RecruitingPhase 3NCT05078047

Study Comparing the Standard Administration of IO Versus the Same IO Administered Each 3 Months in Patients in Response After 6 Months of Standard IO

Randomized Phase III Trial of Standard Immunotherapy (IO) by Checkpoint Inhibitors, Versus Reduced Dose Intensity of IO in Patients With Locally Advanced or Metastatic Cancer in Response After 6 Months of Standard IO


Sponsor

UNICANCER

Enrollment

646 participants

Start Date

Mar 8, 2022

Study Type

INTERVENTIONAL

Conditions

Summary

Immunotherapy (IO), such as treatment with anti-PD-1, PD-L1, or CTLA-4 inhibitors, is a rapidly expanding treatment for multiple metastatic cancers with improved survival for certain cancers. However, the optimal duration of immunotherapies is currently unknown. Our hypothesis is that a reduced dose intensity of IO could be as effective as the current standard treatment in term of prevention of the disease progression. If proved right, this study will have a positive medico-economic impact by reduction of the costs associated with the treatment and the toxicity, and an increase of the patients' quality of life.


Eligibility

Min Age: 18 Years

Inclusion Criteria14

  • Patients must have signed a written informed consent form prior to any trial specific procedures.
  • Patient aged ≥18 years old.
  • Metastatic disease (or locally advanced disease not suitable for local treatment) of initial tumor histologically confirmed including: lung cancer, renal cell cancer, head and neck cancer, urothelial carcinoma, triple negative breast cancer, Merkel cancer, hepatocellular carcinoma, melanoma, colorectal carcinoma with microsatellite instability \[MSI\], esophageal squamous cell carcinoma, endometrial carcinoma,cervical cancer, gastric/gastro-oesophageal junction adenocarcinoma, basal cell carcinoma or squamous skin carcinoma.
  • Patients in partial or complete response after 6 months of standard immunotherapy (whatever the line of therapy) according to the RECIST or PERCIST v1.0 criteria (confirmed by local radiological assessment).
  • For metastatic melanoma only patients in partial response. Patients with metastatic or advanced cancer treated by immunotherapy as maintenance therapy can be included without any lesion at IO initiation. In this case, response after 6 months of standard immunotherapy will be evaluated by the non-appearance of a new lesion.
  • Eligible to maintain the same standard IO treatment.
  • Patient with Eastern cooperative oncology group (ECOG) performance status ≤1.
  • Patients with brain metastases are allowed, provided they are stable according to the following definitions: treated with surgery or stereotactic radiosurgery and without evidence of progression prior to randomization and have no evidence of new or enlarging brain metastases.
  • Patients treated by IO previously combined with chemotherapy are allowed.
  • Patients with Tyrosine Kinase Inhibitor (TKI)-IO or pemetrexed-IO or bevacizumab-IO are allowed.
  • Evidence of post-menopausal status, or negative urinary or serum pregnancy test for pre-menopausal patients.
  • Both sexually active women of childbearing potential and males (and their female partners) patients must agree to use adequate contraception method for the duration of the study treatment and after completing treatment according to the most recent version of the IO Summary of product characteristics (SmPC).
  • Patient is willing and able to comply with the protocol for the duration of the trial including undergoing treatment and scheduled visits, and examinations including follow-up.
  • Patient must be affiliated to a Social Security System.

Exclusion Criteria7

  • Metastatic melanoma in complete response.
  • Metastatic renal cell carcinoma with International Metastatic Renal Cell Carcinoma Database (IMDC) favourable-risk treated TKI/IO combination.
  • Hematologic malignancies (leukaemia, myeloma, lymphoma…)
  • Active infection requiring systemic therapy.
  • Patients enrolled in another therapeutic study within 30 days before the inclusion in and during MOIO study.
  • Patient unable to comply with study obligations for geographic, social, or physical reasons, or who is unable to understand the purpose and procedures of the study.
  • Person deprived of their liberty or under protective custody or guardianship.

Interventions

DRUGReduced dose intensity of IO

After 6 months of treatment with standard IO, IO will be administered every 3 months (at the same dose levels) until disease progression, unacceptable toxicity, death or patient's choice or investigator's decision


Locations(40)

Institut de cancérologie de l'Ouest

Angers, France

Clinique Sainte Catherine

Avignon, France

Centre Hospitalier de la Côte Basque

Bayonne, France

CHU Besançon

Besançon, France

CHU Bordeaux - Hôpial Saint André

Bordeaux, France

CH Boulogne sur Mer

Boulogne-sur-Mer, France

Centre François Baclesse

Caen, France

Centre Jean Perrin

Clermont-Ferrand, France

Centre Hospitalier Intercommunal

Créteil, France

CHU Henri Mondor

Créteil, France

Centre Georges François Leclerc

Dijon, France

GH Mutualiste de Grenoble

Grenoble, France

CHD Vendée

La Roche-sur-Yon, France

Centre Oscar Lambret

Lille, France

Clinique Chenieux

Limoges, France

Hospices Civils de Lyon

Lyon, France

Centre Léon Bérard

Lyon, France

Hôpital La Timone -APHM

Marseille, France

Centre Antoine Lacassagne

Nice, France

CHU Nîmes/Institut de cancérologie du Gard

Nîmes, France

Institut Curie

Paris, France

Hôpital Saint Louis

Paris, France

Hôpital Pitié Salpêtrière

Paris, France

Hôpital Européen Georges Pompidou

Paris, France

Hôpital Cochin APHP

Paris, France

Hôpital Saint Antoine APHP

Paris, France

CHU Poitiers

Poitiers, France

Insitut Godinot

Reims, France

Centre Eugene Marquis

Rennes, France

CHI Elbeuf

Saint-Aubin-lès-Elbeuf, France

Institut Curie

Saint-Cloud, France

Institut de cancérologie de l'Ouest

Saint-Herblain, France

Centre Hospitalier Mémorial de Saint-Lô

Saint-Lô, France

Clinique Mutualiste de l'Estuaire

Saint-Nazaire, France

ICANS

Strasbourg, France

Hôpital Foch

Suresnes, France

HIA Sainte Anne

Toulon, France

IUCT

Toulouse, France

CHU Bretonneau

Tours, France

Centre Gustave Roussy

Villejuif, France

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NCT05078047


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