg Oncol. 2005 Dec;12(12):1005-16. doi: 10.1245/ASO.2005.03.536. Epub 2005 Oct 21.
Results Reference
result
PubMed Identifier
25667295
Citation
Schadendorf D, Hodi FS, Robert C, Weber JS, Margolin K, Hamid O, Patt D, Chen TT, Berman DM, Wolchok JD. Pooled Analysis of Long-Term Survival Data From Phase II and Phase III Trials of Ipilimumab in Unresectable or Metastatic Melanoma. J Clin Oncol. 2015 Jun 10;33(17):1889-94. doi: 10.1200/JCO.2014.56.2736. Epub 2015 Feb 9.
Results Reference
derived

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Monoclonal Antibody Therapy and Interleukin-2 in Treating Patients With Metastatic Melanoma

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