Intraperitoneal Natural Killer Cells and INCB024360 for Recurrent Ovarian, Fallopian Tube, and Primary Peritoneal Cancer

NCT ID: NCT02118285

Last Updated: 2017-12-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

2 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-28

Study Completion Date

2015-11-12

Brief Summary

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This is a single center phase I trial designed to determine the maximum tolerated dose (MTD) of the oral IDO inhibitor INCB024360 when administered as part of a larger regimen of intraperitoneal (IP) delivery of haploidentical donor NK cells and IL-2 after a non-myeloablative cyclophosphamide/fludarabine (Cy/Flu) preparative regimen for the treatment of recurrent ovarian, fallopian tube, and primary peritoneal cancer.

Detailed Description

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Haploidentical donor NK cells and the 1st dose of IL-2 are infused intraperitoneally (IP) after a non-myeloablative preparative regimen of cyclophosphamide and fludarabine. IP IL-2 continues three times a week for 5 additional doses. INCB024360, at the assigned dose, begins 2 days before the NK cell infusion (on day -2) and continues twice daily for 90 days.

Follow-up for disease response and survival is for 1 year from the NK cell infusion with the possibility of re-treatment for patients who experience at least a clinical benefit for a minimum of 6 months prior to disease progression.

The MTD of INCB024360 will be determined using the continual reassessment method (CRM). The 1st 2 patients will be enrolled at dose level 1 (50 mg bid) of INCB024360. Each new cohort of 2 patients will be sequentially assigned to most appropriate dose by the study statistician based on the updated toxicity profile. Up to 4 dose levels of INCB024360 will be tested (50, 100, 200, and 300 mg bid) with a dose level -1 (25 mg bid) used in the event that 50 mg bid proves to be too toxic. The MTD will be identified when the total sample size of 20 patients is exhausted.

Conditions

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Ovarian Cancer Fallopian Tube Carcinoma Primary Peritoneal Carcinoma

Keywords

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Ovarian cancer Fallopian cancer Primary peritoneal cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment

Haploidentical donor NK cells and IL-2 are infused intraperitoneally (IP) after a non-myeloablative preparative regimen of cyclophosphamide and fludarabine. INCB024360, at the assigned dose, begins 2 days before the NK cell infusion and continues twice daily for 90 days.

Group Type EXPERIMENTAL

Fludarabine

Intervention Type DRUG

Fludarabine 25 mg/m\^2 IV on days -6 through -2 from NK cell infusion

Cyclophosphamide

Intervention Type DRUG

Cyclophosphamide 30 mg/kg IV on days -5 and -4 from NK cell infusion

NK cells

Intervention Type BIOLOGICAL

CD3-/CD19- selected NK cells administered by intraperitoneal (IP) infusion on day 0

IL-2

Intervention Type BIOLOGICAL

IL-2 at 6 million units/dose IP 3 times a week x 6 doses with the 1st dose given immediately after the NK cell infusion

INCB024360

Intervention Type DRUG

INCB024360 at assigned dose by mouth twice a day begin day -2 and continue for 90 days (+/- 3 days)

Interventions

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Fludarabine

Fludarabine 25 mg/m\^2 IV on days -6 through -2 from NK cell infusion

Intervention Type DRUG

Cyclophosphamide

Cyclophosphamide 30 mg/kg IV on days -5 and -4 from NK cell infusion

Intervention Type DRUG

NK cells

CD3-/CD19- selected NK cells administered by intraperitoneal (IP) infusion on day 0

Intervention Type BIOLOGICAL

IL-2

IL-2 at 6 million units/dose IP 3 times a week x 6 doses with the 1st dose given immediately after the NK cell infusion

Intervention Type BIOLOGICAL

INCB024360

INCB024360 at assigned dose by mouth twice a day begin day -2 and continue for 90 days (+/- 3 days)

Intervention Type DRUG

Other Intervention Names

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Fludara Endoxan Cytoxan Neosar Procytox Revimmune Natural Killer Cells Interleukin 2

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of recurrent epithelial ovarian cancer, fallopian tube, or primary peritoneal cancer that has failed or progressed after at least 1 prior salvage chemotherapy regimen directed at recurrent/metastatic disease.
* Measurable disease per disease specific RECIST version 1.1- patients with bone as their only site of disease will not be eligible
* If history of brain metastases must be stable for at least 3 months after treatment - A brain CT scan will only be required in subjects with known brain metastases at the time of enrollment or in subjects with clinical signs or symptoms suggestive of brain metastases.
* Available related HLA-haploidentical NK cell donor by at least Class I serologic typing at the A\&B locus
* Age 18 years or older
* GOG Performance Status ≥ 2 - refer to appendix III
* Adequate organ function as determined by the following criteria within 14 days of the start of the preparative regimen, unless otherwise noted:

* Bone marrow: platelets ≥ 80,000 x 109/L and hemoglobin ≥ 9 g/dL, unsupported by transfusions; absolute neutrophil count (ANC) ≥ 1000 x 109/L, unsupported by G-CSF or granulocytes
* Renal function: estimated glomerular filtration rate (GFR) of ≥ 50 ml/min (based on the Fairview Laboratories formula at time of screening)
* Liver function: total bilirubin \< 1.5 times upper limit of institutional normal; AST, ALT, and alkaline phosphatase \< 3 times upper limit of institutional normal
* Cardiac: Left ventricular ejection fraction \> 40% (within 28 days of treatment start)
* Pulmonary function: \> 50% corrected DLCO and FEV1, if presence of pleural effusion due to metastatic disease \> 40% corrected DLCO and FEV1 is acceptable (within 28 days of treatment start)
* Able to be off prednisone or other immunosuppressive medications other than that prescribed per protocol for at least 3 days prior to Day 0
* At least 14 days must lapse between last prior anti-cancer treatment and 1st day of preparative regimen
* Not pregnant or lactating - The agents used in this study may be teratogenic to a fetus and there is no information on the excretion of agents into breast milk. Participants of childbearing potential must have a blood test or urine study within 14 days prior to registration to rule out pregnancy and agree to use adequate birth control during study treatment.
* Able to tolerate intraperitoneal (IP) port placement and IP treatment administration in the opinion of the enrolling investigator
* Voluntary written consent

Exclusion Criteria

* Active infection - must be afebrile and off antibiotics
* Receiving monoamine oxidase inhibitors (MAOI)s or drug which as significant MAOI activity (meperidine, linezolid, methylene blue) within 21 days of 1st dose of fludarabine
* Requiring potent CYP3A4 inducers or inhibitors
* Have ever had Serotonin Syndrome after receiving one or more serotonergic drugs
* Prior therapy with anti-CTLA-4 antibody, anti PD-1, or an experimental immune system-targeted therapy
* Use of any UGT1A9 inhibitor including: diclofenac, imipramine, ketoconazole, mefenamic acid, and probenecid from screening through follow-up period.
* Undergone an organ transplant(s) including allogeneic stem cell or bone marrow transplants.
* Unstable cardiovascular disease (eg, uncontrolled hypertension, peripheral vascular disease, congestive heart failure, cardiac arrhythmia, or acute coronary syndrome) within 6 months of starting study treatment.
* Any gastrointestinal condition causing malabsorption or obstruction (eg, celiac sprue, gastric bypass surgery, strictures, adhesions, history of small bowel resection, blind loop syndrome). Unable or unwilling to swallow tablets BID.
* Active autoimmune process (eg rheumatoid arthritis, moderate or severe psoriasis, multiple sclerosis, inflammatory bowel disease, etc.) or who have been receiving therapy for an autoimmune or inflammatory disease. Vitiligo, thyroiditis, or eczema is permitted if patient is otherwise eligible
* Known HIV-positivity
* History of hepatitis or positive serology as follows:

* Hepatitis B (HepB) screening testing required:
* HepB SAg (hepatitis B surface antigen);
* Anti-HepB SAg (antibody against hepatitis B surface antigen);
* Anti-Hepatitis B core IgG (antibody against hepatitis B core antigen).
* Hepatitis B core IgM antibody

* Hepatitis C screening testing required:
* HCV-antibody (antibody against hepatitis C virus);
* HCV-RNA (serum test for circulating virus, based on detecting RNA)
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Incyte Corporation

INDUSTRY

Sponsor Role collaborator

Masonic Cancer Center, University of Minnesota

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Melissa Geller, MD

Role: PRINCIPAL_INVESTIGATOR

University of Minnesota

Locations

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University of Minnesota Masonic Cancer Center

Minneapolis, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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MT2013-11

Identifier Type: OTHER

Identifier Source: secondary_id

2012LS101

Identifier Type: -

Identifier Source: org_study_id