Protocol – ECOG – EA6192

Please Note: Below is a partial list of eligibility, please contact GHCI Research Department at (810) 762-8181, (810) 762-8079 and/or (810) 762-8038 to discuss full eligibility requirements.

Eligibility:

SCHEMA EA6192

1. Must be at least 18 years of age.
2. Patient must have active advanced melanoma, defined as unresectable stage IIIB-IV by AJCC 8th edition. Patients with mucosal melanoma defined as unresectable stage III or regional/distant metastatic disease are eligible.
3. Patient must have melanoma originating from cutaneous, acrallentiginous, or mucosal primary sites. Patients with melanoma of unknown primary site are eligible. Patients must not have melanoma from an ocular primary site.
4. Patient must have had measurable disease.
5. Patient must be actively receiving standard of care anti-PD-1 therapy, currently be 52 weeks (+/- 2 weeks) from start of anti-PD-1 therapy, and have not experienced a toxicity that prevents them from continuing on therapy. Permitted systemic anti-PD-1 therapy regimens include:
   • Nivolumab 240mg IV Q2weeks or 480mg IV Q4weeks
   • Pembrolizumab 200mg IV Q3weeks or 400mg IV Q6weeks
   • Nivolumab 1mg/kg plus Ipilimumab 3mg/kg IV Q3weeks induction
   x 4 doses, followed by Nivolumab 240mg IV Q2weeks or 480mg
   IV Q4weeks maintenance
   • Nivolumab 3mg/kg plus Ipilimumab 1mg/kg IV Q3weeks induction
   x 4 doses, followed by Nivolumab 240mg IV Q2weeks or 480mg
   IV Q4weeks maintenance
   • Pembrolizumab 2mg/kg (or 200mg flat dose) plus Ipilimumab
   1mg/kg IV Q3weeks induction x 4 doses, followed by
   Pembrolizumab 200mg IV Q3weeks or 400mg IV Q6weeks
   maintenance
6. Patient must not be receiving concurrent anti-tumor therapies in addition to the standard of care anti-PD-1 regimens. Patients who are receiving bisphosphonates and RANKL inhibitors for management of bone metastases are eligible.
7. ECOG Performance Status 0-2.
8. Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial.

Protocol: SWOG – S1801

Please Note: Below is a brief partial list  of eligibility, please contact GHCI Research Department at (810) 762-8181, (810) 762-8079 and/or (810) 762-8038 to discuss full eligibility requirements.

Eligibility:

SCHEMA S1801

1. Patients must have resectable melanoma in order to be eligible for this study. Patients must have clinically detectable Stage III (clinically detectable N1b, N1c, N2b, N2c, N3b and N3c) or Stage IV resectable melanoma. Patients with melanoma of mucosal or acral origin are eligible. Patients with melanoma of uveal origin are not eligible. Patients with a history of brain metastases are not eligible.
2. Patients are eligible for this trial either at initial presentation of their melanoma or at the time of the first detected nodal, satellite/in-transit, distant metastases, or recurrent disease in prior lymphadenectomy basin or distant site. Nodal, satellite/in-transit metastasis, distant metastases or disease in a prior complete lymphadenectomy basin must have been confirmed histologically by H & E stained slides.
3. Patients with multiple regional nodal basin involvement are eligible. Gross or microscopic extracapsular nodal extension is permitted.
4. Patients must have histologically proven Stage IIIB or higher. This would entail pathologic confirmation beyond the primary or initial diagnosis of melanoma involving fine needle aspiration cytology or biopsy confirmation
   of any N-category or M-category resectable site.
5. Patients must not have received previous neoadjuvant treatment for their melanoma. Patients may have received prior non-immunotherapy adjuvant therapy. Patients must not have had prior immunotherapy
   including, but not limited to ipilimumab, interferon alfa-2b, high dose IL-2, PEG-IFN, anti-PD-1, anti-PD-L1 intra-tumoral, or vaccine therapies.
6. Patients must not be planning to receive concomitant other biologic therapy, hormonal therapy, other chemotherapy, surgery, while on protocol therapy.
7. Must be at least 18 years of age.
8. Zubrod Performance Status of 0-2.
9. Patients must not have received live vaccines within 42 days prior to randomization.
10. Prior malignancy is allowed providing it does not require concurrent therapy.

Protocol: ECOG – EA6141

Please Note: Below is a partial list of eligibility, please contact GHCI Research Department at (810) 762-8181, (810) 762-8079 and/or (810) 762-8038 to discuss full eligibility requirements.

Eligibility:

SCHEMA EA6141

1. Must be at least 18 years of age.
2. ECOG Performance Status 0-1
3. Patients must have known BRAF mutational status of tumor; Wildtype (WT) or mutated.
4. Patients must have unresectable stage III or stage IV melanoma according to AJCC v7. Patients must have histological or cytological confirmation of melanoma that is metastatic or unresectable and clearly progressive.
5. Patients must have measurable disease.
6. Patients may have had prior systemic therapy in the adjuvant setting (e.g. interferon, BRAF, or MEK agents). Patients may have had prior anti-CTLA-4 in the adjuvant setting, if at least one year from last dose
   of treatment has passed prior to beginning treatment. Patients may have had any prior anti-PD-1 or anti-PD-L1 agent in the adjuvant setting, if at least one year from last dose of treatment has passed prior to beginning treatment.
7. Patients may not have had any prior ipilimumab and/or anti-PD-1/PDL1 agent in the metastatic setting.
8. Patients must have discontinued chemotherapy, immunotherapy or other investigational agents used in the adjuvant setting ≥ 4 weeks prior to randomization and recovered from adverse events due to those agents.
9. Patients must not receive any other investigational agents while on study or within four weeks prior to randomization.
10. Patient must not have received any live vaccine within 30 days prior to randomization.
11. Patients must not have other current malignancies, other than basal cell skin cancer, squamous cell skin cancer, in situ cervical cancer, ductal or lobular carcinoma in situ of the breast. Patients with other malignancies are eligible if they have been continuously disease-free for > 3 years prior to the time of randomization.
12. Patients must not have autoimmune disorders or conditions of immunosuppression that require current ongoing treatment with systemic corticosteroids.
13. Patients must not have other significant medical, surgical, or psychiatric conditions or require any medication or treatment that in the opinion of the investigator may interfere with compliance, make the administration of the study drugs hazardous or obscure the interpretation of AEs, such as a condition associated with frequent
    diarrhea.