Etigilimab and Nivolumab for the Treatment of Platinum-Resistant Recurrent Clear Cell Ovarian Primary Peritoneal or Fallopian Tube Cancer

  • STATUS
    Recruiting
  • End date
    May 31, 2023
  • participants needed
    20
  • sponsor
    M.D. Anderson Cancer Center
Updated on 1 December 2021

Summary

This phase II trial the side effects and possible benefits of etigilimab and nivolumab in treating patients with platinum-resistant clear cell ovarian, primary peritoneal, or fallopian tube cancer that has come back (recurrent). Immunotherapy with monoclonal antibodies, such as etigilimab and nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. The goal of this clinical trial is to learn if adding etigilimab to nivolumab therapy can help to control clear cell ovarian, fallopian tube, and primary peritoneal cancers that are resistant to platinum-based therapy.

Description

PRIMARY OBJECTIVES:

I. To estimate the objective response rate of the combination of etigilimab and nivolumab in patients with platinum resistant clear cell ovarian cancer.

II. To evaluate the toxicity of the combination of etigilimab and nivolumab in patients with platinum resistant clear cell ovarian cancer.

SECONDARY OBJECTIVES:

  1. To determine progression free survival (PFS) of the combination of etigilimab and nivolumab in patients with platinum resistant clear cell ovarian cancer.

II. To estimate the disease control rate of the combination of etigilimab and nivolumab in patients with platinum resistant clear cell ovarian cancer.

III. To investigate molecular and immunological changes associated with the combination of TIGIT and PD-1 inhibition; specifically to describe changes in T cell populations (including but not limited to CD3, CD8, CD4, FOXP3) and cell proliferation, as well as report changes in the proportion of macrophage phenotypes M1 and M2 (with phenotypic markers potentially including arginase1, CD11b, PDL-1, and CD206).

OUTLINE

Patients receive etigilimab intravenously (IV) over 30-90 minutes on days 1 and 15 and nivolumab IV over 30 minutes on days 2 and 15 of cycle 1 and days 1 and 15 of subsequent cycles. Cycles repeat every 28 days for up to 24 months in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 and 90 days.

Details
Condition Recurrent Platinum-Resistant Fallopian Tube Carcinoma, Recurrent Primary Peritoneal Clear Cell Adenocarcinoma, Recurrent Ovarian Clear Cell Adenocarcinoma, Recurrent Platinum-Resistant Ovarian Carcinoma, Recurrent Fallopian Tube Clear Cell Adenocarcinoma, Recurrent Platinum-Resistant Primary Peritoneal Carcinoma
Treatment Nivolumab, Etigilimab
Clinical Study IdentifierNCT05026606
SponsorM.D. Anderson Cancer Center
Last Modified on1 December 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Patients with grade >= 2 neuropathy will be evaluated on a case-by-case basis after consultation with the primary investigator
Patients with irreversible toxicity not reasonably expected to be exacerbated by treatment with investigational therapy may be included only after consultation with the primary investigator
Any concurrent chemotherapy, investigational produce (IP), biologic, or hormonal therapy for cancer treatment
Major surgical procedure (as defined by the Investigator) within 28 days prior to the first dose of IP
Note: Local surgery of isolated lesions for palliative intent is acceptable
History of allogenic organ transplantation
Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc.]). The following are exceptions to this criterion
Patients with vitiligo or alopecia
Patients with hypothyroidism (e.g., following Hashimoto syndrome) stable on hormone replacement
Any chronic skin condition that does not require systemic therapy
Patients without active disease in the last 5 years may be included but only after consultation with the primary investigator
Patients with celiac disease controlled by diet alone
Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring adverse events (AEs) or compromise the ability of the patient to give written informed consent
Any medical, social, or psychological condition that would interfere with evaluation of study treatment or interpretation of patient safety or study results
Active infection including tuberculosis (clinical evaluation that includes clinical history, physical examination and radiographic findings, and tuberculosis [TB] testing in line with local practice), hepatitis B (known positive hepatitis B virus [HBV] surface antigen [HBsAg] result), hepatitis C, or human immunodeficiency virus (positive HIV 1/2 antibodies). Patients with a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc] and absence of HBsAg) are eligible. Patients positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV ribonucleic acid (RNA)
History of another primary malignancy except for the following histories
Malignancy treated with curative intent and with no known active disease >= 5 years before the first dose of IP and of low potential risk for recurrence
Adequately treated non-melanoma skin cancer or lentigo maligna without evidence of disease
Adequately treated carcinoma in situ without evidence of disease
History of leptomeningeal carcinomatosis
Brain metastases or spinal cord compression. Patients with suspected brain metastases at screening should have a MRI (preferred) or CT each preferably with intravenous (IV) contrast of the brain prior to study entry
Mean QT interval corrected for heart rate using Fridericia's formula (QTcF) >= 470 ms
Current or prior use of immunosuppressive medication within 14 days before the first dose of trial therapies. The following are exceptions to this criterion
Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection)
Systemic corticosteroids at physiologic doses not to exceed 10 mg/day of prednisone or its equivalent
Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication)
Receipt of live attenuated vaccine within 30 days prior to the first dose of IP
Note: Patients, if enrolled, should not receive live vaccine whilst receiving IP and up to 90 days after the last dose of IP
Female patients who are pregnant or breastfeeding or of reproductive potential who are not willing to employ effective birth control from screening to 180 days after the last dose of nivolumab/etigilimab combination therapy
Known allergy or hypersensitivity to any of the study drugs or any of the study drug excipients
Unresolved partial or complete small or large bowel obstruction
Judgment by the investigator that the patient is unsuitable to participate in the study and the patient is unlikely to comply with study procedures, restrictions and requirements

Exclusion Criteria

Participation in another clinical study with an investigational product during the last 28 days
Prior treatment with CD137 agonists, anti-TIGIT antibody, anti-CTLA-4 or anti-PDL1/PD1 antibodies
Concurrent enrollment in another clinical study, unless it is an observational (non-interventional) clinical study or during the follow-up period of an interventional study
Receipt of the last dose of anticancer therapy (chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies) =< 28 days prior to the first dose of study drug. If sufficient wash-out time has not occurred due to the schedule or pharmacokinetic (PK) properties of an agent, a longer wash-out period will be required, as agreed by study sponsors and the investigator
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