Monoclonal Antibody Therapy and Interleukin-2 in Treating Patients With Metastatic Melanoma
Study Details
Study Description
Brief Summary
RATIONALE: Biological therapies, such as MDX-010, work in different ways to stimulate the immune system and stop tumor cells from growing. Interleukin-2 may stimulate a person's white blood cells to kill tumor cells. Combining monoclonal antibody therapy with interleukin-2 may kill more tumor cells.
PURPOSE: Phase I/II trial to study the effectiveness of combining monoclonal antibody therapy with interleukin-2 in treating patients who have metastatic melanoma.
Condition or Disease | Intervention/Treatment | Phase |
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|
Phase 1/Phase 2 |
Detailed Description
OBJECTIVES:
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Determine the maximum tolerated dose (MTD) of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4) in combination with high-dose interleukin-2 (IL-2) in patients with metastatic melanoma. (Phase I is closed to accrual as of 4/13/2004).
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Determine the activity of MDX-CTLA4 administered at the MTD with high-dose IL-2 in these patients.
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Determine whether the administration of IL-2 alters the pharmacokinetics of MDX-CTLA4 in these patients.
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Determine the safety and adverse event profile of this regimen in these patients.
OUTLINE: This is an open-label, dose-escalation study of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4).
- Phase I: Patients receive MDX-CTLA4 IV on days 0, 21, and 42. Patients also receive high-dose interleukin-2 (IL-2) IV over 15 minutes every 8 hours for up to 15 doses beginning on days 22 and 43. Treatment repeats every 63 days for up to 3 courses in the absence of disease progression or unacceptable toxicity. Patients with an ongoing partial response and no greater than grade 1 toxicity may receive additional courses of therapy. Patients who require discontinuation of MDX-CTLA4 due to toxicity may continue receiving IL-2 at the discretion of the investigator.
Cohorts of 3-6 patients receive escalating doses of MDX-CTLA4 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. (Phase I is closed to accrual as of 4/13/2004).
- Phase II: Patients receive treatment as in phase I at the MTD of MDX-CTLA4. Patients who achieve a partial or complete response and later develop recurrent or progressive disease may be retreated at the same dose.
Patients are followed at 3 weeks, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 3-51 patients (3-18 for phase I and 19-33 for phase II) will be accrued for this study within 1 year. (Phase I is closed to accrual as of 4/13/2004).
Study Design
Outcome Measures
Primary Outcome Measures
Eligibility Criteria
Criteria
DISEASE CHARACTERISTICS:
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Histologically confirmed stage IV melanoma
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Mucosal or ocular melanoma also eligible
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Clinically evaluable disease
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At least 1 site of measurable disease
PATIENT CHARACTERISTICS:
Age
- 16 and over
Performance status
- ECOG 0-1
Life expectancy
- At least 3 months
Hematopoietic
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WBC at least 2,500/mm^3
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Absolute neutrophil count at least 1,500/mm^3
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Platelet count at least 100,000/mm^3
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Hemoglobin at least 10 g/dL
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Hematocrit at least 30%
Hepatic
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Bilirubin no greater than upper limit of normal (ULN)* (less than 3.0 mg/dL in patients with Gilbert's syndrome)
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AST no greater than 3 times ULN*
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Hepatitis B surface antigen negative
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Hepatitis C antibody nonreactive
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No evidence or history of significant hepatic disease that would preclude safe administration of high-dose IL-2 NOTE: *Unless attributable to disease
Renal
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Creatinine no greater than 2.0 mg/dL
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No evidence or history of significant renal disease that would preclude safe administration of high-dose IL-2
Cardiovascular
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No evidence or history of significant cardiac disease that would preclude safe administration of high-dose IL-2
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Thallium stress test normal (for patients over 50 years of age or with a history of cardiovascular disease)
Pulmonary
- No evidence or history of significant pulmonary disease that would preclude safe administration of high-dose IL-2
Immunologic
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HIV negative
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No autoimmune disease (including uveitis and autoimmune inflammatory eye disease)
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No active infection
Other
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Not pregnant or nursing
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Negative pregnancy test
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Fertile patients must use effective contraception
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No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix
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No evidence or history of significant gastrointestinal disease that would preclude safe administration of high-dose IL-2
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No evidence or history of psychiatric disease that would preclude safe administration of high-dose IL-2
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No other underlying medical condition that would make the administration of the study drug hazardous or obscure the interpretation of adverse events
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No other concurrent medical condition that would preclude study entry
PRIOR CONCURRENT THERAPY:
Biologic therapy
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At least 3 weeks since prior immunotherapy for melanoma and recovered
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No prior anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4)
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No prior high-dose (at least 600,000 IU/kg every 8 hours) interleukin-2 (IL-2)
Chemotherapy
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At least 3 weeks since prior chemotherapy for melanoma and recovered
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No concurrent chemotherapy
Endocrine therapy
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At least 3 weeks since prior hormonal therapy for melanoma and recovered
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At least 4 weeks since prior corticosteroids
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No concurrent systemic or topical corticosteroids
Radiotherapy
- At least 3 weeks since prior radiotherapy for melanoma and recovered
Surgery
- Not specified
Other
- No concurrent immunosuppressive agents (e.g., cyclosporine or its analog)
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support | Bethesda | Maryland | United States | 20892-1182 |
Sponsors and Collaborators
- National Cancer Institute (NCI)
Investigators
- Study Chair: Steven A. Rosenberg, MD, PhD, NCI - Surgery Branch
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- CDR0000287211
- NCI-03-C-0109
- NCT00055211