Nivolumab and Ipilimumab in Patients With dMMR and/or MSI Metastatic Colorectal Cancer Resistant to Anti-PD1 Monotherapy: An Open-label Phase II GERCOR Trial (NIPIRESCUE)

Status: Recruiting
Location: See all (9) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

NIPIRESCUE evaluates nivolumab and ipilimumab in patients with MSI/dMMR mCRC resistant to anti-PD1 monotherapy and previously treated with fluoropyrimidine, oxaliplatine, irinotecan, and anti- vascular endothelial growth factor (VEGF) or anti- epidermal growth factor receptor (EGFR) therapy.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Signed and dated patient informed consent form and willingness to comply with all study procedures and availability for the study duration,

• Age ≥ 18 years,

• Eastern Cooperative Oncology Group performance status (ECOG PS) of 0, 1, and 2,

• Histologically confirmed colorectal adenocarcinoma,

• Documented metastatic disease not suitable for complete surgical resection,

• Disease progression per iRECIST criteria (i.e., iCPD: immune confirmed PD) during monotherapy with anti-PD1 monoclonal antibody or less than 6 months after the discontinuation of anti-PD1 monoclonal antibody

• Disease progression during, after, or patients who are intolerant or have contraindications to approved standard therapies for the metastatic disease, which must include at least: • Fluoropyrimidine, oxaliplatin, and irinotecan, • Anti-EGFR therapy if wild-type RAS, • Anti-VEGF therapy,

• At least one measurable lesion as assessed by CT-scan or magnetic resonance imaging (MRI) according to RECIST 1.1 and feasibility of repeated radiological assessments,

• dMMR and/or MSI tumor status defined by: - Loss of MMR protein expression using immunohistochemistry with four (anti-MLH1, anti-MSH2, anti-MSH6, and anti-PMS2) antibodies, - and/or ≥ two unstable markers by pentaplex polymerase chain reaction (BAT-25, BAT-26, NR-21, NR-24, and NR-27), NB: In case of loss of expression of only one MMR protein immunohistochemistry, it is necessary to confirm the tumor is MSI using pentaplex PCR.

• NB: In cases with two unstable markers, comparison with matching normal tissue is required.

• NB: Agreement of the Sponsor (GERCOR) is mandatory to include the patient (the patient's file will be verified to confirm MSI/dMMR status before inclusion \[an anonymized fax\] and confirmation of a patient's allocation will be sent by mail to the Investigator within 24h).

⁃ For all patients, a new biopsy must be performed to obtain fresh anti-PD1 resistant tumor tissue prior to study treatment initiation,

⁃ For all patients, archival formalin-fixed paraffin-embedded tissue (FFPE) blocks and/or FFPE unstained slides (minimum of 30 positively charged slides representative of tumor tissue and non-tumor adjacent prior to anti-PD1 therapy (i.e., primary or metastatic site naïve of immunotherapy) must be submitted to the central laboratory,

⁃ Adequate hematologic and end-organ function, defined by the following laboratory test results, obtained within 7 days prior inclusion: - Adequate hematological status (White blood cell \> 2000/μL; o Neutrophils \> 1500/μL; Platelets \> 100.000/μL; Hemoglobin \> 10.0 g/dL; - Adequate renal function: Serum creatinine level \< 120 μM; Clearance \> 50 ml/min (Modification of the Diet in Renal Disease \[MDRD\] or Cockcroft and Gault, - Adequate liver function: Serum bilirubin ≤ 1.5 x upper normal limit (ULN); Alkaline phosphatase (ALP) ≤ 3.0 x ULN; Alanine aminotransferase (ALT) ≤ 3.0 x ULN; Aspartate aminotransferase (AST) ≤ 3.0 x ULN; Hemostasis: Prothrombin time (PT)/International normalized ratio (INR) and activated partial PT (aPTT) ≤ 1.5 x ULN unless participants are receiving anticoagulant therapy and their INR is stable and within the recommended range for the desired level of anticoagulation,

⁃ Females of childbearing potential must have negative serum pregnancy test within 7 days before starting study treatment,

⁃ Women of childbearing potential should use effective contraception during treatment and at least 5 months thereafter.

⁃ Registration in a national health care system (Protection Universelle Maladie \[PUMa\] included)

Locations
Other Locations
France
CHU Jean Minjoz
RECRUITING
Besançon
Institute Bergonie
RECRUITING
Bordeaux
CHRU Lille
RECRUITING
Lille
CHU Dupuytren
RECRUITING
Limoges
Centre Léon Bérard
RECRUITING
Lyon
ICM Val d'Aurelle
RECRUITING
Montpellier
Centre Antoine Lacassagne
RECRUITING
Nice
Hôpital Saint Antoine
RECRUITING
Paris
CHU Poitiers
RECRUITING
Poitiers
Contact Information
Primary
Marie Line GARCIA LARNICOL, MD
marie-line.garcia-larnicol@gercor.com.fr
01 40 29 85 00
Time Frame
Start Date: 2022-05-05
Estimated Completion Date: 2027-09
Participants
Target number of participants: 30
Treatments
Experimental: Treatment phase
Induction therapy: Nivolumab 240 mg + ipilimumab 1 mg/kg every 3 weeks for 4 dosing cycles (4 infusions of nivolumab and ipilimumab).~Maintenance therapy: Nivolumab 480 mg every 4 weeks (21 infusions).
Related Therapeutic Areas
Sponsors
Leads: GERCOR - Multidisciplinary Oncology Cooperative Group

This content was sourced from clinicaltrials.gov