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Various Advanced CancerPhase 2CheckMate 908NCT03130959

A Study to Evaluate the Safety and Efficacy of Nivolumab Monotherapy and Nivolumab in Combination With Ipilimumab in Pediatric Participants With High Grade Primary Central Nervous System (CNS) Malignancies

A Phase 2 study testing Nivolumab and Ipilimumab in people with Various Advanced Cancer, run by Bristol-Myers Squibb at 54 sites in 15 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine the safety and effectiveness of nivolumab alone and in combination with ipilimumab in pediatric patients with high grade primary central nervous system (CNS) malignancies. Read more about this study

Who is it for?
Ages 6 months to 21 years
Conditions the study is for
Various Advanced Cancer
What is being tested?
Nivolumab and Ipilimumab
Could I receive a placebo?
No, everyone receives an active treatment
How many people
166 participants
Where
54 sitesin 15 countries
Study dates
12 Jun 2017to 17 Jan 2022
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 months to 21 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Must have received standard of care therapy, and there must be no potentially-curative treatment available, in one of the following cohorts:
  • A newly diagnosed Diffuse Intrinsic Pontine Glioma (DIPG) that has been treated with radiation therapy (RT) but no chemotherapy
  • A histologically confirmed recurrent or progressive non-brainstem High Grade Glioma (HGG) previously treated with surgical resection and RT
  • A histologically confirmed medulloblastoma that has relapsed or is resistant to at least one line of prior therapy including surgery, RT, and chemotherapy
  • A histologically confirmed ependymoma that has relapsed or is resistant to at least one line of prior therapy including surgical resection and RT
  • A histologically-confirmed high grade CNS malignancy "other than above" which is recurrent or progressive after at least one line of prior therapy
  • Lansky play score (LPS) for ≤ 16 years of age or Karnofsky performance scale (KPS) for > 16 years of age assessed within two weeks of enrollment must be >= 60
  • A tumor sample must be available for submission to central laboratory (not required for DIPG)

Who cannot join

  • An active, known, or suspected autoimmune disease
  • A concurrent condition requiring systemic treatment with either corticosteroids or other immunosuppressive medications within 14 days of start of study treatment
  • Known history of positive test for human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS).
  • Other protocol defined inclusion/exclusion criteria apply

Trial locations and contacts

54 sites in 15 countries.

54 sites in 15 countries

United States14 sites
  • Local Institution - 0016

    Aurora, Colorado, 80045

  • Local Institution - 0005

    Baltimore, Maryland, 21287

  • Local Institution - 0043

    Boston, Massachusetts, 02215

  • Local Institution

    Charleston, South Carolina, 29425

  • Local Institution - 0011

    Chicago, Illinois, 60611-2605

  • Cincinnati Children'S Hospital Medical Center

    Cincinnati, Ohio, 45229

  • Local Institution - 0046

    Gainesville, Florida, 32611

  • Local Institution - 0042

    Houston, Texas, 77030

  • Local Institution - 0057

    Los Angeles, California, 90027

  • Local Institution - 0012

    Memphis, Tennessee, 38105

  • Local Institution - 0004

    New York, New York, 10021

  • Local Institution - 0017

    New York, New York, 10032

  • Local Institution - 0066

    Philadelphia, Pennsylvania, 19104

  • Local Institution - 0044

    St Louis, Missouri, 63110

Other trials in United States

France8 sites
  • Local Institution - 0028

    Angers, 49100

  • Local Institution - 0029

    Bordeaux, 33076

  • Local Institution - 0027

    Lille, 59000

  • Local Institution - 0025

    Lyon, 69008

  • Local Institution - 0024

    Marseille, 13385 cedex 05

  • Local Institution - 0023

    Paris, 75231 cedex 5

  • Local Institution - 0064

    Vandœuvre-lès-Nancy, 54500

  • Local Institution - 0026

    VIillejuif, 94805 CEDEX

Other trials in France

Australia5 sites
  • Local Institution

    Clayton, Victoria, 3168

  • Local Institution - 0033

    Nedlands, Western Australia, 6009

  • Local Institution - 0034

    Parkville, Victoria, 3052

  • Local Institution - 0022

    Randwick, New South Wales, 2031

  • Local Institution - 0035

    Sth Brisbane, Queensland, 4101

Other trials in Australia

Brazil5 sites
  • Local Institution - 0051

    Barretos, São Paulo, 14784-400

  • Local Institution - 0052

    Porto Alegre, Rio Grande do Sul, 90035-074

  • Local Institution - 0053

    Ribeirão Preto, São Paulo, 14048-900

  • Local Institution - 0049

    São Paulo, 04023-062

  • Local Institution - 0050

    São Paulo, 08270-070

Other trials in Brazil

Germany4 sites
  • Local Institution - 0060

    Essen, 45147

  • Local Institution - 0061

    Hamburg, 20246

  • Local Institution - 0063

    Heidelberg, 69120

  • Local Institution - 0062

    Würzburg, 97080

Other trials in Germany

Canada3 sites
  • Local Institution - 0001

    Montreal, Quebec, H4A 3J1

  • Local Institution - 0002

    Québec, Quebec, G1V 4G2

  • Local Institution - 0021

    Toronto, Ontario, M5G 1X8

Other trials in Canada

Spain3 sites
  • Local Institution - 0037

    Esplugues de Llobregat, 08950

  • Local Institution - 0038

    Madrid, 28009

  • Local Institution - 0036

    Valencia, 46026

Other trials in Spain

United Kingdom3 sites
  • Local Institution - 0013

    Liverpool, Merseyside, L12 2AP

  • Local Institution - 0010

    London, Greater London, WC1N 3JH

  • Local Institution - 0015

    Newcastle upon Tyne, Tyne and Wear, NEI 4LP

Other trials in United Kingdom

Israel2 sites
  • Local Institution - 0059

    Haifa, 3109601

  • Local Institution - 0058

    Ramat Gan, 5266202

Other trials in Israel

Netherlands2 sites
  • Local Institution - 0007

    Rotterdam, 3015 GJ

  • Local Institution - 0008

    Utrecht, 3584 EA

Other trials in Netherlands

Hong Kong1 site
  • Local Institution - 0018

    Hong Kong, 852

Other trials in Hong Kong

Norway1 site
  • Local Institution - 0067

    Oslo, 0027

Other trials in Norway

Poland1 site
  • Local Institution - 0047

    Warsaw, 04-730

Other trials in Poland

Russia1 site
  • Local Institution - 0048

    Moscow, 117997

Other trials in Russia

Sweden1 site
  • Local Institution - 0065

    Solna, 171 76

Other trials in Sweden

About this study

Official title: Phase Ib /II Clinical Trial of Nivolumab Monotherapy and Nivolumab in Combination With Ipilimumab in Pediatric Subjects With High Grade Primary CNS Malignancies

The purpose of this study is to determine the safety and effectiveness of nivolumab alone and in combination with ipilimumab in pediatric patients with high grade primary central nervous system (CNS) malignancies.

Being tested
Nivolumab, Ipilimumab

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NivolumabBiological

    Also called Opdivo, BMS-936558

    Specified dose on specified days

  • IpilimumabBiological

    Also called Yervoy, BMS-734016

    Specified dose on specified days

Study groups in NCT03130959
Study groupRoleWhat they receive
Module AExperimentalNot described
Receives: Biological: Nivolumab
Module BExperimentalNot described
Receives: Biological: Nivolumab; Biological: Ipilimumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Safety Lead-In Participants With Dose Limiting Toxicities (DLTs)

    A dose-limiting toxicity (DLT) is defined as a drug-related AE occurring in the first 6 weeks of study treatment. A participant was considered evaluable for a DLT if study treatment was delayed > 2 weeks or was discontinued due to a related Adverse Event (AE), or if planned study treatment (3 doses of nivolumab in Module A, 2 doses of nivolumab plus ipilimumab in Module B) was administered and safety evaluation after 6 weeks on study is available to the study steering committee (SSC).

    Measured: up to 6 weeks post-dosing

  2. Number of Safety Lead-In Participants With Serious Adverse Events (SAEs)

    The number of Safety Lead-In Participants who experienced a Serious Adverse Event (SAE) during the course of the study.

    Measured: up to 6 weeks post-dosing

  3. Number of Safety Lead-In Participants With Adverse Events (AEs) Leading to Discontinuation

    The number of Safety Lead-In Participants who experienced an Adverse Event (AE) during the course of the study that lead to discontinuation of study therapy.

    Measured: From first dose to 30 days post-last dose (up to approximately 6 weeks)

  4. Overall Survival (OS), Cohort 1 Only

    Overall survival (OS) is defined as the time between the date of diagnosis and the date of death in Cohort 1.

    Measured: up to approximately 42 months

  5. Progression-Free Survival (PFS), Cohorts 2-4

    Progression-free survival (PFS) is defined as the time from first dose to the date of the first documented tumor progression or death due to any cause.

    Measured: up to approximately 42 months

  6. Progression-Free Survival (PFS), Cohort 5 Only

    Progression-free survival (PFS) is defined as the time from first dose to the date of the first documented tumor progression or death due to any cause.

    Measured: up to approximately 42 months

Secondary outcomes (11)
  1. Progression-Free Survival (PFS), Cohort 1 Only

    Progression-free survival (PFS) is defined as the time from first dose to the date of the first documented tumor progression or death due to any cause.

    Progression is defined as:

    • ≥ 25% increase in sum of the products of perpendicular diameters of enhancing lesions compared with the smallest tumor measurement
    • Significant increase in T2 or fast fluid-attenuated inversion recovery (FLAIR) non-enhancing lesions on stable or increasing doses of corticosteroids
    • Any new lesion
    • Clear clinical deterioration not attributable to other causes apart from the tumor
    • Failure to return for evaluation as a result of death or deteriorating condition
    • Clear progression of non-measurable disease

    Measured: From first dose to the date of the first documented tumor progression or death due to any cause (up to approximately 55 months)

  2. Overall Survival at 12 Months (OS12), Cohorts 1-4

    Overall survival at 12 months (OS12) is defined as the percentage of participants who are alive at 12 months, measured as the survival rate at 12 months from Kaplan-Meier product limit cumulative probability.

    Measured: From first dose to up to 12 months after first dose

  3. Progression-Free Survival at 6 Months (PFS6), Cohorts 2-5

    Progression-free survival at 6 months (PFS6) is defined as the percentage of participants who are progression free and alive at 6 months following first dose date, measured as the survival rate at 6 months from Kaplan-Meier product limit cumulative probability of progression free.

    Progression is defined as:

    • ≥ 25% increase in sum of the products of perpendicular diameters of enhancing lesions compared with the smallest tumor measurement
    • Significant increase in T2 or fast fluid-attenuated inversion recovery (FLAIR) non-enhancing lesions on stable or increasing doses of corticosteroids
    • Any new lesion
    • Clear clinical deterioration not attributable to other causes apart from the tumor
    • Failure to return for evaluation as a result of death or deteriorating condition
    • Clear progression of non-measurable disease

    Measured: From first dose to up to 6 months after first dose

  4. Overall Survival (OS), Cohorts 2-5

    Overall survival (OS) is defined as the time between date of first dose and the date of death for Cohorts 2-5.

    Measured: From first dose to the date of death (up to approximately 55 months)

  5. Number of Treated Participants With Adverse Events (AEs)

    The number of treated participants who experienced an Adverse Event (AE) during the course of the study.

    An AE is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study drug and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not considered related to the study drug.

    Measured: From first dose to 30 days post-last dose (up to approximately an average of 3 months and a maximum of 51 months)

  6. Number of Treated Participants With Serious Adverse Events (SAEs)

    The number of treated participants who experienced a Serious Adverse Event (SAE) during the course of the study.

    SAE is defined as any untoward medical occurrence that, at any dose:

    • Results in death
    • Is life-threatening
    • Requires inpatient hospitalization or causes prolongation of existing hospitalization
    • Results in persistent or significant disability/incapacity
    • Is a congenital anomaly/birth defect
    • Is an important medical event

    Note: The reporting timeframe of the SAEs for this Outcome Measure (first dose to 30 days post last dose) differs than that of the reporting timeframe of the SAEs reported under the AE section of the results form (first dose to 100 days post last dose) and thus, the data in each table of SAEs reflects the specific timeframe applied.

    Measured: From first dose to 30 days post-last dose (up to approximately an average of 3 months and a maximum of 51 months)

  7. Number of Treated Participants With Drug-Related Adverse Events

    The number of treated participants who experienced a Drug-Related Adverse Event during the course of the study.

    An AE is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study drug and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not considered related to the study drug.

    Measured: From first dose to 30 days post-last dose (up to approximately an average of 3 months and a maximum of 51 months)

  8. Number of Treated Participants With Adverse Events Leading to Discontinuation

    The number of treated participants who experienced an Adverse Event leading to discontinuation during the course of the study.

    An AE is defined as any new untoward medical occurrence or worsening of a preexisting medical condition in a clinical investigation participant administered study drug and that does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (such as an abnormal laboratory finding), symptom, or disease temporally associated with the use of study drug, whether or not considered related to the study drug.

    Measured: From first dose to 30 days post-last dose (up to approximately an average of 3 months and a maximum of 51 months)

  9. Number of Treated Participant Deaths

    The number of treated participants who died during the course of the study.

    Measured: From first dose to the date of death (up to approximately 55 months)

  10. Number of Treated Participant With Laboratory Abnormalities - Liver

    The number of treated participants who experienced a laboratory abnormality of the liver during the course of the study.

    Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Upper Limit of Normal (ULN) Units per Liter (U/L) Results reported in International System of Units (SI)

    Measured: From first dose to 30 days post-last dose (up to approximately an average of 3 months and a maximum of 51 months)

  11. Number of Treated Participant With Laboratory Abnormalities - Thyroid

    The number of treated participants who experienced a laboratory abnormality of the thyroid during the course of the study.

    Free T3 (FT3) Free T4 (FT4) Thyroid stimulating hormone (TSH) Lower Limit of Normal (LLN) Upper limit of normal (ULN) Milliunits per Liter (mlU/L) Results reported in International System of Units (SI)

    Measured: From first dose to 30 days post-last dose (up to approximately an average of 3 months and a maximum of 51 months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Apr 2017
  2. Study start12 Jun 2017
  3. Primary completion10 Mar 2020
  4. Study completion17 Jan 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
166 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03130959
Sponsor's protocol ID
CA209-908
Other IDs
2016-004441-82, 2016
Acronym
CheckMate 908
Status last verified
Jul 2022
First submitted
5 Apr 2017
Last updated
9 Aug 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No
Expanded access
Available

Publications

  • Dunkel IJ, Doz F, Foreman NK, Hargrave D, Lassaletta A, Andre N, Hansford JR, Hassall T, Eyrich M, Gururangan S, Bartels U, Gajjar A, Howell L, Warad D, Pacius M, Tam R, Wang Y, Zhu L, Cohen K. Nivolumab with or without ipilimumab in pediatric patients with high-grade CNS malignancies: Safety, efficacy, biomarker, and pharmacokinetics-CheckMate 908. Neuro Oncol. 2023 Aug 3;25(8):1530-1545. doi: 10.1093/neuonc/noad031.

    PubMed 36808285

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Nivolumab and Ipilimumab in people with Various Advanced Cancer, run by Bristol-Myers Squibb at 54 sites in 15 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 54 sites in United States, France, Australia, Brazil, Germany and 10 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Apr 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Safety Lead-In Participants With Dose Limiting Toxicities (DLTs) (time frame: up to 6 weeks post-dosing). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03130959, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Aug 2022.

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