Phase III, open-label, randomized, controlled multi-center study of the efficacy of L19IL2/L19TNF neoadjuvant intratumoral treatment in Stage III B/C melanoma patients.
Phase III, open-label, randomized, controlled multi-center study. In the study, 214 patients will be enrolled and parallel assigned (via automated randomization system) in a 1:1 fashion to one of two different arms: ARM 1: Patients in Arm 1 will receive multiple intratumoral administrations into all injectable cutaneous, subcutaneous, and nodal tumors of a mixture of L19IL2 and L19TNF once weekly for up to 4 weeks (or until all injectable tumors have disappeared, or intolerance to study treatment or in the opinion of the investigator immediate surgical resection or any other treatment for melanoma is warranted, whichever occurs first). The whole volume of L19IL2/L19TNF will be distributed among all injectable lesions. Newly occurring injectable melanoma lesions within the 4 weeks treatment period will also be treated as described. For the new lesions the treatment period will not be extended beyond the pre-defined 4 week- treatment period with a clock start at the time of the first intralesional L19IL2/L19TNF injection. Surgical resection of all existing metastases will follow within 4 weeks after end of treatment. Surgery will be performed after the safety evaluation carried out at week 5 and, if indicated, may be carried out on the same day of the safety evaluation. Post-surgery EMA-approved adjuvant therapy is allowed at discretion of the treating physician. ARM 2: Patients in Arm 2 will receive directly surgical resection of melanoma tumor lesions within 4 weeks after randomization. Post-surgery EMA-approved adjuvant therapy is allowed at discretion of the treating physician. Patients will be followed on a regular basis for the primary outcome until 36 months from randomization and up to 60 months for overall survival. Expected patient enrollment interval: 60 months. Duration of individual patient's participation: up to 60 months. End of treatment corresponds to the day of surgery for patients randomized to both Arm 1 and Arm 2. End of study corresponds to the last patient last visit (LPLV). The final primary efficacy analysis will be conducted when the 95th recurrence event is observed.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
214
Mixture of L19IL2 and L19TNF once weekly
Surgical resection of melanoma tumor lesions
Hôpital de la Timone
Marseille, France
Recurrence-free survival (RFS) rate
Recurrence-free survival (RFS) in the treatment arm (L19IL2/L19TNF plus surgery; Arm 1) versus control arm (Arm 2).
Time frame: 1 year after randomization
Local recurrence-free survival (LRFS)
Time frame: 1year, 2years, 3years after randomization and 1year after surgery
Distant metastasis-free survival (DMFS) rate
Time frame: 1year, 2years, 3years after randomization and 1year after surgery
Recurrence-free survival (RFS) rate
Time frame: 2years, 3years after randomization
Overall survival (OS)
Time frame: 1year, 2years, 3years after randomization
Percentage of Participants With On-Study Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time frame: up to 3 years
Percentage of Participants With Worst On-Study Hematological and Chemistry Abnormalities
Time frame: up to 36 months
Clinically Meaningful Changes in Vital Signs and Physical Examinations
Time frame: up to 36 months
Changes in absolute counts and relative percentages of lymphocytic subpopulations over time
Immunophenotypic characterization of PBMCs for changes in absolute counts and relative percentages of lymphocytic subpopulations (e.g., Tregs, MDSCs etc.) over time (only for patients recruited in German centers).
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Hôpital Universitaire de Nantes
Nantes, France
Institut Gustave Roussy
Villejuif, France
Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden
Dresden, Dresden, Germany
Hauttumorzentrum Hannover (HTZH)
Hanover, Hannover, Germany
Heidelberg University Hospital
Heidelberg, Heidelberg, Germany
Kiel University Hospital
Kiel, Kiel, Germany
Leipzig University Hospital
Leipzig, Leipzig, Germany
Charité Campus Mitte (CCM)
Berlin, State of Berlin, Germany
Tübingen University Hospital
Tübingen, Tübingen, Germany
...and 12 more locations
Time frame: (1) At screening, (2) At Day of surgery: from Day 1 to Day 54, (3) After 3 months from surgery: Day 91 to Day 144
HAFA
Assessment of the formation of human anti-fusion protein antibodies (HAFA) against L19IL2 and L19TNF.
Time frame: (1) At Day 1, (2) At Day 29, (3) After 3 months from surgery: Day 119 to Day 144