The current clinical trial shall clarify a synergistic effect with regards to efficiency by the combination of intratumoral injection of interleukin-2 (IL-2) and the intra-venous application of ipilimumab.
Intratumoral injection of interleukin-2 (IL-2) into melanoma metastases is a highly efficient local treatment. Furthermore, a systemic effect is assumed based on the observation of a favorable long term outcome. However, objective responses in untreated lesions have not been observed yet. Ipilimumab seems to be efficient in a subset of treated patients by inhibition of down-regulation of tumor-specific cellular immune-responses. In the context of the proposed trial, we assume (i) that ipilimumab could potentiate systemic melanoma-specific immune responses, which are primarily induced by intratumoral IL-2 and (ii) that these immune responses become more effective with regards to not IL-2 injected distant lesions. Therefore we assume a synergistic effect with regards to efficiency by the combination.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
intratumoral injections of 9 MIU/day on days 1, 4, 8, 11, 15, 18, 22 and 25. The administered dose will be distributed between all injectable soft-tissue metastases
IV infusion, 3 mg/kg, day 2, 23, 44, 65
University Hospital Tübingen
Tübingen, Germany
Control rate
To determine efficacy of the combined treatment with ipilimumab and intratumoral IL-2 by assessment of Disease control rate according to immune-related response criteria (irDCR) at week 12
Time frame: at week 12
Tolerability
Tolerability according to NCI-CTCAE-Criteria (version 4)
Time frame: within 12 months after start of treatment
Overall survival
Overall survival
Time frame: within 12 months after start of treatment
Best Overall Response Rate
Best Overall Response Rate (irBORR) according to irRC
Time frame: within 12 months after start of treatment
Overall response rate
Overall response rate (sum of irPR and irCR) according to irRC
Time frame: at week 12
Overall Response Rate
Overall Response Rate according to modified mWHO criteria
Time frame: at week 12
Best Overall Response Rate
Best Overall Response Rate according to modified mWHO criteria
Time frame: within 12 months after start of treatment
Response rate of injected metastases only
Response rate of injected metastases only
Time frame: at week 12
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Rate of patients with substantial increase of anti-melanoma T-cells in peripheral blood during treatment
Rate of patients with substantial increase of anti-melanoma T-cells in peripheral blood during treatment
Time frame: within 22 weeks after start of treatment
Changes in T-cell subsets during treatment
Changes in T-cell subsets during treatment
Time frame: within 22 weeks after start of treatment
Changes in subsets of tumor-infiltrating lymphocytes during treatment
Changes in subsets of tumor-infiltrating lymphocytes during treatment
Time frame: within 22 weeks after start of treatment