Dose Escalation and Cohort Expansion of Safety and Tolerability Study of Intratumoral rAd.CD40L (ISF35) in Combination of Systemic Pembrolizumab in Patients With Refractory Metastatic Melanoma

NCT02719015 | Withdrawn Phase 1 FDA Drug

• 1 other identifier: 2015-0199
• Study Type: interventional
• Target: N/A
• Locations: 0 countries
• Sites: N/A

Brief Summary

The goal of this clinical research study is to find the highest tolerated dose of rAd.CD40L (also called ISF35) when given with pembrolizumab to patients with melanoma. Researchers also want to learn if the highest tolerated dose of ISF35 and pembrolizumab can help to control the disease. The safety of this drug combination will be also be studied.

Conditions

Melanoma

Keywords

Melanoma; Refractory Metastatic Melanoma; rAd.CD40L; ISF35; Intratumoral; IT; Pembrolizumab; Keytruda; MK-3475; SCH-900475; MM

Outcome Measures

Primary Outcomes (2)

• Maximum Tolerated Dose (MTD) of Intratumoral rAd.CD40L

  MTD defined as the dose with the smallest absolute difference between the estimate of pi and the true pT for which Prob (pi \> pT \| data) is less than 5%.

  3 weeks

• Overall Response Rate (ORR) of Intratumoral rAd.CD40L

  Tumor response to therapy assessed using immune-related response criteria (irRC), which is a modified version of the World Health Organization (WHO) criteria.

  12 weeks

Study Arms (1)

rAd.CD40L + Pembrolizumab

EXPERIMENTAL

The dose escalation phase will include rAd.CD40L dose escalation and increase in the number of injected sites/lesions. Once patients tolerate dose level 1 (1 injection site and 1x1011vp-MTD) in Dose Escalation cohort, Expansion cohort will open with same maximum number of injection sites at maximum tolerated dose from Dose Escalation cohort. All participants receive same dosage of Pembrolizumab in both phases.

Drug: rAd.CD40L; Drug: Pembrolizumab

Interventions

rAd.CD40L DRUG

Dose Escalation Phase Starting Dose: 5x10\^10 vp per tumor as an injection directly into 1-3 tumors every 3 weeks. Same tumors injected for each of the 4 injections at week 0, 3, 6 and 9. If the dose well tolerated, the rAd.CD40L escalated to 1x10\^11 vp. Subsequently enrolled patients injected at the same dose of 1x10\^11 vp. Number of injected sites/tumors increased to two sites/lesions if patients have \>/=2 injectable lesions, at the same injection dose of 1x10\^10 up to three separate sites/lesions if patients have \> 3 injectable lesions. Dose Expansion Phase Starting Dose: MTD from Dose Escalation Phase.

Also known as: ISF35

rAd.CD40L + Pembrolizumab

Pembrolizumab DRUG

Dose Escalation and Expansion Phases: 2 mg/kg by vein every 3 weeks.

Also known as: Keytruda, MK-3475, SCH-900475

rAd.CD40L + Pembrolizumab

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Dose escalation: Patients with metastatic melanoma with measurable, stage III (in transit lesions) or stage IVA, IVB or IVC disease (at least 2 measurable lesions/tumors. Patients will be required to have one more lesion present than the number the current dose level requires since one lesion will be left untreated.
• Expansion cohorts: Patients with metastatic melanoma with measurable, stage III (in transit lesions) or stage IVA, IVB or IVC disease at least two measurable lesions/tumors
• Patients who have tested positive for a BRAF mutation may have received prior BRAF inhibitor therapy as a prior line of systemic therapy. Patients may have received up to 2 prior lines of therapy with a checkpoint inhibitor (CPI), which may have included pembrolizumab, nivolumab, or ipilimumab. These agents may have been administered as single-agent treatment, in combination with each other, or in combination with other agents. Patients who have received prior treatment with ipilimumab must have relapsed after achieving a response to prior ipilimumab treatment. This response may have been achieved with ipilimumab administered as single-agent therapy or in combination with another treatment. Patients who have received prior treatment with pembrolizumab or nivolumab must have progression of disease after at least 4 doses of either drug alone or in combination with other agents.
• Age \>/= 18 years
• Clinical performance status of Eastern Cooperative Oncology Group (ECOG) 0 - 1 within 30 days of signing informed consent.
• Total bilirubin less than or equal to 2.0 mg/dl, except in patients with Gilbert's Syndrome who must have a total bilirubin less than 3.0 mg/dl.
• Platelet count greater than or equal to 100,000/mm3
• white blood cell count (WBC) \>/=3000/mm3
• Serum ALT and AST \<3 the upper limit of normal (ULN); \<5 ULN if there is liver involvement secondary to the tumor
• Serum creatinine \</= 2.0 mg/dl
• Seronegative for HIV antibody
• Patients with a negative pregnancy test (urine or serum) must be documented within 14 days of screening for women of childbearing potential (WOCBP). A WOCBP has not undergone a hysterectomy or who has not been naturally postmenopausal for at least 12 consecutive months (i.e. who has not had menses at any time in the preceding 12 consecutive months).
• Unless surgically sterile by bilateral tubal ligation or vasectomy of partner(s), the patient agrees to continue to use a barrier method of contraception throughout the study such as: condom, diaphragm, hormonal, intrauterine device (IUD), or sponge plus spermicide. Abstinence is an acceptable form of birth control.

You may not qualify if:

• Patients who have previously received anti cluster of designation antigen 40 (CD40) (Agonistic) therapy prior Adjuvant Interferon (IFN-α), is allowed if last dose was received at least 6 months from enrolling to protocol.
• Active autoimmune disease requiring disease modifying therapy.
• Concurrent systemic steroid therapy higher than physiologic dose (\>7.5 mg/Day of prednisone).
• Any form of active primary or secondary immunodeficiency.
• Prior malignancy except the following: adequately treated basal cell or squamous cell skin cancer, in-situ cervical cancer, thyroid cancer (except anaplastic) or any cancer from which the patient has been disease-free for 2 years.
• Subjects who have received prior oncolytic therapy or prior therapy with and TLR agonist including topical agents. Subjects that have received experimental vaccines or other immune therapies should be discussed with the medical monitor or the Principal Investigator (PI) to confirm eligibility.
• Active systemic infections requiring intravenous antibiotics.
• Prior systemic therapy, radiation therapy, or surgery within 28 days of starting study treatment. Palliative radiotherapy to a limited field or palliative cryoablation is allowed after consultation with the principle Investigator, at any time during the study participation including screening.
• Patients who are pregnant or nursing.

Sponsors & Collaborators

• M.D. Anderson Cancer Center: lead
• Memgen, LLC: collaborator

Related Links

• University of Texas MD Anderson Cancer Center Website

MeSH Terms

Conditions

Melanoma

Interventions

pembrolizumab

Condition Hierarchy (Ancestors)

Neuroendocrine Tumors; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Nerve Tissue; Nevi and Melanomas; Skin Neoplasms; Neoplasms by Site; Skin Diseases; Skin and Connective Tissue Diseases

Study Officials

• Adi Diab, MD

  M.D. Anderson Cancer Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 21, 2016
• First Posted: March 24, 2016
• Study Start: March 1, 2018
• Primary Completion: March 1, 2022
• Study Completion: March 1, 2022
• Last Updated: November 24, 2017

Record last verified: 2017-11