Trial Outcomes & Findings for Rituximab and Hyaluronidase Human in Patients With Advanced Melanoma Undergoing Nivolumab and Ipilimumab Therapy (NCT NCT03719131)

NCT ID: NCT03719131

Last Updated: 2025-04-22

Results Overview

All patients will be evaluable for toxicity from the time of their first treatment with ipilimumab/nivolumab. Investigators will review the toxicities, grade, and attribute each toxicity.

Recruitment status

ACTIVE_NOT_RECRUITING

Study phase

PHASE2

Target enrollment

15 participants

Primary outcome timeframe

At 6 months after study start

Results posted on

2025-04-22

Participant Flow

Participant milestones

Participant milestones
Measure
Arm A (Standard of Care)
This is standard of care arm: induction with 4 cycles (21 days each) of Ipilimumab and nivolumab followed by continuation with nivolumab alone every month X1 year (13 doses). Nivolumab: Receive standard of care nivolumab therapy Ipilimumab: Receive standard of care ipilimumab therapy
Arm B (Rituximab, Hyaluronidase Human)
This includes induction with 4 cycles of ipilimumab and nivolumab X 4 cycles followed by continuation with nivolumab alone every month for 1 year as in standard of care arm. Each induction cycle is 21 days and includes ipilimumab on day 1 plus nivolumab on day 1. In addition, patients will receive 4 weekly doses of Rituxan (first dose intravenously and then 3 weekly doses subcutaneously). First dose of Rituxan will be administered one week following the start of cycle 1 of ipilimumab and nivolumab. All treatments will have a +/-3 business day window for administration. Nivolumab: Receive standard of care nivolumab therapy Rituximab and Hyaluronidase Human: Given IV or SC Ipilimumab: Receive standard of care ipilimumab therapy
Overall Study
STARTED
7
7
Overall Study
COMPLETED
6
5
Overall Study
NOT COMPLETED
1
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Arm A (Standard of Care)
This is standard of care arm: induction with 4 cycles (21 days each) of Ipilimumab and nivolumab followed by continuation with nivolumab alone every month X1 year (13 doses). Nivolumab: Receive standard of care nivolumab therapy Ipilimumab: Receive standard of care ipilimumab therapy
Arm B (Rituximab, Hyaluronidase Human)
This includes induction with 4 cycles of ipilimumab and nivolumab X 4 cycles followed by continuation with nivolumab alone every month for 1 year as in standard of care arm. Each induction cycle is 21 days and includes ipilimumab on day 1 plus nivolumab on day 1. In addition, patients will receive 4 weekly doses of Rituxan (first dose intravenously and then 3 weekly doses subcutaneously). First dose of Rituxan will be administered one week following the start of cycle 1 of ipilimumab and nivolumab. All treatments will have a +/-3 business day window for administration. Nivolumab: Receive standard of care nivolumab therapy Rituximab and Hyaluronidase Human: Given IV or SC Ipilimumab: Receive standard of care ipilimumab therapy
Overall Study
Death
1
2

Baseline Characteristics

Rituximab and Hyaluronidase Human in Patients With Advanced Melanoma Undergoing Nivolumab and Ipilimumab Therapy

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm A (Standard of Care)
n=7 Participants
This is standard of care arm: induction with 4 cycles (21 days each) of Ipilimumab and nivolumab followed by continuation with nivolumab alone every month X1 year (13 doses). Nivolumab: Receive standard of care nivolumab therapy Ipilimumab: Receive standard of care ipilimumab therapy
Arm B (Rituximab, Hyaluronidase Human)
n=7 Participants
This includes induction with 4 cycles of ipilimumab and nivolumab X 4 cycles followed by continuation with nivolumab alone every month for 1 year as in standard of care arm. Each induction cycle is 21 days and includes ipilimumab on day 1 plus nivolumab on day 1. In addition, patients will receive 4 weekly doses of Rituxan (first dose intravenously and then 3 weekly doses subcutaneously). First dose of Rituxan will be administered one week following the start of cycle 1 of ipilimumab and nivolumab. All treatments will have a +/-3 business day window for administration. Nivolumab: Receive standard of care nivolumab therapy Rituximab and Hyaluronidase Human: Given IV or SC Ipilimumab: Receive standard of care ipilimumab therapy
Total
n=14 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
6 Participants
n=99 Participants
3 Participants
n=107 Participants
9 Participants
n=206 Participants
Age, Categorical
>=65 years
1 Participants
n=99 Participants
4 Participants
n=107 Participants
5 Participants
n=206 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
4 Participants
n=107 Participants
6 Participants
n=206 Participants
Sex: Female, Male
Male
5 Participants
n=99 Participants
3 Participants
n=107 Participants
8 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=99 Participants
0 Participants
n=107 Participants
2 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
5 Participants
n=99 Participants
7 Participants
n=107 Participants
12 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
3 Participants
n=107 Participants
3 Participants
n=206 Participants
Race (NIH/OMB)
White
6 Participants
n=99 Participants
4 Participants
n=107 Participants
10 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
United States
7 participants
n=99 Participants
7 participants
n=107 Participants
14 participants
n=206 Participants

PRIMARY outcome

Timeframe: At 6 months after study start

Population: All patients were evaluated for toxicity from the time of their first treatment with ipilimumab/nivolumab.

All patients will be evaluable for toxicity from the time of their first treatment with ipilimumab/nivolumab. Investigators will review the toxicities, grade, and attribute each toxicity.

Outcome measures

Outcome measures
Measure
Arm A (Standard of Care)
n=7 Participants
This is standard of care arm: induction with 4 cycles (21 days each) of Ipilimumab and nivolumab followed by continuation with nivolumab alone every month X1 year (13 doses). Nivolumab: Receive standard of care nivolumab therapy Ipilimumab: Receive standard of care ipilimumab therapy
Arm B (Rituximab, Hyaluronidase Human)
n=7 Participants
This includes induction with 4 cycles of ipilimumab and nivolumab X 4 cycles followed by continuation with nivolumab alone every month for 1 year as in standard of care arm. Each induction cycle is 21 days and includes ipilimumab on day 1 plus nivolumab on day 1. In addition, patients will receive 4 weekly doses of Rituxan (first dose intravenously and then 3 weekly doses subcutaneously). First dose of Rituxan will be administered one week following the start of cycle 1 of ipilimumab and nivolumab. All treatments will have a +/-3 business day window for administration. Nivolumab: Receive standard of care nivolumab therapy Rituximab and Hyaluronidase Human: Given IV or SC Ipilimumab: Receive standard of care ipilimumab therapy
Number of Participants With Common Terminology Criteria (CTC) (Version [v]5.0) Grade 3 or Greater Immune-related Adverse Events
4 Participants
1 Participants

SECONDARY outcome

Timeframe: Up to 4 weeks after study start

All patients will be evaluable for toxicity from the time of their first treatment with ipilimumab/nivolumab. Investigators will review the toxicities, grade, and attribute each toxicity.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: At 12 weeks and every 12 weeks thereafter up to 1 year

Will be assessed by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 and immune-related (ir)RECIST. Only those patients who have measurable disease present at baseline, have received at least one cycle of therapy, and have had their disease re-evaluated will be considered evaluable for response. Patients who exhibit objective disease progression prior to the end of cycle 1 will also be considered evaluable.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: From start of treatment up to 1 year

Overall survival is defined as the duration of time from start of treatment to time of death or last follow-up, whichever occurs first.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: From start of treatment up to 1 year

PFS is defined as the duration of time from start of treatment to time of progression or death or last follow-up, whichever occurs first.

Outcome measures

Outcome data not reported

Adverse Events

Arm A (Standard of Care)

Serious events: 4 serious events
Other events: 7 other events
Deaths: 1 deaths

Arm B (Rituximab, Hyaluronidase Human)

Serious events: 4 serious events
Other events: 7 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Arm A (Standard of Care)
n=7 participants at risk
This is standard of care arm: induction with 4 cycles (21 days each) of Ipilimumab and nivolumab followed by continuation with nivolumab alone every month X1 year (13 doses). Nivolumab: Receive standard of care nivolumab therapy Ipilimumab: Receive standard of care ipilimumab therapy
Arm B (Rituximab, Hyaluronidase Human)
n=7 participants at risk
This includes induction with 4 cycles of ipilimumab and nivolumab X 4 cycles followed by continuation with nivolumab alone every month for 1 year as in standard of care arm. Each induction cycle is 21 days and includes ipilimumab on day 1 plus nivolumab on day 1. In addition, patients will receive 4 weekly doses of Rituxan (first dose intravenously and then 3 weekly doses subcutaneously). First dose of Rituxan will be administered one week following the start of cycle 1 of ipilimumab and nivolumab. All treatments will have a +/-3 business day window for administration. Nivolumab: Receive standard of care nivolumab therapy Rituximab and Hyaluronidase Human: Given IV or SC Ipilimumab: Receive standard of care ipilimumab therapy
Investigations
Hospitalization
57.1%
4/7 • Number of events 8 • 3 years and 4 months
57.1%
4/7 • Number of events 6 • 3 years and 4 months

Other adverse events

Other adverse events
Measure
Arm A (Standard of Care)
n=7 participants at risk
This is standard of care arm: induction with 4 cycles (21 days each) of Ipilimumab and nivolumab followed by continuation with nivolumab alone every month X1 year (13 doses). Nivolumab: Receive standard of care nivolumab therapy Ipilimumab: Receive standard of care ipilimumab therapy
Arm B (Rituximab, Hyaluronidase Human)
n=7 participants at risk
This includes induction with 4 cycles of ipilimumab and nivolumab X 4 cycles followed by continuation with nivolumab alone every month for 1 year as in standard of care arm. Each induction cycle is 21 days and includes ipilimumab on day 1 plus nivolumab on day 1. In addition, patients will receive 4 weekly doses of Rituxan (first dose intravenously and then 3 weekly doses subcutaneously). First dose of Rituxan will be administered one week following the start of cycle 1 of ipilimumab and nivolumab. All treatments will have a +/-3 business day window for administration. Nivolumab: Receive standard of care nivolumab therapy Rituximab and Hyaluronidase Human: Given IV or SC Ipilimumab: Receive standard of care ipilimumab therapy
Metabolism and nutrition disorders
Anorexia
57.1%
4/7 • Number of events 5 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Ear and labyrinth disorders
Vestibular Disorder
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Gastrointestinal disorders
Constipation
14.3%
1/7 • Number of events 4 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
General disorders
Stabbing Lesion Pain (Back)
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Rash/itching (arms and legs)
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
General disorders
Joint pain
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Musculoskeletal and connective tissue disorders
Muscle Weakness
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
General disorders
Fatigue
57.1%
4/7 • Number of events 6 • 3 years and 4 months
57.1%
4/7 • Number of events 4 • 3 years and 4 months
Psychiatric disorders
Insomnia
0.00%
0/7 • 3 years and 4 months
28.6%
2/7 • Number of events 6 • 3 years and 4 months
Gastrointestinal disorders
Diarrhea
42.9%
3/7 • Number of events 7 • 3 years and 4 months
28.6%
2/7 • Number of events 3 • 3 years and 4 months
Endocrine disorders
Hyperthyroidism
28.6%
2/7 • Number of events 2 • 3 years and 4 months
28.6%
2/7 • Number of events 4 • 3 years and 4 months
Respiratory, thoracic and mediastinal disorders
Pleural Effusion
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Musculoskeletal and connective tissue disorders
Arthralgia
14.3%
1/7 • Number of events 4 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Metabolism and nutrition disorders
Hypokalemia
28.6%
2/7 • Number of events 4 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Tumor Pain
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Respiratory, thoracic and mediastinal disorders
Hypoxia (Hospitalization)
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
General disorders
General Disorders and Administration Site Conditions
14.3%
1/7 • Number of events 2 • 3 years and 4 months
14.3%
1/7 • Number of events 6 • 3 years and 4 months
Gastrointestinal disorders
Nausea
42.9%
3/7 • Number of events 12 • 3 years and 4 months
42.9%
3/7 • Number of events 6 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Pruritus
14.3%
1/7 • Number of events 1 • 3 years and 4 months
14.3%
1/7 • Number of events 10 • 3 years and 4 months
Injury, poisoning and procedural complications
Infusion related reaction (nivo reaction)
14.3%
1/7 • Number of events 2 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
General disorders
Fever
57.1%
4/7 • Number of events 9 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
Respiratory, thoracic and mediastinal disorders
Cough (dry cough)
14.3%
1/7 • Number of events 1 • 3 years and 4 months
0.00%
0/7 • 3 years and 4 months
General disorders
Abdominal Pain
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Nervous system disorders
AE Not Defined
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
Investigations
Alanine aminotransferase increased
0.00%
0/7 • 3 years and 4 months
28.6%
2/7 • Number of events 6 • 3 years and 4 months
Investigations
Alkaline phosphatase increased
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Immune system disorders
Allergic Reaction
0.00%
0/7 • 3 years and 4 months
57.1%
4/7 • Number of events 45 • 3 years and 4 months
Immune system disorders
Allergic reaction
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Investigations
Aspartate Aminotransferase Increased
0.00%
0/7 • 3 years and 4 months
28.6%
2/7 • Number of events 6 • 3 years and 4 months
General disorders
Back Pain
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Ear and labyrinth disorders
Balance Impairment
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Bleeding from inguinal lesion
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 11 • 3 years and 4 months
General disorders
Blood in Urine
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Renal and urinary disorders
Bloody Discharge
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Cardiac disorders
Chest Pain
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 11 • 3 years and 4 months
General disorders
Colitus
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
Metabolism and nutrition disorders
Decreased Appetite
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Gastrointestinal disorders
Dry Mouth
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Dry Skin
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
Respiratory, thoracic and mediastinal disorders
Dyspnea
0.00%
0/7 • 3 years and 4 months
28.6%
2/7 • Number of events 4 • 3 years and 4 months
Investigations
Elevated Creatinine
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 4 • 3 years and 4 months
Eye disorders
Eye Disorders
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Injury, poisoning and procedural complications
Fall
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Nervous system disorders
Headache
0.00%
0/7 • 3 years and 4 months
28.6%
2/7 • Number of events 10 • 3 years and 4 months
Vascular disorders
Hot Flashes
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Metabolism and nutrition disorders
Hyperglycemia
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Renal and urinary disorders
Increased Urinary Frequency
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Itching
0.00%
0/7 • 3 years and 4 months
28.6%
2/7 • Number of events 6 • 3 years and 4 months
General disorders
Left Groin Pain
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
Infections and infestations
Leukocytosis
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Gastrointestinal disorders
Loose Stools
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 4 • 3 years and 4 months
Blood and lymphatic system disorders
LUE + LLE Swelling
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Neoplasms Benign, Malignant and unspecified
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Paper Cut Infection
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
Nervous system disorders
Paresthesia
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 9 • 3 years and 4 months
Respiratory, thoracic and mediastinal disorders
Pneumonitis
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Rash (Upper Back)
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 5 • 3 years and 4 months
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Rathke's Cyst (Pituitary)
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 2 • 3 years and 4 months
General disorders
Red blotches upper + lower trunk
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Skin Irritation
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 1 • 3 years and 4 months
General disorders
Throat Tightness
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 4 • 3 years and 4 months
Nervous system disorders
Tremor
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Nervous system disorders
Trigeminal Nerve Disorder
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Renal and urinary disorders
Urinary Retention
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Gastrointestinal disorders
Watery Stool (Colitis)
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months
Skin and subcutaneous tissue disorders
Worsening Rosacea
0.00%
0/7 • 3 years and 4 months
14.3%
1/7 • Number of events 3 • 3 years and 4 months

Additional Information

Kavita Dhodapkar, MD

Emory University

Phone: 404-785-1112

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place