ACTIVE_NOT_RECRUITING

In Situ Immunomodulation With CDX-301, Radiation Therapy, CDX-1140 and Poly-ICLC in Patients w/ Unresectable and Metastatic Solid Tumors

Conditions

Anatomic Stage IV Breast Cancer AJCC v8 Metastatic Breast Carcinoma Prognostic Stage IV Breast Cancer AJCC v8 Unresectable Breast Carcinoma Metastatic Melanoma Unresectable Melanoma Cutaneous Squamous Cell Carcinoma Merkel Cell Carcinoma Soft Tissue Sarcoma Bone Sarcoma Sarcoma,Soft Tissue Sarcoma of Bone Basal Cell Carcinoma High-grade bone sarcoma High-grade soft tissue sarcoma

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase I trial evaluates the safety and effectiveness of in situ immunomodulation with CDX-301, radiotherapy, CDX-1140 and Poly-ICLC (Cohort A) and these with intravenous (IV) pembrolizumab and subcutaneous (SC) tocilizumab (Cohort B) in treating patients with unresectable and measurable metastatic melanoma, cutaneous squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Merkel cell carcinoma, high-grade bone and soft tissue sarcoma or HER2/neu(-) breast cancer. CDX-301 may induce cross-presenting dendritic cells, master regulators in the immune system. Radiation therapy uses high energy to kill tumor cells and release antigens that may be picked up, processed and presented by cross-presenting dendritic cells. CDX-1140 and Poly-ICLC may activate tumor antigen-loaded,cross-presenting dendritic cells, and generate tumor-specific T lymphocytes, a type of immune cells, that can search out and attack cancers. Giving immune modulators and radiation therapy may stimulate tumor cell death and activate the immune system.

Official Title

A Phase I Study of In Situ Immunomodulation With CDX-301, Radiotherapy, CDX-1140, and Poly-ICLC in Patients With Unresectable and Metastatic Solid Tumors With Injectable Palpable Disease

Quick Facts

Study Start:2023-01-09

Study Completion:2028-01-09

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:ACTIVE_NOT_RECRUITING

Study ID

NCT04616248

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
* Have clinically or pathologically confirmed diagnosis of unresectable and metastatic melanoma, cutaneous SCC, basal cell carcinoma, Merkel cell carcinoma, high-grade bone and soft tissue sarcoma or HER2/neu (-) breast cancer with no curative treatment options. * The unresectable disease to be irradiated and injected with medications must be located in breast, dermal, subcutaneous, or soft tissue, or lymph nodes with the longest axis of the tumor 2-7 centimeters, and should be considered safe for injection by the investigator. * The metastatic disease must be measured per irRECIST criteria. * Patient must have lesion that can be biopsied and is willing to undergo the procedure as part of the protocol. * Have an Eastern Cooperative Oncology Group (ECOG) performance status of =\< 1. * Participants of child-bearing potential and men must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. * For patients with history of radiotherapy to the same location that will be treated on study, he/she will be eligible only if the prior radiation dose was under or equal to 68 Gy total and delivered more than 6 months prior to planned re-treatment. (The cumulative dose received to the irradiated area will be no more than 87 Gy total, including a maximum of 68 Gy allowed from prior treatment course.) * Patient requires the use of radiation therapy to the target lesion of palliation of symptoms and/or achieving local control as part of standard of care as deemed appropriate by treating radiation oncologist. * Patients must agree to radiation to the tumor. * Any line of therapy allowed, radiologically or clinically confirmed progression on prior therapy * Must have adequate organ and marrow function present as defined below: * Platelets \>= 100,000/uL * Hemoglobin \>= 8.0 g/dL * Absolute neutrophil count (ANC) \>= 1500/uL * Total bilirubin =\< 1.5 X institutional upper limit of normal (ULN) * Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 2.5 X institutional ULN. * Creatinine =\< 1.5 X ULN OR creatinine clearance \>= 50 mL/min per Cockcroft-Gault equation for patients with creatinine levels greater than ULN. * Participant or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure. * Patients must agree to injections of CDX-301, CDX-1140, and poly-ICLC. * Patients must agree to appropriate clinical monitoring to receive the study regimens. * Patients must agree to photos of tumors and use of the photos for publication. * Patients should have an administration site for all injections that is free of potentially complicating dermatologic conditions such as rashes.	* Patients currently treated with systemic immunosuppressive agents, including steroids, are ineligible until 3 weeks after removal from immunosuppressive treatment. (inhaled steroids are allowed) * Patients with HER2+ breast cancer * Concurrent use of targeted therapy including CDK4/6, mTOR, PIK3CA, PARP, BRAF, MEK, hedgehog inhibitors or chemotherapy (endocrine therapy is allowed). * Targeted therapy including CDK4/6, mTOR, PIK3CA, PARP, BRAF, MEK, hedgehog inhibitors, chemotherapy, or immunotherapy within 2 weeks prior to first dosing of study agent. (endocrine therapy is allowed). * Patients with active or history of autoimmune disease or history of transplantation except for the patients with Graves' disease with ablative therapy of total thyroidectomy. * Patients with history of (non-infectious) pneumonitis/interstitial lung disease, including grade 1 pneumonitis (asymptomatic; clinical or diagnostic observations only; intervention not indicated). * Patients with prior history of acute myeloid leukemia (AML) or known FLT3 aberrations * Pregnant or nursing female participants. * Unwilling or unable to follow protocol requirements. * Patients with known serious mood disorders. (Major depression diagnosis is an exclusion: Other stable mood disorders on stable therapy for \> 6 months or not requiring therapy may be allowed after consultation with principal investigator \[PI\]). * Cardiac risk factors including: * Patients experiencing cardiac event(s) (acute coronary syndrome, myocardial infarction, or ischemia) within 3 months of signing consent. * Patients with a New York Heart Association classification of III or IV. * Patients with uveal melanoma. * Patients with uncontrolled diseases other than cancer may be excluded if after consultation with PI and research team it is decided it might affect the treatment efficacy or toxicity. * Evidence of current drug or alcohol abuse or psychiatric impairment, which in the investigator's opinion will prevent completion of the protocol therapy or follow-up. Specific testing is not required, however may be done as clinically indicated. * Any condition which in the investigator's opinion deems the participant an unsuitable candidate to receive study drug. * Participants with symptomatic known brain metastases \< 4 weeks from radiation treatment should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events. * Other invasive cancers diagnosed \< 3 years back that required systemic treatment. If diagnosed with other invasive cancer \>= 3 years, should have complete recovery from all systemic toxicity except neuropathy, vitiligo, alopecia, and endocrinopathies on stable hormone replacement therapy. * Live vaccines within 30 days prior to the first dose of trial treatment and while participating in the trial. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster, yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid vaccine. * Has a known history of human immunodeficiency virus (HIV) (HIV 1/2 antibodies). * Has known active hepatitis B (e.g., hepatitis B surface antigen \[HBsAg\] reactive) or hepatitis C (e.g., hepatitis C virus \[HCV\] ribonucleic acid \[RNA\] \[qualitative\] is detected). * Current use of anticoagulants (warfarin, heparin) at therapeutic levels. * Patients who have had stroke/TIA and DVT/PE within the last 12 months. * Patients at risk for impending visceral crisis of the liver and lungs as follows, or any condition which in the patient's primary treating oncologist's opinion deems the participant an unsuitable candidate to receive study drug: * A visceral crisis of the liver exists when bilirubin levels increase very rapidly (\>1.5 times the upper limit of normal) without the presence of Gilbert syndrome (i.e., Meulengracht syndrome) or a biliary tract obstruction. * A visceral crisis of the lungs can be assumed when dyspnea at rest increases more rapidly and cannot be relieved by pleural drainage. * Radiation induced angiosarcoma.

Inclusion Criteria

Exclusion Criteria

* Have clinically or pathologically confirmed diagnosis of unresectable and metastatic melanoma, cutaneous SCC, basal cell carcinoma, Merkel cell carcinoma, high-grade bone and soft tissue sarcoma or HER2/neu (-) breast cancer with no curative treatment options.
* The unresectable disease to be irradiated and injected with medications must be located in breast, dermal, subcutaneous, or soft tissue, or lymph nodes with the longest axis of the tumor 2-7 centimeters, and should be considered safe for injection by the investigator.
* The metastatic disease must be measured per irRECIST criteria.
* Patient must have lesion that can be biopsied and is willing to undergo the procedure as part of the protocol.
* Have an Eastern Cooperative Oncology Group (ECOG) performance status of =\< 1.
* Participants of child-bearing potential and men must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately.
* For patients with history of radiotherapy to the same location that will be treated on study, he/she will be eligible only if the prior radiation dose was under or equal to 68 Gy total and delivered more than 6 months prior to planned re-treatment. (The cumulative dose received to the irradiated area will be no more than 87 Gy total, including a maximum of 68 Gy allowed from prior treatment course.)
* Patient requires the use of radiation therapy to the target lesion of palliation of symptoms and/or achieving local control as part of standard of care as deemed appropriate by treating radiation oncologist.
* Patients must agree to radiation to the tumor.
* Any line of therapy allowed, radiologically or clinically confirmed progression on prior therapy
* Must have adequate organ and marrow function present as defined below:
* Platelets \>= 100,000/uL
* Hemoglobin \>= 8.0 g/dL
* Absolute neutrophil count (ANC) \>= 1500/uL
* Total bilirubin =\< 1.5 X institutional upper limit of normal (ULN)
* Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase \[SGOT\]) and alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 2.5 X institutional ULN.
* Creatinine =\< 1.5 X ULN OR creatinine clearance \>= 50 mL/min per Cockcroft-Gault equation for patients with creatinine levels greater than ULN.
* Participant or legal representative must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure.
* Patients must agree to injections of CDX-301, CDX-1140, and poly-ICLC.
* Patients must agree to appropriate clinical monitoring to receive the study regimens.
* Patients must agree to photos of tumors and use of the photos for publication.
* Patients should have an administration site for all injections that is free of potentially complicating dermatologic conditions such as rashes.

* Patients currently treated with systemic immunosuppressive agents, including steroids, are ineligible until 3 weeks after removal from immunosuppressive treatment. (inhaled steroids are allowed)
* Patients with HER2+ breast cancer
* Concurrent use of targeted therapy including CDK4/6, mTOR, PIK3CA, PARP, BRAF, MEK, hedgehog inhibitors or chemotherapy (endocrine therapy is allowed).
* Targeted therapy including CDK4/6, mTOR, PIK3CA, PARP, BRAF, MEK, hedgehog inhibitors, chemotherapy, or immunotherapy within 2 weeks prior to first dosing of study agent. (endocrine therapy is allowed).
* Patients with active or history of autoimmune disease or history of transplantation except for the patients with Graves' disease with ablative therapy of total thyroidectomy.
* Patients with history of (non-infectious) pneumonitis/interstitial lung disease, including grade 1 pneumonitis (asymptomatic; clinical or diagnostic observations only; intervention not indicated).
* Patients with prior history of acute myeloid leukemia (AML) or known FLT3 aberrations
* Pregnant or nursing female participants.
* Unwilling or unable to follow protocol requirements.
* Patients with known serious mood disorders. (Major depression diagnosis is an exclusion: Other stable mood disorders on stable therapy for \> 6 months or not requiring therapy may be allowed after consultation with principal investigator \[PI\]).
* Cardiac risk factors including:
* Patients experiencing cardiac event(s) (acute coronary syndrome, myocardial infarction, or ischemia) within 3 months of signing consent.
* Patients with a New York Heart Association classification of III or IV.
* Patients with uveal melanoma.
* Patients with uncontrolled diseases other than cancer may be excluded if after consultation with PI and research team it is decided it might affect the treatment efficacy or toxicity.
* Evidence of current drug or alcohol abuse or psychiatric impairment, which in the investigator's opinion will prevent completion of the protocol therapy or follow-up. Specific testing is not required, however may be done as clinically indicated.
* Any condition which in the investigator's opinion deems the participant an unsuitable candidate to receive study drug.
* Participants with symptomatic known brain metastases \< 4 weeks from radiation treatment should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
* Other invasive cancers diagnosed \< 3 years back that required systemic treatment. If diagnosed with other invasive cancer \>= 3 years, should have complete recovery from all systemic toxicity except neuropathy, vitiligo, alopecia, and endocrinopathies on stable hormone replacement therapy.
* Live vaccines within 30 days prior to the first dose of trial treatment and while participating in the trial. Examples of live vaccines include, but are not limited to, the following: measles, mumps, rubella, varicella/zoster, yellow fever, rabies, Bacillus Calmette-Guerin (BCG), and typhoid vaccine.
* Has a known history of human immunodeficiency virus (HIV) (HIV 1/2 antibodies).
* Has known active hepatitis B (e.g., hepatitis B surface antigen \[HBsAg\] reactive) or hepatitis C (e.g., hepatitis C virus \[HCV\] ribonucleic acid \[RNA\] \[qualitative\] is detected).
* Current use of anticoagulants (warfarin, heparin) at therapeutic levels.
* Patients who have had stroke/TIA and DVT/PE within the last 12 months.
* Patients at risk for impending visceral crisis of the liver and lungs as follows, or any condition which in the patient's primary treating oncologist's opinion deems the participant an unsuitable candidate to receive study drug:
* A visceral crisis of the liver exists when bilirubin levels increase very rapidly (\>1.5 times the upper limit of normal) without the presence of Gilbert syndrome (i.e., Meulengracht syndrome) or a biliary tract obstruction.
* A visceral crisis of the lungs can be assumed when dyspnea at rest increases more rapidly and cannot be relieved by pleural drainage.
* Radiation induced angiosarcoma.

Contacts and Locations

Principal Investigator

Fumito Ito, MD

PRINCIPAL_INVESTIGATOR

University of Southern California

Study Locations (Sites)

Los Angeles General Medical Center

Los Angeles, California, 90033

United States

USC/Norris Comprehensive Cancer Center

Los Angeles, California, 90033

United States

Collaborators and Investigators

Sponsor: University of Southern California

Fumito Ito, MD, PRINCIPAL_INVESTIGATOR, University of Southern California

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2023-01-09

Study Completion Date2028-01-09

Study Record Updates

Study Start Date2023-01-09

Study Completion Date2028-01-09

Terms related to this study

Keywords Provided by Researchers

High-grade bone sarcoma
High-grade soft tissue sarcoma
Basal Cell Carcinoma

Additional Relevant MeSH Terms

Anatomic Stage IV Breast Cancer AJCC v8
Metastatic Breast Carcinoma
Prognostic Stage IV Breast Cancer AJCC v8
Unresectable Breast Carcinoma
Metastatic Melanoma
Unresectable Melanoma
Cutaneous Squamous Cell Carcinoma
Merkel Cell Carcinoma
Soft Tissue Sarcoma
Bone Sarcoma
Sarcoma,Soft Tissue
Sarcoma of Bone
Basal Cell Carcinoma