This is a Phase 1b/2 study designed to evaluate combination of the human T-cell cytokine Interleukin-2 (IL-2) and a checkpoint inhibitor Ipilimumab immediately following a course of hypofractionated palliative radiation therapy in the management of unresectable, relapsed/refractory metastatic melanoma.
The sequential administration of Interleukin-2 (IL-2) following radiation therapy offers a rational immunologic priming strategy to expand antigen primed T cells under the growth promoting effects of Interleukin-2 therapy. This clinical trial is designed to evaluate the combination of the T cell cytokine Interleukin-2 and the checkpoint inhibitor Ipilimumab in sequential combination following a course of hypofractionated palliative radiation therapy. The addition of single dose Ipilimumab offers rational timing of CTLA-4 checkpoint blockade to decrease activity of regulatory and suppressor T cell subsets following IL-2 based immunotherapy.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Phase Ib: \- Ipilimumab will be administered in a 3 + 3 dose escalation design. * The starting dose will be 0.3 mg/kg administered within 7 days of day 1 cycle 2 ALdesleukin (IL-2). * If dose limiting autoimmune toxicities (DLTs) are not observed, the next cohort will receive 1.5 mg/kg. * The final cohort will receive 3 mg/kg, in the event that cohort 2 does not exhibit DLTs. * In the event of excessive toxicity in cohort 1, then a -1 dose level of 0.1 mg/kg may be evaluated in subsequent cohorts. Cohort sizes will increase to 6 patients if 1 of 3 patients in a cohort experience a DLT. * Once the maximum tolerated dose/recommended phase 2 dose (MTD/RP2D) is declared, no staggering of enrollment is required for accrual.
Phase II: \- Interleukin-2 \& Ipilimumab will be administered at the maximum tolerated dose/recommended phase 2 dose (MTD/RP2D).
Masonic Cancer Center - University of Minnesota
Minneapolis, Minnesota, United States
Phase 1: Maximum Tolerated Dose (MTD)
Incidence of Adverse Events
Time frame: Cycle 2 Day 1
Phase 1: Maximum Tolerated Dose (MTD)
Incidence of Adverse Events
Time frame: Cycle 2 Day 15
Phase 1: Maximum Tolerated Dose (MTD)
Incidence of Adverse Events
Time frame: 30 days after last IL-2
Phase 2: Objective Response Rate (ORR)
Disease re-assessment includes physical examination, as well as radiographic response assessment (RECIST v1.1) of non-irradiated target lesions using CT (or PET/CT) and/or at MRI.
Time frame: Day 35
Phase 2: Objective Response Rate (ORR)
Disease re-assessment includes physical examination, as well as radiographic response assessment (RECIST v1.1) of non-irradiated target lesions using CT (or PET/CT) and/or at MRI.
Time frame: 30 days after last IL-2
Progression-free survival (PFS)
Incidence of PFS
Time frame: Every 3 Months until 2 Years from 1st IL-2 Dose
Overall survival (OS)
Incidence of OS
Time frame: Every 3 Months until 2 Years from 1st IL-2 Dose
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