This is a dose escalation protocol to determine the feasibility of co-administration of RRx-001 and nivolumab. Immune surveillance is an endogenous mechanism to cause remission of neoplastic growth. Epigenetic agents like RRx-001 are associated not only with enhanced gene transcription and restored expression of silenced genes but also with increased expression of pro-inflammatory mediators, upregulation of PD-L1 on tumor cells and de-repression of antigens that promote immune recognition of tumors. It is hypothesized that RRx-001, will prime or sensitize to immune checkpoint therapy targeting PD-1 interaction with nivolumab.
This is an open-label dose escalation study, consisting of the following periods: * 1\) Screening Period (Up to 16 days): Eligibility for the study will be determined by Screening tests, physical examination/medical history, and fulfillment of eligibility criteria. Potential participants are required to provide written informed consent prior to the performance of any study specific Screening procedures. * 2\) Treatment Period (Day 1 to 57): Between 15 and 45 eligible male and female adult subjects will receive weekly RRx-001 for a total of nine doses and every other week nivolumab for a total of 5 doses (odd cycles) or 4 doses (even cycles). Study medication (RRx-001 and nivolumab) will be administered intravenously at the study center. The Treatment Period will end following the last dose of nivolumab. Subjects will attend the study center weekly for on-study assessments. * 3\) Follow-up Period: Subjects that have completed nivolumab dosing will undergo a follow-up assessment monthly, up to 100 days, for the emergence of delayed toxicity with particular attention to delayed immune related toxicities.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Walter Reed National Military Medical Center
Bethesda, Maryland, United States
Number, frequency and type of adverse events
Time frame: 23 weeks
Time to Tumor Progression (TTP)
Time to Tumor Progression (TTP) using Response Evaluation Criteria in Solid Tumors \[RECIST v1.1\] criteria
Time frame: 23 weeks
Overall Survival
Time frame: 2 years
Clinical benefit Rate
Duration of clinical benefit (Stable disease or better) using Response Evaluation Criteria in Solid Tumors \[RECIST v1.1\] criteria
Time frame: 23 weeks
Progression-Free Survival (PFS)
Progression-Free Survival (PFS) using Response Evaluation Criteria in Solid Tumors \[RECIST v1.1\] criteria
Time frame: 23 weeks
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