This phase I trial studies the side effects of anti-PD-1 monoclonal antibody REGN2810 (REGN2810) and/or ipilimumab when given together with stereotactic body radiation therapy before surgery in treating participants with prostate cancer that is growing, spreading, or getting worse, and has spread to other places in the body, or formed a small number of new tumors in one or two other parts of the body. Monoclonal antibodies, such as anti-PD-1 monoclonal antibody REGN2810 and ipilimumab, may interfere with the ability of tumor cells to grow and spread. Stereotactic body radiation therapy uses special equipment to position a patient and deliver radiation to tumors with high precision. This method can kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. Giving anti-PD-1 monoclonal antibody REGN2810 and ipilimumab with stereotactic body radiation therapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT03477864.
PRIMARY OBJECTIVES:
I. To determine the safety and tolerability for an established effective dose of systemic REGN2810 and intraprostatic ipilimumab with stereotactic body radiation therapy (SBRT) in patients with locally advanced prostate cancer with or without oligometastatic disease.
SECONDARY OBJECTIVES:
I. To determine overall pathologic response rate after radical prostatectomy.
II. To determine prostate-specific antigen (PSA) progression free survival in men treated with REGN2810 and intraprostatic ipilimumab with SBRT.
III. To determine radiographic progression free survival in men treated with REGN2810 and intraprostatic ipilimumab with SBRT.
IV. Acute and chronic adverse events (AEs).
CORRELATIVE OBJECTIVES:
I. T-cell receptor (TCR) sequencing and repertoire diversity.
II. Alterations in lymphocyte subsets as a function of immune therapy combinations.
III. Exosome profiles corresponding to tumor- and immune-phenotypes.
OUTLINE:
PART I: Participants are randomized to 1 of 2 arms.
ARM A: Participants receive anti-PD-1 monoclonal antibody REGN2810 intravenously (IV) over 30 minutes on day 1 of week 1 and in week 4, and undergo SBRT for 4 fractions on days 2-5 of week 3. Within 14-21 days, participants undergo radical prostatectomy.
ARM B: Participants receive ipilimumab via intraprostatic injection on day 1 of week 1, and undergo SBRT for 4 fractions on days 2-5 of week 3. Within 14-21 days, participants undergo radical prostatectomy.
PART II: After recommended doses in Arms A and B are established as safe and tolerable, participants are assigned to Arm C.
ARM C: Participants receive anti-PD-1 monoclonal antibody REGN2810 as in Arm A and ipilimumab as in Arm B. Participants also undergo SBRT for 4 fractions on days 2-5 of week 3. Within 14-21 days, participants undergo radical prostatectomy.
After completion of study treatment, participants are followed up periodically.
Lead OrganizationThomas Jefferson University Hospital
Principal InvestigatorAdam Paul Dicker