Phase i clinical trial of ipilimumab in pediatric patients with advanced solid tumors

Melinda S. Merchant, Matthew Wright, Kristin Baird, Leonard H. Wexler, Carlos Rodriguez-Galindo, Donna Bernstein, Cindy Delbrook, Maya Lodish, Rachel Bishop, Jedd D. Wolchok, Howard Streicher, Crystal L. Mackall

Research output: Contribution to journalArticle

Abstract

Purpose: Ipilimumab is a first-in-class immune checkpoint inhibitor approved for treatment of metastatic melanoma but not studied in children until this phase I protocol. Experimental Design: This study examined safety, pharmacokinetics, and immunogenicity, and immune correlates of ipilimumab administered to subjects ≤21 years old with recurrent or progressive solid tumors. Dose escalation cohorts received 1, 3, 5, or 10 mg/m2 intravenously every 3 weeks in a 3 + 3 design. Response was assessed after 6 weeks and 12 weeks, and then every 3 months. Treatment was continued until disease progression or unacceptable toxicity. Results: Thirty-three patients received 72 doses of ipilimumab. Patients enrolled had melanoma (n = 12), sarcoma (n = 17), or other refractory solid tumors (n = 4). Immune-related adverse events included pancreatitis, pneumonitis, colitis, endocrinopathies, and transaminitis with dose-limiting toxicities observed at 5 and 10 mg/kg dose levels. Pharmacokinetics revealed a half-life of 8 to 15 days. At day 21, subjects had increased levels of cycling T cells, but no change in regulatory T-cell populations. Six subjects had confirmed stable disease for 4 to 10 cycles (melanoma, osteosarcoma, clear cell sarcoma, and synovial sarcoma). Conclusions: Ipilimumab was safely administered to pediatric patients using management algorithms for immune-related toxicities. The spectrum of immune-related adverse events is similar to those described in adults; however, many of the pediatric toxicities were evident after a single dose. Although no objective tumor regressions were observed with ipilimumab as a single agent, subjects with immune-related toxicities had an increased overall survival compared with those who showed no evidence of breaking tolerance. Clin Cancer Res; 22(6); 1364-70.

Original languageEnglish (US)
Pages (from-to)1364-1370
Number of pages7
JournalClinical Cancer Research
Volume22
Issue number6
DOIs
Publication statusPublished - Mar 15 2016
Externally publishedYes

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Merchant, M. S., Wright, M., Baird, K., Wexler, L. H., Rodriguez-Galindo, C., Bernstein, D., ... Mackall, C. L. (2016). Phase i clinical trial of ipilimumab in pediatric patients with advanced solid tumors. Clinical Cancer Research, 22(6), 1364-1370. https://doi.org/10.1158/1078-0432.CCR-15-0491