This phase Ib trial studies the side effects and best dose of nivolumab with or without ipilimumab in treating patients with female reproductive cancer that has come back (recurrent) or is high grade and has spread extensively throughout the peritoneal cavity (metastatic). Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread.
PRIMARY OBJECTIVE: I. To determine the recommended phase II dose (RP2D) of intraperitoneal (i.p.) nivolumab in combination with ipilimumab. SECONDARY OBJECTIVES: I. To describe the pharmacokinetics (PK), toxicities, and immune-related adverse events associated with i.p. checkpoint inhibitor therapy. II. To estimate the clinical benefit rate (rate of partial response \[PR\], complete response \[CR\], and stable disease \[SD\] using Response Evaluation Criteria in Solid Tumors \[RECIST\] version 1.1 modified to include immune-related response criteria) for the expansion cohort. EXPLORATORY OBJECTIVES: I. To determine blood based transcriptional changes associated with pharmacokinetics (PK) time points and determine their correlation with serum drug concentrations, clinical response, and immune related adverse events. II. To determine baseline and on-treatment molecular alteration (ribonucleic acid \[RNA\] and protein) associated with i.p. and nivolumab (Nivo) (for the expansion cohort). OUTLINE: This is a dose-escalation study. Patients are assigned to 1 of 2 groups. GROUP I: Patients receive nivolumab i.p. over 90 minutes on days 1, 15, and 29. Cycles repeat every 6 weeks in the absence of disease progression or unacceptable toxicity. GROUP II: Patients receive nivolumab as in group I and ipilimumab i.p. on day 1. Cycles repeat every 6 weeks in the absence of disease progression or unacceptable toxicity. After completion of the study treatment, patients are followed up every 6 weeks for at least 100 days.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
26
M D Anderson Cancer Center
Houston, Texas, United States
Maximum tolerated dose (MTD)/recommended phase II dose (RP2D) of intraperitoneal (i.p.) nivolumab in combination with ipilimumab
The RP2D or the MTD is defined as the combination of ipilimumab + nivolumab with the dose limiting toxicity (DLT) rate =\< 30%. Dose-finding for the combination of ipilimumab plus nivolumab will be done using the data-augmentation continuous reassessment method (DA-CRM).
Time frame: 12 weeks
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