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Genital Diseases

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Female Urogenital Diseases and Pregnancy Complications

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Antineoplastic Agents

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Pembrolizumab

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Antineoplastic Agents, Immunological

Immune Checkpoint Inhibitors

Three antibodies combination against PD1, PDL1, and CTLA4.

This study has 3 subgroups:

1. Ipilimumab +pembrolizumab +durvalumab is administrated with a total dose of 1-2mg/kg via vein, every 3 weeks.
2. Ipilimumab +pembrolizumab +durvalumab is administrated with a total dose of 1-2mg/kg via sustained (10min) micro-pump infusion via artery, every 3 weeks.
3. Ipilimumab +pembrolizumab +durvalumab is administrated with a total dose of 50-150mg via intra-tumor fine needle injection in 5 min, every 3 weeks.

ipilimumab +pembrolizumab +durvalumab

Zhenfeng Zhang, MD, PHD

Bingjia He, MD

This trial is designed to investigate the safety, response rates and survival outcomes of patients with advanced solid tumors by infusion of CTLA4, PD1 and PDL1 antibodies combination through venous (IV), artery (IA) or intra-tumor (IT).

Malignant solid tumors including lung and liver cancers are the most common malignancy worldwide, and their mortality rates are very high. China has a huge population base with about 4,000,000 new cancer cases each year. More than 60% of the solid tumors in China are diagnosed at mid-to-late stage and have lost the chance of surgery. Recently a lot of therapeutic strategies have been developed and applied to clinic including targeted therapy and immunotherapy, but the overall therapeutic efficiency is still low. It is very difficult to treat patients with recurrent/refractory/metastatic advanced solid cancers and more alternative therapies are urgently needed.

Antibodies against CTLA4, PD1 and PDL1 are representative drugs for the check-points inhibitory agents, and their clinical indications have been approved in various types of tumors, including advanced melanoma, non-small cell lung cancer, renal cell carcinoma, and classical Hodgkin's lymphoma and late recurrent head and neck squamous cell carcinoma patients, et al. Those drugs are regularly systemically administrated by vein infusion, however, local delivery of those drugs via interventional radiology technique including trans-artery or intra-tumor injection may increase the local drug concentration of the tumor, improve the efficacy, and reduce systemic adverse reactions. CTLA4 antibody ipilimumab has been widely effectively using to combine with PD1 or PDL1 antibody and this study is to combine ipilimumab, PD1 antibody and PDL1 antibody, so called triplex checkpoint inhibitors combination therapy, for advanced solid tumors. To the investigator's knowledge, no studies have been developed on the safety, efficacy and survival benefit of the triplex checkpoint inhibitors combination therapy for cancer patients. This phase I-II clinical trial is designed to assess the safety and survival benefit of ipilimumab, pembrolizumab and durvalumab combination on patients with advanced solid cancers, including PFS, ORR, DCR, and median survival time.

Triplex Checkpoint Inhibitors Therapy for Advanced Solid Tumors

Triplex CTLA4/PD1/PDL1 Checkpoint Inhibitors Combination Therapy for Advanced Solid Tumors

Safety will be assessed by recording all types of advise effects upon and after the treatment.

Progression-free survival (PFS) will be defined as the elapsed time from the first date of study treatment until documented disease progression (as per RECIST 1.1) or death from any cause, whichever is earlier. For patients who remain alive without progression, follow-up time will be censored at the date of last disease assessment.

Disease control rate will be defined as objective response rate + steady disease rate.

DOR will be defined as the duration of the cancer remission

Overall survival (OS) will be defined as the elapsed time from the enrollment to death from any cause. For surviving patients, follow-up will be censored at the date of last contact (or last date known to be alive). Follow-up for OS will occur every 12 weeks (±1 month) until death or withdrawal of consent from the study.

Second Affiliated Hospital of Guangzhou Medical University

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Triplex Checkpoint Inhibitors Therapy for Advanced Solid Tumors	NCT05187338	Lung Cancer Liver Cancer Colorectal Canc... Pancreas Cancer Ovary Cancer Head and Neck C... Breast Cancer Gastric Cancer Cervical Cancer Esophageal Canc... Sarcoma	ipilimumab +pem...	18 Years - 70 Years	Second Affiliated Hospital of Guangzhou Medical University
Triplex Checkpoint Inhibitors Therapy for Advanced Solid Tumors	NCT05187338	Lung Cancer Liver Cancer Colorectal Canc... Pancreas Cancer Ovary Cancer Head and Neck C... Breast Cancer Gastric Cancer Cervical Cancer Esophageal Canc... Sarcoma	ipilimumab +pem...	18 Years - 70 Years	Second Affiliated Hospital of Guangzhou Medical University

Spots Global Cancer Trial Database for ctla4 antibody