A Phase II Study of IO102/IO103 and Nivolumab-relatlimab Fixed Dose Combination in Untreated, Unresectable Stage III/IV Melanoma

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Investigational drug late phase More information Active drug More information Moderate burden on patient More information

Trial Details

Sponsor: Memorial Sloan Kettering Cancer Center (other)

Phase: 2

Start date: June 9, 2023

Planned enrollment: 43

Trial ID: NCT05912244
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More trial details at ClinicalTrials.gov More info

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Goal: Evaluate safety and antitumor activity of the IO102/IO103 therapeutic cancer vaccine combined with fixed-dose nivolumab–relatlimab as first-line therapy for unresectable stage III/IV melanoma.

Patients: Adults ≥18 years with histologically confirmed unresectable stage III or metastatic stage IV cutaneous/subcutaneous melanoma, at least one measurable extracranial, extraskeletal lesion by RECIST v1.1, ECOG 0–1, and adequate organ function. Prior systemic therapy for unresectable disease is not allowed; prior neoadjuvant/adjuvant ICI or BRAF/MEK therapy permitted if recurrence occurred >6 months after last dose. Excludes uveal melanoma, untreated/active CNS or leptomeningeal disease (treated, asymptomatic brain metastases allowed), active significant autoimmune neuropathies, active HBV/HCV with viral load >100 IU/mL, significant immunosuppression, and pregnancy or breastfeeding.

Design: Single-arm, open-label phase II treatment study with planned enrollment of 43 participants; no randomization or comparator.

Treatments: Experimental regimen: IO102/IO103 plus nivolumab–relatlimab fixed-dose combination. Nivolumab–relatlimab is standard-of-care dual checkpoint blockade targeting PD-1 and LAG-3, administered Day 1 of each 28-day cycle for up to 2 years. IO102/IO103 is an off-the-shelf long-peptide vaccine pair consisting of imsapepimut (IO102, targets IDO1) and etimupepimut (IO103, targets PD-L1), given subcutaneously on Days 1 and 15 of cycles 1–2, then Day 1 of subsequent cycles for up to 2 years. The vaccine aims to prime and expand CD4+ and CD8+ T cells specific for IDO1- and PD-L1-expressing tumor and immunosuppressive cells, complementing checkpoint inhibition. In a prior single-arm phase 1/2 study in first-line advanced melanoma with IO102/IO103 plus nivolumab (n=30), ORR was 80% with 43% CR, median PFS 26 months, and safety comparable to PD-1 monotherapy aside from injection-site reactions; these data supported FDA Breakthrough Therapy Designation. A subsequent randomized phase 3 with IO102/IO103 plus pembrolizumab versus pembrolizumab improved median PFS but narrowly missed statistical significance, with no new safety signals and a favorable OS trend.

Outcomes: Primary: Overall response rate by RECIST v1.1. Secondary: Safety and tolerability by CTCAE v5.0; progression-free survival by RECIST v1.1. Assessment window up to 3 years for efficacy endpoints and up to 100 days post–last dose for safety.

Burden on patient: Moderate. Treatment requires clinic visits every 28 days for infusions and vaccine injections, with additional Day 15 visits during the first two cycles. Imaging at typical intervals for advanced melanoma and routine laboratory monitoring will be needed. There are no stated intensive pharmacokinetic schedules or mandatory research biopsies, which limits added burden, but the first two cycles include mid-cycle visits and ongoing injections that increase visit frequency compared with checkpoint therapy alone.

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Sites (9)

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Hartford Healthcare Alliance (Data Collection Only)

Hartford, Connecticut, 06102, United States

No email / 860-676-7000

Status: Recruiting

Memorial Sloan Kettering Basking Ridge (Limited Protocol Activities)

Basking Ridge, New Jersey, 07920, United States

No email / 646-888-6782

Status: Recruiting

Memorial Sloan Kettering Monmouth (Limited Protocol Activities)

Middletown, New Jersey, 07748, United States

No email / 646-888-6782

Status: Recruiting

Memorial Sloan Kettering Bergen (Limited Protocol Activities)

Montvale, New Jersey, 07645, United States

No email / 646-888-6782

Status: Recruiting

Memorial Sloan Kettering Suffolk - Commack (Limited Protocol Activities)

Commack, New York, 11725, United States

No email / 646-888-6782

Status: Recruiting

Memorial Sloan Kettering Westchester (All Protocol Activities)

Harrison, New York, 10604, United States

No email / 646-888-6782

Status: Recruiting

Memorial Sloan Kettering Cancer Center (All Protocol Activities)

New York, New York, 10065, United States

No email / 646-888-6782

Status: Recruiting

Memorial Sloan Kettering Nassau (Limited Protocol Activities)

Uniondale, New York, 11553, United States

No email / 646-888-6782

Status: Recruiting

Lehigh Valley Health Network (Data Collection Only)

Allentown, Pennsylvania, 18103, United States

No email / 610-402-7880

Status: Recruiting

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