This pilot phase 1-2 trial studies the side effects and best of dose ipilimumab when given together with local radiation therapy and to see how well it works in treating patients with recurrent melanoma, non-Hodgkin lymphoma, colon, or rectal cancer. Monoclonal antibodies, such as ipilimumab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Radiation therapy uses high energy x rays to kill cancer cells. Giving monoclonal antibody therapy together with radiation therapy may be an effective treatment for melanoma, non-Hodgkin lymphoma, colon, or rectal cancer. * The phase 1 component ("safety") of this study is ipilimumab 25 mg monotherapy. * The phase 2 component ("treatment-escalation") of this study is ipilimumab 25 mg plus radiation combination therapy.
PRIMARY OBJECTIVES: 1\. To assess the safety of combining intratumoral anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4) immunotherapy with local radiation therapy in patients with melanoma, non-Hodgkin lymphoma, and colorectal carcinoma with a monotherapy ipilimumab safety lead-in. SECONDARY OBJECTIVES: 1. To assess the induction of an anti-tumor immune responses using laboratory correlative studies. 2. To determine tumor response rates and duration of response at unirradiated tumor sites in patients with advanced malignancies. 3. To identify putative immunologic biomarkers of tumor response. OUTLINE: This is a phase I safety study of ipilimumab monotherapy, followed by a phase 2 study. Only a few subjects participated in the phase 1 portion of this study. The phase 2 treatment-escalation portion of this study (ipilimumab plus radiation combination therapy) was not conducted. Patients receive ipilimumab intratumorally on day 1 and undergo local radiation therapy within 48 hours for at least 3 fractions. After completion of study treatment, patients are followed up at 4 and 8 weeks, and then every 24 weeks for 5 years.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
3
Given intratumorally
Undergo local radiation therapy, 10 Gy x 3 fractions
Stanford University
Stanford, California, United States
Dose-limiting Toxicity
Safety as the percentage of patients in Phase 1 (ipilimumab monotherapy) of the study, who experienced dose-limiting toxicities (DLTs) or serious adverse events (SAEs), using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
Time frame: 4 weeks
Immune Response (Phase 2 Only)
Data will be summarized using proportions with exact 95% confidence intervals, means, standard deviations, and ranges.
Time frame: 4 weeks
Immune Response (Phase 2 Only)
Data will be summarized using proportions with exact 95% confidence intervals, means, standard deviations, and ranges.
Time frame: 8 weeks
Response Rate (Phase 2 Only)
Response rates calculated based on the Response Evaluation Criteria in Solid Tumors (RECIST)/RECIST Immunotherapy and Cheson criteria (Phase 2 only). Response rate data will be summarized using proportions with exact 95% confidence intervals, means, standard deviations, and ranges.
Time frame: 8 weeks
Overall Survival (Phase 2 Only)
Data will be summarized using Kaplan-Meier estimates for time to event data.
Time frame: Up to 5 years
Duration of Response (Phase 2 Only)
Data will be summarized using Kaplan-Meier estimates for time to event data.
Time frame: Up to 5 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.