Melanoma Clinical Trial
Ipilimumab and Nivolumab With Immunoembolization in Treating Participants With Metastatic Uveal Melanoma in the Liver
Summary
This phase II trial studies ipilimumab and nivolumab with immunoembolization in treating patients with uveal melanoma that has spread to the liver. Immunotherapy with monoclonal antibodies, such as ipilimumab 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. Immunoembolization may kill tumor cells due to loss of blood supply and develop an immune response against tumor cells. Giving ipilimumab and nivolumab with immunoembolization may work better in treating patients with uveal melanoma.
Full Description
PRIMARY OBJECTIVES:
I. Determine the clinical benefit of treatment with immunoembolization (IEMBO) in combination with ipilimumab and nivolumab.
SECONDARY OBJECTIVES:
I. Determine all treatment and immune related toxicities. II. Determine progression free survival. III. Determine overall survival.
Eligibility Criteria
Inclusion Criteria:
Histologically confirmed metastatic uveal melanoma in the liver; patients must have at least one measurable liver metastasis that is >= 10 mm in longest diameter by computed tomography (CT) scan or magnetic resonance imaging (MRI)
The total volume of the tumors must be less than 50% of the liver volume
Willingness and ability to give informed consent
Agreement to access archival tissue or agreement for tumor biopsy prior to treatment
Eastern Cooperative Oncology Group (ECOG) performance status of 0, or 1
Serum creatinine =< 2.0 mg/dl
Granulocyte count >= 1000/mm^3
Platelet count >= 100,000/mm^3
Bilirubin =< 2.0 mg/ml
Albumin >= 3.0 g/dl
Prothrombin time (PT)/partial thromboplastin time (PTT) less than 1.5 times normal
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) less than 3 x upper limit of normal (ULN)
Alkaline phosphatase less than 1.5 times ULN (grade 1)
Women must not be pregnant or breast-feeding
Women of child-bearing potential must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 23 weeks after the last dose of nivolumab and/or ipilimumab and sexually active males must use at least two other accepted and effective methods of contraception and/or to abstain from sexual intercourse for at least 31 weeks after the last dose of nivolumab and/or ipilimumab
Exclusion Criteria:
Failure to meet any of the criteria set forth in the inclusion criteria section
Previous systemic exposure to anti-CTLA-4 antibody or anti-PD1 antibody
Previous liver-directed treatments including chemoembolization, radiosphere, hepatic arterial perfusion, or drug-eluting beads; liver resection and focal ablation are permitted
Presence of symptomatic liver failure including ascites and hepatic encephalopathy
Presence of untreated brain metastases; if patients have had previous treatment for the brain metastasis, an MRI or CT scan of the brain must confirm the stabilization of the brain metastasis for more than 2 months
Presence of uncontrolled hypertension or congestive heart failure, or acute myocardial infarction within 6 months of entry
Presence of any other medical complication that implies survival of less than six months
Uncontrolled severe bleeding tendency or active gastrointestinal (GI) bleeding
Significant allergic reaction to contrast dye or granulocyte-macrophage colony-stimulating (GM-CSF)
Immunosuppressive treatments within 4 weeks prior to embolization, unless prednisone =< 5 mg or equivalent
Pregnancy or breast-feeding women
Patients with active hepatitis with serum glutamic-oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) equal or greater than 5 times normal
Biliary obstruction, biliary stent or prior biliary surgery except cholecystectomy
Positive for known human immunodeficiency virus (HIV) Infection
Uncontrolled chronic obstructive pulmonary disease or previous known pulmonary fibrosis
Active infection
Auto-immune disease including inflammatory bowel disease, lupus, rheumatoid arthritis, but not including hypothyroidism or psoriasis if condition has been stable for 2 months or greater
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There is 1 Location for this study
Philadelphia Pennsylvania, 19107, United States
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