This is a single center, single arm phase I trial to test the feasibility and safety of
Tumor- Infiltrating Lymphocyte-Adoptive Cell Therapy (TIL-ACT) followed by nivolumab rescue
in unresectable locally advanced or metastatic melanoma patients. The trial is based on
lymphodepleting chemotherapy followed by ACT, utilizing ex vivo expanded TILs in combination
with high dose interleukin-2 (IL-2) (optional, depending on patient's tolerance), followed by
nivolumab rescue (if indicated) for a maximum duration of 2 years.
The objective of the trial is to define the feasibility and safety of TIL-ACT in metastatic
melanoma patients. In addition, the feasibility and safety of nivolumab rescue in patients
with advanced metastatic disease is examined.
Study treatment will begin with intravenous non-myeloablative (NMA) lymphodepleting
chemotherapy composed by fludarabine and cyclophosphamide. Both treatments will be started on
the same day. Fludarabine will be administered for five days, and cyclophosphamide for two
days. TILs will be infused intravenously over a period of 20-30 minutes. Between 3 and 24
hours after the infusion of TILs, optional IL-2 will be started as a bolus administration
every eight hours at minimum form the start of each administration, for a maximum of eight
doses, with a maximum interval of 24 hours. In order to avoid profound and long-lasting
neutropenia, pegfilgrastim will be given subcutaneously. Supportive care will be given during
the recovery phase from immune depletion and IL-2 therapy.
Nivolumab rescue will be initiated for eligible patients. For all patients, the first
on-treatment radiological assessment will be performed 30 days after the TIL infusion, and
then at month 3, and then every 12 weeks for the first 3 years of follow-up and every 4-6
months for the next 2 years, until progression.
Two Positron Emission Tomography-Computed Tomography (PET-CT) (18FDG (Fludeoxyglucose (F18))
and 68Ga-NODAGA-RGD ((68)Ga-labelled NOTA-conjugated RGD peptide) will be performed at
baseline, following chemotherapy, and between 22-30 days after the TIL infusion.
The safety assessment for TIL-ACT (TLT (treatment-limiting toxicity) period) will extend from
day -7 (when NMA chemo starts) till 30 days after TIL infusion.
The first three evaluable patients will be enroled no less than 2 weeks apart from each
other. An interim analysis of safety at our center will be performed at the completion of the
TLT period of the third evaluable patient.
Clinical Study Identifier
Centre Hospitalier Universitaire Vaudois
Last Modified on
19 July 2020
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