Memory-Like Natural Killer Cells With Nivolumab and Relatlimab in Advanced or Metastatic Melanoma After Progression on Checkpoint Inhibitors

NCT05629546 | Recruiting Phase 1 DMC FDA Drug

• 1 other identifier: 202404189
• Study Type: interventional
• Target: 33
• Locations: 1 country
• Sites: 1

Brief Summary

This is a Phase 1 open-label, study designed to characterize the safety, tolerability, and preliminary anti-tumor activity of memory-like natural killer cells (ML NK) in combination with nivolumab and relatlimab in subjects with advanced and/or metastatic melanoma. There will be two arms to test the variables of ML NK cell source. ML NK cells from an autologous source will be used for Arm 1, and ML NK cells from an allogeneic source will be used for Arm 2. The investigators hypothesize that ML NK cells from either an autologous source or allogeneic source are safe and tolerable in subjects with advanced and/or metastatic melanoma.

Conditions

Advanced Melanoma; Metastatic Melanoma

Keywords

advanced melanoma; metastatic melanoma; checkpoint inhibitor resistant melanoma

Outcome Measures

Primary Outcomes (2)

• For treatment with cells from an autologous source: Incidence and severity of adverse events

  -As determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0)

  From start of treatment through end of safety follow-up (estimated to be 15 months)

• For treatment with cells from an allogeneic source: Incidence and severity of adverse events

  -As determined according to National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0 (NCI CTCAE v5.0)

  From start of treatment through end of safety follow-up (estimated to be 15 months)

Secondary Outcomes (5)

• Objective response rate (ORR)

  Through completion of treatment (estimated to be 12 months)

• Duration of response (DOR)

  Through completion of follow-up (estimated to be 3 years)

• Progression-free survival (PFS)

  Through completion of follow-up (estimated to be 3 years)

• Disease control rate (DCR)

  Through completion of follow-up (estimated to be 3 years)

• Overall survival (OS)

  Through completion of follow-up (estimated to be 3 years)

Study Arms (3)

Arm 1: Autologous: Memory-like natural killer cells + nivolumab + relatilimab

EXPERIMENTAL

* Subjects enrolled into arm 1 will receive autologous ML NK cells on Day 0. * Relatlimab and nivolumab will be initiated at day 29 and continue every 28 days for 11 cycles, or until unacceptable toxicity, or progression, whichever is earlier.

Biological: Cytokine-induced memory-like natural killer cells; Biological: Relatilmab; Biological: Nivolumab

Arm 2: Allogeneic: Memory-like natural killer cells + nivolumab + relatilimab

EXPERIMENTAL

* Subjects with a haploidentical donor will enroll into Arm 2 * Subjects will receive the IV infusion of ML NK cells on Day 0. * Relatlimab and nivolumab will be initiated at day 29 and continue every 28 days for 11 cycles, or until unacceptable toxicity, or progression, whichever is earlier.

Allogeneic Donors

NO INTERVENTION

Interventions

Cytokine-induced memory-like natural killer cells BIOLOGICAL

Cell product processing is performed at the Siteman Cancer Center Biological Therapy Core Facility (BTCF).

Also known as: ML NK cells, CIML

Arm 1: Autologous: Memory-like natural killer cells + nivolumab + relatilimab

Relatilmab BIOLOGICAL

Standard of care

Also known as: Opdualag

Arm 1: Autologous: Memory-like natural killer cells + nivolumab + relatilimab

Nivolumab BIOLOGICAL

Standard of care

Arm 1: Autologous: Memory-like natural killer cells + nivolumab + relatilimab

Eligibility Criteria

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

You may qualify if:

• Diagnosis of histologically confirmed advanced or metastatic melanoma that has progressed after at least 12 weeks or a minimum of 2 doses of treatment with a standard of care PD1/PDL1 containing therapy (nivolumab, pembrolizumab, atezolizumab, or durvalumab).
• Age: ≥18 years of age
• Have an Eastern Cooperative Oncology Group Performance Status (ECOG) ≤ 2 at screening Form Arm 1 only: Patients must meet the eligibility criteria to undergo apheresis to obtain autlogous NK cells.
• For Arm 2 only: Patient must have an available allogeneic NK cell donor who meets the eligibility criteria.
• Adequate organ function as defined below:
• Total bilirubin \< 2 mg/dL
• AST(SGOT)/ALT(SGPT) \< 3.0 x ULN
• Creatinine within normal institutional limits OR creatinine clearance \> 40 mL/min/1.73 m\^2 by Cockcroft-Gault Formula
• Oxygen saturation ≥ 90% on room air
• Ejection fraction ≥ 45%
• Patients with a prior history of symptomatic CNS metastases must have received treatment and be neurologically stable for at least for 4 weeks and off anti-seizure medication and steroids for 7 days prior to initiation of LDC.
• Able to be off corticosteroids and any other immune suppressive medications for at least 14 days prior to apheresis or lymphodepletion and continuing until 30 days after the infusion of the ML NK cells. However, use of physiological dosing of corticosteroids (defined as ≤15mg prednisone or equivalent) is permitted if deemed medically necessary.
• Women of childbearing potential must have a negative pregnancy test within 28 days prior to study registration. Female and male patients (along with their female partners) must agree to use two forms of acceptable contraception, including one barrier method, throughout participation in the study and for at least 5 months after the last dose of relatlimab.
• Life expectancy \>12 weeks
• Ability to understand and willingness to sign an IRB approved written informed consent document

You may not qualify if:

• Active autoimmune disorder requiring immunosuppression (physiologic steroids defined as ≤15mg prednisone or equivalent are acceptable).
• Prior history of an immune-related Grade 3 or 4 AE attributed to prior cancer immunotherapy (other than endocrinopathy managed with either replacement therapy or asymptomatic elevation of serum amylase or lipase) that resulted in permanent discontinuation of the prior immunotherapeutic agent.
• Patients with Grade ≤2 irAE who have not completely recovered from irAE (i.e. have residual toxicities \>Grade 1) related to prior cancer immunotherapy (other than endocrinopathy management with replacement therapy or stable vitiligo). Patients treated with corticosteroids for irAE must demonstrate absence of related signs or symptoms for ≥7 days following discontinuation of corticosteroids.
• Leptomeningeal disease, carcinomatous meningitis, or symptomatic CNS metastases. Patients with asymptomatic brain metastasis with no pending intervention needed, or patients with treated CNS disease and stable for at least 4 weeks and off anti-seizure medication and steroids for 7 days prior to initiation of LDC are eligible.
• Known hypersensitivity to one or more of the study agents.
• Comorbidities and any conditions, that in the opinion of the investigator, that put the subject at unacceptable risk for study therapy or prevent the participant from consenting or participating in the study.
• Uncontrolled and active systemic infections, including but not limited to HIV, Hepatitis B or C infection.
• Uncontrolled angina, severe uncontrolled ventricular arrhythmias, or EKG suggestive of acute ischemia or active conduction system abnormalities.
• New progressive pulmonary infiltrates concerning for new or uncontrolled infectious process. Infiltrates attributed to infection must be stable/ improving after 1 week of appropriate therapy (4 weeks for presumed or proven fungal infections).
• Received any investigational or off-label drugs, or cytotoxic chemotherapy within the 14 days or five half-lives (whichever is greater) prior to apheresis.
• Pregnant or breastfeeding.
• Subjects are not acceptable candidates if they received prior tumor infiltrating lymphocytes (TIL) therapy (either in the setting of clinical trial or standard of care if TIL therapy is FDA approved in the future), or an organ allograft.
• Has a known additional malignancy that is progressing or required active treatment within the past 2 years. Note: participants with basal cell carcinoma of the skin, squamous cell carcinoma of the skin, or carcinoma in situ (eg. Breast carcinoma, cervical cancer in situ) that has undergone potentially curative therapy are not excluded.
• Received a live or attenuated vaccine within 28 days prior to the beginning of the lymphodepletion therapy.
• Eligibility Criteria for Haploidentical Donors (For Arm 2 only)

Sponsors & Collaborators

• Washington University School of Medicine: lead
• Melanoma Research Alliance: collaborator
• Rising Tide Foundation: collaborator

Study Sites (1)

Washington University School of Medicine

St Louis, Missouri, 63110, United States

RECRUITING

Related Links

• Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

MeSH Terms

Conditions

Melanoma

Interventions

Opdualag; Nivolumab

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

Intervention Hierarchy (Ancestors)

Antibodies, Monoclonal, Humanized; Antibodies, Monoclonal; Antibodies; Immunoglobulins; Immunoproteins; Blood Proteins; Proteins; Amino Acids, Peptides, and Proteins; Serum Globulins; Globulins

Study Officials

• Alice Y Zhou, M.D., Ph.D.

  Washington University School of Medicine

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Alice Y Zhou, M.D., Ph.D.

CONTACT

314-362-5677; alice.y.zhou@wustl.edu

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Enrollment will occur in parallel into arms 1 and 2, but sequence of enrollment will be staggered for the first 3 patients, with sequential patients being enrolled upon the previous patient completing 30 days of observation. Approximately 11 allogeneic donors will also be enrolled for subjects in Arm 2.

Study Record Dates

• First Submitted: November 16, 2022
• First Posted: November 29, 2022
• Study Start: November 6, 2024
• Primary Completion (Estimated): February 28, 2029
• Study Completion (Estimated): November 30, 2030
• Last Updated: September 12, 2025

Record last verified: 2025-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)