Duration of Anti-PD-1 Therapy in Metastatic Melanoma

NCT ID: NCT02821013

Last Updated: 2025-12-18

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

614 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-31

Study Completion Date

2029-12-31

Brief Summary

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The purpose of this study is to compare the effects on patients with metastatic melanoma of taking a government approved and paid-for PD-1 inhibitor intermittently, with taking the same type of agent continuously. Researchers want to see if the two ways of giving this type of treatment work equally well in extending the life of patients with melanoma, or not.

Detailed Description

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The standard or usual treatment for this disease is to receive treatment with a class of agents known as PD-1 inhibitors, or also with the names anti-PD-1 therapy, immunotherapy and checkpoint inhibitors. PD-1 inhibitors turn on the immune system, so that it can fight the cancer cells in the body. Clinical trials have shown that PD-1 inhibitors (such as pembrolizumab and nivolumab) can shrink tumours and extend the life of patients with melanoma.

To-date, PD-1 inhibitors have been given to patients with melanoma continuously (non-stop), for as long as they remain beneficial, for up to a total duration of 2 years. The 2 year duration was chosen because doctors thought it was reasonable, and has been adopted as the standard or usual duration because it was shown to work in clinical trials. However, some recent observations suggest that PD-1 inhibitors may work just as well if they are given for a shorter time and/or in an intermittent schedule. Intermittent means to take breaks from receiving the drug when, and for as long as, the melanoma is better.

The investigators doing this study are interested to find out whether patients with melanoma live as long when the PD-1 inhibitors are given continuously (non-stop) or in an intermittent schedule (taking breaks). If the two ways of giving the treatment were to be shown to be just as good, benefits of an intermittent schedule may include less clinic visits and side effects, better quality of life, and less cost over time for the Health Care System. However, this is not known at present.

Conditions

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Unresectable/Metastatic Melanoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm 1: Intermittent PD-1 Inhibitor therapy

Any PD-1 inhibitor that is commercially available, government approved and publicly funded. Dose as recommended by the manufacturer.

Group Type ACTIVE_COMPARATOR

Intermittent PD-1 inhibitor therapy

Intervention Type DRUG

Arm 2: Continuous PD-1 Inhibitor therapy

Any PD-1 inhibitor that is commercially available, government approved and publicly funded. Dose as recommended by the manufacturer.

Group Type ACTIVE_COMPARATOR

Continuous PD-1 inhibitor therapy

Intervention Type DRUG

Interventions

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Continuous PD-1 inhibitor therapy

Intervention Type DRUG

Intermittent PD-1 inhibitor therapy

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed melanoma that is unresectable / metastatic (stage III or stage IV).
* Eligible to receive treatment with a government approved and publically-funded PD-1 inhibitor, according to the guidance / indications described in the Product Monograph / Provincial Formulary.
* Patients must have evidence of unresectable / metastatic disease, that is considered evaluable by the investigator and can be followed, but measurable disease is not mandatory.
* Patients with brain metastases are allowed, provided they are stable according to the following definitions:

1. Without evidence of progression for at least four weeks prior to randomization and have no evidence of new or enlarging brain metastases.
2. Treated with surgery and without evidence of progression prior to randomization and have no evidence of new or enlarging brain metastases.
3. Treated with stereotactic radiosurgery and without evidence of progression prior to randomization and have no evidence of new or enlarging brain metastases.
* Patient is able (i.e. sufficiently fluent) and willing to complete the quality of life and health utility questionnaires in either English or French. The baseline assessment must be completed within required timelines, prior to randomization. Inability (lack of comprehension in English or French, or other equivalent reason such as cognitive issues or lack of competency) to complete the questionnaires will not make the patient ineligible for the study. However, ability but unwillingness to complete the questionnaires will make the patient ineligible.
* Patient consent must be appropriately obtained in accordance with applicable local and regulatory requirements. Each patient must sign a consent form prior to enrollment in the trial to document their willingness to participate.
* Patients must be accessible for treatment and follow-up. Investigators must assure themselves the patients randomized on this trial will be available for complete documentation of the treatment, adverse events, and follow-up.
* Patients must be randomized prior to the start of, or within 16 weeks from, the initiation of PD-1 inhibitor treatment. For patients who are being randomized before the start of treatment, the PD-1 inhibitor should be started within 5 working days after randomization. Patients who initiate treatment with combination anti-PD-1 and anti-CTLA-4 therapies who experience toxicity may be randomized at the time prior to starting single-agent PD-1 inhibitor. Repeat imaging must be done within 50 days prior to randomization to ensure the patient has no evidence of disease progression

Exclusion Criteria

* Patients not willing to stop anti-PD-1 therapy, if randomized to the intermittent arm.
* Patients with any contraindications to PD-1 inhibitors, as described in the Product Monograph or Provincial Formulary, and/or not eligible to receive anti-PD-1 therapy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Melanoma and Skin Cancer Trials Limited

OTHER

Sponsor Role collaborator

Canadian Cancer Trials Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Xinni Song

Role: STUDY_CHAIR

Ottawa Hospital Research Institute

Tara Baetz

Role: STUDY_CHAIR

Cancer Centre of Southeastern Ontario at Kingston

Locations

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Mildura Base Public Hospital

Victoria, Mildura, Australia

Site Status RECRUITING

Coffs Habour Health Campus - NCCI

Coffs Harbour, New South Wales, Australia

Site Status RECRUITING

Riverina Cancer Care Centre Wagga Wagga

Wagga Wagga, New South Wales, Australia

Site Status NOT_YET_RECRUITING

Calvary Mater Newcastle Hospital

Waratah, New South Wales, Australia

Site Status RECRUITING

Westmead Hospital

Westmead, New South Wales, Australia

Site Status RECRUITING

Sunshine Coast University Hospital

Birtinya, Queensland, Australia

Site Status RECRUITING

Cairns Hospital

Cairns, Queensland, Australia

Site Status RECRUITING

Gold Coast University Hospital

Southport, Queensland, Australia

Site Status RECRUITING

The Queen Elizabeth Hospital

Woodville, South A., Australia

Site Status RECRUITING

Monash Medical Centre

Clayton, Victoria, Australia

Site Status RECRUITING

Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Royal Brisbane and Womens Hospital

Herston, , Australia

Site Status RECRUITING

Cross Cancer Institute

Edmonton, Alberta, Canada

Site Status RECRUITING

BCCA - Surrey

Surrey, British Columbia, Canada

Site Status RECRUITING

BCCA - Vancouver

Vancouver, British Columbia, Canada

Site Status RECRUITING

BCCA - Victoria

Victoria, British Columbia, Canada

Site Status RECRUITING

Horizon Health Network

Fredericton, New Brunswick, Canada

Site Status RECRUITING

Royal Victoria Regional Health Centre

Barrie, Ontario, Canada

Site Status RECRUITING

Health Sciences North

Greater Sudbury, Ontario, Canada

Site Status RECRUITING

Juravinski Cancer Centre at Hamilton Health Sciences

Hamilton, Ontario, Canada

Site Status RECRUITING

Kingston Health Sciences Centre

Kingston, Ontario, Canada

Site Status RECRUITING

Waterloo Regional Health Network (WRHN)

Kitchener, Ontario, Canada

Site Status RECRUITING

London Health Sciences Centre Research Inc.

London, Ontario, Canada

Site Status RECRUITING

Trillium Health Partners - Credit Valley Hospital

Mississauga, Ontario, Canada

Site Status RECRUITING

Lakeridge Health Oshawa

Oshawa, Ontario, Canada

Site Status RECRUITING

Ottawa Hospital Research Institute

Ottawa, Ontario, Canada

Site Status RECRUITING

Odette Cancer Centre

Toronto, Ontario, Canada

Site Status RECRUITING

University Health Network

Toronto, Ontario, Canada

Site Status RECRUITING

The Research Institute of the McGill University

Montreal, Quebec, Canada

Site Status RECRUITING

Allan Blair Cancer Centre

Regina, Saskatchewan, Canada

Site Status RECRUITING

Saskatoon Cancer Centre

Saskatoon, Saskatchewan, Canada

Site Status RECRUITING

Countries

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Australia Canada

Central Contacts

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Janet Dancey

Role: CONTACT

Phone: 613-533-6430

Email: [email protected]

Facility Contacts

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Jose Leal

Role: primary

Karen Briscoe

Role: primary

Renuka Chittajallu

Role: primary

Ina Nordman

Role: primary

Matteo Carlino

Role: primary

Mary Wagih Azer

Role: primary

Megan Lyle

Role: primary

Marcin Dzienis

Role: primary

Rachel Roberts-thomson

Role: primary

Muhammad Alamgeer

Role: primary

Mark Shackleton

Role: primary

Melissa Eastgate

Role: primary

John Walker

Role: primary

Christopher Lee

Role: primary

Kerry J. Savage

Role: primary

Tara Baetz

Role: primary

M. Saleem Raza

Role: primary

Jason Yu

Role: primary

Lacey Pitre

Role: primary

Elaine McWhirter

Role: primary

Mihaela Mates

Role: primary

Gregory J. Knight

Role: primary

John Lenehan

Role: primary

Sudha Rajagopal

Role: primary

Rama Koneru

Role: primary

Xinni Song

Role: primary

Teresa M. Petrella

Role: primary

Marcus Butler

Role: primary

Catalin Mihalcioiu

Role: primary

Mussawar Iqbal

Role: primary

Tahir Abbas

Role: primary

Other Identifiers

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UQ-QMP-0001

Identifier Type: OTHER

Identifier Source: secondary_id

ME13

Identifier Type: -

Identifier Source: org_study_id