BIOLUMA is a multicentric non-randomised phase II trial in patients with non-squamous non-small cell lung cancer (NSCLC) (Cohort 1) and patients with small-cell lung cancer (SCLC) (Cohort 2) after failure of platinum-based first-line therapy. NSCLC patients are treated with nivolumab until disease progression and subsequently receive a combination therapy of nivolumab and ipilimumab. SCLC patients receive four cycles of nivolumab in combination with ipilimumab and subsequent nivolumab monotherapy. Primary endpoint for both cohorts is overall response rate of combination therapy. Within the diagnostic part tumor biopsies will be analysed. Tumor tissue will be obtained before initiation of therapy and after progression on nivolumab monotherapy before addition of ipilimumab in Cohort 1 and after completion of the four nivolumab/ipilimumab combination cycles before continuation of nivolumab monotherapy in Cohort 2, respectively. Flow cytometry of blood samples and microbiome analysis of deep rectal swaps are performed prior to therapy as well as during course of treatment. Cohort 1 (NSCLC) is closed for enrollment due to Sponsor decision. In Cohort 2 (SCLC) a prescreening for high Tumor Mutation Burden is necessary before enrollment.
Cohort 2 (SCLC) has been subdivided by amendment in Cohort 2a without prescreening and Cohort 2b with TMB-prescreening. For Cohort 2a enrollment has been stopped in December 2017. Cohort 2b is closed for enrollment as the cohort is fully recruited.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
90
Cohort 1: addition of ipilimumab in case of progression on nivolumab monotherapy.
Cohort 2: upfront combination therapy of nivolumab and ipilimumab for four cycles, followed by nivolumab monotherapy.
SLK-Fachklinik Löwenstein
Löwenstein, Baden-Wurttemberg, Germany
Universitätsklinikum Tübingen, Innere Medizin VIII - Medizinische Onkologie und Pneumologie
Tübingen, Baden-Wurttemberg, Germany
Universitätsklinikum Würzburg - Comprehensive Cancer Center Mainfranken
Würzburg, Bavaria, Germany
Universitätsklinikum Frankfurt - Medizinische Klinik II
Frankfurt am Main, Hesse, Germany
Klinikum Kassel - Klinik für Hämatologie und Onkologie
Kassel, Hesse, Germany
Pius Hospital Oldenburg
Oldenburg, Lower Saxony, Germany
Uniklinik RWTH - Klinik für Hämatologie, Onkologie, Hämostaseologie und Stammzellentransplantation
Aachen, North Rhine-Westphalia, Germany
Universitätsklinikum Bonn - Medizinische Klinik und Poliklinik III
Bonn, North Rhine-Westphalia, Germany
University Hospital Cologne
Cologne, North Rhine-Westphalia, Germany
Kliniken der Stadt Köln - Lungenkrebszentrum Köln-Merheim
Cologne, North Rhine-Westphalia, Germany
...and 6 more locations
Cohort 1: ORR after addition of ipilimumab to nivolumab treatment.
ORR is defined as proportion of patients with reduction in tumor burden as assessed by RECIST 1.1 criteria (investigator-assessed).
Time frame: From beginning of combination therapy until the date of first documented progression, or date of death of any cause, whichever occurs first, assessed up to 120 months.
Cohort 2: ORR of the combination therapy nivolumab and ipilimumab.
ORR is defined as proportion of patients with reduction in tumor burden as assessed by RECIST 1.1 criteria (investigator-assessed).
Time frame: From beginning of combination therapy until the date of first documented progression, or date of death of any cause, whichever occurs first, assessed up to 120 months.
Overall survival of nivolumab monotherapy/nivolumab + ipilimumab combination therapy
Time from date of first dose to the date of death to any cause.
Time frame: From date of first dose until death, withdrawal of informed consent or lost to follow-up, through study completion, an average of 1 year, up to 120 months.
Progression-free survival of nivolumab monotherapy/nivolumab + ipilimumab combination therapy
Time from the date of first dose to first documentation of objective disease progression or to death on study due to any cause, whichever occurs first.
Time frame: From date of first dose to first documentation of objective disease progression or to death on study due to any cause, an average of 6 months, up to 120 months.
Duration of response of nivolumab monotherapy/nivolumab + ipilimumab combination therapy
Time from the first documentation of objective tumor response (CR or PR) that is subsequently confirmed to the first documentation of objective disease progression or to death due to any cause, whichever occurs first
Time frame: First on-study tumor assessment is performed at Week 9 in Cohort 1 and at Week 5 in Cohort 2 and subsequently every 8 weeks through study completion, an average of 1 year.
Incidence, severity and grading of adverse events (AEs) during nivolumab monotherapy/ nivolumab + ipilimumab combination therapy
Adverse events are documented according to the Common Terminology Criteria for Adverse Events (CTCAE)
Time frame: From initiation of study drug, continuously during the treatment period and for a minimum of 100 days following the last dose of study treatment.
Incidence, severity and grading of serious adverse events (SAEs) during nivolumab monotherapy/ nivolumab + ipilimumab combination therapy
Serious adverse events are documented according to the Common Terminology Criteria for Adverse Events (CTCAE)
Time frame: Following the subject's written consent, SAEs are collected that occur within survival follow-up through study completion, an average of 6 months. For subjects who did not receive study medication, SAEs are collected until resolved.
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