Extracorporeal photopheresis (ECP) is an immunomodulatory therapy in which the photoactivating agent methoxsalen (also known as UVADEX) is used in combination with ultraviolet A (UVA) light. Immune checkpoint inhibitor therapy is widely used for the treatment of several cancers, including melanoma. However, a common immune-related adverse event associated with this therapy is Immune-related colitis or hepatitis. Corticosteroids are typically the first-line treatment for this condition, but some participants do not respond adequately. The purpose of this study is to evaluate the efficacy of ECP in the treatment of immune-related (ir)-colitis and ir-hepatitis with inadequate response to corticosteroids, and to compare its efficacy to other second-line immunosuppressant therapies. The ECP procedure in this study is performed using the CELLEX® device, a fully closed-loop extracorporeal blood circulation device. The CELLEX device is used in conjunction with methoxsalen.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
112
Sterile solution used in conjunction with CELLEX ECP
Methoxsalen is used in conjunction with the CELLEX ECP
Vedolizumab will be administered intravenously
Infliximab will be administered intravenously
Mycophenolate Mofetil will be administered orally or intravenously
Azathioprine will be administered orally or intravenously
Proportion of Participants Who are in Steroid-free response at Week 12 for the Randomized Immune-related Adverse Event (irAE) (ir-colitis or ir-hepatitis)
Time frame: Week 12
Duration of irAE response
Time from the start of irAE response to either the relapse of irAE (if relapse occurs), or a censoring event.
Time frame: Week 64
Progression Free Survival (PFS) for Melanoma
Time frame: Week 64
Overall Survival (OS)
Time frame: Week 64
Proportion of Participants With at Least Stable Disease as Assessed by RECIST 1.1 at Week 12 and During Follow-up
Time frame: Week 12 and Week 64
Proportion of Participants with Treatment-Emergent Adverse Event (TEAEs) per Common Toxicity Criteria for Adverse Events (CTCAE) v5.0
Time frame: From first dose of the study drug up to end of study (up to Week 64)
Cumulative Systemic Corticosteroid Exposure From Randomization to Week 12
Time frame: Up to Week 12
Peak Dose of Systemic Corticosteroid Exposure From Randomization to Week 12
Time frame: Up to Week 12
Proportion of Participants who Completely Discontinue Systemic Corticosteroid Treatment Until Week 12
Time frame: Week 12
Time to Complete Discontinuation of Systemic Corticosteroids for at Least 1 Week
Time frame: From screening up to the first documentation of the discontinuation of systemic corticosteroid (up to Week 64)
Time to First Response of Randomized irAE Based on ASCO Criteria
Time frame: Week 64
Proportion of Participants With at Least one irAE who Achieve Response (as Defined per ASCO Criteria) at Week 12
Time frame: Week 12
Proportion of Participants With at Least One irAE That Resolves Completely (as per CTCAE v5.0) and Remains Resolved Until Week 12
Time frame: Week 12
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