This pilot clinical trial studies the side effects and how well durvalumab and tremelimumab work in treating patients with microsatellite stable colorectal cancer that has spread to the liver. Monoclonal antibodies, such as durvalumab and tremelimumab, may interfere with the ability of tumor cells to grow and spread.
PRIMARY OBJECTIVES: I. Establish the safety of durvalumab and tremelimumab following radioembolization with selective internal radiation (SIR)-Spheres in patients with microsatellite stable (MSS) metastatic colorectal cancer to the liver. II. Determine the hepatic response rate of SIR-Spheres followed by durvalumab and tremelimumab in patients with MSS metastatic colorectal cancer to the liver. SECONDARY OBJECTIVES: I. Estimate the progression free survival (PFS) and overall survival (OS) of the overall treated population. II. Describe the overall response rate of the treated population. III. Describe the extra-hepatic response in the treated population (abscopal responses). TERTIARY OBJECTIVES: I. Describe intra-tumor immune alterations following SIR-Spheres, and following durvalumab plus tremelimumab in comparison to baseline through serial hepatic metastases biopsies. II. Describe the immune alterations in the blood following SIR-Spheres and following durvalumab plus tremelimumab. OUTLINE: Patients receive durvalumab intravenously (IV) over 60 minutes and tremelimumab IV over 60 minutes on day 1. Treatment repeats every 4 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity. Beginning at week 17, patients receive durvalumab IV over 60 minutes on day 1. Treatment repeats every 4 weeks for up to 9 courses in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up periodically.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
City of Hope Medical Center
Duarte, California, United States
Hepatic tumor response as assessed by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
Will be summarized using a 90% exact Clopper-Pearson confidence interval
Time frame: Up to 1 year
Incidence of adverse events assessed by NCI CTCAE version 4.03
Toxicities observed will be summarized in terms of type and severity.
Time frame: Up to 1 year
Extrahepatic disease response assessed by RECIST 1.1
Time frame: Up to 1 year
Hepatic PFS
This will be reported for the overall population (safety analysis set) and will be described for liver only (time to hepatic progress or death) and for overall disease burden (progression free survival per se). Progression free survival will be estimated using the product-limit (Kaplan-Meier) method, with any loss to follow-up as censoring.
Time frame: From study treatment to first progression in the treated liver or death (whichever occurs first), assessed up to 1 year
OS
Overall survival will be estimated using the product-limit (Kaplan-Meier) method, with any loss to follow-up as censoring.
Time frame: From study treatment to death, assessed up to 1 year
Overall PFS
This will be reported for the overall population (safety analysis set) and will be described for liver only (time to hepatic progress or death) and for overall disease burden (progression free survival per se). Progression free survival will be estimated using the product-limit (Kaplan-Meier) method, with any loss to follow-up as censoring.
Time frame: From study treatment to progressive disease (hepatic and extrahepatic) and death, assessed up to 1 year
Overall response rate (both hepatic and extrahepatic disease) assessed by RECIST 1.1
Time frame: Up to 1 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.