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Monoclonal Antibody Therapy and Interleukin-2 in Treating Patients With Metastatic Melanoma
This study has been completed.
Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00058279
  Purpose

RATIONALE: Biological therapies, such as MDX-010, work in different ways to stimulate the immune system and stop tumor cells from growing. Interleukin-2 may stimulate a person's white blood cells to kill tumor cells. Combining monoclonal antibody therapy with interleukin-2 may kill more tumor cells.

PURPOSE: Phase I/II trial to study the effectiveness of combining monoclonal antibody therapy with interleukin-2 in treating patients who have metastatic melanoma.


Condition Intervention Phase
Intraocular Melanoma
Melanoma (Skin)
Drug: aldesleukin
Drug: ipilimumab
Phase I
Phase II

Genetics Home Reference related topics: retinoblastoma
MedlinePlus related topics: Cancer Melanoma
Drug Information available for: Aldesleukin Immunoglobulins Globulin, Immune Ipilimumab Interleukin-2 Cytotoxic T-lymphocyte antigen 4
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: MDX-CTLA4 Combined With IL-2 for Patients With Metastatic Melanoma

Further study details as provided by National Cancer Institute (NCI):

Study Start Date: February 2003
Detailed Description:

OBJECTIVES:

  • Determine the maximum tolerated dose (MTD) of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4) in combination with high-dose interleukin-2 (IL-2) in patients with metastatic melanoma. (Phase I is closed to accrual as of 4/13/2004).
  • Determine the activity of MDX-CTLA4 administered at the MTD with high-dose IL-2 in these patients.
  • Determine whether the administration of IL-2 alters the pharmacokinetics of MDX-CTLA4 in these patients.
  • Determine the safety and adverse event profile of this regimen in these patients.

OUTLINE: This is an open-label, dose-escalation study of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4).

  • Phase I: Patients receive MDX-CTLA4 IV on days 0, 21, and 42. Patients also receive high-dose interleukin-2 (IL-2) IV over 15 minutes every 8 hours for up to 15 doses beginning on days 22 and 43. Treatment repeats every 63 days for up to 3 courses in the absence of disease progression or unacceptable toxicity. Patients with an ongoing partial response and no greater than grade 1 toxicity may receive additional courses of therapy. Patients who require discontinuation of MDX-CTLA4 due to toxicity may continue receiving IL-2 at the discretion of the investigator.

Cohorts of 3-6 patients receive escalating doses of MDX-CTLA4 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. (Phase I is closed to accrual as of 4/13/2004).

  • Phase II: Patients receive treatment as in phase I at the MTD of MDX-CTLA4. Patients who achieve a partial or complete response and later develop recurrent or progressive disease may be retreated at the same dose.

Patients are followed at 3 weeks, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 3-51 patients (3-18 for phase I and 19-33 for phase II) will be accrued for this study within 1 year. (Phase I is closed to accrual as of 4/13/2004).

  Eligibility

Ages Eligible for Study:   16 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed stage IV melanoma

    • Mucosal or ocular melanoma also eligible
  • Clinically evaluable disease

    • At least 1 site of measurable disease

PATIENT CHARACTERISTICS:

Age

  • 16 and over

Performance status

  • ECOG 0-1

Life expectancy

  • At least 3 months

Hematopoietic

  • WBC at least 2,500/mm^3
  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin at least 10 g/dL
  • Hematocrit at least 30%

Hepatic

  • Bilirubin no greater than upper limit of normal (ULN)* (less than 3.0 mg/dL in patients with Gilbert's syndrome)
  • AST no greater than 3 times ULN*
  • Hepatitis B surface antigen negative
  • Hepatitis C antibody nonreactive
  • No evidence or history of significant hepatic disease that would preclude safe administration of high-dose IL-2 NOTE: *Unless attributable to disease

Renal

  • Creatinine no greater than 2.0 mg/dL
  • No evidence or history of significant renal disease that would preclude safe administration of high-dose IL-2

Cardiovascular

  • No evidence or history of significant cardiac disease that would preclude safe administration of high-dose IL-2
  • Thallium stress test normal (for patients over 50 years of age or with a history of cardiovascular disease)

Pulmonary

  • No evidence or history of significant pulmonary disease that would preclude safe administration of high-dose IL-2

Immunologic

  • HIV negative
  • No autoimmune disease (including uveitis and autoimmune inflammatory eye disease)
  • No active infection

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix
  • No evidence or history of significant gastrointestinal disease that would preclude safe administration of high-dose IL-2
  • No evidence or history of psychiatric disease that would preclude safe administration of high-dose IL-2
  • No other underlying medical condition that would make the administration of the study drug hazardous or obscure the interpretation of adverse events
  • No other concurrent medical condition that would preclude study entry

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 3 weeks since prior immunotherapy for melanoma and recovered
  • No prior anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (MDX-CTLA4)
  • No prior high-dose (at least 600,000 IU/kg every 8 hours) interleukin-2 (IL-2)

Chemotherapy

  • At least 3 weeks since prior chemotherapy for melanoma and recovered
  • No concurrent chemotherapy

Endocrine therapy

  • At least 3 weeks since prior hormonal therapy for melanoma and recovered
  • At least 4 weeks since prior corticosteroids
  • No concurrent systemic or topical corticosteroids

Radiotherapy

  • At least 3 weeks since prior radiotherapy for melanoma and recovered

Surgery

  • Not specified

Other

  • No concurrent immunosuppressive agents (e.g., cyclosporine or its analog)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00058279

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
Bethesda, Maryland, United States, 20892-1182
Sponsors and Collaborators
Investigators
Study Chair: Steven A. Rosenberg, MD, PhD NCI - Surgery Branch
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Publications of Results:
Study ID Numbers: CDR0000287211, NCI-03-C-0109
Study First Received: April 7, 2003
Last Updated: December 13, 2008
ClinicalTrials.gov Identifier: NCT00058279  
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
stage IV melanoma
extraocular extension melanoma
recurrent melanoma
iris melanoma
ciliary body and choroid melanoma, medium/large size
ciliary body and choroid melanoma, small size
recurrent intraocular melanoma

Study placed in the following topic categories:
Eye Neoplasms
Eye Diseases
Cytotoxic T-lymphocyte antigen 4
Recurrence
Melanoma
Neuroendocrine Tumors
Melanoma of the choroid
Antibodies, Monoclonal
Neuroectodermal Tumors
Antibodies
Uveal melanoma
Aldesleukin
Interleukin-2
Neoplasms, Germ Cell and Embryonal
Nevus, Pigmented
Intraocular melanoma
Neuroepithelioma
Nevus
Immunoglobulins

Additional relevant MeSH terms:
Anti-Infective Agents
Neoplasms
Anti-HIV Agents
Neoplasms by Site
Neoplasms by Histologic Type
Anti-Retroviral Agents
Antineoplastic Agents
Therapeutic Uses
Neoplasms, Nerve Tissue
Nevi and Melanomas
Antiviral Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009