Overview

Nivolumab in Patients With Advanced Non-Small Cell Lung Cancer and Pre-existing Autoimmune Disease

Status:
Active, not recruiting
Trial end date:
2022-10-31
Target enrollment:
0
Participant gender:
All
Summary
The purpose of this study is to explore the safety, tolerability and activity of Nivolumab, a PD-1 inhibitor, in cohorts of patients with autoimmune disease. Two cohorts of patients will be enrolled, based on autoimmune disease type. Patients will be screened within 28 days prior to the start of dosing. Eligible patients will be enrolled in either of the two cohorts. Patients will receive treatment every two weeks, in an outpatient setting. One cycle is a 28-day period, with Nivolumab given on days 1 and 15 of a 28-day cycle. Subjects will be permitted to continue treatment beyond initial RECIST 1.1.
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Alliance Foundation Trials, LLC.
Collaborator:
Bristol-Myers Squibb
Treatments:
Antibodies, Monoclonal
Nivolumab
Criteria
Inclusion Criteria:

1. Age > 18

2. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1

3. Metastatic, locally advanced or recurrent NSCLC, not amenable to curative therapy.

4. Patients should have received at least one platinum-based chemotherapy regimen for
recurrent or metastatic disease or have received platinum-based chemotherapy as part
of adjuvant or neoadjuvant therapy and experienced progression of disease within 6
months of completing therapy.

5. Patients with tumor genetic alterations such as EGFR, ALK, ROS1 or BRAF V600E
alterations for which there is FDA-approved targeted therapy must have been treated
with the appropriate targeted inhibitors in prior therapy

6. No limit on number of prior therapies

7. Ability to provide written, informed consent

8. Patients must be on a stable regimen of treatment for their autoimmune condition
without need for addition of new medications or escalating doses of preexisting
medications in the previous 12 weeks prior to study entry

9. In addition, patients with the following autoimmune diseases must have baseline
disease activity scores as follows (please see Appendix A):

- For rheumatoid arthritis: DAS28 < 5.1

- For polymyalgia rheumatica: PMR-AS < 17

- For Sjogrens: ESSDAI < 14

- For ulcerative colitis: SSCAI < 5

- For Crohn's disease: CDAI < 450

- For systemic lupus erythroderma: SLEDAI-2K < 20

- For multiple sclerosis: EDSS < 5.5

10. Adequate organ and marrow function as defined by:

- absolute neutrophil count ≥ 1,500/mcL

- platelets ≥ 100,000/mcL

- total bilirubin ≤ 2.5 × institutional upper limit of normal

- AST(SGOT)/ALT(SGPT) ≤ 2.5 × institutional upper limit of normal, OR

- AST(SGOT)/ALT(SGPT ) ≤5 × institutional upper limit of normal if liver metastases
are present

- Creatinine within normal institutional limits OR

- Creatinine clearance ≥60 mL/min/1.73 m2 for participants with creatinine levels
above institutional normal.

11. Non-pregnant and non-nursing.

12. Women of childbearing potential (WOCBP) must be willing to use 2 methods of birth
control or be surgically sterile, or abstain from heterosexual activity for the course
of the study through 5 months after the last dose of study medication. Patients of
childbearing potential are those who have not been surgically sterilized or have not
been free of menses > 1 year.

13. Male patients must agree to use an adequate method of contraception starting with the
first dose of study therapy through 7 months after the last dose of study therapy.

Exclusion Criteria:

1. No chemotherapy or radiotherapy within two weeks of study entry. Prior targeted
therapy is allowed as long as at least 5 half-lives have elapsed since last dose.

2. All adverse events (other than alopecia) from prior therapy must be resolved to Grade
1 or less.

3. Patients who are known to be HIV positive are excluded due to the known immunologic
alterations associated with the disease. HIV testing is not required.

4. No uncontrolled intercurrent illness such as active infection, or psychiatric illness
or social situation that in the judgment of the investigator would limit compliance
with study requirements

5. No active interstitial lung disease (ILD) or pneumonitis, or a history of ILD or
pneumonitis requiring treatment with corticosteroids

6. No live vaccine within 30 days of start of study treatment

7. No carcinomatous meningitis or untreated CNS metastases

8. No history of significant cardiac disease or presence of an abnormality in
electrocardiograms that, in the investigator's opinion, is medically exclusionary or
clinically meaningful

9. No other active malignancy

10. No known history of or positivity for active hepatitis B or C. HBV DNA and/or HCV RNA
must be undetectable and HBsAg must be negative at the time of screening

11. No active unstable angina and/or congestive heart failure, or myocardial infarction
within 6 months prior to protocol participation