Safety Study of Anti-Programmed Death-1 in Hematologic Malignancy
Status: Recruiting
Phase: Phase 1
Diagnosis: Hodgkin's Lymphoma, Lymphoma
NCT ID: NCT01592370
(View complete trial on ClinicalTrials.gov)
DFCI Protocol ID: 12-317
The purpose of this study is to determine the side effects of treatment with the monoclonal antibody anti-PD-1 (BMS-936558) in subjects with relapsed/refractory hematologic malignancy and the dose that should be recommended for use in future studies.
Conducting Institutions:
Dana-Farber Cancer Institute, Brigham and Women's Hospital, Beth-Israel Deaconess Medical Center
Overall PI:
Philippe Armand, MD,
Dana-Farber Cancer Institute
Site-responsible Investigators:
David Avigan, MD,
Beth Israel Deaconess Medical Center
Contacts:
Dana-Farber Cancer Institute:
Kathleen McDermott,
kmcdermott@partners.org
Beth-Israel Deaconess Medical Center:
Cancer Trials Call Center, 617-667-3060
Eligibility Criteria
Inclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) Performance of 0 or 1
- Subjects must have histological confirmation of relapsed or refractory hematologic malignancy
- Subjects with non-Hodgkin's lymphoma or Hodgkin lymphoma must have at least one measureable lesion > 1.5 cm as defined by lymphoma response criteria. Tumor sites that are considered measureable must not have received prior radiation therapy
- Subjects with Multiple Myeloma (MM) must have detectable disease as measured by presence of monoclonal immunoglobulin protein in a serum electrophoresis: IgG, IgA,IgM,(M-protein ≥ 0.5 g/dl or serum IgD M-protein ≥ 0.05 g/dl) or serum free-light chain or 24 hour urine with free light chain. Excluded are subjects with only plasmacytomas, plasma cell leukemia, or non-secretory myeloma
- Life expectancy of at least 3 months
- For subjects with lymphoma, either a formalin fixed tissue block or 7 to 15 slides of tumor sample (archival or fresh) must be available for performance of correlative studies
- Subjects must have received at least one prior chemotherapy regimen. Subjects must be off therapy for at least 3 weeks ( 2 weeks for oral agents) prior to Day 1
- Prior palliative radiation must have been completed at least 2 weeks prior to study
Day 1
- Toxicities related to prior therapy must have returned to Grade 1 or less, except for
alopecia. Peripheral neuropathy must be Grade 2 or less
- Adequate bone marrow function defined as:
- Absolute neutrophil count ≥ 1000/μl (stable off any growth factor within 1 week
of study drug administration)
- Hemoglobin ≥ 9 g/dL (transfusion to achieve this level is permitted)
- Platelet count ≥ 50 X 1000/ μl (transfusion to achieve this level is not
permitted)
- Adequate renal parameters defined as: Creatinine clearance (CrCl) > 40 ml/min
(Cockcroft-Gault formula)
- Adequate hepatic parameters defined as:
- Aspartate aminotransferase (AST) ≤ 3 x Upper limit of normal (ULN)
- Alanine aminotransferase (ALT) ≤ 3 x ULN
- Bilirubin ≤ 1.5 x ULN (except subjects with Gilbert's Syndrome, who must have
total bilirubin < 3.0 mg/dL and direct bilirubin < 0.5 mg/dL)
- Women of child bearing potential (WOCBP) must use highly effective methods of birth
control for up to 18 weeks after the last dose of investigational product
- Men and women ≥ 18 years of age
Exclusion Criteria:
- Subjects with myelodysplasia, polycythemia vera, idiopathic thrombocythemia,
myelofibrosis, acute leukemias, blast phase CML, T cell lymphoblastic or Burkitt
lymphoma acute leukemias
- Subjects with a history of central nervous system involvement by hematologic
malignancy or symptoms suggestive of central nervous system involvement
- Subjects with concomitant second malignancies (except adequately treated
nonmelanomatous skin cancers, ductal carcinoma in situ, treated superficial bladder
cancer or prostate cancer or in situ cervical cancers) are excluded unless a complete
remission was achieved at least 3 years prior to study entry and no additional
therapy is required or anticipated to be required during the study period
- Subjects with any active autoimmune disease or a history of known or suspected
autoimmune disease, or history of syndrome that requires systemic corticosteroids or
immunosuppressive medications, except for subjects with vitiligo, resolved childhood
asthma/atopy or autoimmune thyroid disorders
- A serious uncontrolled medical disorder or active infection which would impair the
ability of the subject to receive protocol therapy or whose control may be
jeopardized by the complications of this therapy
- Prior therapy with an anti-Programmed death-1 (anti-PD-1), anti-Programmed death
ligand 1 (anti-PD-L1), anti Programmed death ligand 2 (anti-PD-L2), anti-CD137 or
anti-Cytotoxic T lymphocyte-associated antigen 4 (anti-CTLA-4) antibody (or any other
antibody or drug specifically targeting T-cell costimulation or checkpoint pathways)
- Non-oncology vaccine therapies for prevention of infectious diseases [eg human
papilloma virus (HPV) vaccine) within 4 weeks of study drug administration. The
inactivated seasonal influenza vaccine can be given to subjects before treatment and
while on therapy without restriction. Influenza vaccines containing live virus or
other clinically indicated vaccinations for infectious diseases (ie, pneumovax,
varicella, etc.] may be permitted; but must be discussed with the Sponsor's Medical
Monitor and may require a study drug washout period prior to and after administration
of vaccine
- Prior organ allograft or allogeneic bone marrow transplantation
- Positive for human immunodeficiency virus (HIV 1/2) or known acquired
immunodeficiency syndrome (AIDS)
- Positive tests for hepatitis B virus surface antigen (HBsAg), or antibody to
hepatitis B core Antigen or hepatitis C virus antibody (confirmed by Western Blot) or
hepatitis C Ribonucleic acid (RNA) in serum
- Ejection fraction less than 45% in subjects with prior anthracycline exposure
- History of Grade 4 anaphylactic reaction to monoclonal antibody therapy
- Women who are pregnant or breastfeeding
- WOCBP who are unwilling or unable to use an acceptable method to minimize the risk of
pregnancy for the entire study period and for at least 18 weeks after the last dose
of investigational product