Center for Cancer Immune Therapy, Dept. of Haematology/Oncology
Copenhagen, Herlev, 2730, Denmark
NCT Number: NCT02379195
Adoptive T cell therapy with tumor infiltrating lymphocytes (TIL) has achieved impressive clinical results with durable complete responses in patients with metastatic melanoma. The TILs are isolated from the patients own tumor tissue followed by in vitro expansion and activation for around 4-6 weeks. Before TIL infusion the patients receive 1 week of preconditioning chemotherapy with cyclophosphamide and fludarabine. After TIL infusion Interleukin-2 are administered to support T cell activation and proliferation in vivo.
In this trial the therapy is combined with peginterferon (the pegylated form of interferon alpha 2b). Interferon alpha has immunomodulatory effects and is known to upregulate HLA expression on melanoma cells and are hypothesized to synergize with TIL therapy.
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Notify Me18 year–70 year
All sexes
Interventional
Phase 1 / Phase 2
Copenhagen, Herlev, 2730, Denmark
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Histologically confirmed unresectable stage III or stage IV metastatic melanoma Metastasis available for surgical resection (about 2 cm3) and residual measurable disease after resection
ECOG performance status 0-1
Life expectancy ≥ 3 months
No significant toxicity from prior treatments
Adequate renal, hepatic and hematologic function
Women of childbearing potential (WOCBP) and men in a sexual relationship with a WOCBP must be using an effective method of contraception during treatment and for at least 6 months after completion af treatment.
Able to comprehend the information given and willing to sign informed consent
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Exclusion criteria
Other Malignancies, unless followed for ≥ 5 years with no sign of disease, except squamous cell carcinoma or adequately treated carcinoma in situ colli uteri.
Cerebral metastasis. Patients with previously treated CNS metastases can participate if CNS metastases are surgically removed or treated with stereotactic radiosurgery and stable ≥ 28 days after treatment measured by MRI. Patients with asymptomatic, stable and untreated CNS metastasis can in be included according to investigators and sponsors decision.
Patients with ocular melanoma
Severe allergies, history of anaphylaxis or known allergies to the administered drugs.
Serious medical or psychiatric comorbidity
Creatinine clearance < 70 ml/min
Acute or chronic infection with e.g. HIV, hepatitis, tuberculosis
Severe and active autoimmune disease
Pregnant and nursing women
Need for immunosuppressive treatment, e.g. corticosteroids or methotrexate
Concomitant treatment with other experimental drugs
Patients with uncontrolled hypercalcemia
Less than four weeks since prior systemic antineoplastic treatment at the time of treatment.
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Cyclophosphamide 60 mg/kg are administered i.v on day -7 and -6
Fludarabine 25 mg/m2 are administered i.v on day -5 to -1
Other names: Fludarabinephosphate, Fludara
The maximum number of expanded TILs are infused over 30-45 min on day 0
Other names: T cell infusion
Interleukin-2 are administered as a continuous i.v. infusion in a decrescendo regimen (18 MIU/m2 IL-2 over 6 hours, 18 MIU/m2 IL-2 over 12 hours, 18 MIU IL-2 over 24 hours followed by 4.5 MIU/m2 IL-2 over another 24 hours for three days)
Other names: IL-2, Proleukin
Peginterferon alpha-2b, 3 microgram/kg are administered as subcutaneous injection on day -2, day 7 and day 14.
Other names: PegIntron
Time frame: 0-24 weeks
Determine the safety of the administration of peginterferon in combination with TIL therapy including lymphodepleting chemotherapy and Interleukin-2 by reporting adverse events according to CTCAE v. 4.0
Time frame: Up to 12 months
Number of participants with detectable in vitro immune responses in the TIL infusion product using intracellular flow cytometry.
Time frame: Up to 36 months
Clinical responses will be evaluated by RECIST 1.1 (Response Criteria In Solid Tumors Criteria version 1.1) and assessed by CT scan. Complete response (CR), disapperance of all lesions; Partial response (PR), >=30% decrease in the sum of the longest diameter of target lesions; Objective response (OR) = CR + PR
Time frame: Up to 36 months
Overall survival (OS), defined as time from treatment initiation to death, described using the Kaplan Meier method
Time frame: Up to 36 months
Progression free survival (PFS), defined as the time from treatment initiation to disease progression, relapse or death due to any cause, which ever comes first, will be described with the Kaplan Meier method.
Inge Marie Svane
Other
T Cell Therapy in Combination With Peginterferon for Patients With Metastatic Melanoma
OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.
View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.
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