Metronomic Cyclophosphamide With Pembrolizumab in Checkpoint Inhibitor Refractory Melanoma
This is a phase 2, single-arm, open label clinical trial determining efficacy of Cyclophosphamide and Pembrolizumab in subjects with melanoma.
• Age ≥18 years at the time of signing informed consent form (ICF)
• Patients must have unresectable Stage III or Stage IV non-ocular melanoma per American Joint Committee on Cancer 8th Edition Staging Criteria not amenable to local therapy
• Participants must have measurable disease by RECIST v1.1 criteria as assessed by investigator/ radiology. Lesions situated in a previously irradiated area are considered measurable if progression has been shown in such lesions.
• Participants must have Eastern Cooperative Group (ECOG) performance status score of 0, 1 or 2 at screening visit.
• Life expectancy of at least 12 weeks
• Adequate bone marrow, liver, and renal function
• Hemoglobin ≥9.0 g/dL
• Platelets ≥100/mm3
• ANC ≥1.5/mm3
• Creatinine Clearance ≥ 30mL/min Cockcroft-Gault CrCl, mL/min = (140 - age) × (weight, kg) × (0.85 if female) / (72 × Cr, mg/dL).
• AST and ALT less than 3 times the Upper Limit of Normal or less than 5 times the Upper Limit of normal with liver metastases. T Bilirubin \< 3.1 mg/dL.
• Has progressed on a prior PD-1/PD-L1 treatment
• Recovered from toxicities of pembrolizumab to Grade ≤1, excluding endocrine toxicities
• Prior Receipt of PD-1/PD-L1 therapy within 9 weeks prior to the first dose of the investigational therapy.
• Women of childbearing potential must have had a negative pregnancy test performed within 7 days prior to the start of treatment
• Females of childbearing potential and males must be willing and able to use an adequate method of contraception to avoid pregnancy for the duration of the study.
• Male and female participants of childbearing potential who are sexually active with a non-sterilized partner must agree to use highly effective methods of birth control from the trial screening date until 3 months after the final dose of study intervention; cessation of birth control after this point shall be discussed with a responsible physician.
• Pregnant or lactating women are prohibited from enrolling in this study.
• Male participants are not allowed to donate sperm from the time of enrollment until 6 months after administration of study interventions.