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Tebentafusp in Molecular Relapsed Disease (MRD) Melanoma (TebeMRD)

Primary Purpose

Melanoma (Skin), Melanoma, Uveal

Status
Recruiting
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
Tebentafusp
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Melanoma (Skin) focused on measuring D008545

Eligibility Criteria

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

Inclusion Criteria:

A patient will be eligible for inclusion in cohort A or B if all of the following criteria apply:

  1. Uveal or cutaneous melanoma with MRD detected in molecular screening.
  2. Written (signed and dated) informed consent.
  3. Male or female, Age 18 years and above.
  4. Life expectancy of at least 3 months.
  5. ECOG performance score of 0 or 1.
  6. No evidence of metastatic disease on a CT scan of neck/thorax/abdomen/pelvis for cohorts A and B and also on MRI liver for uveal melanoma for cohort B.
  7. Those receiving prior immunotherapy must have recovered from any immune-mediated adverse events (≤ grade 1) other than endocrinopathies on stable replacement therapy.
  8. Haematological and biochemical indices within normal ranges (refer to protocol for ranges)

Exclusion Criteria:

A patient will not be eligible for tebentafusp administration if any of the following apply:

  1. Treatment with any other investigational agent, or participation in another interventional clinical trial within 28 days prior to enrolment.
  2. Uveal or cutaneous melanoma patients who present radiologically or clinically detectable disease during screening.
  3. Active infection requiring systemic antibiotic therapy. Patients requiring systemic antibiotics for infection must have completed therapy before Screening is initiated
  4. Other psychological, social or medical condition, physical examination finding or a laboratory abnormality that the Investigator considers would make the patient a poor trial candidate or could interfere with protocol compliance or the interpretation of trial results.
  5. Any other active malignancy, with the exception of malignancies that were treated curatively and have not recurred within 2 years after completion of treatment; completely resected basal cell and squamous cell skin cancers; any malignancy considered to be indolent and that has never required therapy; and completely resected carcinoma in situ of any type
  6. Patients who are known to be serologically positive for Hepatitis B, Hepatitis C or HIV. This study does not require testing to confirm eligibility unless clinically indicated.
  7. Clinically significant cardiac disease or impaired cardiac function (New York Heart Association grade ≥ 2), including myocardial infarction or unstable angina pectoris within 6 months of screening.
  8. Active autoimmune disease or a documented history of autoimmune disease within 3 years of screening (diabetes mellitus, vitiligo, managed hypothyroidism, psoriasis and managed asthma are not exclusions).
  9. Systemic anti-cancer therapy within 2 weeks of the first dose of study treatment. For cytotoxic agents that have major delayed toxicity and any prior immunotherapy approach, 4 weeks is indicated as washout period
  10. Presence of NCI CTCAE ≥ grade 2 toxicity (except alopecia, peripheral neuropathy, and ototoxicity, which are excluded if ≥ NCI CTCAE grade 3) due to prior cancer therapy.
  11. Patients currently requiring chronic, systemic corticosteroid therapy at any dose for longer than 2 weeks. Replacement treatment for pituitary or adrenal insufficiency is permitted. Local steroid therapies (e.g. otic, ophthalmic, intra-articular, or inhaled medications) are acceptable.
  12. Use of any live vaccines against infectious diseases within 4 weeks of initiation of study treatment. Non-live vaccination (e.g. influenza) are permitted anytime during treatment.
  13. Major surgery as defined by the investigator within 2 weeks of the first dose of study treatment (minimally invasive procedures such as bronchoscopy, insertion of a central venous access device, and insertion of a feeding tube are not considered major surgery).
  14. Pregnant or lactating women, or women of childbearing potential unless effective methods of contraception are used.
  15. Women of child-bearing potential who are sexually active with a non-sterilized male partner, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective contraception during study treatment, and must agree to continue using such precautions for 6 months after the final dose of investigational product; cessation of birth control after this point should be discussed with a responsible physician.
  16. Male patients must be surgically sterile or use double barrier contraception method from enrolment through treatment and for 6 months following administration of the last dose of study drug.

Sites / Locations

  • The Clatterbridge Cancer CentreRecruiting
  • University College London HospitalRecruiting
  • The Christie HospitalRecruiting
  • Mount Vernon Cancer CentreRecruiting
  • Churchill Hospital, Oxford University Hospitals NHS TrustRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cutaneous melanoma with molecular relapsed disease

Uveal melanoma with molecular relapsed disease

Arm Description

tebentafusp weekly IV escalating in the first treatment cycle with dose 20 mcg on day 1, 30 mcg on day 8, 68 mcg on days 15 and 22. Thereafter weekly doses will be 68 mcg IV for 6 months.

tebentafusp weekly IV escalating in the first treatment cycle with dose 20 mcg on day 1, 30 mcg on day 8, 68 mcg on days 15 and 22. Thereafter weekly doses will be 68 mcg IV for 6 months.

Outcomes

Primary Outcome Measures

Estimate the rate of molecular response (MR) to tebentafusp in each of 2 cohorts A. Cutaneous melanoma with MRD B. Uveal melanoma with MRD
Best response to treatment, with partial molecular response (pMR) defined as a decrease in the allele frequency of the index mutation(s), and complete molecular response (cMR) as no detectable mutation(s)

Secondary Outcome Measures

Efficacy of tebentafusp
Evaluate the efficacy of tebentafusp in each cohort - Relapse free survival at 12 months; duration of MR; overall survival
Safety and tolerability of tebentafusp
Assess the safety and tolerability of tebentafusp in MRD. Incidence and severity of adverse events according to NCIC CTCAE v5.0/2019 Lee et all criteria; dose reductions, interruptions and cessations in the course of treatment
Assess the rate of molecular relapse in; A. Cutaneous melanoma B. Uveal melanoma
Percentage of patients with molecular relapse at baseline, within 6 months and over 12 months of monitoring

Full Information

First Posted
August 23, 2021
Last Updated
June 6, 2023
Sponsor
University of Oxford
Collaborators
Immunocore Ltd, Natera, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05315258
Brief Title
Tebentafusp in Molecular Relapsed Disease (MRD) Melanoma
Acronym
TebeMRD
Official Title
A Phase II Non-Randomized, Open-label, Multi-centre Study of the Safety and Efficacy of Tebentafusp in Melanoma With Molecular Relapsed Disease
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
July 25, 2022 (Actual)
Primary Completion Date
June 30, 2025 (Anticipated)
Study Completion Date
June 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford
Collaborators
Immunocore Ltd, Natera, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Researchers are trying to find ways to improve the management of people with intermediate or high risk resected cutaneous melanoma or with primary uveal melanoma. This research study is investigating using a new blood test to decide when to give a drug called tebentafusp. Tebentafusp has been used in clinical trials in patients with advanced cutaneous and uveal melanoma. This study is designed to determine if tebentafusp can help patients with cutaneous or uveal melanoma live longer.
Detailed Description
TebeMRD is an unblinded non-randomised, open labelled, safety and efficacy study involving 2 patient cohorts: A: Cutaneous melanoma with molecular relapsed disease (MRD) B: Uveal melanoma with MRD Approximately 850 patients (600 cutaneous melanoma, 250 uveal melanoma) will be enrolled from 50 centres to screen for HLA-A*0201 status and then followed for up to 12 months for MRD at those same centres. Patients identified with MRD will be invited to be treated with tebentafusp at up to 10 treating centres in the UK. Patients in cohorts A and B will receive up to six months of tebentafusp, administered weekly IV, and then will be followed-up for 12 months for molecular and clinical relapse. Patients will be in the pre-screening phase for determination of HLA-A*0201 status for up to 2 weeks. Those patients who are positive for HLA-A*0201 will be followed for MRD and will attend the clinical sites for 3 monthly testing for up to 12 months. Patients will leave the study if no molecular relapse is detected during the molecular screening period. When MRD is identified, patients will be evaluated for eligibility to enter the main study at one of up to 10 specialist treatment centres, where patients will enter the screening period for determination of eligibility to start tebentafusp administration within 6 weeks. After a maximum 6 months treatment patients will be followed up for 12 months, or until the study is completed, if this is longer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma (Skin), Melanoma, Uveal
Keywords
D008545

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
850 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cutaneous melanoma with molecular relapsed disease
Arm Type
Experimental
Arm Description
tebentafusp weekly IV escalating in the first treatment cycle with dose 20 mcg on day 1, 30 mcg on day 8, 68 mcg on days 15 and 22. Thereafter weekly doses will be 68 mcg IV for 6 months.
Arm Title
Uveal melanoma with molecular relapsed disease
Arm Type
Experimental
Arm Description
tebentafusp weekly IV escalating in the first treatment cycle with dose 20 mcg on day 1, 30 mcg on day 8, 68 mcg on days 15 and 22. Thereafter weekly doses will be 68 mcg IV for 6 months.
Intervention Type
Drug
Intervention Name(s)
Tebentafusp
Other Intervention Name(s)
IMCgp100
Intervention Description
Tebentafusp supplied as concentrate for solution for infusion and diluted prior to administration. 0.2 mg/mL drug product will be provided as a sterile, refrigerated solution in glass vials.
Primary Outcome Measure Information:
Title
Estimate the rate of molecular response (MR) to tebentafusp in each of 2 cohorts A. Cutaneous melanoma with MRD B. Uveal melanoma with MRD
Description
Best response to treatment, with partial molecular response (pMR) defined as a decrease in the allele frequency of the index mutation(s), and complete molecular response (cMR) as no detectable mutation(s)
Time Frame
ctDNA taken at baseline until end of treatment (maximum of 6 months)
Secondary Outcome Measure Information:
Title
Efficacy of tebentafusp
Description
Evaluate the efficacy of tebentafusp in each cohort - Relapse free survival at 12 months; duration of MR; overall survival
Time Frame
ctDNA taken at baseline until end of treatment (maximum of 6 months); CT or MRI assessment as per standard of care
Title
Safety and tolerability of tebentafusp
Description
Assess the safety and tolerability of tebentafusp in MRD. Incidence and severity of adverse events according to NCIC CTCAE v5.0/2019 Lee et all criteria; dose reductions, interruptions and cessations in the course of treatment
Time Frame
Up to 6 months of treatment
Title
Assess the rate of molecular relapse in; A. Cutaneous melanoma B. Uveal melanoma
Description
Percentage of patients with molecular relapse at baseline, within 6 months and over 12 months of monitoring
Time Frame
ctDNA taken at baseline and every 3 months during molecular screening
Other Pre-specified Outcome Measures:
Title
Changes in peripheral T cell populations and in serum cytokines and other analytes
Description
From blood drawn every 4 weeks
Time Frame
Up to 6 months of treatment
Title
Preliminary evaluation of response rate in gp100 expressing melanoma
Description
Best molecular response in cohorts A and B
Time Frame
ctDNA taken at baseline until end of treatment (maximum of 6 months)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A patient will be eligible for inclusion in cohort A or B if all of the following criteria apply: Uveal or cutaneous melanoma with MRD detected in molecular screening. Written (signed and dated) informed consent. Male or female, Age 18 years and above. Life expectancy of at least 3 months. ECOG performance score of 0 or 1. No evidence of metastatic disease on a CT scan of neck/thorax/abdomen/pelvis for cohorts A and B and also on MRI liver for uveal melanoma for cohort B. Those receiving prior immunotherapy must have recovered from any immune-mediated adverse events (≤ grade 1) other than endocrinopathies on stable replacement therapy. Haematological and biochemical indices within normal ranges (refer to protocol for ranges) Exclusion Criteria: A patient will not be eligible for tebentafusp administration if any of the following apply: Treatment with any other investigational agent, or participation in another interventional clinical trial within 28 days prior to enrolment. Uveal or cutaneous melanoma patients who present radiologically or clinically detectable disease during screening. Active infection requiring systemic antibiotic therapy. Patients requiring systemic antibiotics for infection must have completed therapy before Screening is initiated Other psychological, social or medical condition, physical examination finding or a laboratory abnormality that the Investigator considers would make the patient a poor trial candidate or could interfere with protocol compliance or the interpretation of trial results. Any other active malignancy, with the exception of malignancies that were treated curatively and have not recurred within 2 years after completion of treatment; completely resected basal cell and squamous cell skin cancers; any malignancy considered to be indolent and that has never required therapy; and completely resected carcinoma in situ of any type Patients who are known to be serologically positive for Hepatitis B, Hepatitis C or HIV. This study does not require testing to confirm eligibility unless clinically indicated. Clinically significant cardiac disease or impaired cardiac function (New York Heart Association grade ≥ 2), including myocardial infarction or unstable angina pectoris within 6 months of screening. Active autoimmune disease or a documented history of autoimmune disease within 3 years of screening (diabetes mellitus, vitiligo, managed hypothyroidism, psoriasis and managed asthma are not exclusions). Systemic anti-cancer therapy within 2 weeks of the first dose of study treatment. For cytotoxic agents that have major delayed toxicity and any prior immunotherapy approach, 4 weeks is indicated as washout period Presence of NCI CTCAE ≥ grade 2 toxicity (except alopecia, peripheral neuropathy, and ototoxicity, which are excluded if ≥ NCI CTCAE grade 3) due to prior cancer therapy. Patients currently requiring chronic, systemic corticosteroid therapy at any dose for longer than 2 weeks. Replacement treatment for pituitary or adrenal insufficiency is permitted. Local steroid therapies (e.g. otic, ophthalmic, intra-articular, or inhaled medications) are acceptable. Use of any live vaccines against infectious diseases within 4 weeks of initiation of study treatment. Non-live vaccination (e.g. influenza) are permitted anytime during treatment. Major surgery as defined by the investigator within 2 weeks of the first dose of study treatment (minimally invasive procedures such as bronchoscopy, insertion of a central venous access device, and insertion of a feeding tube are not considered major surgery). Pregnant or lactating women, or women of childbearing potential unless effective methods of contraception are used. Women of child-bearing potential who are sexually active with a non-sterilized male partner, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective contraception during study treatment, and must agree to continue using such precautions for 6 months after the final dose of investigational product; cessation of birth control after this point should be discussed with a responsible physician. Male patients must be surgically sterile or use double barrier contraception method from enrolment through treatment and for 6 months following administration of the last dose of study drug.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lisa Poulton
Phone
01865617075
Email
octo-tebemrd@oncology.ox.ac.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Lakisha Marshall
Email
octo-tebemrd@oncology.ox.ac.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Middleton
Organizational Affiliation
Consultant Medical Oncologist and Professor of Experimental Cancer Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Clatterbridge Cancer Centre
City
Liverpool
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joesph Sacco
Facility Name
University College London Hospital
City
London
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heather Shaw
Facility Name
The Christie Hospital
City
Manchester
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rebecca Lee
Facility Name
Mount Vernon Cancer Centre
City
Middlesex
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Nathan
Facility Name
Churchill Hospital, Oxford University Hospitals NHS Trust
City
Oxford
ZIP/Postal Code
OX3 7LE
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mark Middleton

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Tebentafusp in Molecular Relapsed Disease (MRD) Melanoma

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