Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| Merck Sharp & Dohme LLC | INDUSTRY |
Not provided
Not provided
Not provided
This is a phase 1b study for patients with metastatic (cancer has spread to various parts of the body) melanoma and ovarian cancer. The main purpose is to examine the safety and efficacy of administering pembrolizumab after receiving chemotherapy, tumor-infiltrating lymphocytes (TIL) and low dose interleukin 2 (IL-2).
Patients will first receive either cyclophosphamide, or cyclophosphamide and fludarabine. These are chemotherapy agents that prepare the body to receive TILs.
Patients are then infused with autologous TILs, a type of white blood cell that recognizes tumor cells and enters them, thereby causing tumor cells to break down.
Following TILs infusion, patients will receive low-dose IL-2 therapy. This is a type of protein that is intended to activate and stimulate the growth of cells in the patient's immune system.
If the patient meets the required criteria, they will be given pembrolizumab, a monoclonal antibody (drug made up of cloned immune cells) that is designed to block a protein called programed cell death ligand 1 (PD-L1) which will allow the body's immune system to kill the cancer cells.
This study will involve treatment with chemotherapy, TILs, IL-2, pembrolizumab, tests and procedures done for safety, and the collection of archival tumor tissue, fresh tumor biopsies, and blood samples for biomarker research.
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Advanced metastatic melanoma (Cohort 1) | Experimental | Cyclophosphamide and fludarabine followed by Tumor-Infiltrating Lymphocytes (TILs), Interleukin-2 (IL-2), and pembrolizumab |
|
| Advanced ovarian cancer (Cohort 2): | Experimental | Cyclophosphamide followed by Tumor-Infiltrating Lymphocytes (TILs), Interleukin-2 (IL-2), and pembrolizumab |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cyclophosphamide | Drug | Cohort 1: i.v., 60mg/kg per day for 2 days Cohort 2: i.v., 30mg/kg per day for 2 days |
|
| Measure | Description | Time Frame |
|---|---|---|
| Monitoring of serious adverse events to determine the safety of initiating pembrolizumab following lymphodepleting chemotherapy, TIL administration, and low dose IL-2 injections within 35 days of TIL infusion. | Toxicities will be monitored on an ongoing basis. Severe adverse events will be reviewed for attribution to the study drug and whether they resolve to an acceptable grade within 35 days of TIL infusion. This information will be used to determine if the patient will go on to receive pembrolizumab. The regimen will be deemed feasible if at least 80% of patients enrolled go on to receive pembrolizumab. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Overall Response Rate | To evaluate the response rate of pembrolizumab following or in combination with ACT using measurable disease by RECIST v1.1. | 2 years |
| Overall and Progression Free Survival |
Not provided
Pre-TIL Inclusion Criteria:
Cohort 1 Pre-TIL inclusion criteria:
Cohort 2 Pre-TIL inclusion criteria:
Platinum resistant ovarian cancer, histologically confirmed
• Platinum resistant as defined by evidence of radiographic progression within 6 months of the last dose of platinum.
Prior systemic anti-CTLA-4 therapy is allowed, provided that the first dose of pembrolizumab is administered more than 6 weeks after the last dose of anti-CTLA-4 treatment.
Eligible for ACT with autologous TIL
Both Cohorts 1 and 2 (pre-TIL):
Subjects may have 3 or fewer asymptomatic brain metastases, ≤ 1 cm in size each. Note: If lesions are symptomatic, >1 cm each in size, or more than 3 in number, these lesions must undergo definitive treatment with surgery and/or radiation at least four weeks days prior to the first dose of lymphodepleting chemotherapy. If in the opinion of the PI or his designee the lesion(s) no longer represents active disease, the subject will be considered eligible.
No history of serious cardiac illness including (but not confined to):
Subjects who have a prolonged history of cigarette smoking or symptoms of respiratory dysfunction should not have abnormal pulmonary function test as evidenced by a FEV1 < 60% predicted within 4 weeks of chemotherapy.
Exclusion Criteria:
Subjects with ongoing prior use of systemic steroid therapy within 4 weeks before the TILs infusion will be excluded. Use of topical, intranasal and inhaled corticosteroids, or systemic corticosteroids at physiologic doses are allowed.
Cohort 1 and 2 Post-TIL (pembrolizumab) inclusion criteria:
Cohort 1 and 2 Post-TIL (pembrolizumab) exclusion criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Marcus Butler, M.D. | Tumor Immunotherapy Program, Princess Margaret Cancer Centre | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Princess Margaret Cancer Centre | Toronto | Ontario | M5G 2M9 | Canada |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
Not provided
Not provided
| ID | Term |
|---|---|
| D003520 | Cyclophosphamide |
| C024352 | fludarabine |
| C042382 | fludarabine phosphate |
| C582435 | pembrolizumab |
| D007376 | Interleukin-2 |
| C082598 | aldesleukin |
| ID | Term |
|---|---|
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| Fludarabine | Drug | Cohort 1: i.v., 25mg/m2 per day for 5 days |
|
|
| Pembrolizumab | Procedure | Cohort 1 and 2: i.v., 200mg every 3 weeks |
|
|
| Tumor-Infiltrating Lymphocytes (TILs) | Biological | Cohort 1 and 2: i.v., 1x10^10 - 1.6x10^11 cells |
|
| Interleukin-2 (IL-2) | Biological | Cohort 1 and 2: i.v., 125,000 IU/kg subcutaneous per day |
|
|
To evaluate the survival outcomes of overall and progression free survival per tumour type
| 2 years |
| Safety profile of pembrolizumab therapy given after or in combination with ACT in patients with advanced melanoma and ovarian cancer using CTCAE v4.0 | Events that are both unrelated and related to treatment will be captured using CTCAE v4.0. The total number of episodes for each event will be reported, as well as the severity and attribution to study therapy. | 2 years |
| D009369 | Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D012878 | Skin Neoplasms |
| D009371 | Neoplasms by Site |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D007378 | Interleukins |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D008222 | Lymphokines |
| D011506 | Proteins |
| D001685 | Biological Factors |