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Brief Title: A Combination of Ipilimumab and Fotemustine for Treat Unresectable Locally Advanced or Metastatic Melanoma
Official Title: A Phase II Study of the Combination of Ipilimumab and Fotemustine in Patients With Unresectable Locally Advanced or Metastatic Malignant Melanoma
Study ID: NCT01654692
Brief Summary: This study is designed to assess the safety and efficacy of a combination of ipilimumab and fotemustine in Patients with Unresectable Locally Advanced or Metastatic Malignant Melanoma.
Detailed Description: Immunotherapy, chemotherapy and chemotherapy combinations are currently the most effective accepted systemic treatments for metastatic melanoma. However, significant and prolonged responses are rare. The trial will determine the additional benefit achieved from adding fotemustine to the anti-CTLA-4 monoclonal antibody,ipilimumab . It is assumed that the mechanism by which ipilimumab augments the effects of chemotherapy in animal models relies on the ability of the cytotoxic agent to induce apoptosis of tumor cells. These apoptotic cells then can function as potent inducers of an immune response against any non-tolerized antigen that they contain. Thus, the chemotherapy may be creating an in vivo autologous tumor vaccine. Ipilimumab prevents the down regulation of this immune response, allowing for tumor rejection. Animal models evaluating the combination of anti-CTLA4 antibody and chemotherapy have given only a brief acute treatment with chemotherapy - presumably adequate to induce some tumor apoptosis, but inadequate to induce significant prolonged tumor rejection. Since patients with metastatic melanoma generally require therapy within a relatively short period of time, this protocol will allow for the use of fotemustine. Standard dosing of fotemustine will be used to optimize the chance for tumor control.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
National Institute for Cancer Research, Genoa, , Italy
Immunotherapy and Somatic Cell Therapy Unit, Scientific Institute of Romagna, Meldola, , Italy
European Institute of Oncology, Milan, , Italy
Melanoma Unit, San Raffaele Hospital, Milan, , Italy
Surgical Oncology, National Cancer Institute, Milan, , Italy
Medical Oncology and Innovative Therapy, National Cancer Institute, Naples, , Italy
Medical Oncology and Immunotherapy-University Hospital of Siena, Siena, , Italy
Name: Michele Maio, MD, PhD
Affiliation: Medical Oncology and Immunotherapy Unit, University Hospital of Siena
Role: PRINCIPAL_INVESTIGATOR