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A non-inferiority randomized phase III trial of standard immunotherapy by checkpoint inhibitors vs. reduced dose intensity in responding patients with metastatic cancer: the MOIO protocol study

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  • Additional Information
    • Contributors:
      Centre de Recherche en Cancérologie de Marseille (CRCM); Aix Marseille Université (AMU)-Institut Paoli-Calmettes (IPC); Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD); Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM); Institut des sciences de la santé publique Marseille (ISSPAM); Institut Paoli-Calmettes (IPC); Fédération nationale des Centres de lutte contre le Cancer (FNCLCC); Imagerie Moléculaire et Stratégies Théranostiques (IMoST); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA); Centre Jean Perrin Clermont-Ferrand (UNICANCER/CJP); UNICANCER; Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037); Université Toulouse III - Paul Sabatier (UT3); Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM); Institut Claudius Regaud; Méthodes computationnelles pour la prise en charge thérapeutique en oncologie : Optimisation des stratégies par modélisation mécaniste et statistique (COMPO); Inria Sophia Antipolis - Méditerranée (CRISAM); Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche en Cancérologie de Marseille (CRCM); Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Institut Paoli-Calmettes (IPC); This research was supported by a grant from the French National Cancer Institute (INCa) in 2020 (PHRC-K 2020–150).
    • Publication Information:
      HAL CCSD
      BioMed Central
    • Publication Date:
      2023
    • Collection:
      Inserm: HAL (Institut national de la santé et de la recherche médicale)
    • Abstract:
      International audience ; Immunotherapy (IO) has become a standard of care for treating various types of metastatic cancers and has significantly improved clinical outcome. With the exception of metastatic melanoma in complete response for which treatment can be stopped at 6 months, these treatments are currently administered until either disease progression for some IO, 2 years for others, or unacceptable toxicity. However, a growing number of studies are reporting maintenance of response despite discontinuation of therapy. There is currently no evidence of a dose effect of IO in pharmacokinetic studies. Maintaining efficacy despite a reduction in treatment intensity by decreasing the frequency of administration in patients with highly selected metastatic cancer, is the hypothesis evaluated in the MOIO study. Method/design This non-inferiority, randomized phase III study aims to compare the standard regimen to a 3 monthly regimen of variousIO drugs in adult patients with metastatic cancer in partial (PR) or complete response (CR) after 6 months of standard IO dosing (except melanoma in CR). This is a French national study conducted in 36 centers. The main objective is to demonstrate that the efficacy of a three-monthly administration is not unacceptably less efficacious than a standard administration. Secondary objectives are cost-effectiveness, quality of life (QOL), anxiety, fear of relapse, response rate, overall survival and toxicity. After 6 months of standard IO, patients with partial or complete response will be randomized 1:1 between standard IO or a reduced intensity dose of IO, administered every 3 months. The randomization will be stratified on therapy line,, tumor type, IO type and response status. The primary endpoint is the hazard ratio of progression-free survival. With a planned study duration of 6 years, including 36 months enrolment time, 646 patients are planned to demonstrate with a statistical level of evidence of 5% that the reduced IO regimen is non-inferior to the standard IO regimen, ...
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/37131154; hal-04109560; https://amu.hal.science/hal-04109560; https://amu.hal.science/hal-04109560/document; https://amu.hal.science/hal-04109560/file/s12885-023-10881-8.pdf; PUBMED: 37131154; PUBMEDCENTRAL: PMC10155443
    • Accession Number:
      10.1186/s12885-023-10881-8
    • Online Access:
      https://amu.hal.science/hal-04109560
      https://amu.hal.science/hal-04109560/document
      https://amu.hal.science/hal-04109560/file/s12885-023-10881-8.pdf
      https://doi.org/10.1186/s12885-023-10881-8
    • Rights:
      http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess
    • Accession Number:
      edsbas.76848090