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Uterine Cervical NeoplasmsPhase 2NCT05492123

Nivolumab-ipilimumab and Chemoradiation for Cervical Cancer

A Phase 2 study testing Nivolumab 40 mg in 4 ml Injection, Ipilimumab 200 MG in 40 ML Injection and Chemoradiation in people with Uterine Cervical Neoplasms, run by Hospital Israelita Albert Einstein at 14 sites in Brazil.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

A total of 112 patients with locally advanced cervical cancer will be randomized 1:1 to standard therapy with cisplatin-based chemoradiation or nivolumab-ipilimumab induction followed by cisplatin-based chemoradiation. The primary outcome will be 3-year disease-free survival. Read more about this study

Who is it for?
Ages 18 to 95 years, women only
Conditions the study is for
Uterine Cervical Neoplasms
What is being tested?
Nivolumab 40 mg in 4 ml Injection, Ipilimumab 200 MG in 40 ML Injection and Chemoradiation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
112 participants
Where
14 sitesBrazil
Study dates
30 Aug 2022to 31 Mar 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 18 to 95 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female participants older than 18 years
  • Documented evidence of cervical adenocarcinoma or squamous carcinoma FIGO Stage IB2-IB3 node positive or Stage IIB-IVA
  • No prior chemotherapy, immune checkpoint inhibitors or radiotherapy for cervical cancer
  • WHO/ECOG performance status of 0-1
  • At least 1 lesion, not previously irradiated, that qualifies as a RECIST 1.1 Target Lesion at baseline.

Who cannot join

  • Diagnosis of small cell (neuroendocrine) histology cervical cancer
  • Intent to administer a fertility-sparing treatment regimen
  • Undergone a previous hysterectomy
  • Evidence of metastatic disease per RECIST 1.1 including lymph nodes ≥15 mm (short axis) above the L1 cephalad body or outside the planned radiation field.
  • History of allogeneic organ transplantation
  • Active or prior documented autoimmune or inflammatory disorders
Show all 21Show fewer
  • Uncontrolled intercurrent illness
  • History of another primary malignancy and active primary immunodeficiency
  • Patients with active infection
  • Laboratory values that fall into:
  • WBC count (WBC) < 2000/μL ;
  • Neutrophil count < 1500/μL;
  • Platelet count < 100 x 103/μL;
  • Hemoglobin level < 9.0 g/dL;
  • Serum creatinine > 1.5 x upper limit of normal (ULN) unless creatinine clearance is
  • ≥ 40 mL/min (measured or calculated using the Cockcroft-Gault formula);
  • Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT): > 3.0 x ULN;
  • Total bilirubin > 1.5 x ULN (except participants with Gilbert Syndrome who must have a total bilirubin level of < 3.0 x ULN);
  • Any positive test result for hepatitis B virus or hepatitis C virus that indicates the presence of the virus, for example, positive Hepatitis B surface antigen (HBsAg, Australia antigen) or Hepatitis C antibodies (anti- HCV) positive (unless the HCV-RNA is negative).
  • Participants with a condition requiring systemic treatment or with corticosteroids (>10 mg daily of a prednisone equivalent) or other immunosuppressive drugs within 14 days of initiating study treatment.
  • Pregnant or breastfeeding woman

Trial locations and contacts

14 sites in 1 country. Contact the study team or a site near you to ask about taking part.

14 sites in 1 country

Brazil14 sites, 14 recruiting
  • Hospital de Amor

    Barretos, São Paulo, 14784-400

    Maria Fernanda Biazzotto, +55(17)3321-6638, nandabiazotto@hotmail.com

    Maria Fernanca Biazzotto, MD

    Not yet recruiting
  • Hospital das Clinicas da UFMG

    Belo Horizonte, Minas Gerais, 30130-100

    Angélica Nogueira, +55(31)3307-9255, angélica.onco@uol.com.br

    Angélica Nogueira, MD

    Not yet recruiting
  • Universidade Federal de Roraima

    Boa Vista, Roraima, 69310-000

    Allex Jardim, +55(95)3224-4712, allex.j.fonseca@gmail.com

    Allex Jardim, MD, PhD

    Recruiting
  • Hospital Erasto Gaertner

    Curitiba, Paraná, 81520-060

    Reitan Ribeiro, +55(41)3361-5195, reitanribeiro@hotmail.com

    Reitan Ribeiro, MD

    Not yet recruiting
  • CEPON - Florianópolis

    Florianópolis, Santa Catarina, 88034-000

    Anne Schmitz, +55(48)3331-1553, anneschmitz@uol.com.br

    Anne Schmitz, MD

    Not yet recruiting
  • CRIO -Centro Regional Integrado de Oncologia

    Fortaleza, Ceará, 60335-480

    Eduardo Cronemberger, +55(85)3286-5934, cronmeberger.eduardo@gmail.com

    Eduardo Cronemberger, MD

    Recruiting
  • Hospital São Lucas - PUCRS

    Porto Alegre, Rio Grande do Sul, 90610-001

    Fernanda Damian, +55(51)3320-3039, fernandadamian@yahoo.com.br

    Fernanda Damian

    Not yet recruiting
  • Multi Oncoclinicas Recife

    Recife, Pernambuco, 50070-460

    Carla Rameri, +55(81)2122-4792, carla.rameri.de.azevedo@gmail.com

    Carla Rameri, MD

    Recruiting
  • INCA - Instituto Nacional do Cancer

    Rio de Janeiro, 20230-130

    Adriana Melo, +55(21)3207-2985, andreia.melo@inca.gov.br

    Andreia Melo, MD

    Not yet recruiting
  • Clinica AMO

    Salvador, Estado de Bahia, 41810-011

    Aknar Calabrich, +55(71)3021-8735, aknar@clinicaamo.com.br

    Aknar Calabrich

    Recruiting
  • Hospital De Base de São José do Rio Preto - CIP São José

    São José do Rio Preto, São Paulo, 15090-000

    João Daniel, +55(17)3201-5054, joaodcguedes@gmail.com

    João Daniel, MD

    Not yet recruiting
  • AC Camargo Cancer Center

    São Paulo, 01509-001

    Natasha Carvalho, +55(11)2189-5021, natasha.pandolfi@accamargo.org.br

    Natasha Carvalho, MD

    Not yet recruiting
  • Hospital Municipal Vila Santa Catarina

    São Paulo, 04378-500

    Ana Lucia Neves, 2151-1223 ext. 0, ana.neves@einstein.br

    Henrique A Helber, MD

    Recruiting
  • Hospital Israelita Albert Einstein

    São Paulo, 05652-900

    Fernando Maluf

    Diogo Bugano, diogo.gomes@einstein.br

    Recruiting

Other trials in Brazil

About this study

Official title: Randomized Phase II Study to Evaluate Induction Nivolumab-Ipilimumab, Followed by Nivolumab With Chemoradiotherapy Versus Chemoradiotherapy for Advanced Cervical Cancer

A total of 112 patients with locally advanced cervical cancer will be randomized 1:1 to standard therapy with cisplatin-based chemoradiation or nivolumab-ipilimumab induction followed by cisplatin-based chemoradiation. The primary outcome will be 3-year disease-free survival.

Read the detailed description

Patients with adenocarcinoma or squamous cell carcinoma of the cervix, FIGO Stage IB2-IB3 node positive or Stage IIB-IVA will be randomized to conventional cisplatin-based chemo-radiation or to 4 cycles of induction immunotherapy with nivolumab 1mg/kg and ipilimumab 3mg/kg every 3 weeks, followed by cisplatin chemo-radiation with concurrent nivolumab 240mg every 2 weeks. Primary outcome will be 3-year progression-free survival.

Being tested
Nivolumab 40 mg in 4 ml Injection, Ipilimumab 200 MG in 40 ML Injection, Chemoradiation
Keywords
Uterine Cervical Neoplasms, Nivolumab, Ipilimumab, Chemoradiation, Anti-PD1, Anti-PDL1, Anti-CTLA4, Immunotherapy
Medical subject headings
Uterine Cervical Neoplasms

What participants receive

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

  • Nivolumab 40 mg in 4 ml InjectionDrug

    Also called Opdivo

    Nivolumab 1mg/kg every 3 weeks for 4 cycles prior to radiation and 240mg every 2 weeks with concurrent radiation

  • Ipilimumab 200 MG in 40 ML InjectionDrug

    Also called Yervoy

    Ipilimumab 3mg/kg every 3 weeks for 4 cycles prior to radiation

  • ChemoradiationRadiation

    Also called Cisplatin-based chemoradiation

    Radiation to a dose of 45Gy over 25 1.8Gyfractions and brachytherapy with concurrent weekly cisplatin 40mg/m2/w or carboplatin AUC 2/w

Study groups in NCT05492123
Study groupRoleWhat they receive
Standard ChemoradiationActive comparatorTraditional radiation therapy with a target of 45 Gy in 25 1.8Gy fractions with concurrent weekly cisplatin 40mg/m2/week or carboplatin AUC 2/week
Receives: Radiation: Chemoradiation
ImmunotherapyExperimental4 cycles of induction therapy with nivolumab 1mg/kg and ipilimumab 3mg/kg every 3 weeks followed by traditional radiation therapy with a target of 45 Gy in 25 1.8Gy fractions with concurrent weekly cisplatin 40mg/m2/week (or carboplatin AUC 2/week) with concurrent nivolumab 240mg every 2 weeks.
Receives: Drug: Nivolumab 40 mg in 4 ml Injection; Drug: Ipilimumab 200 MG in 40 ML Injection; Radiation: Chemoradiation

What is being measured

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

  1. 3-year progression-free survival

    No evidence of disease recurrence/regrowth after 3 years of follow-up

    Measured: 3 years

Secondary outcomes (6)
  1. 3-year overall survival

    Rate of survival 3 years after the end of chemoradiation

    Measured: 3 years

  2. Objective response rate

    RECIST response

    Measured: 90 days after the end of chemoradiation

  3. Response duration

    Time from maximum response to disease progression

    Measured: Through study completion, an average of 3 year

  4. To evaluate health related quality of life (HRQoL): defined as the change from baseline of disease-related symptoms and quality of life of patients undergoing treatment Nivolumab-ipilimumab and Chemoradiation for Cervical Cancer

    Evaluate health related quality of life using the instrument EORTC QLQ-C30 v3 based on European Organization for Research and Treatment of Cancer (EORTC). The EORTC QLQ-C30 v3 questionnaire, consisting of 30 questions covering 15 domains, divided into three distinct scales: state scale global health and quality of life (it has only one domain, global health measure); functional scale (physical function, role performance, emotional function, cognitive function and social function domains); and symptom scale (fatigue, nausea and vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, diarrhea and financial difficulties). The scores on each scale range from 0 - 100. The global and functional health scales indicate better quality of life as their score approaches 100. For the symptoms scale, the analysis is inverse, with better performance for quality of life when the scores approach the score minimum (zero).

    Measured: Baseline (time from screening - before starting treatment) and at the end of treatment (56 days after the last dose of radiotherapy).

  5. Evaluate health related quality of life using supplemental cervical cancer module (EORTC CX24) to evaluate patients submitted to treatment with Nivolumab-ipilimumab and Chemoradiation for Cervical Cancer.

    The EORTC - CX24 questionnaire contains 24 questions, divided into three multiple-item scales and six single-item scales, of which 11 refer to symptoms (questions 31-37, 39 and 41-43), three about body image. (questions 45-47), four questions on sexual/vaginal function (questions 50-53), one on lymphedema (question 38), one for evaluation of peripheral neuropathy (question 40), one for evaluation of menopausal symptoms (question 44) ), one on sexual concerns (question 48), one on sexual activity (question 49) and one on sexual pleasure (question 54). The answers are transformed into a score from 0 - 100 and calculated separately for each scale.

    Measured: Baseline (time from screening - before starting treatment) and at the end of treatment (56 days after the last dose of radiotherapy).

  6. Treatment-related toxicity

    Treatment-related toxicity according to CTCAE version 4.0 (Common Toxicity Criteria for Adverse Events )

    Measured: Through study completion, an average of 3 year

Timeline

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

  1. First posted8 Aug 2022
  2. Study start30 Aug 2022
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Mar 2028 (estimated)

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
Randomised
Intervention model
Parallel groups
Model description
Prospective randomized trial, stratified by center, disease stage and type of radiation
Masking
None (open label)
Enrolment
112 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05492123
Sponsor's protocol ID
BRAVA- Cervical - SGPP 5031-21
Status last verified
Jan 2023
First submitted
22 Jul 2022
Last updated
5 Jan 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Chemoradiotherapy for Cervical Cancer Meta-Analysis Collaboration. Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials. J Clin Oncol. 2008 Dec 10;26(35):5802-12. doi: 10.1200/JCO.2008.16.4368. Epub 2008 Nov 10.

    PubMed 19001332
  • Naumann RW, Hollebecque A, Meyer T, Devlin MJ, Oaknin A, Kerger J, Lopez-Picazo JM, Machiels JP, Delord JP, Evans TRJ, Boni V, Calvo E, Topalian SL, Chen T, Soumaoro I, Li B, Gu J, Zwirtes R, Moore KN. Safety and Efficacy of Nivolumab Monotherapy in Recurrent or Metastatic Cervical, Vaginal, or Vulvar Carcinoma: Results From the Phase I/II CheckMate 358 Trial. J Clin Oncol. 2019 Nov 1;37(31):2825-2834. doi: 10.1200/JCO.19.00739. Epub 2019 Sep 5.

    PubMed 31487218
  • Santin AD, Deng W, Frumovitz M, Buza N, Bellone S, Huh W, Khleif S, Lankes HA, Ratner ES, O'Cearbhaill RE, Jazaeri AA, Birrer M. Phase II evaluation of nivolumab in the treatment of persistent or recurrent cervical cancer (NCT02257528/NRG-GY002). Gynecol Oncol. 2020 Apr;157(1):161-166. doi: 10.1016/j.ygyno.2019.12.034. Epub 2020 Jan 7.

    PubMed 31924334

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Nivolumab 40 mg in 4 ml Injection, Ipilimumab 200 MG in 40 ML Injection and Chemoradiation in people with Uterine Cervical Neoplasms, run by Hospital Israelita Albert Einstein at 14 sites in Brazil.

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 5 inclusion and 21 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: looking for participants now, as of the sponsor's last update on 5 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in Brazil. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Diogo Bugano, MD (+55-11-2151-0240, diogo.gomes@einstein.br), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

3-year progression-free survival (time frame: 3 years). 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 NCT05492123, which also lists 3 linked publications.

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 5 Jan 2024.

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