Monitoring of Immunological Mechanisms and Biomarkers Underlying Efficacy and Toxicity of Cancer Immunotherapy

Study Overview
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Brief Summary
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This trial is a translational, open-label, multi-site, prospective cohort study of 520 patients aiming to identify and to monitor immunological biomarkers associated with therapeutic response to immune checkpoints blockade (ICB), in patients with multiple types of advanced (unresectable and/or metastatic) solid cancers. The study will be conducted on a population of patients receiving ICB (anti-PD-1 or anti-PD-L1 or anti-CTLA4, alone or in combination) in the context of either routine care or a clinical study protocol. Patients with any of the following tumor types may be enrolled in the trial: Non-Small Cell Lung Cancer (NSCLC), Head and neck cancer, Melanoma, Bladder cancer, Other tumor types when Immuno-Oncology agent is expected to be efficient or when a clinical trial is an option. For each included patient, tumor biopsy specimens and blood samples will be collected at different time points. All included patients will be followed-up until progression. After this date, survival data will be collected.

Official Title
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Monitoring of Immunological Mechanisms and Biomarkers Underlying Efficacy and Toxicity of Cancer Immunotherapy

Conditions
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Solid Cancers

Intervention / Treatment
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* Other: Patients treated with immune checkpoint blockade


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 years at the time of study entry. Patient with histologically documented metastatic and/or unresectable solid malignant tumor (NSCLC, head and neck, melanoma (except uveal melanoma), bladder cancer or any other advanced solid tumor when I-O agent is expected to be efficient or when a clinical trial is an option). Patient for which a treatment with immune checkpoint blockade including, but not limited to, anti-PD-1, anti-PD-L1 and anti-CTLA-4 mAb alone or in combination has been decided. Archived tumor specimen available or feasible for pre-treatment tumor biopsy. Current treatment with ICB not yet started. Evaluable disease (measurable as per RECIST 1.1. or not). ECOG Performance status 0-2. Patient able to participate and willing to give informed consent prior to performance of any study-related procedures. Patient affiliated to a Social Health Insurance in France. Exclusion Criteria: Patient pregnant, or breast-feeding. Uveal melanoma Any condition contraindicated with tumor /blood sampling procedures required by the protocol. Known history of positive test for hepatitis B virus or hepatitis C virus or human immunodeficiency virus (HIV) or known acquired immunodeficiency syndrome (AIDS). Any current severe or uncontrolled disease, including, but not limited to ongoing or active infection and auto immune disorders. Any psychological, familial, geographic or social situation, according to the judgment of investigator, potentially preventing the provision of informed consent or compliance to study procedure. Patient who has forfeited his/her freedom by administrative or legal award or who is under guardianship.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Patients treated with immune checkpoint blockade<br> | Other: Patients treated with immune checkpoint blockade<br>* Tumor biopsy specimens and blood samples will be collected at different time points: Baseline before the 3rd ICB administration (blood samples only) before the 5th ICB administration (blood samples only) at the time of treatment permanent discontinuation (blood samples only) at the time of progression (tumor biopsy specimens only) after the last dose of ICB treatment (blood samples only taken twice per year until study termination)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of objective response (complete or partial response) | Response will be assessed according to RECIST 1.1 / investigator judgment | 18 months by patient | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression Free Survival defined as the time from inclusion until progression according to investigator judgment, or death, whichever occurs first. |  | 18 months by patient | 
| Anti-tumor immune responses under immunotherapy defined by investigator judgment and/or iRECIST criteria |  | 18 months by patient | 
| Immune related adverse event (irAE) will be evaluated using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) Version 4.03 |  | 12 months by patient | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Immune checkpoint modulation, Tumor antigens, Adaptive immune responses, Tumor molecular signature