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Study Withdrawn by Sponsor prior to Enrollment.
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The photoactivating agent UVADEX (methoxsalen) is used in conjunction with extracorporeal photopheresis (ECP) as an immunomodulatory therapy approved for the treatment of cutaneous T-cell lymphoma. ECP involves collecting whole blood from the patient, separating white blood cells (WBCs) via centrifugation, combining them with UVADEX, and then exposing them to ultraviolet A (UVA) light. All blood components, including the treated WBCs, are then returned to the patient.
Immune Checkpoint inhibitor (ICI) therapy is used to treat different types of cancer, and one major side-effect of ICI therapy is immune-related colitis (ir-colitis). The main purpose of the study is to evaluate the efficacy of UVADEX in conjunction with ECP versus best available therapy (BAT) in participants with melanoma or NSCLC that suffer from ir-colitis with inadequate response to steroids.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| UVADEX in conjunction with extracorporeal photopheresis | Experimental | Participants will receive UVADEX, in conjunction with ECP procedure twice weekly for four weeks and then every other week for 8 weeks during the 12-week treatment period according to the treatment schedule. |
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| Best available therapy (BAT) | Active Comparator | Participants will receive either infliximab or vedolizumab as per the investigator's choice during the 12-week treatment period. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Methoxsalen | Drug | Sterile solution used in conjunction with photopheresis procedure. |
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| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Participants with Remission of ir-colitis at End of Treatment | Composite endpoint of remission measured by diarrhea frequency (CTCAE grade 0 or 1 at Week 12) and colonic mucosal endoscopy score (modified Mayo Score 0 or 1 at Week 13). | Week 12 (diarrhea frequency) / Week 13 (colonic mucosal endoscopy score) |
| Measure | Description | Time Frame |
|---|---|---|
| Total Duration of Remission for ir-colitis Based on the Criteria for Diarrhea | Duration of remission is the time from when diarrhea improves until the time it comes back (if it does). | Week 64 |
| Proportion of Participants with Complete Resolution of Diarrhea |
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Inclusion Criteria:
Exclusion Criteria:
Note: Other Inclusion/Exclusion criteria also apply.
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| Name | Affiliation | Role |
|---|---|---|
| Clinical Team Leader | Therakos LLC | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pittsburgh Medical Center | Pittsburgh | Pennsylvania | 15213 | United States |
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| ID | Term |
|---|---|
| D008545 | Melanoma |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| D008730 | Methoxsalen |
| D000069285 | Infliximab |
| C543529 | vedolizumab |
| ID | Term |
|---|---|
| D011564 | Furocoumarins |
| D003374 | Coumarins |
| D001578 | Benzopyrans |
| D011714 | Pyrans |
| D006573 |
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| Infliximab | Drug | Infliximab will be administered intravenously. |
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| Vedolizumab | Drug | Vedolizumab will be administered intravenously. |
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Complete resolution of diarrhea refers to normal stool frequency. |
| Week 12 |
| Proportion of Participants with Complete Resolution of Colonic Endoscopic Changes | Complete resolution of colonic endoscopic changes refers to no signs of inflammation or damage in the colon. | Week 13 |
| Proportion of Participants with Corticosteroid-free Clinical Remission | Corticosteroid-free clinical remission is assessed based on the absence of diarrhea and daily corticosteroid dose <5 mg prednisolone or equivalent at week 12. | Week 12 |
| Changes in the Nancy Score | The Nancy histological index comprises 3 histological items defining 5 grades of disease activity: Grade 0 is absence of significant histological disease; Grade 1 is chronic inflammatory infiltrate with no acute inflammatory infiltrate; Grade 2 is mildly active disease; Grade 3 is moderately active disease; and Grade 4 is severely active disease. | Week 13 |
| Proportion of Participants with Stool Calprotectin Level <150 micrograms per gram (μg/g) | Week 26 |
| Proportion of Participants with Complete Resolution of Other Symptoms of ir-colitis | Week 64 |
| Time to Complete Resolution of ir-colitis Based on Common Terminology Criteria for Adverse Events (CTCAE) Criteria for Colitis | Week 64 |
| Time to Complete Resolution of Other Specified Immune-related Adverse Events (irAEs) (other than ir-colitis) | The other specified irAEs may include pruritis, rash, inflammatory dermatitis, esophagitis, gastritis, hepatitis, pneumonitis, arthritis, myositis, polymyalgia and nephritis. | Week 64 |
| Time to Complete Discontinuation of Systemic Corticosteroids for at least 1 Week | This is the time taken by a participant to stop using systemic corticosteroids entirely for at least one week. | Week 12 |
| Progression Free Survival (PFS) for Melanoma and NSCLC | The approximate time from the start of treatment until the first incidence of cancer worsening or participants dying due to any cause. | Week 64 |
| Overall Survival (OS) | The approximate time from the start of treatment until death due to any cause. | Week 64 |
| 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 |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006575 | Heterocyclic Compounds, 3-Ring |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |