Nivolumab and Ipilimumab in Treating Patients With Metastatic/Recurrent ACC of All Sites and Non-ACC Salivary Gland Cancer

Recurrent Salivary Gland Carcinoma Clinical Trial

Official title: Phase II Study of Nivolumab and Ipilimumab for Treatment of Metastatic/Recurrent Adenoid Cystic Carcinoma of All Anatomic Sites of Origin and Non-adenoid Cystic Carcinoma Malignant Tumors of the Salivary Gland

Status Active, not recruiting

Clinical Trial Summary

This phase II trial studies the efficacy (the effect on the tumor) and the safety (the effect on the body) of the study drugs when given as a combination in participants with this type of cancer. Another purpose of the study is to see which tumor markers (proteins in the blood that the body produces in response to the cancer) lead to better results in participants treated with the study drugs. Nivolumab and ipilimumab are antibodies, which are human proteins that recognize and attach to a part of the tumor and/or body's immune cells. They work in slightly different ways to activate the immune system and help the body's immune system to work against tumor cells. Nivolumab and ipilimumab are investigational because they are not approved by the FDA to be used for the type of cancer being studied.

Clinical Trial Description

PRIMARY OBJECTIVES:

I. To assess median progression-free survival rate (PFSR) as well as PFSR at 6 and 12 months in patients with recurrent or metastatic adenoid cystic carcinoma (ACC) treated with a combination of nivolumab and ipilimumab.

SECONDARY OBJECTIVES:

I. To assess the efficacy of nivolumab and ipilimumab according to response rate (RR), disease control rate (DCR; complete response [CR], partial response [PR], and stable disease [SD] at 6 and 12 months), overall survival (OS) and progression free survival (PFS) using Response Evaluation Criteria in Solid Tumors (RECIST) criteria in patients with recurrent or metastatic ACC.

II. To assess the efficacy of nivolumab and ipilimumab according to overall response rate (ORR), DCR, progression free survival (PFS), and OS in patients with recurrent or metastatic ACC using immune-related response criteria (irRC) criteria.

III. To assess the safety and tolerability profile of nivolumab and ipilimumab therapy in patients with recurrent or metastatic ACC using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03.

TERTIARY OBJECTIVES:

I. Assess safety, tolerability and activity of Nivolumab and Ipilimumab in non-ACC malignant salivary gland tumors (MSGT's) using clinical benefit rate (CBR), ORR, PFS, OS.

II. To assess the predictive value of genomic aberrations observed upon comprehensive genomic profiling of the tumor deoxyribonucleic acid (DNA) derived from archival tumor tissue, if available, or blood from patients with recurrent or metastatic ACC and non-ACC MSGTs.

III. Circulating cell free DNA genomic profiling will also be performed at baseline and during treatment with each imaging to explore the genomic landscape of clonal evolution that may elucidate mechanisms behind response or resistance with immunotherapy in adenoid cystic carcinoma and non-ACC MSGTs.

IV. Correlation between expression of PD-L1 and response to treatment will be explored in all patients enrolled in the study.

V. Correlations between other markers of inflammatory/immune signature will be performed that may include but not be limited to PD-1, OX40, CD73, CD39, T cell immunoglobulin and mucin domain containing protein 3 (TIM3), GITRL, CTLA-4, CD3, CD4, CD8, protein tyrosine phosphatase receptor type C (CD45RO), forkhead box P3 (FOXP3), and granzyme by immunohistochemistry analysis and/or flow cytometry.

OUTLINE:

Patients receive nivolumab intravenously (IV) over 30 minutes on days 1, 15, 29, 43, 57, and 71 of course 1 and on days 1 and 15 of course 2, over 60 minutes on days 29 and 57 of course 2 and on days 1, 29, and 57 of subsequent courses. Patients also receive ipilimumab over 90 minutes on days 1 and 43. Courses repeat every 84 days in the absence of disease progression, unexpected toxicity, or withdrawal of consent.

After completion of study treatment, patients are followed up for 30 days, every 4 weeks for 12 weeks, and then every 12 weeks for up to 2 years. ;

Related Conditions & MeSH terms

• Carcinoma
• Major Salivary Gland Carcinoma
• Minor Salivary Gland Carcinoma
• Recurrence
• Recurrent Salivary Gland Carcinoma
• Salivary Gland Neoplasms
• Stage IV Major Salivary Gland Carcinoma
• Stage IVA Major Salivary Gland Carcinoma
• Stage IVB Major Salivary Gland Carcinoma
• Stage IVC Major Salivary Gland Carcinoma

• NCT number: NCT03146650
• Study type: Interventional
• Source: Northwestern University
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: May 19, 2017
• Completion date: August 11, 2025