Patient case: 49-year-old male with melanoma; genetic feature: extensive tumor infiltrating lymphocytes

Clinical trial: A Clinical Trial of Adoptive Transfer With Autologous NKT Cells in Metastatic Melanoma Patients

Summary: Considerable progress in the treatment of metastatic melanoma has been made in the past 5years, with the approval of immune checkpoint-blocking antibodies and agents targeting BRAF mutation. Investigators conducted a open label, dose escalation, phase I clinical trial of to explore the maximum tolerated dose (MTD) and dose limiting toxicity (DLT) of intravenous administration of autologous NKT Cells in metastatic melanoma patients.

Detailed description: Considerable progress in the immunotherapy of metastatic melanoma has been made in the past 5 years, with the approval of immune checkpoint-blocking antibodies. NKT cells are a potent immunoregulatory cell population heavily implicated in promoting immunity to infection and cancer. And now with new generation of amplification method, more than 1,000 folds amplification of NKT cells can be obtained, so NKT cell based adoptive cell transfer is now available and might show its efficacy in melanoma. Investigators conducted this open label, dose escalation, phase I clinical trial of to explore the maximum tolerated dose (MTD) and dose limiting toxicity (DLT) of intravenous administration of autologous NKT Cells in metastatic melanoma patients.

Eligibility: Inclusion Criteria:
  -  Patients must have pathological or cytologically confirmed malignant melanoma with unresectable Stage III or Stage IV (including skin and distant lymph node metastasis M1a, lung metastasis M1b).
  -  Patients who are resistant /refractory to approved therapies, or for whom no curative therapies are available.
  -  Male or female, aged ≥18 and ≤70 years; ECOG performance status score of 0-2; Life expectancy of at least six months.
  -  For women of childbearing potential, a negative pregnancy test within 7 days prior to the first treatment.
  -  At least four weeks since prior other anti-tumor therapy, including endocrine, chemotherapy/radiotherapy and targeted therapy, at least six weeks since prior nitrosourea and mitomycin dosing, and have recovered from the adverse reactions due to prior therapy.
  -  At least 4 weeks before prior surgery.
  -  Must have one measurable or evaluable lesion according to RECIST 1.1
  -  With enough tumor tissues and diagnosed by the designated laboratory.
  -  Body weight >50kg.
  -  Without functional disorder of major organs ( laboratory examination): Neutrophils≥1.5×10^9/L, lymphocyte≥1.0×10^9/L, PLT≥100×10^9/L, Hb≥110g/L; BUN and Cr within normal range; TBIL≤1.5 times upper limit; ALT/AST≤2.5 times upper limit; PT/APTT within normal range.
  -  Without obvious hereditary disease.
  -  Must sign a written informed consent form prior to entering the study, with good compliance.
  Exclusion Criteria:
  -  With extrapulmonary metastatic of melanoma, for instance, distant metastasis of liver, brain, bone, adrenal gland.
  -  With serious internal disease, including serious heart disease, cerebral vascular disease, uncontrolled diabetes, uncontrolled hypertension, serious infections, active peptic ulcer, renal failure and respiratory failure.
  -  Uncontrolled infectious diseases or other serious diseases, for example, HIV, Hepatitis B and Hepatitis C.
  -  Uncontrolled brain metastases.
  -  Lymphoma or leukemia patients.
  -  Patients who have received bone marrow, stem cells or organ transplantation.
  -  With immunodeficiency or autoimmune disease, leucoderma excluded.
  -  Allergic constitution.
  -  Chronic diseases needed immunosuppressive therapy or hormone therapy.
  -  Patients treated with steroid hormone.
  -  Unable to evaluate the immune status, or patients cannot comply with follow-up clinical evaluation.
  -  Patients diagnosed with MDS (myelodysplastic syndromes).
  -  Patients who are pregnant or breast-feeding.
  -  Women (or patients' wife) of child-bearing without effective contraceptive measures.
  -  Patients receiving any investigational drug or investigational treatment within 4 weeks prior to first dosing.
  -  With uncontrolled mental disorders.

Relevance to patient case: possibly relevant