Description:
Phase I/II trial in which participants with recurrent glioblastoma will receive a combination of tumor treating fields(portable device), nivolumab with or without ipilimumab.
Phase I/II trial in which participants with recurrent glioblastoma will receive a combination of tumor treating fields(portable device), nivolumab with or without ipilimumab.
Terminated
Phase 2
Drug | Synonyms | Arms |
---|---|---|
Nivolumab 240 mg IV | Nivolumab Monotherapy | Nivolumab Monotherapy |
Nivolumab 3 mg/kg | Nivolumab+Ipilimumab | Nivolumab+Ipilimumab |
Ipilimumab 1 mg/kg | Nivolumab+Ipilimumab | Nivolumab+Ipilimumab |
Phase I/II trial in which participants with recurrent glioblastoma will receive a combination of tumor treating fields(portable device), nivolumab with or without ipilimumab. The NovoTTF200A (OptuneTM) device is worn continuously for a goal of 75% or more of the time, ranging from at least 18 hours daily uninterrupted or 22 hours daily with 2-3 days off monthly. Therapy is planned for approximately 24 months. Infusions with nivolumab will start within 1 week of study start. Ipilimumab will either start with the second nivolumab infusion or at after tumor progression. Nivolumab is infused intravenously at 240 mg once every 2 weeks with or without ipilimumab for a maximum of 24 months. Ipilimumab is dosed at 1 mg/kg once every 6 weeks for a maximum of 4 doses (24 weeks). Infusions will continue until maximum doses are completed or there is confirmed tumor progression, intolerable adverse effects or withdrawal of consent.
Name | Type | Description | Interventions |
---|---|---|---|
Nivolumab Monotherapy | Experimental | Nivolumab 240 mg IV every 2 weeks for maximum of 24 months. TTF (Optune) for max of 24 months |
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Nivolumab+Ipilimumab | Experimental | Nivolumab 3 mg/kg IV with ipilimumab then 240 mg every 2 weeks for maximum of 24 months. Ipilimumab 1 mg/kg IV every 6 weeks maximum of 4 times. NovoTTF200A (Optune) TTF for maximum 24 months |
|
Inclusion Criteria: - Histologically confirmed World Health Organization Grade IV glioblastoma with supratentorial distribution. - Unequivocal evidence of progressive disease on contrast-enhanced brain CT or MRI as defined by RANO criteria, or documented recurrent glioblastoma on biopsy. - Prior therapies including radiation and temozolomide. - Only 1-2 prior treatments for recurrences are allowed. Resection of recurrent glioblastoma is not considered a prior treatment. - Must be at least 12 weeks from radiotherapy or progression outside of the high-dose radiation target volume or unequivocal evidence of progressive tumor on biopsy. - All adverse events Grade > 1 related to prior therapies (chemotherapy, radiotherapy, and/or surgery) must be resolved, except for alopecia. - Karnofsky Performance Status (KPS) ≥ 60 - Adequate organ and marrow function as defined below, all screening labs should be performed within 14 days of treatment initiation: - absolute neutrophil count ≥ 1,000/mcL - platelets ≥ 100,000/mcL - hemoglobin > 8.0 mg/dL - total bilirubin ≤ 2.0 x upper limit of normal - AST (SGOT)/ALT (SGPT) ≤2.5 × upper limit of normal - creatinine or creatinine clearance ≥60 mL/min/1.73 m2 for creatinine >ULN - Corticosteroid dose must be stable or decreasing for at least 5 days prior to enrollment. - Ability to understand and the willingness to provide written informed consent. Exclusion Criteria: - Infratentorial disease. - Prior use of bevacizumab, ipilimumab or other CTLA-4 inhibitor, or TTFields. - Tumors with known IDH1 or IDH2 mutations. - History of allergic reactions attributed to compounds of similar chemical or biologic composition to nivolumab or ipilimumab or their excipients. - Current or planned participation in a study of an investigational agent or using an investigational device. - Uncontrolled intercurrent illness that would limit compliance with study requirements. - Active or life-threatening infection requiring intravenous or >2 weeks of systemic therapy. - Prior stereotactic radiotherapy, convection enhanced delivery (CED) or brachytherapy requires a biopsy to confirm radiographic progression is consistent with progressive tumor and not treatment-related necrosis unless the recurrent lesion is outside of any prior high-dose radiation target volume or distant from the prior CED or brachytherapy site. - breastfeeding must be discontinued by enrollment on study. - Uncontrolled HIV or AIDS is not allowed. Patients with known history of HIV but with undetectable viral load on antiretroviral therapy are allowed. - CHF, or MI or hemorrhagic/ischemic stroke in the last 3 months. - Active illicit drug use or diagnosis of alcoholism - Known additional malignancy that is progressing or requires active treatment within 3 years of start of study drug. - Any surgery (not including minor diagnostic procedures such as lymph node biopsy) within 2 weeks of start of treatment. - Any significant autoimmune disorders expected to impact multiple or internal organs, excluding mild eczema or autoimmune thyroiditis treated with thyroidectomy and requiring systemic immunosuppressive or immunomodulatory therapy. - Any implanted programmable cranial device, including reprogrammable ventriculoperitoneal shunt (VPS) or cochlear implants, that precludes use of TTFields (Optune) therapy.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Measure: | Objective response rate according to modified iRANO criteria |
Time Frame: | Analyses will occur 4 months after accrual of 15 patients for each arm. |
Safety Issue: | |
Description: | Overall response rate is the proportion of patients whose best overall response per modified iRANO criteria is complete (CR) or partial (PR) after at least 6 weeks from start of therapy |
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Terminated |
Lead Sponsor: | Baptist Health South Florida |
March 17, 2021