Clinical Trials /

Window Study of Nivolumab With or Without Ipilimumab in Squamous Cell Carcinoma of the Oral Cavity

NCT02919683

Description:

This research study is studying nivolumab, an investigational drug, in combination with ipilimumab, also an investigational drug, as a possible treatment for Squamous Cell Carcinoma of the oral cavity. The following drugs are involved in this study: - Nivolumab (Opdivo™) - Ipilimumab (Yervoy™)

Related Conditions:
  • Oral Cavity Squamous Cell Carcinoma
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Window Study of Nivolumab With or Without Ipilimumab in Squamous Cell Carcinoma of the Oral Cavity
  • Official Title: Window Study of Nivolumab With or Without Ipilimumab in Squamous Cell Carcinoma of the Oral Cavity

Clinical Trial IDs

  • ORG STUDY ID: 16-284
  • NCT ID: NCT02919683

Conditions

  • Head and Neck Cancer

Interventions

DrugSynonymsArms
NivolumabOpdivoNivolumab With Ipilimumab
IpilimumabYervoyNivolumab With Ipilimumab

Purpose

This research study is studying nivolumab, an investigational drug, in combination with ipilimumab, also an investigational drug, as a possible treatment for Squamous Cell Carcinoma of the oral cavity. The following drugs are involved in this study: - Nivolumab (Opdivo™) - Ipilimumab (Yervoy™)

Detailed Description

      This research study is a Phase II clinical trial. Phase II clinical trials test the safety
      and effectiveness of an investigational intervention to learn whether the intervention works
      in treating a specific disease. "Investigational" means that the intervention is being
      studied.

      The purpose of this study is to evaluate effectiveness (how well the drug/s work) of
      Nivolumab or Nivolumab combined with Ipilimumab prior to standard of care surgery.

      Nivolumab and Ipilimumab are types of immunotherapy. Immunotherapy works by encouraging the
      body's own immune system to attack cancer cells. Both nivolumab and Ipilimumab have been
      demonstrated to activate the immune system to attack cancer cells in laboratory studies and
      in patients with different types of cancers.

      Nivolumab (Opdivo ™) has been approved by the US Food and Drug Administration (FDA) for the
      treatment of metastatic melanoma (a type of skin cancer), and specific types of previously
      treated advanced lung and kidney cancers. Ipilimumab (Yervoy™) is approved by the FDA for
      the treatment of metastatic melanoma.

      Because Nivolumab and Ipilimumab help the immune system work in different ways, the
      combination of Nivolumab and Ipilimumab was tested in laboratory studies. The data from
      these studies suggested that giving the two drugs together could be of benefit to patients,
      and this was indeed found to be the case in patients with melanoma. The combination of
      Nivolumab and Ipilimumab is now FDA approved as treatment for patients with metastatic
      melanoma. However, the use of Nivolumab as well as Ipilimumab alone or in combination for
      the treatment of patients with head and neck cancer is not approved. Results from clinical
      trials investigating the safety and efficacy of Nivolumab and Ipilimumab in patients with
      head and neck cancer are not available at this time.

      In the proposed study, either Nivolumab or the combination of Nivolumab and Ipilimumab is
      being tested is being tested prior to surgery to remove cancers of the oral cavity. By
      stimulating the immune system to attack cancer cells, these drugs may cause the cancer to
      decrease in size prior to surgery and prevent the cancer from coming back.
    

Trial Arms

NameTypeDescriptionInterventions
Nivolumab With IpilimumabExperimentalNivolumab to be delivered at a pre-determine dose for two weeks Ipilimumab to be delivered at a pre-determine dose for one week Blood Sample Collected Standard of Care Surgery
  • Nivolumab
  • Ipilimumab
NivolumabExperimentalNivolumab to be delivered at a pre-determine dose for two weeks Blood Sample Collected Standard of Care Surgery
  • Nivolumab

Eligibility Criteria

        Inclusion Criteria:

          -  Pathologically confirmed squamous cell carcinoma of the oral cavity. Clinical stage
             >=T2 (primary tumor greater than 2 cm in size) and/or evidence of regional nodal
             involvement by clinical exam or imaging

          -  Only patients 18 years and older are eligible. There is no upper age limit but the
             patients must be able to medically tolerate the regimen. Adverse event data are
             currently unavailable on the use immune checkpoint blockade for participants < 18
             years of age, and thus children are excluded from this study

          -  ECOG performance status <=1

          -  Patients much be a surgical candidate (e.g. their disease must be considered
             resectable before any treatment and must have no serious medical contraindications
             that definitively preclude undergoing general anesthesia) Ability to understand and
             the willingness to sign a written informed consent document

          -  Women of childbearing potential (WOCBP) must agree to use appropriate method(s) of
             contraception (see Appendix B). WOCBP should use an adequate method to avoid
             pregnancy for 23 weeks (30 days plus the time required for nivolumab to undergo five
             half-lives) after the last dose of investigational drug. WOCBP is defined as any
             woman or adolescent who has begun menstruation and is not post- menopausal. A
             post-menopausal woman is defined as a woman who is over the age of 45 and has not had
             a menstrual period for at least 12 months

          -  Women of childbearing potential must have a negative serum or urine pregnancy test
             (minimum sensitivity 25 IU/L or equivalent units of HCG) within 24 hours prior to the
             start of nivolumab

          -  Men who are sexually active with WOCBP must agree to use any contraceptive method
             (see Appendix B) with a failure rate of less than 1% per year. Men receiving
             nivolumab and who are sexually active with WOCBP will be instructed to adhere to
             contraception for a period of 31 weeks after the last dose of investigational product
             Women who are not of childbearing potential (ie, who are postmenopausal or surgically
             sterile as well as azoospermic men do not require contraception)

          -  Participants must have normal organ and marrow function as defined below:

        Laboratory parameters: WBC ≥ 2000/uL, Absolute neutrophil count (ANC) ≥ 1500/mm3;
        Platelets ≥ 100,000/mm3; Hemoglobin (Hgb) ≥ 9 g/dL; Hgb-A1C ≤ 7.5%; Aspartate
        aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 3 × upper limit of normal
        (ULN); Bilirubin ≤ 2.5 × ULN (≤ 4 × ULN for subjects with Gilbert's disease); Alkaline
        phosphatase ≤ 2.5 × ULN; Creatinine ≤ 1.5 × ULN

        Exclusion Criteria:

          -  Pathologically proven, radiologic or clinical evidence of distant metastatic disease
             (this includes all disease below the clavicles, as well as disease metastatic to the
             bone, brain, or in the spinal canal)

          -  Any prior immunologic cancer therapy with systemic inhibitors of the PD-1 or CTLA-4
             pathway

          -  Uncontrolled intercurrent illness including but not limited to ongoing or active
             infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
             arrhythmia, or psychiatric illness/social situations that would limit compliance with
             study requirements

          -  Individuals with a history of a different malignancy are ineligible except for the
             following circumstances: if they have been disease-free for at least 2 years and are
             deemed by the investigator to be at low risk for recurrence of that malignancy; or if
             diagnosed and treated within the past 2 years for cervical cancer in situ or basal
             cell or squamous cell carcinoma of the skin

          -  Prior radiation to the head and neck region

          -  Prior chemotherapy within the last 2 years

          -  History of pneumonitis or interstitial lung disease

          -  Has evidence of active, noninfectious pneumonitis that required treatment with
             steroids.

          -  Active, suspected or prior documented autoimmune disease that has required systemic
             treatment in the last 2 years with immune modifying agents (e.g. replacement therapy
             such as thyroxine, insulin or physiologic corticosteroids is not an exclusion
             criteria). This does not include patients with vitiligo or type 1 diabetes mellitus,
             residual hypothyroidism due to autoimmune condition only requiring hormone
             replacement, psoriasis not requiring systemic treatment, or conditions not expected
             to recur in the absence of an external trigger

          -  The subject is known to be positive for the human immunodeficiency virus (HIV),
             HepBsAg, or HCV RNA

          -  Lack of availability for follow up assessments

          -  Concurrent administration of other cancer specific therapy during the course of this
             study is not allowed

          -  Patients who require systemic treatment with either corticosteroids (> 10 mg daily
             prednisone equivalents) or other immunosuppressive medications within 14 days of
             study drug administration. Inhaled or topical steroids and adrenal replacement doses
             > 10 mg daily prednisone equivalents are permitted in the absence of active
             autoimmune disease

          -  History of allergy to study drug components

          -  History of severe hypersensitivity reaction to any monoclonal antibody

          -  The investigator's belief that the subject is medically unfit to receive nivolumab,
             and/or ipilimumab or unsuitable for any other reason

          -  Has received a live vaccine within 28 days of planned start of study therapy
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Response rates to treatment
Time Frame:At time of surgery
Safety Issue:
Description:

Secondary Outcome Measures

Measure:Pathological Response
Time Frame:At the time of surgery
Safety Issue:
Description:
Measure:Local failure Rate
Time Frame:2 years
Safety Issue:
Description:
Measure:Regional Failure Rate
Time Frame:2 years
Safety Issue:
Description:
Measure:Local Progression Free Survival
Time Frame:2 years
Safety Issue:
Description:
Measure:Regional Progression Free Survival
Time Frame:2 years
Safety Issue:
Description:
Measure:Disease Free Survival
Time Frame:2 years
Safety Issue:
Description:
Measure:Overall Survival
Time Frame:2 years
Safety Issue:
Description:
Measure:Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame:At the time of surgery
Safety Issue:
Description:

Details

Phase:Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Dana-Farber Cancer Institute

Trial Keywords

  • Head and Neck Cancer

Last Updated

November 12, 2016