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Study of the Combination of Anti-OX40 and Ipilimumab in Patients With Metastatic Melanoma

Primary Purpose

Metastatic Melanoma

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Anti-OX40
Ipilimumab
Sponsored by
Ludwig Institute for Cancer Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Metastatic Melanoma focused on measuring OX40, Anti-OX40, Ipilimumab, Melanoma

Eligibility Criteria

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

Inclusion Criteria:

  • Patients with unresectable or metastatic melanoma, for whom treatment with Ipilimumab is indicated
  • Radiologically measurable disease by immune-related Response Criteria
  • ECOG performance status of 0-1.
  • Anticipated lifespan greater than 12 weeks.
  • At the time of day 1 of the study, patients must be at least 3 weeks since surgery
  • At the time of day 1 of the study, patients with brain metastases must be asymptomatic and, at least 8 weeks without tumor progression after any whole brain radiotherapy, at least 4 weeks since craniotomy and resection or stereotactic radiosurgery, at least 3 weeks without new brain metastases as evidenced by MRI/CT
  • The following laboratory parameters must be within the ranges specified: Hemoglobin-≥ 9 g/dL, WBC-≥ 3.0 x 109/L, INR-≤ 1.5, Total Bilirubin-≤ 1.9 g/dL & AST/ALT-≤ 3 x ULN
  • Have been informed of other treatment options.
  • At least 18 years. Able and willing to give valid written informed consent.

Exclusion Criteria:

  • Any contraindications for ipilimumab/Yervoy®.
  • Prior exposure to ipilimumab/Yervoy®
  • Prior exposure to Anti-OX40 or a mouse monoclonal antibody.
  • History of severe allergic reactions to any unknown allergens or anti-OX40 Autoimmune disease except for autoimmune thyroiditis or vitiligo.
  • Unresolved immune related adverse events following prior biological therapy.
  • Metastatic disease to the central nervous system for which other therapeutic options, including radiotherapy, may be available.
  • Known immunodeficiency or HIV, Hepatitis B or Hepatitis C positivity.
  • Other serious illnesses (e.g., serious infections requiring antibiotics).
  • Participation in any other clinical trial involving another investigational agent within 4 weeks prior to day 1 of the study.
  • Mental impairment that may compromise the ability to give informed consent and comply with the requirements of the study.
  • Lack of availability for immunological and clinical follow-up assessments.
  • Women who are breast feeding or pregnant as evidenced by positive serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) done within 72 hours of first dosing.
  • Women of childbearing potential not using a medically acceptable means of contraception for the duration of the study.
  • Any condition that, in the clinical judgment of the treating physician, is likely to prevent the patient from complying with any aspect of the protocol or that may put the patient at unacceptable risk.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Phase 1 Cohort 1

    Phase 1 Cohort 2

    Phase 1 Cohort 3

    Phase 2 Cohort 4

    Arm Description

    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered at 0.1 mg/kg over 60 minutes only in the first week on Days 1, 3 and 5.

    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered at 0.2 mg/kg over 60 minutes only in the first week on Days 1, 3 and 5.

    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered at 0.4 mg/kg over 60 minutes only in the first week on Days 1, 3 and 5.

    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered i.v. at the Phase 1 Maximum Tolerated Dose over 60 minutes only in the first week on Days 1, 3 and 5.

    Outcomes

    Primary Outcome Measures

    Assess safety and tolerability according to the National Cancer Institute CTCAE v4.0 (Phase 1 and 2)
    Laboratory tests, vital sign measurements, physical exams and patient interviews will be performed to detect new abnormalities and deteriorations of any pre-existing conditions
    Assess Tumor Response by the Immune-related Response Criteria (Phase 2)
    Tumor Response by irRC is defined as irPR or irCR over a period of at least 4 weeks

    Secondary Outcome Measures

    Determine Anti-OX40 serum concentrations
    The serum concentration of Anti-OX40 (CD134) will be determined from its binding to OX40 as measured by ELISA
    Assess the biological activity of anti-OX40 in combination with ipilimumab
    The biological activity of anti-OX40 in combination with ipilimumab will be assessed by: Determining immunologic changes in the tumor microenvironment by characterization of tumor-infiltrating lymphocytes (TILs), assessment of antigen-specific T cell responses and immunohistochemical (IHC) characterization of tumor and peri-tumoral tissue Characterizing circulating T-cell subsets by flow cytometry Assessing antigen specific immune responses by ELISA Characterizing surface markers on lymphocytes and peripheral blood cells by flow cytometry Measuring serum level of soluble factors (cytokine profiling) mRNA/miRNA profiling to analyse gene transcription and/or miRNA expression

    Full Information

    First Posted
    September 18, 2012
    Last Updated
    March 31, 2014
    Sponsor
    Ludwig Institute for Cancer Research
    Collaborators
    AgonOx
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01689870
    Brief Title
    Study of the Combination of Anti-OX40 and Ipilimumab in Patients With Metastatic Melanoma
    Official Title
    Phase 1/2 Study of the Combination of a Mouse Monoclonal Antibody to OX40 and Ipilimumab in Patients With Metastatic Melanoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2014
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    March 2014 (undefined)
    Primary Completion Date
    June 2014 (Anticipated)
    Study Completion Date
    August 2014 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Ludwig Institute for Cancer Research
    Collaborators
    AgonOx

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    This is an open label, two-phase study combining a dose escalation Phase 1 with a proof-of-concept Phase 2 in patients with unresectable or metastatic melanoma, for whom treatment with ipilimumab is indicated. The purpose of the Phase 1 is to determine the Anti-OX40 Maximum Tolerated Dose (MTD) and the secondary objectives are anti-OX40 pharmacokinetics, biological activity and the tumor response assessed by the Immune-related Response Criteria. The purpose of Phase 2 is to determine tumor response (by irRC) and the secondary objectives are anti-OX40 pharmacokinetics, biological activity and Safety/Tolerability.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Metastatic Melanoma
    Keywords
    OX40, Anti-OX40, Ipilimumab, Melanoma

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    Phase 1 Cohort 1
    Arm Type
    Experimental
    Arm Description
    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered at 0.1 mg/kg over 60 minutes only in the first week on Days 1, 3 and 5.
    Arm Title
    Phase 1 Cohort 2
    Arm Type
    Experimental
    Arm Description
    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered at 0.2 mg/kg over 60 minutes only in the first week on Days 1, 3 and 5.
    Arm Title
    Phase 1 Cohort 3
    Arm Type
    Experimental
    Arm Description
    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered at 0.4 mg/kg over 60 minutes only in the first week on Days 1, 3 and 5.
    Arm Title
    Phase 2 Cohort 4
    Arm Type
    Experimental
    Arm Description
    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1. Anti-OX40 will be administered i.v. at the Phase 1 Maximum Tolerated Dose over 60 minutes only in the first week on Days 1, 3 and 5.
    Intervention Type
    Drug
    Intervention Name(s)
    Anti-OX40
    Other Intervention Name(s)
    CD134 mab
    Intervention Description
    Anti-OX40 will be administered i.v. over 60 minutes only in the first week on Days 1, 3 and 5
    Intervention Type
    Drug
    Intervention Name(s)
    Ipilimumab
    Other Intervention Name(s)
    YERVOY
    Intervention Description
    Ipilimumab will be administered at 3 mg/kg i.v. over 90 minutes every 3 weeks for a total of 4 doses, starting on Day 1
    Primary Outcome Measure Information:
    Title
    Assess safety and tolerability according to the National Cancer Institute CTCAE v4.0 (Phase 1 and 2)
    Description
    Laboratory tests, vital sign measurements, physical exams and patient interviews will be performed to detect new abnormalities and deteriorations of any pre-existing conditions
    Time Frame
    Up to 16 weeks
    Title
    Assess Tumor Response by the Immune-related Response Criteria (Phase 2)
    Description
    Tumor Response by irRC is defined as irPR or irCR over a period of at least 4 weeks
    Time Frame
    Baseline, Week 12 & week 16
    Secondary Outcome Measure Information:
    Title
    Determine Anti-OX40 serum concentrations
    Description
    The serum concentration of Anti-OX40 (CD134) will be determined from its binding to OX40 as measured by ELISA
    Time Frame
    Baseline, on days 1, 3 & 5 30 minutes after Anti-OX40 end of infusion, and on days 8 and 15
    Title
    Assess the biological activity of anti-OX40 in combination with ipilimumab
    Description
    The biological activity of anti-OX40 in combination with ipilimumab will be assessed by: Determining immunologic changes in the tumor microenvironment by characterization of tumor-infiltrating lymphocytes (TILs), assessment of antigen-specific T cell responses and immunohistochemical (IHC) characterization of tumor and peri-tumoral tissue Characterizing circulating T-cell subsets by flow cytometry Assessing antigen specific immune responses by ELISA Characterizing surface markers on lymphocytes and peripheral blood cells by flow cytometry Measuring serum level of soluble factors (cytokine profiling) mRNA/miRNA profiling to analyse gene transcription and/or miRNA expression
    Time Frame
    Baseline, Day1, day 3, day 5 day8, day 15, day 22 day 43, day 64, day 85 & 113

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients with unresectable or metastatic melanoma, for whom treatment with Ipilimumab is indicated Radiologically measurable disease by immune-related Response Criteria ECOG performance status of 0-1. Anticipated lifespan greater than 12 weeks. At the time of day 1 of the study, patients must be at least 3 weeks since surgery At the time of day 1 of the study, patients with brain metastases must be asymptomatic and, at least 8 weeks without tumor progression after any whole brain radiotherapy, at least 4 weeks since craniotomy and resection or stereotactic radiosurgery, at least 3 weeks without new brain metastases as evidenced by MRI/CT The following laboratory parameters must be within the ranges specified: Hemoglobin-≥ 9 g/dL, WBC-≥ 3.0 x 109/L, INR-≤ 1.5, Total Bilirubin-≤ 1.9 g/dL & AST/ALT-≤ 3 x ULN Have been informed of other treatment options. At least 18 years. Able and willing to give valid written informed consent. Exclusion Criteria: Any contraindications for ipilimumab/Yervoy®. Prior exposure to ipilimumab/Yervoy® Prior exposure to Anti-OX40 or a mouse monoclonal antibody. History of severe allergic reactions to any unknown allergens or anti-OX40 Autoimmune disease except for autoimmune thyroiditis or vitiligo. Unresolved immune related adverse events following prior biological therapy. Metastatic disease to the central nervous system for which other therapeutic options, including radiotherapy, may be available. Known immunodeficiency or HIV, Hepatitis B or Hepatitis C positivity. Other serious illnesses (e.g., serious infections requiring antibiotics). Participation in any other clinical trial involving another investigational agent within 4 weeks prior to day 1 of the study. Mental impairment that may compromise the ability to give informed consent and comply with the requirements of the study. Lack of availability for immunological and clinical follow-up assessments. Women who are breast feeding or pregnant as evidenced by positive serum pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) done within 72 hours of first dosing. Women of childbearing potential not using a medically acceptable means of contraception for the duration of the study. Any condition that, in the clinical judgment of the treating physician, is likely to prevent the patient from complying with any aspect of the protocol or that may put the patient at unacceptable risk.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Jedd Wolchok, MD, PhD
    Organizational Affiliation
    Memorial Sloan Kettering Cancer Center
    Official's Role
    Principal Investigator
    First Name & Middle Initial & Last Name & Degree
    Brendan D Curti, MD
    Organizational Affiliation
    Providence Health & Services
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Study of the Combination of Anti-OX40 and Ipilimumab in Patients With Metastatic Melanoma

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