The goal of this study is to further evaluate feasibility and tolerability of Opdualag for patients with replication repair deficient HGG, including DIPG.
This is a multicenter, international study of post-radiotherapy (RT) fixed dose combination of nivolumab and relatlimab (Opdualag) to treat adolescent and young adult patients newly diagnosed with replication repair deficient (RRD) HGG and DIPG. The objectives of the study are to further evaluate feasibility and tolerability of Opdualag after RT, and to further characterize the safety and toxicity of Opdualag for patients with RRD HGG. We will also assess the progression free survival and overall survival distribution in patients. Protocol maintenance therapy of Opdualag must begin no later than 56 days post-completion of RT. The earliest patients can begin protocol treatment is 28 calendar days post-completion of RT. Each cycle will be 28 days in duration and treatment can continue up to a total of 26 cycles. Opdualag will be given intravenously once every 4 weeks.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Fixed dose combination of relatlimab and nivolumab (Opdualag)
Number of Participants with Adverse Events, Immune Related Adverse Events, and Dose Modifying Toxicities as assessed by CTCAE v6
Assess the feasibility of fixed dose combination of nivolumab and relatlimab as adjuvant therapy following radiation therapy in patients with newly diagnosed replication repair deficiency HGG. Adverse event data will be summarized in tables which will incorporate grade, attribution, and dose delays.
Time frame: 4 years
Number of participants that complete the first 3 cycles of maintenance therapy without experiencing dose modifying toxicities
Assess the tolerability of fixed dose combination of nivolumab and relatlimab (Opdualag) as adjuvant therapy following radiation therapy in patients with newly diagnosed replication repair deficient HGG by quantifying the number of participants that complete at least the first 3 cycles of maintenance therapy without experiencing dose modifying toxicities that require permanent discontinuation of Opdualag therapy.
Time frame: 4 years
Progression Free Survival in HGG
Estimate PFS distribution for patients with newly diagnosed RRD-HGG who received Opdualag following RT compared to molecularly stratified and matched historical controls
Time frame: Day 1 of treatment until date of Progressive Disease or death due to any cause or date of last follow-up, assessed up to 5 years
Overall Survival in HGG
Estimate overall survival distribution for patients with newly diagnosed RRD-HGG who receive Opdualag following RT compared to molecularly stratified and matched historical controls.
Time frame: Day 1 of treatment until date of death due to any cause or date of last follow-up, assessed up to 5 years
Correlations between genomic tumor alterations with radiographic response
Explore longitudinal associations of genomic, transcriptomic, epigenetic, and/or immunologic alterations of tumor at diagnosis, recurrence, or autopsy with radiographic response and advanced neuro-imaging measures. Incidence of significant genomic/transcriptomic/epigenetic and/or immunologic alterations found by sequencing and proteomics will be correlated with percent of patients that achieve radiographic responses using RAPNO guidelines.
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Time frame: Diagnosis until date of death due to any cause or date of last follow-up, assessed up to 5 years
Evaluate health-related quality of life outcomes using PROMIS questionnaire
Using PROMIS questionnaire, evaluate health-related quality of life outcomes of patients newly diagnosed with RRD-HGG from diagnosis through the end of treatment.
Time frame: From diagnosis through the end of treatment with Opdualag, usually 2 years per patient