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The goal of this clinical trial is to learn if DOC1021 + pIFN will be safe and will lead to tumor responses in patients with refractory melanoma. DOC1021 is a dendritic cell immunotherapy derived from a patient's own blood cells and loaded with antigens from the patient's tumor in the form of tumor lysate and mRNA. The goal is to stimulate a T cell immune response that eliminates tumor cells.
The study consists of two components: an initial phase I safety study to confirm safety/tolerability of the treatment regimen, and, subsequently, a single-arm phase II cohort to assess efficacy of the treatment regimen.
All participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental: DOC1021 + pIFN | Experimental | DOC1021 administered by injection near active tumor lesion lymph nodes + pIFN |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DOC1021 | Biological | Double-loaded dendritic cell vaccine, loaded with tumor lysate and mRNA using proprietary method |
|
| Measure | Description | Time Frame |
|---|---|---|
| Phase I: To evaluate the number of dose limiting toxicities reported | From time of first DOC1021 dose administration to 6 weeks later | |
| Phase II: To evaluate the objective response rate (ORR) as the proportion of patients with a confirmed complete response (CR) or partial response (PR) to treatment, as per RECIST 1.1 criteria | 5 years |
| Measure | Description | Time Frame |
|---|---|---|
| Overall survival (time in months from the date of study enrollment until death for from any cause) | 5 years | |
| Time in months from the first documentation of complete or partial response to disease progression by RECIST 1.1 criteria or death, whichever occurs first. |
| Measure | Description | Time Frame |
|---|---|---|
| Health-related quality of life in all participants as assessed by EORTC Quality of Life Questionnaire Cancer QLC-C30 (Cancer 30-items). | All items are scored 1 (worse outcome) to 4 (better outcome) or 1 (worse outcome) to 7 (better outcome). All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. | 5 years |
Inclusion Criteria:
Provision of signed and dated informed consent form
Stated willingness to comply with all study procedures and avail-ability for the duration of the study
Age 18 years or older
Patients diagnosed with unresectable or metastatic melanoma and progressed following ≥1 prior systemic therapy including anti-PD-1 (i.e., refractory to anti-PD-1). Refractory defined as primary or secondary resistance as per SITC guidelines, except that confirmatory scan not required if clinical progression requiring surgery or radiation to relieve symptoms
Willing and able to withhold anti-PD-1 treatment from the time of enrollment through ~6 weeks after the first DOC1021 administration
One or more lesions available for biopsy or resection to yield at least 50 mg (e.g., 5 core biopsies) and preferably 100 mg of tumor for generating DOC1021 and at least 1 measurable target tumor lesion evaluable after DOC1021 by RECIST version 1.1.
Brain metastases allowed if stable after prior treatment
Ability to receive filgrastim (e.g. Neupogen), leukapheresis and perinodal injections of DOC1021 near regional nodes + weekly pIFN x 4 weeks.
Females of reproductive potential must have a negative serum pregnancy test and agree to use effective contraception (as deter-mined appropriate for the patient by the investigator) during study treatment.
Adequate kidney, liver, bone marrow function, and immune function, as follows:
i. For males = (140 - age[years]) x (body weight [kg]) / (72 x serum creatinine [mg/dL]) ii. For females = 0.85 x value from male formula e. Total bilirubin ≤ 1.5 times upper limit of normal (ULN) except in patients with Gilbert's disease for which total bilirubin must be ≤ 3 times ULN f. Aspartate transaminase AST (SGOT) and alanine aminotransferase ALT (SGPT) ≤ 3 times the ULN (or ≤ 5.0 × ULN if liver metastases)
Eastern Cooperative Group (ECOG) Performance Score 0 or 1
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Alabama at Birmingham | Recruiting | Birmingham | Alabama | 35233 | United States |
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| ID | Term |
|---|---|
| D008545 | Melanoma |
| 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 |
|---|---|
| D000094463 | Transurethral Resection of Bladder |
| C100416 | peginterferon alfa-2a |
| ID | Term |
|---|---|
| D013520 | Urologic Surgical Procedures |
| D013519 | Urogenital Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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| Tumor resection | Procedure | Tumor resection or biopsy |
|
| pIFN (peginterferon alfa-2a) | Drug | pIFN 180 mcg subcutaneously every week for 4 total doses |
|
Duration of Response (DOR)
| 5 years |
| Time in months from date of study enrollment to disease progression by RECIST 1.1 criteria or death from any cause | Progression-free survival (PFS) | 3 years |
| The proportion of participants with complete response, partial response, or stable disease out of the total eligible and evaluable participants. | Disease control rate (DCR) | 5 years |
| Number of participants with adverse events as assessed by CTCAE v5.0 | 3 years |
| To evaluate the objective response rate (ORR) as the proportion of patients with a confirmed complete response (CR) or partial response (PR) to treatment, as per immune-related response criteria (iRECIST) | 5 years |
| Change in circulating tumor DNA (ctDNA) levels after DOC1021 administration. | 5 years |
| Banner MD Anderson Cancer Center | Recruiting | Gilbert | Arizona | 85234 | United States |
|
| City of Hope | Recruiting | Duarte | California | 91010 | United States |
|
| Massachusetts General Hospital Cancer Institute | Recruiting | Boston | Massachusetts | 02114 | United States |
|
| UT Southwestern | Recruiting | Dallas | Texas | 75235 | United States |
|
| 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 |