Intratumoral Targeted Hyperthermia Therapy (THT) for Cutaneous Metastatic Melanoma

Official title

Intra-tumoral Targeted Hyperthermic Therapy (THT) for Stage 3C/3D/4M1 Cutaneous Metastatic Melanoma in Patients With Targetable Cutaneous and/or Sub-cutaneous Tumors

Overview

This device phase I/II, first in human, early feasibility study (EFS), open-label, single-arm trial aims to evaluate the safety, tolerability, and preliminary efficacy of Gold Nanorod (GNR)-enabled sub-ablative targeted hyperthermia therapy (THT) in patients with unresectable stage 3C/3D/4M1 cutaneous metastatic malignant melanoma that have failed to respond to systemic checkpoint and localized intra-tumoral immunotherapy. The study will involve up to 10 participants with stable or progressive cutaneous and/or subcutaneous skin lesions (Immune Stable Disease (iSD) or Immune Confirmed/Unconfirmed Progressive Disease (iCPD/iUPD)). GNRs, when administered via intra-tumoral injection and activated by NIR light, generate localized heat through a process called THT. This approach selectively targets tumor cells while minimizing damage to surrounding healthy tissue. In this study, 10 participants will receive two THT treatments spaced 7 days apart. The primary objective of this study is to assess the safety and tolerability of THT treatment.

Interventions

• Device Targeted Hyperthermia Therapy
  Intra-tumoral gold nanorods (SivaRods) exposed to Near Infrared Light (860 +/- 10nm) mediated targeted hyperthermia therapy

Primary outcome measures

• Number of participants that successfully complete THT (maintain intra-tumoral temperatures of 42-48C) [Time frame: 1 year]
• Number of participants with treatment-related adverse events as assessed by CTCAE v5.0 [Time frame: 1 year]
• Number of participants that have a tumor response as assessed by iRECIST 1.1 criteria [Time frame: 1 year]

Secondary outcome measures (1)

• Number of participant's that have an increase in immune cell infiltrates in the tumor biopsy and blood samples post THT compared to pre-treatment patient samples [Time frame: 1 year]

Eligibility criteria

Inclusion criteria

• 16 years of age or older;
• Participants with histologically or cytologically confirmed stage 3C/3D/4M1 advanced or cutaneous metastatic melanoma, with measurable disease by iRECIST 1.1 criteria, including any number of cutaneous lesions;
• Present a visible and accessible primary tumor or metastatic deposit (any site) that has not been surgically removed;
• Present target tumors of ≤2.5 cm in diameter;
• Participants must have received and failed systemic and local intra-tumoral therapy at least one prior standard therapy, including immune checkpoint inhibitors (e.g., anti- PD1 or anti-CTLA-4), and failed local intra-tumoral IL-2 treatment. Failed response to treatment will be categorized according to iRECIST guidelines. Patients who have: a) Immune partial response (iPR): At least a 30% decrease in the sum of diameters of target lesions compared to baseline, no progression of non-target lesions, No new lesions; or b) Immune Stable Disease (iSD): Neither sufficient reduction to qualify for iPR nor sufficient increase to qualify for iCPD (immune confirmed progressive disease), no new lesions; or c) Immune Unconfirmed Progressive Disease (iUPD): At least a 20% increase in the sum of diameters of target lesions, taking the smallest sum on study as the reference, appearance of new lesions, iUPD needs confirmation after at least 4 weeks; if confirmed, it becomes iCPD; or d) Immune Confirmed Progressive Disease (iCPD): iUPD must be confirmed in a follow-up assessment (minimum of 4 weeks after initial iUPD), if progressive disease (increase in lesion size or additional new lesions) is still evident upon re-evaluation, iCPD is confirmed.
• Participants must agree to discontinue treatment with local intralesional immunotherapies during the study, with resumption after completion of the trial;
• ECOG Performance Status: ≤1;
• Life expectancy: ≥6 months;
• Participants able and willing to provide written informed consent and comply with the trial protocol.
• Either BRAF positive (BRAF+) or BRAF negative (BRAF-).

Exclusion criteria

• Women who are pregnant, breastfeeding, or planning to become pregnant during the study. Women of childbearing potential must have a negative pregnancy test within 72 hours prior to enrollment and agree to use adequate contraception throughout the study;
• Any infection requiring systemic therapy or other concurrent medical conditions (e.g., hepatitis B, hepatitis C, HIV) that would interfere with the study;
• Myocardial infarction or stroke within the past 6 months, uncontrolled angina, or significant arrhythmia;
• Participants receiving blood thinners as part of therapeutic anticoagulation therapy;
• Any severe or uncontrolled comorbid condition that, in the investigator's opinion, would pose excessive risk to the participants (e.g., immunodeficiencies, severe hypertension, uncontrolled diabetes, liver failure);
• Participation in another clinical trial involving an investigational product/device within 30 days prior to screening;
• Any condition that would impede compliance with study procedures;
• Participants with a known allergy to gold of any kind;
• Participants who are unable to tolerate cutaneous injections for any reason will not be eligible;
• Participants with a known allergy to injectable local analgesics;
• Participants with ocular melanoma or melanoma involving periorbital skin.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Device feasibility

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT06870994 · 69231

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗