Training Your Own Immune Cells to Fight Metastatic Melanoma
Locoregional or Systemic Administration of Autologous Tumor Infiltrating Lymphocytes in Patients With Metastatic Melanoma
In Plain English
This trial is testing a new way to fight melanoma that has spread to other parts of your body. Here's how it works: doctors will remove some of your own immune cells (called tumor infiltrating lymphocytes, or TILs) that are already fighting your cancer. They'll grow millions more of these cells in the lab, essentially creating an army of your body's own cancer-fighting soldiers. Then they'll put these cells back into your body—either directly into the liver through a special catheter, or through your bloodstream—along with two helper drugs (melphalan and interleukin-2) that boost their power. This is an early-stage trial (Phase 1), which means doctors are mainly checking if this approach is safe and if your body can handle it. You'll be closely monitored for side effects. The goal is to see if your own immune cells, when grown in large numbers and reinfused, can recognize and destroy cancer cells throughout your body. This trial is specifically for people with melanoma that has spread beyond the original tumor. If you're interested, your doctor will need to confirm you're a good candidate and that your cancer type matches what the trial is studying.
What This Trial Does
The purpose of this study is to evaluate the feasibility, safety and tolerability of locoregional or systemic administration of autologous tumor infiltrating lymphocytes in patients with melanoma
Who Can Join
Inclusion Criteria
- 1. Participants must be at least 18 years of age.
- 2. Can provide a signed informed consent as described in the protocol, including compliance with the requirements and restrictions listed in the ICF and in this protocol.
- 3. World Health Organization (WHO) Performance Status 0 or 1.
- 4. Patient must have a histologically/cytologically confirmed diagnosis of:
- stage IV uveal melanoma with confirmed progression following prior systemic therapy with tebentafusp (if HLA A2:01 positive) OR
- stage IV cutaneous melanoma with confirmed progression following prior systemic therapy with a programmed cell death protein-1 (PD-1) inhibitor with or without a CTLA-4 inhibitor
- 5. At least one resectable lesion in the liver (or aggregate of lesions resected) of a minimum size of 0.5 cm in diameter to generate TILs.
- 6. Measurable disease by computed tomography (CT) per RECIST 1.1 criteria after resection of lesion for TILs production
- 7. No other malignancies, except if treated with curative intent and with a cancer-related life expectancy of more than 5 years.
- 8. Female patient of childbearing potential should have a negative urine or serum pregnancy test within 72 hours prior to receiving the first treatment. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
- 9. Female patients of childbearing potential must be willing to use a highly efficient method of contraception (Pearl index \<1), for the course of the study through 120 days after the last dose of study medication.
- 10. Male patients with women of childbearing potential partners must agree to use a condom for contraception, starting with the first dose of study therapy through 120 days after the last dose of study therapy.
Exclusion Criteria
- 1. Any serious or uncontrolled medical conditions that, in the investigator's opinion, may increase the risk associated with study participation or study drug administration, impair the ability of the subject to receive protocol therapy (including operation), or interfere with the interpretation of study results.
- 2. Subjects with a condition requiring systemic treatment with either corticosteroids (\> 10 mg daily prednisone equivalents) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical steroids and adrenal replacement doses \> 10 mg daily prednisone equivalents are permitted in the absence of active autoimmune disease.
- 3. Women who are pregnant or breastfeeding.
- 4. Any condition that potentially hamper compliance with the study protocol and follow-up schedule; those conditions should be discussed with the subject before registration in the trial.
Treatments
Autologous Tumor Infiltrating Lymphocytes (TIL) (DRUG)
Cohort 1: Administered via hepatic arterial infusion Cohort 2: Administered via intravenous infusion
Melphalan (DRUG)
1 mg/kg, IV
Interleukin-2 (DRUG)
2 MIU, subcutaneous twice daily for up to 14 days.