Melanoma
Conditions
Brief summary
The purpose of this study is to assess the safety and tolerability of cancer immunotherapy ECI-006 and to determine its ability to induce a measurable immune response against the tumor associated antigens. In Cohort 1, ECI-006 will be administered 5 times by intranodal injection in melanoma patients after resection of their tumor. In Cohort 2, ECI-006 will be administered 9 times by intranodal injection on top of standard of care anti PD1 in metastatic melanoma patients with stable disease after 3 to 12 months treatment. ECI-006 activates key immunologically active cells to direct the immune system against the cancer. Expected potential risks for ECI-006 are non-serious and related to the local administration of the product. Hence, the therapy suggested here has the promise to offer considerable benefit to patients without any major risk.
Interventions
BIOLOGICALECI-006
ECI-006 consists of TriMix and 5 tumor associated antigens mRNA. TriMix is a mixture of mRNAs that encodes potent immune stimulating molecules
Sponsors
eTheRNA immunotherapies
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
• Drug: ECI-006 mRNA Cohort 1: 5 intranodal injections of either 600 µg or 1800 µg mRNA Cohort 2: 9 intranodal injections of either 1800 µg or 3600 µg mRNA
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Main inclusion criteria Cohort 1: 1. Age greater than or equal to 18 years and less than or equal to 80 years. 2. Patients must have histologically proven primary malignant melanoma of skin which has been surgically removed (see exclusion criterion on patients with primary uveal melanoma or melanoma of the mucosae). 3. Patients with American Joint Committee on Cancer (AJCC) Stage IIc, III or IV. 4. Patients must have no evidence of disease as evidenced by a whole body 18F fluorodeoxyglucose (FDG) positron emission tomography \[PET\]/computed tomography \[CT\] scan to be done at maximum 2 weeks before Visit 2. To exclude the presence of tumor lesions in the brain magnetic resonance imaging (MRI) may be performed. 5. Full recovery from all prior therapies. A maximum period of 12 weeks following major surgery, or any other major invasive procedure is allowed before start of the study medication; at least 4 weeks should be between major surgery and the start of the immunotherapy 6. Female patients of childbearing potential should have a negative serum pregnancy test at Visit 1 (Screening) and should use an efficient method of birth control from screening until the first menses after a 4 week period after the last dose of study medication. Main
Exclusion criteria
Cohort 1: 1. Patients with primary uveal or mucosal melanoma. 2. Patients who have received prior systemic therapy and/or active immunotherapy for melanoma, such as antigen loaded dendritic cells or chimeric antigen receptor (CAR) T cells, are excluded. Systemic adjuvant treatment for melanoma that is more than 5 years ago and prior local treatment of primary and metastatic tumor lesions (e.g., surgical resection, isolated limb perfusion radiotherapy) are allowed. 3. Patients with a history of autoimmune disease such as, but not restricted to, inflammatory bowel disease, systemic lupus erythematosus, ankylosing spondylitis, scleroderma, rheumatoid arthritis or multiple sclerosis. Vitiligo is not an exclusion criterion 4. Patients with serious intercurrent chronic or acute illness such as pulmonary \[asthma or chronic obstructive pulmonary disease (COPD)\] or cardiac (New York Heart Association \[NYHA\] class III or IV) or hepatic disease or other illness considered by the investigator to constitute an unwarranted high risk for investigational drug treatment. 5. Concurrent second malignancy other than non-melanoma skin cancer, or controlled superficial bladder cancer. In the event of prior malignancies treated surgically, the patient must be considered NED (no evidence of disease) for a minimum of 3 years prior to enrolment. 6. Patients on steroid therapy \> 10 mg prednisone (or equivalent) or other immunosuppressive agents such as azathioprine or cyclosporine A (but not limited to these) are excluded on the basis of potential immune suppression. Patients must have had 8 weeks of discontinuation of any steroid therapy exceeding \> 10 mg prednisone (or equivalent) before first dose. Main inclusion criteria Cohort 2: 1. Histologically confirmed AJCC Stage III or Stage IV unresectable disease. 2. Patient must be free of progression and have stable disease after at least 3 months but less than 12 months of first-line immunotherapy (pembrolizumab, nivolumab or combination of nivolumab and ipilimumab). Patients with clinically stable disease can be either: 1. Patients with stable disease as defined by RECIST1.1 criteria as assessed on 2 consecutive imagings, or 2. Patients deemed unlikely to respond further to the standard of care immunotherapy by the investigator, after an initial partial response. 3. Patient must continue with standard of care pembrolizumab or nivolumab during the study. 4. Measurable disease by means of clinical examination, computed tomography (CT) or magnetic resonance imaging (MRI) according to the Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1, defined as: * At least 1 tumor lesion that can be accurately and serially measured in at least 1 dimension, and for which the greatest diameter is ≥ 10 mm or at least one malignant lymph node for which the short axis is ≥ 15 mm as measured by contrast enhanced or spiral CT scan and/or * At least 1 superficial cutaneous melanoma lesion ≥ 10 mm as measured by calipers and/or * At least 1 subcutaneous melanoma ≥ 10 mm lesion and/or * Multiple superficial melanoma lesions which in aggregate have a total diameter of ≥ 10 mm Main
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence and severity of treatment-emergent adverse events (TEAEs), including the incidence of dose-limiting toxicities (DLTs), graded using the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.03 | 24 weeks | Types of toxicities, incidences and severity will be summarized by descriptive statistics |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Immune response associated with ECI-006 administration | 24 weeks | Antigen-specific T cell responses will be investigated at several time points |
Countries
Belgium, Spain
Outcome results
None listed