This phase II trial tests how well lifileucel, with reduce dose fludarabine and cyclophosphamide for lymphodepletion and interleukin-2, work for treating patients with melanoma that cannot be removed by surgery (unresectable) or that has spread from where it first started (primary site) to other places in the body (metastatic).Lifileucel is made up of specialized immune cells called lymphocytes or T cells that are taken from a patient's tumor, grown in a manufacturing facility and infused back into the preconditioned patient to attack the tumor. Giving Lifileucel with a reduced dose of fludarabine and cyclophosphamide for lymphodepletion and interleukin -2 is being studied in patients with unresectable or metastatic melanoma.
PRIMARY OBJECTIVE: I. The percentage of total TIL clones as measured by the T-cell receptor (TCR) population shared between the tumor infiltrating lymphocyte (TIL) product and peripheral blood mononuclear cells (PBMC). SECONDARY OBJECTIVES: I. To evaluate the efficacy parameters of lifileucel (LN-144) in combination with a reduced dose lymphodepletion in patients with unresectable or metastatic melanoma by assessing objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). II. To characterize the safety profile of lifileucel (LN-144) in combination with a reduced dose lymphodepletion regimen in patients with unresectable or metastatic melanoma. EXPLORATORY OBJECTIVE: I. Blood and tumor samples will be banked for future correlative analyses, including flow cytometry, next generation sequencing, immunogenomics and RNA sequencing to characterize the immunome and microenvironment. OUTLINE: Patients undergo tumor resection surgery. After the lifileucel is manufactured (approximately 4 weeks later), patients receive cyclophosphamide intravenously (IV) on days -4 to -2 and fludarabine IV on days -4 to -1. Patients then receive lifileucel IV on day 0. Patients also receive up to 6 doses of intraleukin-2 IV. After completion of study treatment, patients are followed up at day 28, 42, 84, 126, 180, 365, month 18, and month 24.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
A tumor sample is resected from each patient and cultured ex vivo to expand the population of tumor infiltrating lymphocytes. After lymphodepletion, patients are infused with Lifileucel followed by IL-2
Given IV
Undergo echocardiography
Given IV
Given IV
Given IV
Undergo MRI
Undergo MUGA scan
Undergo tumor resection
University of Kansas Cancer Center
Kansas City, Kansas, United States
RECRUITINGPercentage of total T-cell receptor (TCR) populations shared between the TIL product and peripheral blood mononuclear cells (PBMCs)
The TCR population is calculated as the frequencies of unique CDR3 sequences as measured by HTBIvc assay. Will be summarized with respect to mean and standard deviation. The percentage changes will also be presented with respect to visual diagrams for each person, e.g., waterfall plot
Time frame: At day + 42
Safety: Incidence of treatment emergent adverse events
Defined as all grades and any attribution until day 28 (EOT visit) after infusion, grade 3-4 of any attribution from day 28 to 6 months, only grade 3-4 attributed to study drugs after 6 months evaluated by Common Terminology Criteria in Adverse Events (CTCAE). Will be presented as percentage with 95% confidence intervals and tabulated by type and grade.
Time frame: From start of treatment to 6 months after TIL
Safety: Incidence of serious adverse events
Defined as all grades and any attribution until day 28 (EOT visit) after infusion, grade 3-4 of any attribution from day 28 to 6 months, only grade 3-4 attributed to study drugs after 6 months evaluated by CTCAE. Will be presented as percentage with 95% confidence intervals and tabulated by type and grade.
Time frame: From start of treatment to 6 months after TIL
Transfusion requirements
Defined as all grades and any attribution until day 28 (EOT visit) after infusion, grade 3-4 of any attribution from day 28 to 6 months, only grade 3-4 attributed to study drugs after 6 months evaluated by CTCAE. Will be presented as percentage with 95% confidence intervals and will be summarized with respect to mean and standard deviation.
Time frame: From start of treatment to 6 months after TIL
Length of hospital stay
Defined as all grades and any attribution until day 28 (EOT visit) after infusion, grade 3-4 of any attribution from day 28 to 6 months, only grade 3-4 attributed to study drugs after 6 months evaluated by CTCAE. Will be presented as percentage with 95% confidence intervals and will be summarized with respect to mean and standard deviation.
Time frame: From start of treatment to 6 months after TIL
Overall response rate
Measured by Response Evaluation Criteria in Solid Tumor (RECIST) 1.1. Will be presented as percentage with 95% confidence internal using Clopper-Pearson Exact method.
Time frame: From start of treatment until the end of treatment, up to 2 years
Progression free survival
Will be summarized with Kaplan-Meir curves and estimation of medians with 95% confidence intervals.
Time frame: From start of treatment until objective tumor progression or death, up to 2 years
Overall survival
Will be summarized with Kaplan-Meir curves and estimation of medians with 95% confidence intervals.
Time frame: From start of treatment to death due to any cause, up to 2 years
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