VO and Nivolumab vs Physician's Choice in Advanced Melanoma That Progressed on Anti-PD-1 & Anti-CTLA-4 Drugs (IGNYTE-3)

Launched by REPLIMUNE INC. · Feb 9, 2024

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ClinConnect Summary

The IGNYTE-3 clinical trial is studying a new treatment option for patients with advanced melanoma (a type of skin cancer) that has not responded to previous therapies. Specifically, the trial is comparing a combination of two treatments—VO and nivolumab—with the standard treatment chosen by the patient's doctor. This trial is for individuals aged 12 and older who have advanced Stage IIIb-IV melanoma that has progressed after receiving specific cancer therapies that target certain proteins in the immune system (anti-PD-1 and anti-CTLA-4).

To be eligible, participants must have a confirmed diagnosis of advanced melanoma, have seen their condition worsen after at least 8 weeks of prior treatment, and have at least one tumor that can be measured. They should also be in overall good health, with certain blood tests confirming their body functions are stable. Participants can expect regular check-ups and monitoring throughout the trial, as well as the possibility of receiving either the new combination therapy or the standard treatment. It's important to note that certain health conditions, such as active infections or autoimmune diseases, may exclude someone from participating in the trial.

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Eligibility criteria

• Key Inclusion Criteria:
• • Male or female who is 12 years of age or older at the time of signed informed consent.
• • Patients with histologically or cytologically confirmed unresectable or metastatic Stage IIIb through IV/M1a through M1d cutaneous melanoma.
• • Confirmed disease progression (PD) on an approved anti-PD-1 and an anti-CTLA-4 treatment, administered either as a combination regimen (eg, nivolumab + ipilimumab) or in sequence.
• • 1. Treatment with prior anti-PD-1 therapy must have continued for a minimum of 8 weeks
• • 2. Patients who in the physician's judgement are not candidates for treatment with an anti-CTLA-4 antibody are eligible
• • Has documented BRAF V600 mutation status. Patients with BRAF mutation should have received prior BRAF-directed therapy (with or without a MEK inhibitor) prior to enrollment in the study, unless deemed not clinically indicated at Investigator's discretion due to concurrent medical condition or prior toxicity.
• • Has at least 1 measurable and injectable tumor of ≥1 cm in longest diameter (or shortest diameter for lymph nodes).
• • Has adequate hematologic function.
• • Has adequate hepatic function.
• • Has adequate renal function.
• • Prothrombin time (PT) ≤1.5 × ULN and partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT) ≤1.5 × ULN
• • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 to 1 for patients 18 years and older or a Lansky performance score (PSc) ≥80 for patients 12 to 17 years of age.
• • Life expectancy of at least 3 months.
• • Female and male patients of reproductive potential must agree to avoid becoming pregnant or impregnating a partner and adhere to highly effective contraception requirements during the treatment period and for at least 6 months after the last dose of study treatment.
• • Women of childbearing potential must have a negative serum beta-human chorionic gonadotropin (β-hCG) test within 72 hours before the first dose of study treatment.
• Key Exclusion Criteria:
• • Primary mucosal or uveal melanoma.
• • More than 2 lines of systemic therapy for advanced melanoma.
• • Known acute or chronic hepatitis.
• • Known human immunodeficiency virus (HIV) infection.
• • Active significant herpetic infections or prior complications of HSV-1 infection.
• • Had systemic infection requiring IV antibiotics or other serious active infection requiring antimicrobial, antiviral, or antifungal treatment within 14 days prior to dosing.
• • With active significant herpetic infections or prior complications of HSV-1 infection.
• • Evidence of spinal cord compression or at high risk of spinal cord compression.
• • Known active central nervous system (CNS) metastases and/or carcinomatous meningitis at time of screening.
• • Serum lactate dehydrogenase (LDH) \>2 × ULN.
• • Major surgery ≤2 weeks prior to starting study drug.
• • Prior malignancy active within the previous 3 years, except for locally curable cancers that have apparently been cured
• • History of significant cardiac disease including myocarditis or congestive heart.
• • History of life-threatening toxicity related to prior immune.
• • Active, known, or suspected autoimmune disease requiring systemic treatment.
• • History of (noninfectious) pneumonitis that required steroids or has current pneumonitis.
• • Prior oncolytic virus or other therapy given by intratumoral administration.
• • Requires intermittent or chronic use of systemic (oral or IV) antivirals with known antiherpetic activity (eg, acyclovir).
• • Has received a live vaccine within 28 days prior to the first dose of study treatment.
• • Systemic anticancer therapies within 5 half-lives or 4 weeks of the first dose, whichever is shorter.
• • Conditions requiring treatment with immunosuppressive doses (\>10 mg per day of prednisone or equivalent) of systemic corticosteroids other than for corticosteroid replacement therapy within 14 days after enrollment.