E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Stage III, IV metastatic advanced melanoma |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To monitor the safety of ipilimumab (MDX-010) administered either as Re-Induction (10 mg/kg or 3 mg/kg) or as Maintenance therapy (0.3, 3 or 10 mg/kg) in this ipilimumab (MDX-010) clinical study. |
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E.2.2 | Secondary objectives of the trial |
For all patients: 1)OS from 1st dose of ipi. in parent study 2)survival rate at 1 year from 1st dose of ipi. in parent study 3)monitor patients (except in Group C Survival Follow-Up Only) who experience irAEs after ipi. treatment
For patients receiving Re-Induction in this study at time of disease progression, following clinical benefit (SD, PR or CR) after ipi. treatment: 4)Best ORR following 1st Re-Induction in this study 5)Disease control rate following 1st Re-Induction in this study 6)Duration of response following 1st Re-Induction in this study 7)Time to resp. following 1st Re-Induction in this study 8)OS following 1st Re-Induction in this study 9)Repeat response following 2nd Re-Induction in this study
For all patients receiving re-induction in this study, estimate: 10)PFS from 1st Re-Induction in this study
For all patients receiving Maintenance (Group B incl. TA only patients) treatment upon enrollment in this study. 11)PFS from the baseline in this study. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients eligible for this study must represent one of the three patient populations described in Section 3.2 of the Protocol and meet the inclusion/exclusion criteria detailed below.
Group C (except Group C Survival Follow-Up Only) patients must meet Inclusion Criteria 1, 2, and 3 and Exclusion Criteria 1 and 2. Group C Survival Follow-Up Only patients must meet Inclusion Criteria 1, 2, 3 and Exclusion Criterion 2.
1. Willing and able to give written informed consent;
Target population 2. Diagnosis of advanced melanoma; 3. Prior treatment in one of the following studies: CA184008, CA184-022, CA184007, CA184004, MDX010-08 or MDX010-15; and meets criteria for Group A, B or C (see Section 3.2.) 4. Accessible for treatment and Follow-Up; 5. All patients entering the study as Group A to receive Re-Induction must have their case discussed with a BMS Medical Monitor prior to enrollment in the companion study; 6. Patients who have not experienced IBE related to ipilimumab, or patients who have experienced a select IBE related to ipilimumab that has completely resolved with immunosuppressive therapy or controlled with hormone therapy (* see below for IBEs eligible for consideration, also refer to Section 3.2.2 for definition of select reversible IBEs): * List of IBEs eligible for consideration: a) Reversible autoimmune hepatitis b) Medically manageable endocrinopathy c) Reversible dermatological toxicity 7. Have the complete set of baseline (i.e., Screening) images of lesions and radiographic images, including, but not limited to: brain, chest, abdomen pelvis and bone scans (bone scan only as applicable). All images must be of adequate quality; 8. Life expectancy ≥16 weeks; 9. ECOG performance status of 0 or 1 (Group A patients only, refer to Appendix 3); 10. Required values for initial laboratory tests (Group A patients only): • WBC ≥ 2000/uL • ANC ≥ 1000/uL • Platelets ≥ 50 x 10³/uL • Hemoglobin ≥ 8 g/dL • Creatinine ≤ 3.0 x ULN • AST/ALT ≤ 2.5 x ULN for patients without liver metastasis ; ≤ 5 x ULN for patients with liver metastasis • Bilirubin ≤ 3.0 x ULN, (except patients with Gilbert’s Syndrome, who must have a total bilirubin less than 3.0 mg/dL); 11. No active or chronic infection with HIV, Hepatitis B or Hepatitis C;
Age and Sex 12. Men and women ≥18 years of age (or, ≥ 16, if allowable per local regulatory authority);
Women of childbearing potential (WOCBP) must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 8 weeks after the last date of study treatment in such a manner that the risk of pregnancy is minimized.
WOCBP must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) within 72 hours prior to the start of study medication.
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E.4 | Principal exclusion criteria |
For Group A, B, and C patients:
1) Prior treatment with a CD137 agonist or CTLA-4 inhibitor or agonist, except for ipilimumab; 2) Prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious disease) illness must not be enrolled in this study.
For Group A and Group B patients:
Sex and Reproductive Status 3) WOCBP who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study period and for up to 8 weeks after the study; 4) Women who are pregnant or breastfeeding; 5) Women with a positive pregnancy test on enrollment or prior to study drug administration; 6) Sexually active fertile men whose partners are WOCBP, unless using an adequate method of birth control;
Target Disease Exceptions 7) Primary ocular melanoma;
Medical History and Concurrent Diseases 8) Any underlying medical or psychiatric condition or acute infection, which in the opinion of the Investigator, will make the administration of study drug hazardous or obscure the interpretation of AEs (such as a condition associated with frequent diarrhea) or efficacy data (such as active lung infection that interferes with response assessments); 8a) Autoimmune disease: subjects with a documented history of inflammatory bowel disease, including ulcerative colitis and Crohn’s disease are excluded from this study as are subjects with a history of symptomatic disease (eg, rheumatoid arthritis, systemic progressive sclerosis [scleroderma], Systemic Lupus Erythematosus, autoimmune vasculitis [eg, Wegener’s Granulomatosis]). Subjects with motor neuropathy considered of autoimmune origin (eg, Guillain-Barré Syndrome) are excluded from this study.
Prohibited Therapies and/or Medications 9) Concomitant therapy with any anti-cancer agent (for up to 30 days prior to 1st dose of ipilimumab in this study and except as defined in Section 6.2.8.5), immunosuppressive agents (for up to 30 days prior to 1st dose of ipilimumab in this study), surgery or radiotherapy (except as defined in Sections 6.2.8.3 and 6.2.8.4) (for up to 30 days prior to 1st dose of ipilimumab in this study); and chronic use of systemic corticosteroids (used in the management of cancer or non-cancer-related illnesses and for up to 30 days prior to 1st dose of ipilimumab in this study). 10) Any non-oncology vaccine therapy used for prevention of infectious diseases (for up to 4 weeks prior to or after any dose of ipilimumab); 11) Treatment with other investigational products within the last 4 weeks prior to or during this study.
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E.5 End points |
E.5.1 | Primary end point(s) |
Efficacy Measures: The Investigator will make all tumor evaluations based on modified World Health Organization (WHO) criteria (Refer to Protocol Section 3.3.2). Throughout the study each respective Investigator will determine disease status of patients at the protocol-defined time points and as clinically indicated.
Immunogenicity: Human anti-human antibodies (HAHA) and serum ipilimumab concentration will be evaluated.
Safety Measures: Safety will be evaluated for all patients except Group C Survival Follow-Up Only using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events v3.0 (CTCAE). Safety assessments will be based on medical review of adverse event (AE) reports and the results of vital sign measurements, physical examinations and clinical laboratory tests. The incidence of AEs will be tabulated and reviewed for potential significance and clinical importance. The reporting period for safety data will either be: 1) from the date of the first dose of ipilimumab received in this study (Group A and B patients) to 70 days (5 half-lives) following the last dose received; or 2) 70 days from the last dose of ipilimumab received in the prior/parent study (Group C patients).
Interim Analyses: Interim analyses for overall survival may be performed following periodic survival data collection. No statistical hypothesis tests will be performed as a result of these analyses. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 75 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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This study will continue to enroll new patients until/if ipilimumab becomes commercially available at all open sites or the Investigational New Drug Application (IND) is closed by the Sponsor. It will remain open until the last enrolled patient discontinues from any study Phase, including Follow-Up or the study is otherwise terminated by the Sponsor. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |