In the proposed study, NM-IL-12 will be evaluated as immunotherapy to increase antitumor efficacy against CTCL, while reducing skin-related toxicity, when combined with low-dose TSEBT therapy. Determination of the maximum tolerated dose (MTD) for NM-IL-12 is not planned in this study, rather, a pre-defined starting dose will be explored; this dose is based on two safety and tolerability studies of NM-IL-12 in healthy volunteers.
This is a single arm, open-label, non-randomized study with NM-IL-12 dosed in combination with low dose TSEBT in CTCL patients. This study is planned to be conducted in 10 patients, 18 years or older in age, undergoing low dose TSEBT of 12 Gy over a 3-week period. The study will initially enroll 4 patients and then will be expanded to enroll 6 additional patients (total 10 patients) depending on the presence or absence of Dose Modifying Criteria (DMC). Decision whether to de-escalate will be made after first 4 patients are followed up for 28 days from the first dose of NM-IL-12. Safety monitoring will continue throughout the whole period of drug administration and the treatment will be discontinued if intolerable toxicity or disease progression occurs during this period.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
The LD-TSEBT treatment will start on Day 1 of the study. NM-IL-12 will be administered subcutaneously.
Stanford Cancer Center
Stanford, California, United States
Columbia University Medical Center
New York, New York, United States
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Safety and tolerability will be evaluated on the basis of the following parameters (Vital signs, physical examination,Toxicity according to the NCI CTCAE, Immunogenicity evaluated by the presence of anti-drug antibody) :
General safety: Vital signs (temperature, blood pressure, pulse rate, respiratory rate) and physical examination. Toxicity according to the NCI CTCAE (v4.03) for AEs and clinical laboratory profile; AEs will be collected in all patients who received at least one dose of NM-IL-12 and up to four weeks post last NM-IL-12 dose. Immunogenicity of NM-IL-12 will be evaluated by the presence of anti-drug antibody (ADA)
Time frame: 107 weeks
Clinical Response measured by a modified severity-weighted assessment tool (mSWAT)
Exploratory skin clinical responses measured by a modified severity-weighted assessment tool (mSWAT)
Time frame: 107 weeks
Progression free survival
Progression free survival based on every 4 week follow up after the monthly dose until one of the events below occurs first: * Progressive disease is documented * Another treatment for CTCL is administered (topical or systemic) * 107 weeks are completed after the patient's first dose of NM-IL-12
Time frame: 107 weeks
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