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Phase 2 N=24 Randomized Other

MEDI4736 Or MEDI4736 + Tremelimumab In Surgically Resectable Malignant Pleural Mesothelioma

Mesothelioma

Enrolled (actual)
24
Serious AEs
37.5%
Results posted
Jan 2022
Primary outcome: Primary: Change in Ratio of Intratumoral Cytotoxic T Cells to Regulatory T Cells (CD8/Treg) — 8.6 no unit of ratios with same units(%) — p=0.109

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
MEDI4736 (Drug); Tremelimumab (Drug); no other name (Other)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Baylor College of Medicine
Primary completion
Aug 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
Change in Ratio of Intratumoral Cytotoxic T Cells to Regulatory T Cells (CD8/Treg)
8.6 0.109
SECONDARY
Change in Percentage of Inducible T-cell Co-stimulator (ICOS) + CD4 T Cells.
-2.1 1
SECONDARY
Change in Tumor Expression Programmed Death-ligand 1 (PD-L1).
0.07 0.461
SECONDARY
Ratio of Intratumoral Cytotoxic T Cells to Regulatory T Cells (CD8/Treg) in Patients Treated With Combination Therapy (MEDI-4736 and Tremelimumab) and in Patients Treated With MEDI-4736 Alone.
8; 9.7 0.954
SECONDARY
Ratio of Intratumoral Cytotoxic T Cells to Regulatory T Cells (CD8/Treg) in Patients Treated With Combination Therapy (MEDI-4736 and Tremelimumab) and Untreated Patients.
9.7; 4.03 0.799
SECONDARY
Percentage of Inducible T-cell Co-stimulator (ICOS) + CD4 T Cells in Patients Treated With Combination Therapy (MEDI-4736 and Tremelimumab) and in Patients Treated With MEDI-4736 Alone
1.2; 4.5
SECONDARY
Percentage of Inducible T-cell Co-stimulator (ICOS) + CD4 T Cells in Patients Treated With Combination Therapy (MEDI-4736 and Tremelimumab) and in Untreated Patients.
4.5
SECONDARY
Tumor Expression Programmed Death-ligand 1 (PD-L1) in Patients Treated With Combination Therapy (MEDI-4736 and Tremelimumab) and in Patients Treated With MEDI-4736 Alone.
0.31; 0.18 0.418
SECONDARY
Tumor Expression Programmed Death-ligand 1 (PD-L1) in Patients Treated With Combination Therapy (MEDI-4736 and Tremelimumab) and in Untreated Patients.
0.18; 0.24 0.932
SECONDARY
Median Recurrence-free Survival (RFS)
14; NA
SECONDARY
Median Overall Survival (OS)
14.4; NA

Summary

The objective of this study is to determine whether MEDI4736 or combination therapy with MEDI4736 + tremelimumab are associated with favorable alterations of the intratumoral immunologic environment in subjects undergoing resectional surgery for Malignant Pleural Mesothelioma MPM.

Eligibility Criteria

Inclusion Criteria

  • Written informed consent obtained from the subject prior to performing any protocol-related procedures, including screening evaluations
  • Age >/= 18 years at time of study entry
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Adequate normal organ and marrow function as defined below:

Hemoglobin ≥ 9.0 g/dL Absolute neutrophil count (ANC) ≥ 1.5 × 109/L (> 1500 per mm3) Platelet count ≥ 100 × 109/L (>100,000 per mm3) Serum bilirubin ≤ 1.5× institutional upper limit of normal (ULN)AST 50mL/miN Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 2.5 × ULN (≤ 5 × ULN if documented liver metastasis are present); Serum creatinine ≤ 2.0 mg/dL or calculated creatinine clearance ≥ 50 mL/min as determined by the Cockcroft-Gault equation;

Males:

Creatinine CL (mL/min) = Weight (kg) × (140 - Age) 72 × serum creatinine (mg/dL)

Females:

Creatinine CL (mL/min) = Weight (kg) × (140 - Age) × 0.85 72 × serum creatinine (mg/dL)

  • Female subjects must either be of non-reproductive potential (i.e., post-menopausal by history: ≥60 years old and no menses for >/=1 year without an alternative medical cause; OR history of hysterectomy, OR history of bilateral tubal ligation, OR history of bilateral oophorectomy) or must have a negative serum pregnancy test upon study entry.
  • Subject is willing and able to comply with the protocol for the duration of the study including undergoing treatment and scheduled visits and examinations including follow up.
  • Surgically resectable MPM with no disease extension beyond the ipsilateral hemithorax
  • Planned resectional surgery for MPM [extrapleural pneumonectomy (EPP) or pleurectomy and decortication (P/D)]
  • Any MPM histology (epithelial, mixed, sarcomatoid)
  • N0 or N1 nodal disease as present on perioperative chest CT and/or PET CT.
  • N2 nodal disease if no progression after 2 cycles of standard chemotherapy. Progression will be considered if additional N1 or N2 disease develop during chemotherapy

Exclusion Criteria

  • Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site) or previous enrollment or randomization in the present study
  • Participation in another clinical study with an investigational product during the last 3 months
  • Any previous treatment with a PD1 or PD-L1 inhibitor, including MEDI4736
  • Receipt of the last dose of anti-cancer therapy (chemotherapy, immunotherapy, endocrine therapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies, other investigational agent) 30 days prior to the first dose of study drug, and 30 days prior to the first dose of study drug for subjects who have received prior TKIs [e.g., erlotinib, gefitinib and crizotinib] and within 6 weeks for nitrosourea or mitomycin C).
  • Current or prior use of immunosuppressive medication within 28 days before the infusion with MEDI4736 or MEDI4736 + tremelimumab and through 90 days post infusion, with the exceptions of intranasal and inhaled corticosteroids or systemic corticosteroids at physiological doses, which are not to exceed 10 mg/day of prednisone, or an equivalent corticosteroid.
  • Any unresolved toxicity (>CTCAE grade 2) from previous anti-cancer therapy.
  • Any prior Grade ≥3 immune-related adverse event (irAE) while receiving any previous immunotherapy agent, or any unresolved irAE >Grade 1
  • Active or prior documented autoimmune disease within the past 2 years NOTE: Subjects with vitiligo, Grave's disease, or psoriasis not requiring systemic treatment (within the past 2 years) are not excluded.
  • Active or prior documented inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis)
  • History of primary immunodeficiency
  • History of allogeneic organ transplant
  • History of hypersensitivity to MEDI4736 or any excipient
  • History of hypersensitivity to tremelimumab or the combination of MEDI4736 + tremelimumab
  • Uncontrolled i
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02592551). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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