NCT03465592 Trial of Nivolumab Following Partially Human Leukocyte Antigen (HLA) Mismatched BMT in Children & Adults With Sarcoma
| NCT ID | NCT03465592 |
| Status | Recruiting |
| Phase | Phase 1, Phase 2 |
| Sponsor | Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins |
| Condition | Sarcoma |
| Study Type | INTERVENTIONAL |
| Enrollment | 39 participants |
| Start Date | 2018-05-01 |
| Primary Completion | 2027-01 |
Eligibility & Interventions
Eligibility Fast-Check
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What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
Phase 1 is the earliest stage of human testing — safety and dosage are the primary focus. Visits are frequent and medical supervision is intensive. You will be among the first people to receive this treatment.
This trial targets 39 participants in total. It began in 2018-05-01 with a primary completion date of 2027-01.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
This research is being done to find out if an investigational drug, Nivolumab, can be safely administered after a "half-matched" (haplo) bone marrow transplant (BMT), and if the investigational drug will help to prevent or delay relapse or progression of sarcomas. In this study investigators will also be trying to learn more about how the investigational drug changes blood and/or tumors. Participants are eligible for this trial if they have recently undergone a "half-matched" (haplo) bone marrow transplant and have either relapsed or are at high risk to relapse.
Eligibility Criteria
Inclusion Criteria: 1. Patients must be ≥ 12 months and ≤ 50 years of age at the time of study enrollment. 2. Patients with histologically confirmed solid tumors with an estimated poor long term survival. 3. Performance Level: Karnofsky ≥ 50% for patients \> 16 years of age and Lansky ≥ 60 for patients ≤16 years of age. 4. Patients must be post RIC haploidentical BMT. 5. Patients must have fully recovered from the acute toxic effects of prior BMT. 6. Concomitant radiation therapy can be administered in the setting of this trial. 7. Subjects must consent to allow for a baseline tumor biopsy. If a biopsy is not feasible, then archival tumor material must be made available. Tumor biopsies to be taken (if a subject's tumor is thought to be reasonably safe and easy to biopsy) at baseline (any time prior to the first dose after eligibility is met) and at Cycle 2 (4-6 cores per time point) or when lesions are visualized on physical examination or imaging studies in the case of no identifiable masses at cycle 2. Additional optional biopsies may be obtained later in the course of study treatment. The proposed investigation is considered a non-significant risk (NSR). A significant risk procedure is generally considered to be one for which the procedure-associated absolute risk of mortality or major morbidity, in the patient's clinical setting and at the institution completing the procedure, is 2% or higher. Diagnostic Tissue Samples Tissue, fluid, or blood may be collected from standard of care procedures used to treat or diagnose immune related toxicities/GVHD. 8. Organ Function Requirements: I. Adequate Hematologic Parameters: 1. For patients with solid tumors without known bone marrow involvement: * Peripheral absolute neutrophil count (ANC) ≥ 500/mm3 * Platelet count ≥ 50,000/mm3 2. Patients with known bone marrow metastatic disease will be eligible for study without the above criteria. They may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions. These patients will not be evaluable for hematologic toxicity. II. Adequate Renal Function Defined as: 1. Creatinine clearance or radioisotope Glomerular filtration rate (GFR) ≥ 70ml/min/1.73 m2 or 2. A serum creatinine based on age/gender as follows: * Age 1 to \<2 years, Male: 0.6 and Female: 0.6 * Age 2 to \<6 years, Male: 0.8 and Female: 0.8 * Age 6 to \<10 years, Male: 1 and Female:1 * Age 10 to \<13 years, Male: 1.2 and Female 1.2 * Age 13 to \<16 years, Male: 1.5 and Female 1.4 * Age ≥ 16 years, Male: 1.7 and Female 1.4 III. Adequate Liver Function Defined as: 1. Bilirubin (sum of conjugated + unconjugated) ≤1.5 x upper limit of normal (ULN) for age 2. Serum glutamic pyruvic transaminase (SGPT) (ALT) ≤110 U/L. For the purpose of this study, the ULN for SGPT is 45 U/L. 9. Patients must have been registered on protocol J12106 "A Phase II Trial of Reduced Intensity Conditioning and HLA-matched or Partially HLA-mismatched (HLA-haploidentical) Related Donor Bone Marrow Transplant for High-risk Solid Tumors" before enrolling on this study.Patient may be screened prior to Day +120 but first dose of study drug must be given on or after Day +120. Exclusion Criteria: 1. GVHD: any history of Stage 4 skin GVHD or Stage 3 gut/liver GVHD (a.k.a. overall Grade III/IV GVHD) or any severe chronic GVHD. Any person with ≤ Grade II GVHD must be off systemic immunosuppressive therapy for at least 2 weeks prior to receiving Nivolumab therapy. 2. Inhaled or topical steroids and adrenal replacement steroid doses are permitted in the absence of active auto- or allo-immune disease 3. BMT-related toxicities: patients who developed idiopathic pneumonia syndrome (IPS) or veno-occlusive hepatic disease (VOD) must be off systemic immunosuppression and/or defibrotide for at least 14 days to be eligible. 4. Infection: Patients who have an uncontrolled infection. 5. Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible. 6. Has active, known or suspected autoimmune disease. Subjects with vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune thyroiditis only requiring hormone replacement, or conditions not expected to recur in the absence of an external trigger are permitted to enroll. 7. Allergies and Adverse Drug Reaction 1. History of allergy to study drug components. 2. History of severe hypersensitivity reaction to any monoclonal antibody. 8. Pregnancy or Breast Feeding: Women of childbearing potential (WOCBP) must agree to follow instructions for method(s) of contraception for the duration of study treatment with nivolumab and 5 months after the last dose of study treatment {i.e., 30 days (duration of ovulatory cycle) plus the time required for the investigational drug to undergo approximately five half-lives. Males who are sexually active with WOCBP must agree to follow instructions for method(s) of contraception for the duration of study treatment with nivolumab and 7 months after the last dose of study treatment {i.e., 90 days (duration of sperm turnover) plus the time required for the investigational drug to undergo approximately five half-lives.
Contact & Investigator
Nicolas Llosa, MD
PRINCIPAL INVESTIGATOR
Johns Hopkins University
Frequently Asked Questions
Who can join the NCT03465592 clinical trial?
This trial is open to participants of all sexes, aged 12 Months or older, up to 40 Years, studying Sarcoma. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
What phase is the NCT03465592 trial and what does that mean for participants?
Phase 1 trials are the first stage of human testing. The primary goal is to assess safety and determine appropriate dosage levels. Participants are closely monitored. These trials typically involve a small number of volunteers.
Is NCT03465592 currently recruiting?
Yes, NCT03465592 is actively recruiting participants. Contact the research team at mpetryc1@jhmi.edu for enrollment information.
Where is the NCT03465592 trial being conducted?
This trial is being conducted at St. Petersburg, United States, Baltimore, United States, The Bronx, United States, Valhalla, United States.
Who is sponsoring the NCT03465592 clinical trial?
NCT03465592 is sponsored by Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. The principal investigator is Nicolas Llosa, MD at Johns Hopkins University. The trial plans to enroll 39 participants.