This phase I trial studies the side effects of nivolumab with or without stereotactic radiosurgery (SRS) in treating patients with chordoma that has come back or spread from where it started to other places in the body. Monoclonal antibodies, such as nivolumab, may interfere with the ability of tumor cells to grow and spread. Stereotactic radiosurgery is a specialized radiation therapy that delivers a single, high dose of radiation directly to the tumor and may cause less damage to normal tissue. It is not yet known whether giving nivolumab with or without stereotactic radiosurgery may work better in treating patients with chordoma.
PRIMARY OBJECTIVES: I. To assess the safety profile of nivolumab alone and nivolumab in combination with stereotactic radiosurgery to treat patients with recurrent or advanced chordoma. SECONDARY OBJECTIVES: I. To evaluate toxicity and tolerability of nivolumab alone and nivolumab in combination with stereotactic radiosurgery. II. To estimate growth modulation index on target lesion. III. To estimate a clinical response (partial response \[PR\] + complete response \[CR\] within 6 month + stable disease \[SD\] beyond 6 months). IV. To assess progression-free survival and progression-free survival (PFS) rate at 6 months. V. To assess overall survival rate at 1 year, 3 years and 5 years. TERTIARY OBJECTIVES: I. To explore peripheral blood immune response during and after treatment. OUTLINE: Patients are assigned to 1 of 2 arms. ARM I: Patients receive nivolumab intravenously (IV) over 30 minutes on day 1. Courses repeat every 14 days for 2 years in the absence of disease progression or unacceptable toxicity. ARM II: Patients receive nivolumab as in Arm I. Patients undergo stereotactic radiosurgery (SRS) as per standard of care on day 8 of course 1. After completion of study treatment, patients are followed up at 100 days and every 10 weeks thereafter.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
21
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, United States
Memorial Sloan-Kettering Cancer Center
New York, New York, United States
Incidence of dose limiting toxicities evaluated according to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
Proportion of serious adverse events will be estimated using the binomial distribution along with 95% confidence interval (exact method).
Time frame: Up to 12 weeks after initial dose of nivolumab
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