Adoptive Tumor-infiltrating Lymphocyte Transfer With Nivolumab for Melanoma
NCT ID: NCT04165967
Last Updated: 2024-04-10
Study Results
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Basic Information
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COMPLETED
PHASE1
9 participants
INTERVENTIONAL
2020-09-17
2023-03-30
Brief Summary
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The study uses a personalized Investigational Medicinal Product (IMP), i.e. TIL product and in combination with IL-2 treatment and nivolumab.
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Detailed Description
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Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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Tumor-infiltrating lymphocyte product (TIL) transfer
The TIL product will be produced from excised tumor lesions from the patient. Expanded TILs will be transferred to the patient after non-myeloablative chemotherapy with cyclophosphamide and fludarabine. TIL transfer will be combined with low dose IL-2 and nivolumab anti-PD-1 treatment. The transplant product will be produced in the Good Manufacturing Practice (GMP) facility of the University Hospital in Basel. TIL transfer to Patient at Day 0.
Combination of TIL Transfer with anti-PD-1 Therapy and low dose IL-2
The study uses a personalized IMP, i.e. TIL product and in combination with IL-2 treatment and nivolumab.
Day 0: Autologous TIL: (minimum 5 x 109 and up to a maximum of 2 x 1011 lymphocytes) administered intravenously over 20 to 30 minutes.
Day 0: Interleukin-2 (Proleukin): 125.000 IU/kg/day s.c. for maximum 12 days as inpatients with a 2 days break after the first 4-5 doses (maximum 10 days dosing). Actual body weight will be used in calculating the dose of interleukin-2.
Starting Day 14: Nivolumab application 240 mg i.v. over 30 minutes ever 2 weeks with a maximum to 2 years, or until disease progression or inacceptable toxicity.
Interventions
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Combination of TIL Transfer with anti-PD-1 Therapy and low dose IL-2
The study uses a personalized IMP, i.e. TIL product and in combination with IL-2 treatment and nivolumab.
Day 0: Autologous TIL: (minimum 5 x 109 and up to a maximum of 2 x 1011 lymphocytes) administered intravenously over 20 to 30 minutes.
Day 0: Interleukin-2 (Proleukin): 125.000 IU/kg/day s.c. for maximum 12 days as inpatients with a 2 days break after the first 4-5 doses (maximum 10 days dosing). Actual body weight will be used in calculating the dose of interleukin-2.
Starting Day 14: Nivolumab application 240 mg i.v. over 30 minutes ever 2 weeks with a maximum to 2 years, or until disease progression or inacceptable toxicity.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* At least 1 PD-1 targeted immunotherapy and BRAF inhibition in case of BRAF mutated melanoma
* Resectable tumor mass and measurable disease by CT or MRI per RECIST 1.1 criteria (in addition to the resected lesion)
* World Health Organization (WHO) clinical performance Status (ECOG) 0-1
* Adequate organ function
* Patients of both genders must be willing to practice a highly effective method of birth control during treatment and for five months after receiving the last dose of nivolumab for women and seven months for men
* Patients must be able to understand and sign the Informed consent document
* Hematology: Absolute neutrophil count greater than 1.5 x 109/L without support of filgrastim. Platelet count greater than 100 x 109/L. Hemoglobin greater than 5 mmol/L, or 80 g/L.
* Chemistry: Serum alanine aminotransferase (ALAT)/ aspartate transaminase (ASAT) less than 3 times the upper limit of normal, unless patients have liver metastases (\< 5 times ULN). Serum creatinine clearance 50 ml/min or higher. Total Bilirubin less than or equal to 20 micromol/L, except in patients with Gilbert's Syndrome who must have a total bilirubin less than 50 micromol/L. Lactate dehydrogenase (LDH) ≤ 2x ULN
* Serology: Seronegative for HIV antibody. Seronegative for hepatitis B antigen, and hepatitis C antibody. Seronegative for syphilis.
Exclusion Criteria
* Patients with metastatic ocular/ mucosal or other non-cutaneous melanoma.
* Requirement for immunosuppressive doses of systemic corticosteroids (\>10 mg/day prednisone or equivalent) or other immunosuppressive drugs within the last 3 weeks prior to randomization
* Uncontrolled central nervous system (CNS) metastases. Controlled CNS metastases must be for at least 4 weeks stable.
* Documented Forced expiratory volume at one second (FEV1) less than or equal to 50% predicted for patients with:
* A prolonged history of cigarette smoking (greater than 20 pack/year within the past 2 years)
* Symptoms of respiratory distress
* All patients' toxicities due to prior non-systemic treatment must have recovered to a grade 1 or less. Patients may have undergone minor surgical procedures or focal palliative radiotherapy (to non-target lesions) within the past 4 weeks, as long as all toxicities have recovered to grade 1 or less.
* Women who are pregnant or breastfeeding, because of the potentially dangerous effects of the preparative chemotherapy on the fetus or infant.
* Any active systemic infections, coagulation disorders or other active major medical illnesses.
* Contraindication for IL-2 or nivolumab (allergies etc.).
* Any autoimmune disease: patients with a documented history of inflammatory bowel disease, including ulcerative colitis and Crohn's disease are excluded from this study as are patients with a history of symptomatic disease (e.g., rheumatoid arthritis, autoimmune thyroiditis (e.g. Hashimoto's disease), autoimmune hepatitis, systemic progressive sclerosis (scleroderma), Systemic Lupus Erythematosus, autoimmune vasculitis (e.g., Wegener's Granulomatosis). Subjects with motor neuropathy considered of autoimmune origin (e.g., Guillain-Barré Syndrome) are excluded from this study. Patients with vitiligo are eligible to enter the study
18 Years
75 Years
ALL
No
Sponsors
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GMP network of Basel
UNKNOWN
University Hospital, Basel, Switzerland
OTHER
Responsible Party
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Principal Investigators
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Heinz Läubli, Prof.
Role: PRINCIPAL_INVESTIGATOR
Division of Medical Oncology and Cancer Immunology, University Hospital Basel
Alfred Zippelius, Prof.
Role: STUDY_CHAIR
Division of Medical Oncology and Cancer Immunology, University Hospital Basel
Locations
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Division of Medical Oncology and Cancer Immunology, University Hospital Basel
Basel, , Switzerland
Countries
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References
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Other Identifiers
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2019-01908; me18Laeubli
Identifier Type: -
Identifier Source: org_study_id
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