This study is an open-label, phase 1/1b study of the pressure-enabled hepatic artery infusion of SD-101, a TLR 9 agonist, alone or in combination with intravenous checkpoint blockade in adults with metastatic uveal melanoma.
In the Sentinel Cohort, patients will receive 2 SD-101 infusions (2 weeks apart) with assessments for toxicity prior to escalating from the first dose level (0.5 mg) to the second dose level (2 mg). In the absence of dose-limiting toxicities (DLTs), each patient will be eligible to transition into Cohort A. In Cohorts A-C and Phase 1b, patients will receive 2 cycles of SD-101. Each cycle consists of 3 consecutive weekly infusions. Escalating doses of SD-101 will be administered alone (Cohort A), together with nivolumab (Cohort B), together with combined ipilimumab and nivolumab (Cohort C), or together with nivolumab and relatlimab (Cohort C1 - optional). Cohorts B and C will begin dosing at the minimum anticipated biological effect level (MABEL(2mg SD-101)). An optional Cohort D may be opened to explore the combination of one or more of the following three CPI regimens with a modified SD-101 dosing schedule with only 2 weekly SD-101 infusions per cycle for 2 cycles: 1. Single-agent nivolumab IV at 480mg every 4 weeks; 2. IV ipilimumab 3mg/kg and IV nivolumab 1mg/kg every 3 weeks for 4 doses each followed thereafter by nivolumab 480mg IV every 4 weeks; 3. Nivolumab 480mg and relatlimab 160mg IV every 4 weeks. Following determination of the recommended MTD or optimal dose of SD-101 for PEDD/HAI and which checkpoint inhibitor (CPI) regimen(s) are tolerated, the study will progress to Phase 1b. Patients in Phase 1b will receive the SD-101 dose selected from Phase 1 together with systemic single- or double-agent checkpoint blockade. The choice of single- or double-agent CPI therapy together with SD-101 for Phase 1b will consider safety data in addition to response rates from Cohorts B and C in Phase 1. Patients enrolled into the main study are eligible to enroll into an optional imaging sub-study investigating the use of 89Zr-Df-crefmirlimab, a biologic PET radioligand for detecting CD8+ T cell lymphocytes. 89Zr-Df-crefmirlimab will be administered by IV at screening and again prior to C2D1 procedures. A PET scan is conducted within 72 hours following the tracer infusion.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
67
SD-101 doses will be delivered via hepatic artery infusion using pressure enabled drug delivery using the TriNav device
During Cohort B, nivolumab will be administered together with SD-101 and during Cohort C, it will be administered with ipilimumab and SD-101
During Cohort C, ipilimumab will be administered together with nivolumab and SD-101
UCLA
Los Angeles, California, United States
Stanford
Stanford, California, United States
University of Colorado
Denver, Colorado, United States
University of Miami
Phase 1: To Determine the Safety of SD-101 Alone, in Combination with Nivolumab, and in Combination with Both Nivolumab and Ipilimumab
As a measure of safety, adverse events will be graded according to CTCAE v5.0.
Time frame: 12 months
Phase 1: To Determine the Maximum Tolerable Dose (MTD) or Optimal Dose of SD-101 alone, in Combination with Nivolumab, and in Combination with Both Nivolumab and Ipilimumab
A standard 3+3 dose-escalation design will be employed to determine the MTD or optimal dose.
Time frame: 12 months
Phase 1b: To Assess Overall Response Rate (ORR)
As a measure of activity, ORR will be assessed. ORR will be assessed using Response Evaluation Criteria in Solid Tumours (RECIST) v1.1.
Time frame: 12 months
Phase 1b: To Assess Overall Survival (OS)
As a measure of activity, OS will be assessed. The events for the assessment of 12-month OS are death events.
Time frame: 12 months
Phase 1: Determination of Single vs. Dual-agent CPI in Phase 1b using CTCAE v5.0
The choice of single- or dual-agent CPI therapy together with SD-101 for Phase 1b will consider AEs/SAEs per CTCAE v5.0.
Time frame: 6 months
Phase 1: Determination of Single vs. Dual-agent CPI in Phase 1b using RECIST v1.1
The choice of single- or dual-agent CPI therapy together with SD-101 for Phase 1b will consider response rates per RECIST v1.1 from Cohorts B and C in Phase 1.
Time frame: 6 months
Phase 1b: To Assess Treatment-Emergent Adverse Events of the Chosen MTD or Optimal Dose of SD-101 in Combination with CPI
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
During optional Cohort C1, nivolumab and relatlimab will be administered with SD-101
Miami, Florida, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Columbia University Medical Center
New York, New York, United States
Thomas Jefferson University
Philadelphia, Pennsylvania, United States
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
MD Anderson Cancer Center
Houston, Texas, United States
Washington University
Seattle, Washington, United States
As a measure of safety, adverse events will be graded according to CTCAE v5.0.
Time frame: 6 months
Phase 1b: Assess Preliminary Efficacy in Terms of iRECIST for Immune Based Therapeutics
As a measure of activity, iRECIST will be utilized to determine ORR.
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of modified RECIST (mRECIST) for Immune Based Therapeutics
As a measure of activity, mRECIST will be utilized to determine ORR.
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
As a measure of activity, RECIST 1.1 will be utilized to determine hepatic-specific response rate (HRR).
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
As a measure of activity, RECIST 1.1 will be utilized to determine duration of response (DOR).
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
As a measure of activity, RECIST 1.1 will be utilized to determine overall progression-free survival (PFS).
Time frame: 12 months
Phase 1b: Assess Preliminary Efficacy in Terms of RECIST v1.1 for Immune Based Therapeutics
As a measure of activity, RECIST 1.1 will be utilized to determine clinical benefit (complete response \[CR\] + partial response \[PR\] + stable disease \[SD\]).
Time frame: 12 months