melanoma skin cancer
Conditions
Interventions
A metastatic lesion will be removed and used to culture tumor-infiltrating T
cells and if possible an autologous tumor cell line. Seven days before the
first T cell infusion the patients will start
melanoma
Sponsors
Leids Universitair Medisch Centrum
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: 1. Age * 18 years. 2. Histologically or cytologically proven metastatic skin melanoma. 3. Melanoma must be at one of the following AJCC 2009 stages: -Unresectable (or residual) regional metastatic melanoma, i.e. in terms of AJCC 2009 classification unresectable stage III melanoma, or -Stage IV melanoma, i.e. distant metastatic disease (any T, any N, M1a, M1b or M1c), and normal LDH. 4. Patients with brain metastases have to be neurologically stable for at least 2 months and should not use dexamethasone. 5. Presence of measurable progressive disease according to RECIST version 1.1. 6. Expected survival of at least 3 months. 7. WHO performance status *1. 8. Within the last 2 weeks prior to study day 1, vital laboratory parameters should be within normal range, except for the following laboratory parameters, which should be within the ranges specified : Lab Parameter Range Hemoglobin * 6,0 mmol/l Granulocytes * 1,500/µl Lymphocytes * 700/µl Platelets * 100,000/µl Creatinine clearance * 60 min/ml Serum bilirubin * 40 mol/l ASAT and ALAT * 5 x the normal upper limit LDH * 2 x the normal upper limit 9. Viral tests: -Negative for HIV type 1/2, HTLV and TPHA -No HBV (hepatitis B virus) antigen or antibodies against HBc in the serum -No antibodies against HCV (hepatitis C virus) in the serum 10. Able and willing to give valid written informed consent. 11. Prior treatment is allowed, including anti-PD1 treatment, but systemic therapy must have been discontinued for at least four weeks before study entry. Radiotherapy and targeted therapy should be discontinued for at least two weeks before study entry.
Exclusion criteria
Exclusion criteria: 1. Patients with brain metastases who are neurologically unstable and/or on use of dexamethasone. 2. Clinically significant heart disease (NYHA Class III or IV). 3. Other serious acute or chronic illnesses, e.g. active infections requiring antibiotics, bleeding disorders, or other conditions requiring concurrent medications not allowed during this study. 4. Active immunodeficiency disease or autoimmune disease requiring immune suppressive drugs. Vitiligo is not an exclusion criterion. 5. Other malignancy within 2 years prior to entry into the study, except for treated non-melanoma skin cancer and in situ cervical carcinoma. 6. Mental impairment that may compromise the ability to give informed consent and comply with the requirements of the study. 7. Lack of availability for follow-up assessments. 8. Pregnancy or breastfeeding.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary objective of this phase I/II clinical trial is to evaluate the safety and toxicity of ACT plus nivolumab according to CTCAE 4.0 criteria. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary objectives include the evaluation of the clinical response according to RECIST 1.1 criteria and immune related response criteria (irRC) and overall survival (OS). Clinical benefit is defined as Stable Disease (SD), Partial Response (PR), or Complete response (CR). An additional endpoint is to determine the induced immune response in the patient's blood and serum and in the T cells used for infusion. | — |
Countries
The Netherlands
Outcome results
None listed