This Phase 3 clinical trial is evaluating whether adding iSCIB1+, an investigational DNA-based cancer vaccine, to standard immunotherapy with nivolumab and ipilimumab can improve outcomes for people with advanced unresectable melanoma. Participants will be randomly assigned to receive either iSCIB1+ or a placebo, in addition to standard treatment with nivolumab and ipilimumab. Neither participants nor study doctors will know which treatment has been assigned. The study will compare how long participants live without their cancer worsening, overall survival, tumor response, safety, and quality of life. iSCIB1+ is designed to stimulate the immune system to recognize and attack melanoma cells by targeting proteins commonly found on melanoma tumors. Earlier studies have shown encouraging signs of immune activation and anti-tumor activity when iSCIB1+ was combined with checkpoint inhibitor immunotherapy. This study aims to determine whether adding iSCIB1+ to standard immunotherapy provides additional benefit compared with standard immunotherapy alone
This is a multicenter, randomized, double-blind, placebo-controlled Phase 3 study evaluating the efficacy and safety of iSCIB1+ in combination with nivolumab and ipilimumab as first-line treatment for adults with advanced unresectable Stage III or Stage IV melanoma who express specific human leukocyte antigen (HLA) types. Checkpoint inhibitor therapy has significantly improved outcomes for patients with advanced melanoma; however, many patients still experience disease progression. iSCIB1+ is a DNA-based therapeutic cancer vaccine designed to enhance immune recognition of melanoma-associated antigens and may improve the depth and durability of anti-tumor responses when used alongside checkpoint inhibition. Approximately 550 participants will be randomized in a 1:1 ratio to receive either: iSCIB1+ plus nivolumab and ipilimumab, or Placebo plus nivolumab and ipilimumab. The primary objective is to determine whether the addition of iSCIB1+ improves progression-free survival (PFS) compared with placebo when both are administered in combination with nivolumab and ipilimumab. Secondary objectives include evaluation of: Overall survival (OS) Objective response rate (ORR) Duration of response (DoR) Disease control rate (DCR) Safety and tolerability Patient-reported quality of life outcomes The study will also explore immune and biomarker responses in selected participants to better understand the relationship between vaccine-induced immune responses and clinical outcomes. Participants will continue to be followed for disease progression, survival, safety, and other outcomes for up to four years after randomization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
550
iSCIB1+ is a DNA-based therapeutic cancer vaccine designed to enhance T-cell immune responses against melanoma-associated antigens. The vaccine encodes epitopes derived from glycoprotein 100 (gp100) and tyrosinase-related protein 2 (TRP-2) that are delivered using Scancell's ImmunoBody® platform. In this study, iSCIB1+ is administered by intramuscular injection with electroporation in combination with nivolumab and ipilimumab for the treatment of advanced unresectable melanoma. The intervention is intended to augment anti-tumor immune responses and improve clinical outcomes when added to standard checkpoint inhibitor therapy.
Nivolumab is a programmed death-1 (PD-1) immune checkpoint inhibitor monoclonal antibody administered according to the protocol-defined treatment regimen. Ipilimumab is a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) immune checkpoint inhibitor monoclonal antibody administered according to the protocol-defined treatment regimen.
The placebo is a Dulbecco's Phosphate-Buffered Saline (D-PBS) solution for intramuscular injection that contains no iSCIB1+ plasmid DNA. It is formulated to be visually and physically indistinguishable from iSCIB1+ and is administered using the same procedures to maintain study blinding. The placebo serves as the comparator in this trial when administered in combination with nivolumab and ipilimumab.
University of Colorado Cancer Center
Aurora, Colorado, United States
Mount Vernon Cancer Centre
London, United Kingdom
Progression-Free Survival (PFS)
Progression-free survival (PFS), defined as the time from randomization to the earliest occurrence of disease progression per RECIST v1.1 as assessed by Blinded Independent Central Review (BICR) or death from any cause.
Time frame: Up to 4 years after randomization.
Overall Survival (OS)
Overall survival, defined as the time from randomization to death from any cause.
Time frame: Up to approximately 4 years months after randomization.
Objective Response Rate (ORR)
Objective response rate, defined as the proportion of participants achieving a confirmed complete response (CR) or partial response (PR) according to RECIST v1.1 as assessed by BICR.
Time frame: Up to 4 years after randomization.
Duration of Response (DoR)
Duration of response, defined as the time from first documented objective response (CR or PR) until disease progression per RECIST v1.1 or death from any cause.
Time frame: Up to 4 years after randomization.
Disease Control Rate (DCR)
Disease control rate, defined as the proportion of participants achieving complete response, partial response, or stable disease according to RECIST v1.1 as assessed by BICR.
Time frame: Up to 4 years after randomization.
Incidence of Treatment-Emergent Adverse Events (TEAEs)
Incidence, nature, severity, and relationship of treatment-emergent adverse events, graded according to NCI CTCAE.
Time frame: From informed consent and up to 4 years from randomization
Incidence of Serious Adverse Events (SAEs)
Incidence of serious adverse events.
Time frame: From informed consent and up to 4 years from randomization
Change from baseline in EORTC QLQ-C30 Global Health Status/Quality of Life score
The EORTC QLQ-C30 Global Health Status/Quality of Life scale ranges from 0 to 100, with higher scores indicating better quality of life.
Time frame: From informed consent and up to 4 years from randomization
Change from baseline in EQ-5D-5L Health Utility Index Score
EQ-5D-5L index values are derived from participant responses across five health dimensions.
Time frame: From informed consent and up to 4 years from randomization
Number of participants reporting symptomatic adverse events according to PRO-CTCAE items
Participant-reported symptom burden will be assessed using selected PRO-CTCAE symptom items. Individual responses are scored according to the PRO-CTCAE scoring manual.
Time frame: From informed consent and up to 4 years from randomization
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