The primary objective of this single arm phase 2 trial is to assess the response rate \[complete response (CR) + partial response (PR)\] of combined nivolumab and HD IL-2 in subjects with metastatic melanoma and renal cell carcinoma. Response will be performed after each course of nivolumab and IL-2 using RECIST 1.1. Patients will be treated for one course past best response for a maximum of 3 courses.
PrimaryObjective Determine the overall response rate (complete response and partial response) for patients receiving anti-PD-1 (nivolumab) and high dose IL-2 (HD IL-2) in subjects with metastatic melanoma or renal cell carcinoma who have previously progressed on anti-PD-1 therapy. Response assessment will be performed using revised RECIST guideline (v 1.1). Secondary Objectives * Characterize safety, tolerability and adverse effects (AE) profile of nivolumab with HD IL-2 in subjects with metastatic malignant melanoma or renal cell carcinoma * Measure Progression-Free Survival (PFS) using RECIST 1.1 after completion of at least one course of therapy (2 doses of nivolumab, 2 cycles of HD IL-2) for subjects enrolled in the study. ExploratoryObjectives * Correlate PD-L1 expression and tumor mutational burden (TMB) in archived diagnostic tumor tissue with best clinical response for subjects with metastatic melanoma and renal cell carcinoma * Correlate myeloid-derived suppressor cells and T-cell subsets in peripheral blood during therapy with best clinical response (RECIST criteria) and treatment outcome in subjects with metastatic melanoma or renal cell carcinoma. Data will be collected prior to each treatment and after each course of treatment. Study Duration: 48 months Amount of Subjects: up to 25 subjects
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
6
Course length will be 35 days. Subjects will receive 480 mg IV of nivolumab on day 1 of the cycle. The patient will be admitted to UCSD Jacobs Medical center for standard HD IL-2 which will be administered every 8 hrs for up to 14 doses days 8-12 per institutional practice. The patient will be readmitted days 22-28 for HD IL-2 every 8 hrs for up to 14 doses. Nivolumab 480 mg IV will be administered day 35. Scans for response will occur 4 weeks after day 35 nivolumab dose and response will be determined by RECIST 1.1 to determine if the patient will receive the next course.
UC San Diego Moores Cancer Center
La Jolla, California, United States
Overall Response Rate
Overall response rate of combined therapy with nivolumab and HD IL-2 in metastatic melanoma and renal cell carcinoma evaluated per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v 1.1) for target lesions: complete response (CR), disappearance of all target lesions; partial response (PR), ≥ 30% decrease in the sum of the longest diameter of target lesions; overall response (OR) = CR + PR
Time frame: Up to 45 months
Drug Toxicity
Percentage of subjects with grade 3 or higher adverse events as defined by CTCAE v 5.0
Time frame: Up to 6 months or start of a new anti-cancer therapy or death
Progression Free Survival
Progression Free Survival of combined therapy with nivolumab and HD IL-2 in metastatic melanoma and renal cell carcinoma evaluated per Response Evaluation Criteria In Solid Tumors Criteria (RECIST v 1.1): 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of new lesions.
Time frame: Up to 45 months
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