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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chevron Show for: IO102 (imsapepimut)

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Goal: Evaluate the safety and antitumor activity of adding the IO102/IO103 therapeutic cancer vaccine regimen to the standard fixed‑dose combination of nivolumab and relatlimab in the first‑line treatment of unresectable stage III/IV melanoma.

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

Design: Single‑arm, open‑label, phase 2 study with nonrandomized allocation, planned enrollment of 43 patients, assessing efficacy and safety of the combination regimen in the first‑line setting.

Treatments: All patients receive nivolumab‑relatlimab fixed‑dose combination on Day 1 of each 28‑day cycle for up to 2 years, plus the IO102/IO103 vaccine on Days 1 and 15 of cycles 1–2, then Day 1 of subsequent cycles through 2 years. IO102/IO103 (also known as Cylembio components imsapepimut [IDO1‑targeted peptide] and etimupepimut [PD‑L1‑targeted peptide]) is an off‑the‑shelf long‑peptide vaccine given subcutaneously with the goal of generating CD4+ and CD8+ T‑cell responses against IDO1‑ and PD‑L1‑expressing tumor and immunosuppressive cells, complementing PD‑1/PD‑L1 axis blockade. In earlier melanoma studies, IO102/IO103 combined with anti‑PD‑1 therapy produced high response rates in a phase 1/2 single‑arm trial and demonstrated improved, though not statistically significant, progression‑free survival versus anti‑PD‑1 alone in a subsequent phase 3 trial; safety has been broadly consistent with anti‑PD‑1 therapy with mainly low‑grade injection‑site reactions attributed to the vaccine.

Outcomes: Primary: Overall response rate (RECIST v1.1). Secondary: Incidence and severity of adverse events (CTCAE v5.0), and progression‑free survival by RECIST v1.1. Assessment window extends up to 3 years for efficacy and up to 100 days post‑last dose for safety.

Burden on patient: Moderate. Treatment requires clinic visits every 28 days for nivolumab‑relatlimab infusions and additional vaccination visits on Day 1 and Day 15 during the first two cycles, then Day 1 only in later cycles. Routine safety labs and imaging at standard first‑line melanoma intervals are expected; no intensive pharmacokinetic sampling is specified. Subcutaneous vaccine injections may cause local reactions and add chair time and travel, especially in the first two cycles, but overall visit frequency aligns closely with immunotherapy standard of care after cycle 2.

Last updated: Oct 2025

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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 Bergen (Limited Protocol Activities)

Montvale, New Jersey, 07645, 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 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

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

Lehigh Valley Health Network (Data Collection Only)

Allentown, Pennsylvania, 18103, United States

No email / 610-402-7880

Status: Recruiting

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