A first-in-human clinical trial in adult patients with metastatic or recurrent melanoma of a personalised therapy targeting specific mutations that occur in all cancer cells within a single patient
EU CTIS ID: 2024-513062-19-00
What this study is testing
To assess the safety and tolerability of ATL001 as a monotherapy and in combination with nivolumab
- Phase I and Phase II (Integrated)- First administration to humans
A plain-language read of the study's public EU CTIS listing. The study team confirms the details.
Who can take part
You may be able to join if
- Patient must be at least 18 years old at the screening visit
- Female patients who are of childbearing potential must agree to use a highly effective method of contraception during the study and for at least 12 months after the ATL001 infusion. Non-sterilised male participants who intend to be sexually active with a female partner of childbearing potential must use an acceptable method of contraception from the time of screening, throughout the duration of the study and for at least 6 months after the ATL001 infusion
- To be eligible to enter this study for procurement, the patient must fall into one of the following groups: a. Patients with metastatic or recurrent disease who have had no prior systemic therapy for advanced disease and who have accessible sites of disease suitable for collection of adequate tissue for ATL001 manufacture. b. Patients with metastatic or recurrent disease who are on or have completed first line systemic therapy and have accessible sites of disease suitable for collection of adequate tissue for ATL001 manufacture. c. Other patients with advanced stage disease for whom no other alternative approved treatments are available, may be considered on a case-by-case basis and should be discussed with the Sponsor prior to enrolment
- Anticipated life expectancy ≥ 6 months at the time of tissue procurement
- Patients must have metastatic melanoma and: a. Whose disease has progressed or recurred following standard of care. This includes patients who have received a component of standard of care therapy as part of a previous clinical trial in first line treatment; or b. Who are ineligible for, or who cannot tolerate, standard of care therapies. Patients who stop treatment due to immunotherapy toxicities do not need to progress in order to receive treatment with ATL001.
- Patients must have measurable disease according to RECIST v1.1 criteria prior to lymphodepletion
You likely can't join if
- Patients with known leptomeningeal disease or central nervous system (CNS) metastases that are untreated or symptomatic or progressing. Lesions should be clinically and radiologically stable for 2 months after treatment, as determined by MRI or CT evaluation, in line with accepted standard of care procedures, and should not require steroids
- Patients who have undergone major surgery in the previous 3 weeks
- Patients with an active concurrent cancer or a history of cancer within the past 3 years (except for in situ carcinomas, early prostate cancer with normal Prostate-Specific Antigen (PSA) or non-melanomatous skin cancers)
- Patients with a history of organ transplantation
- Patients who have previously received any investigational cell or gene therapies
- Patients with contraindications for cyclophosphamide, fludarabine and IL-2 at per protocol doses
See the full eligibility criteria
- Patient must be at least 18 years old at the screening visit
- Female patients who are of childbearing potential must agree to use a highly effective method of contraception during the study and for at least 12 months after the ATL001 infusion. Non-sterilised male participants who intend to be sexually active with a female partner of childbearing potential must use an acceptable method of contraception from the time of screening, throughout the duration of the study and for at least 6 months after the ATL001 infusion
- To be eligible to enter this study for procurement, the patient must fall into one of the following groups: a. Patients with metastatic or recurrent disease who have had no prior systemic therapy for advanced disease and who have accessible sites of disease suitable for collection of adequate tissue for ATL001 manufacture. b. Patients with metastatic or recurrent disease who are on or have completed first line systemic therapy and have accessible sites of disease suitable for collection of adequate tissue for ATL001 manufacture. c. Other patients with advanced stage disease for whom no other alternative approved treatments are available, may be considered on a case-by-case basis and should be discussed with the Sponsor prior to enrolment
- Anticipated life expectancy ≥ 6 months at the time of tissue procurement
- Patients must have metastatic melanoma and: a. Whose disease has progressed or recurred following standard of care. This includes patients who have received a component of standard of care therapy as part of a previous clinical trial in first line treatment; or b. Who are ineligible for, or who cannot tolerate, standard of care therapies. Patients who stop treatment due to immunotherapy toxicities do not need to progress in order to receive treatment with ATL001.
- Patients must have measurable disease according to RECIST v1.1 criteria prior to lymphodepletion
- Patient is considered, in the opinion of the Investigator, well enough (i.e. ECOG Performance Status 0-1) to receive ATL001 treatment (this will be checked prior to lymphodepletion and again prior to receiving ATL001)
- Prior to treatment with ATL001, the treatment regimen must have included a PD-1/PD-L1 inhibitor and patients should have experienced: a. Radiological disease progression; or b. Stable disease following at least 4 doses of a PD-1/PD-L1 inhibitor
- In addition to the need for highly effective contraception as outlined in Inclusion Criterion 10 above, female patients in Cohort B of childbearing potential must agree to use effective contraception during treatment with nivolumab and for at least 5 months after the last dose of nivolumab. Patients must also agree to provide a serum or urine pregnancy test before each nivolumab administration during the treatment period in Cohort B
- Patient must have given written informed consent to participate in the study
- Patients must have histologically confirmed diagnosis of melanoma
- Patients must have received a PD-1/PD-L1 inhibitor prior to treatment with ATL001 (unless contraindicated)
- Patients whose tumour is known to have a BRAF V600 mutation must have received BRAF targeted therapy (as well as a PD-1/PD-L1 inhibitor unless contraindicated) prior to treatment with ATL001
- Patient is considered medically fit enough to undergo all study procedures and interventions: procedures to procure blood and tumour tissue, including a general anaesthetic if required, and to receive fludarabine, cyclophosphamide and IL-2 at protocol doses and schedules
- Patient is considered, in the opinion of the Investigator, capable of adhering to the protocol
- Eastern Cooperative Oncology Group (ECOG) Performance Status 0-1
- Adequate organ function indicated by the following laboratory parameters: a. Haemoglobin ≥ 10.0 g/dL. b. White Blood Cell Count (WBC) ≥ 3.0 x10⁹/L. c. Absolute Neutrophil Count (ANC) ≥ 1.5 x10⁹/L. d. Platelets ≥ 100 x10⁹/L. e. INR/PT and APTR/APTT < 1.5x ULN, unless receiving therapeutic anticoagulation. Investigator discretion is required to ensure surgery is safe or that anticoagulants can be safely stopped. f. AST or ALT ≤ 2.5x ULN. g. Bilirubin < 1.5x ULN (or < 3x ULN if Gilbert’s Syndrome) h. Creatinine clearance/estimated glomerular filtration rate (GFR) ≥ 50 mL/min.
- Patients with known leptomeningeal disease or central nervous system (CNS) metastases that are untreated or symptomatic or progressing. Lesions should be clinically and radiologically stable for 2 months after treatment, as determined by MRI or CT evaluation, in line with accepted standard of care procedures, and should not require steroids
- Patients who have undergone major surgery in the previous 3 weeks
- Patients with an active concurrent cancer or a history of cancer within the past 3 years (except for in situ carcinomas, early prostate cancer with normal Prostate-Specific Antigen (PSA) or non-melanomatous skin cancers)
- Patients with a history of organ transplantation
- Patients who have previously received any investigational cell or gene therapies
- Patients with contraindications for cyclophosphamide, fludarabine and IL-2 at per protocol doses
- Patients with a confirmed history of allergic reactions to amphotericin b, penicillin and/or streptomycin
- Patients who have received any cytotoxic chemotherapy within the 3 weeks prior to tissue and blood procurement
- Patients with a history of (non-infectious) pneumonitis that required systemic steroids, or current pneumonitis/interstitial lung disease
- Patients with a history of severe hypersensitivity to a monoclonal antibody, allergy or hypersensitivity to nivolumab itself and/or its components
- Patients who have received a live vaccination within the 28 days prior to the first dose of nivolumab
- Patients with ocular, acral or mucosal melanoma
- Patients with any contraindications for nivolumab
- Patients with a Left Ventricular Ejection Fraction (LVEF) < 45%
- Patients with a forced expiratory volume in one second (FEV1) of less than or equal to 60% of their predicted normal
- Patients who have received a live vaccination within the 28 days prior to lymphodepletion
- Patients with an active infection requiring antibiotics
- Patients who have received any cytotoxic chemotherapy within the 3 weeks prior to lymphodepletion
- Patients with hepatitis B or C, human immunodeficiency virus infection (HIV1/2), syphilis or HTLVI/II infection
- Patients with active, known, or suspected, autoimmune disease requiring immunosuppressive treatments
- Patients requiring regular treatment with steroids at a dose higher than prednisolone 10 mg/day (or equivalent)
- Patients with a current or recent history, as determined by the Investigator, of clinically significant, progressive, and/or uncontrolled renal, hepatic, haematological, endocrine, pulmonary, cardiac, gastroenterological or neurological disease
- Patients with a history of immune mediated central nervous system toxicity that was caused by, or suspected to be caused by, immunotherapy
- Patients with a history of ≥ Grade 2 diarrhoea/colitis caused by previous immunotherapy within 6 months of screening. Patients that have been asymptomatic for at least 6 months or have had a normal colonoscopy post-immunotherapy (with uninflamed mucosa by visual assessment following discontinuation of immune suppression other than permitted modified release steroids) are not excluded
- Patients who are pregnant or breastfeeding
The study team makes the final eligibility decision.
Where it's taking place
- United Kingdom
Questions & answers
Do participants get paid in this trial?
This listing doesn't specify compensation. Many trials still reimburse travel or offer a stipend, so it's worth asking the study team when you connect.
Is it free to join, and do I need insurance?
Searching and applying through BridgeMD is free. In clinical trials the study-related treatment and visits are generally provided at no cost to you. You usually don't need insurance to take part - confirm specifics with the study team.
How long does this study last?
The listing doesn't state an exact length. The study team walks you through the schedule and number of visits before you decide to enroll.
Who can join this trial?
This study is enrolling all sexes, 18-64 years, 65+ years. The study team makes the final eligibility decision.
Where is this trial taking place?
Study sites include United Kingdom. Enter your location above to see the nearest site and check your eligibility.
Explore other conditions
BridgeMD is an information and trial-matching tool - not medical advice, and not the study sponsor. Details come from EU CTIS; the study team decides eligibility.