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MSB0010445 and Stereotactic Body Radiation Therapy in Advanced Melanoma

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ClinicalTrials.gov Identifier: NCT01973608
Recruitment Status : Terminated (The study is terminated prematurely as the sponsor decided to discontinue program of NHS-IL2 [MSB0010445])
First Posted : October 31, 2013
Results First Posted : October 31, 2016
Last Update Posted : October 31, 2016
Sponsor:
Collaborator:
Merck KGaA, Darmstadt, Germany
Information provided by (Responsible Party):
EMD Serono

Brief Summary:
This is a Phase 2a, open-label, parallel group, partly randomized dose escalation trial to assess the safety and efficacy of a low dose, an intermediate dose, and high dose MSB0010445 given by intravenous infusion to subjects with advanced (unresectable or metastatic) melanoma in combination with stereotactic body radiation therapy (SBRT).

Condition or disease Intervention/treatment Phase
Melanoma Drug: MSB0010445 (0.3 milligram per kilogram [mg/kg]) Drug: MSB0010445 (1.0 mg/kg) Drug: MSB0010445 (1.8 mg/kg) Drug: MSB0010445 (2.4 mg/kg) Radiation: Stereotactic Body Radiation Therapy (SBRT) Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 12 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Safety Study for MSB0010445 in Combination With Stereotactic Body Radiation in Advanced Melanoma Subjects Following Prior Treatment With Ipilimumab
Study Start Date : January 2014
Actual Primary Completion Date : April 2015
Actual Study Completion Date : June 2015

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Melanoma

Arm Intervention/treatment
Experimental: MSB0010445 Low Dose Cohort 0.3 mg/kg Drug: MSB0010445 (0.3 milligram per kilogram [mg/kg])
MSB0010445 will be administered at a single dose of 0.3 mg/kg as intravenous (IV) infusion over approximately 1 hour every 3 weeks (q3w) for the first 12 Weeks as a part of induction phase followed by maintenance dose of 0.3 mg/kg drug every three weeks until significant clinical progression, occurrence of unacceptable toxicity, or withdrawal of consent. The first administration of MSB0010445 will be performed 3 days after the last dose of Stereotactic Body Radiation Therapy (SBRT) to the targeted reference lesion.

Radiation: Stereotactic Body Radiation Therapy (SBRT)
SBRT will be administered using a dose and schedule recommended based upon the data showing the best abscopal effect using multiple fractions if one site will be targeted subject received 3 fractions (1 per day) of 8 Gray (Gy) each (total: 24 Gy). If the target lesion will be located in the thorax, the maximum total dose administered will be 18 Gy (3 x 6 Gy).

Experimental: MSB0010445 Intermediate Dose Cohort 1.0 mg/kg Drug: MSB0010445 (1.0 mg/kg)
MSB0010445 will be administered at a single dose of 1.0 mg/kg as IV infusion over approximately 1 hour q3w for the first 12 Weeks as a part of induction phase followed by maintenance dose of 0.3 mg/kg drug every three weeks until significant clinical progression, occurrence of unacceptable toxicity, or withdrawal of consent. The first administration of MSB0010445 will be performed 3 days after the last dose of SBRT to the targeted reference lesion.

Radiation: Stereotactic Body Radiation Therapy (SBRT)
SBRT will be administered using a dose and schedule recommended based upon the data showing the best abscopal effect using multiple fractions if one site will be targeted subject received 3 fractions (1 per day) of 8 Gray (Gy) each (total: 24 Gy). If the target lesion will be located in the thorax, the maximum total dose administered will be 18 Gy (3 x 6 Gy).

Experimental: MSB0010445 High Dose Cohort 1.8 mg/kg Drug: MSB0010445 (1.8 mg/kg)
MSB0010445 will be administered at a single dose of 1.8 mg/kg as IV infusion over approximately 1 hour q3w for the first 12 Weeks as a part of induction phase followed by maintenance dose of 0.3 mg/kg drug every three weeks until significant clinical progression, occurrence of unacceptable toxicity, or withdrawal of consent. The first administration of MSB0010445 will be performed 3 days after the last dose of SBRT to the targeted reference lesion.

Radiation: Stereotactic Body Radiation Therapy (SBRT)
SBRT will be administered using a dose and schedule recommended based upon the data showing the best abscopal effect using multiple fractions if one site will be targeted subject received 3 fractions (1 per day) of 8 Gray (Gy) each (total: 24 Gy). If the target lesion will be located in the thorax, the maximum total dose administered will be 18 Gy (3 x 6 Gy).

Experimental: MSB0010445 High Dose Cohort 2.4 mg/kg Drug: MSB0010445 (2.4 mg/kg)
MSB0010445 will be administered at a single dose of 2.4 mg/kg as IV infusion over approximately 1 hour q3w for the first 12 Weeks as a part of induction phase followed by maintenance dose of 0.3 mg/kg drug every three weeks until significant clinical progression, occurrence of unacceptable toxicity, or withdrawal of consent. The first administration of MSB0010445 will be performed 3 days after the last dose of SBRT to the targeted reference lesion.

Radiation: Stereotactic Body Radiation Therapy (SBRT)
SBRT will be administered using a dose and schedule recommended based upon the data showing the best abscopal effect using multiple fractions if one site will be targeted subject received 3 fractions (1 per day) of 8 Gray (Gy) each (total: 24 Gy). If the target lesion will be located in the thorax, the maximum total dose administered will be 18 Gy (3 x 6 Gy).




Primary Outcome Measures :
  1. Number of Subjects With at Least 1 Dose Limiting Toxicity (DLT) [ Time Frame: Baseline up to Day 21 ]
    DLT was defined as any Grade>= 3 toxicity related to drug, occurring during 21 days post first dose of drug except Grade 3 infusion-related adverse reaction resolving within 6 hours and Transient (<=6 hours) Grade 3 flu-like symptoms/fever controlled with medical management; Transient (<= 24 hours) Grade 3 fatigue, local reactions, headache, nausea, emesis that resolved to <= Grade 1; Grade 3 skin toxicity ,Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) < 8 x upper limit of normal (ULN)/total bilirubin < 5 x ULN resolving to <= Grade 1 in <7 days after medical management; Grade 3 diarrhea controlled with maximal medical management within 72 hours; Grade 4 lymphopenia that resolves to <= Grade 1 within 7 days & with no clinical manifestations; Grade 3 lab abnormality with no clinical correlation and resolves to <= Grade 1 within 7 days with adequate medical management Tumor flare defined as local pain, irritation or rash localized at sites of known/suspected tumor.


Secondary Outcome Measures :
  1. Number of Subjects With Best Overall Response (BOR) According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1 [ Time Frame: Screening up to 28 days after last dose of drug; assessed up to maximum of 1.41 years ]
    BOR was defined as a confirmed complete response (CR) or partial response (PR) during second-line treatment. For target lesions (TLs), CR was defined as the disappearance of all TLs, and PR was defined as at least a 30% decrease in the SLD of the TLs, taking as a reference the baseline SLD. For non-target lesions (NTLs), CR was defined as the disappearance of all NTLs and normalization of tumor marker levels.

  2. Number of Subjects With Treatment-Emergent Adverse Events (AEs) or Serious AEs [ Time Frame: Screening up to 28 days after last dose of drug; assessed up to maximum of 1.41 years ]
    TEAE was defined as an AE that started on or after the first administration of SBRT. An SAE was an AE that resulted in any of the following outcomes: death; life threatening; persistent/ significant disability/incapacity; initial or prolonged inpatient hospitalization; congenital anomaly/birth defect.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Advanced unresectable or metastatic melanoma, previously treated with ipilimumab; anti-melanoma treatments, including anti-PD/PD-L1 or any other immunotherapy, are allowed provided no treatment from last dose of that treatment to trial enrolment
  • Subjects need to have

    • one lesion that can be irradiated
    • at least 1 measurable lesion outside the radiation field, different from the lesion that will be irradiated
    • one lesion that can be biopsied before treatment with SBRT and MSB0010445
    • one lesion outside the radiation field that can be biopsied while on treatment with MSB0010445
  • The lesion that is biopsied at Baseline can be the lesion that will be irradiated
  • The lesion that will be biopsied while on treatment should not be a lesion that has been irradiated or biopsied at Baseline
  • Signed written informed consent
  • Male and female subjects at least 18 years of age
  • Life expectancy greater than or equal to (>=) 4 months
  • Eastern cooperative oncology group (ECOG) performance status of 0 or 1
  • Other protocol defined inclusion criteria could apply

Exclusion Criteria:

  • Active central nervous system metastasis
  • Treatment with systemic anti-cancer therapy within the 30 days before the first dose of SBRT
  • Pre-existing pericardial effusion or history of Grade >=2 pleural effusion or ascites within 3 months before first dose of SBRT
  • Concurrent systemic therapy with steroids or other immunosuppressive agents except short-term systemic steroids for allergic reactions
  • Other protocol defined exclusion criteria could apply

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01973608


Locations
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United States, Massachusetts
Please Contact U.S. Medical Information
Rockland, Massachusetts, United States
Sponsors and Collaborators
EMD Serono
Merck KGaA, Darmstadt, Germany
Investigators
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Study Director: Medical Responsible EMD Serono, Inc., Rockland MA, a subsidiary of Merck KGaA, Darmstadt, Germany

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Responsible Party: EMD Serono
ClinicalTrials.gov Identifier: NCT01973608     History of Changes
Other Study ID Numbers: EMR 062235-005
First Posted: October 31, 2013    Key Record Dates
Results First Posted: October 31, 2016
Last Update Posted: October 31, 2016
Last Verified: September 2016

Keywords provided by EMD Serono:
Melanoma
MSB0010445
Dose limiting toxicity
Stereotactic body radiation therapy

Additional relevant MeSH terms:
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Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas