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The TIME Trial - Phase II Randomized Controlled Trial of Time-of-Day Specified Immunotherapy for Advanced Melanoma
This phase II trial tests the safety and effectiveness of giving ipilimumab and nivolumab in the morning compared to other times of day in treating patients with melanoma that is stage IV or that cannot be removed by surgery (unresectable). Immunotherapy with monoclonal antibodies, such as ipilimumab and nivolumab, may help the body's immune system attack the tumor and may interfere with the ability of tumor cells to grow and spread. While some patients have impressive outcomes with both of these drugs, over 40% of patients do not experience any clinical benefit. Studies have shown that the time of day that vaccines and other therapies are given have had an impact on response and survival. It is not known, however, whether time of day has an impact on response to immune checkpoint inhibitors, such as ipilimumab and nivolumab. Giving ipilimumab and nivolumab earlier in the day compared to later in the day may improve response to treatment and survival in patients with stage IV or unresectable melanoma.
Eligibility Criteria
Inclusion Criteria
- 1Pathologically confirmed American Joint Committee on Cancer (AJCC) 8th edition stage IV unresectable cutaneous, acral, or mucosal melanoma
- 2No uveal melanoma
- 3Patients with asymptomatic, non-hemorrhagic brain metastases \< 2 cm are eligible
- 4No prior immunotherapy within 1 year, (serine/threonine-protein kinase B-raf \[BRAF\]/mitogen-activated protein kinase \[MEK\] inhibitors allowed)
- 5Eastern Cooperative Oncology Group (ECOG) 0-1
- 6Age ≥ 18
- 7Adequate organ function to receive ipilimumab/nivolumab
Exclusion Criteria
- 1Immunosuppression (\> 10mg prednisone daily)
- 2Active autoimmune disease that would preclude the administration of immunotherapy
- 3Active leptomeningeal disease
Locations
2 sites participating in this study
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia 30322
Michael C. Lowe, MD, MA
Emory Saint Joseph's Hospital
Atlanta, Georgia 30342
Michael C. Lowe, MD, MA