ClinicalTrials.gg
Not yet recruitingNCT07838974Updated Sep 24, 2026

Adding Anakinra and Tocilizumab to Nivolumab and Ipilimumab for the Treatment of Melanoma Patients 50 Years of Age or Older

A Phase 1 interventional study of Anakinra and Biospecimen Collection in Melanoma, sponsored by University of Southern California. Not yet recruiting at 1 site in United States. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by University of Southern California · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
50 Years and older
Sex
All
01

Study summary

This phase I trial studies the side effects of adding anakinra and tocilizumab to standard treatment with nivolumab and ipilimumab and to see how well it works in treating melanoma patients who are 50 years of age or older. Anakinra and tocilizumab are used to decrease the body's immune response and lower side effects. Immunotherapy with monoclonal antibodies, such as nivolumab and ipilimumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Researchers think that anakinra and tocilizumab may reduce the side effects experienced from standard treatment with nivolumab and ipilimumab while also preserving their anti-cancer effects. Adding anakinra and tocilizumab to standard treatment with nivolumab and ipilimumab may be safe, tolerable, and/or effective in treating melanoma patients who are 50 years of age or older.

Read the detailed description

PRIMARY OBJECTIVES:

I. To establish the tolerated dose of the combination of anakinra and tocilizumab that can be used in conjunction with nivolumab and ipilimumab for further evaluation in patients 50 years of age or older at the start of treatment.

SECONDARY OBJECTIVES:

I. To evaluate the safety of the combination based on Common Terminology Criteria for Adverse Events (CTCAE) version (v) 6.0.

II. To evaluate the incidence of discontinuation of immune checkpoint inhibitor (ICI) therapy due to grade 3 or higher immune-related adverse events (irAEs).

III. To evaluate objective response rate per Response Evaluation Criteria in Solid Tumors (RECIST) (v1.1) by investigator assessment (objective response rate [ORR] will be reported separately for patients treated neoadjuvant therapy versus [vs.] others).

IV. To evaluate overall survival (OS). V. To assess progression-free survival (PFS).

EXPLORATORY OBJECTIVES:

I. To evaluate change in serum cytokine/chemokine profile. II. To profile peripheral blood (PB) immune subsets.

OUTLINE: This is a dose de-escalation study of anakinra in combination with tocilizumab, nivolumab, and ipilimumab.

Patients receive anakinra subcutaneously (SC) once daily (QD) on days 1-21 of each cycle, once every other day of each cycle, or once every 3 days of each cycle. Patients also receive tocilizumab intravenously (IV), nivolumab IV, and ipilimumab IV on day 1 of each cycle. Cycles repeat every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo magnetic resonance imaging (MRI) and computed tomography (CT) or positron emission tomography (PET)/CT during screening and as clinically indicated as well as blood sample collection throughout the study.

After completion of study treatment, patients are followed up at 1 week and then every 6 months for up to 2 years.

02

Conditions studied

  • Melanoma

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03

In context

Melanoma

3,370 studies on the registry are indexed under Melanoma; 578 are open to participants now.

This study's planned enrollment of 40 is close to the median of 40 across 2,649 interventional studies indexed under Melanoma.

Browse Melanoma studies →

Lead sponsor

University of Southern California is the lead sponsor of 791 studies on the registry; 136 are open to participants now.

Of its 70 completed or terminated interventional studies of FDA-regulated products, 32 (46%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥ 50 years old
  • Patients with melanoma, who are going to be treated with ipilimumab 1mg/Kg and nivolumab 3mg/Kg as a standard of care (SOC)
  • (ECOG) performance status score of 0 or 1
  • ≥ 50 000/µL
  • ≥ 8.0 g/dL
  • (ANC) ≥ 1500/μL
  • Total ≤ 1.5 institutional (ULN)
  • (AST) (serum glutamic oxaloacetic transaminase [SGOT]) ≤ 3.0 X institutional ULN (up to 5 X institutional ULN if patient has liver )
  • Alanine aminotransferase (ALT) (serum glutamic pyruvic transaminase [SGPT]) ≤ 3.0 X institutional ULN (up to 5 X institutional ULN if patient has liver metastases)
  • Creatinine \< 2.0 ULN
  • Women of and men must agree to use adequate (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
  • Willingness to adhere to the study visit schedule and the prohibitions and restrictions specified in this protocol

Exclusion criteria

Exclusion Criteria:

  • Patients must not be receiving other concomitant biologic therapy, targeted therapy, chemotherapy, other anti-cancer therapy or any other agents while on this protocol
  • systemic equivalent to prednisone 10 mg or greater in the 14 days prior to the first cycle
  • Active disease requiring systemic treatment in the past 2 years (i.e. use of disease modifying agents or immunosuppressive drugs). Replacement therapy (e.g. thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc) is not considered a form of systemic treatment
  • Uncontrolled, intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness / social situations that would limit compliance with study requirements
  • Positive pregnancy test, active pregnancy or nursing / breast-feeding, due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants
  • History of solid organ or bone marrow transplantation
  • Any condition which in the investigator's opinion deems the participant an unsuitable candidate to receive study drug
Terms in these criteria, in plain language(15)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Absolute neutrophil count (ANC)

The number of neutrophils, white blood cells that help fight infection, in a given amount of blood. Too few raises the risk of infection.

It is a count, not a percentage of the white cells. Limits are written in units that mean the same: ≥ 1.5 × 10⁹/L is ≥ 1,500 per mm³ (µL). Each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (estimated)

Study arms

  • Experimental
    Treatment (anakinra, tocilizumab, nivolumab, ipilimumab)

    Patients receive anakinra SC QD on days 1-21 of each cycle, once every other day of each cycle, or once every 3 days of each cycle. Patients also receive tocilizumab IV, nivolumab IV, and ipilimumab IV on day 1 of each cycle. Cycles repeat every 21 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Additionally, patients undergo MRI and CT or PET/CT during screening and as clinically indicated as well as blood sample collection throughout the study.

    Biological: Anakinra · Procedure: Biospecimen Collection · Procedure: Computed Tomography · Other: Electronic Health Record Review · Biological: Ipilimumab · Procedure: Magnetic Resonance Imaging · Biological: Nivolumab · Procedure: Positron Emission Tomography · Biological: Tocilizumab

Interventions

  • BiologicalAnakinra

    Given SC

    Also known as: Kinaret, Kineret, rIL-1ra, rIL1RN

  • ProcedureBiospecimen Collection

    Undergo blood sample collection

    Also known as: Biological Sample Collection, Biospecimen Collected, Sample Collection, Specimen Collection

  • ProcedureComputed Tomography

    Undergo CT or PET/CT

    Also known as: CAT, CAT Scan, Computed Axial Tomography, Computerized Axial Tomography, Computerized axial tomography (procedure), Computerized Tomography, Computerized Tomography (CT) scan, CT, CT Scan, Diagnostic CAT Scan, Diagnostic CAT Scan Service Type, tomography

  • OtherElectronic Health Record Review

    Ancillary studies

  • BiologicalIpilimumab

    Given IV

    Also known as: Anti-Cytotoxic T-Lymphocyte-Associated Antigen-4 Monoclonal Antibody, BMS 734016, BMS-734016, BMS734016, Ipilimumab Biosimilar CS1002, MDX 010, MDX-010, MDX-CTLA4, MDX010, Yervoy

  • ProcedureMagnetic Resonance Imaging

    Undergo MRI

    Also known as: Magnetic Resonance, Magnetic Resonance Imaging (MRI), Magnetic resonance imaging (procedure), Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR, MR Imaging, MRI, MRI Scan, MRIs, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging, sMRI, Structural MRI

  • BiologicalNivolumab

    Given IV

    Also known as: ABP 206, BCD-263, BMS 936558, BMS-936558, BMS936558, CMAB819, MDX 1106, MDX-1106, MDX1106, NIVO, Nivolumab Biosimilar ABP 206, Nivolumab Biosimilar BCD-263, Nivolumab Biosimilar CMAB819, ONO 4538, ONO-4538, ONO4538, Opdivo

  • ProcedurePositron Emission Tomography

    Undergo PET/CT

    Also known as: Medical Imaging, Positron Emission Tomography, PET, PET Scan, Positron emission tomography (procedure), Positron Emission Tomography Scan, Positron-Emission Tomography, PT

  • BiologicalTocilizumab

    Given IV

    Also known as: Actemra, Avtozma, IL-6 receptor monoclonal antibodies: tocilizumab, Immunoglobulin G1, Anti-(Human Interleukin 6 Receptor) (Human-Mouse Monoclonal MRA Heavy Chain), Disulfide with Human-Mouse Monoclonal MRA Kappa-Chain, Dimer, MRA, R-1569, RoActemra, Tocilizumab-aazg, Tocilizumab-anoh, Tyenne

06

What researchers measure

Primary outcomes

  1. Tolerated dose of the combination of anakinra and tocilizumab that can be used in conjunction with nivolumab and ipilimumab in patients 50 years or older

    Time frame: Up to 12 weeks

Secondary outcomes

  1. Incidence of discontinuation of immune checkpoint inhibitor therapy due to grade 3 or higher immune-related adverse events

    This analysis will be conducted for each dose level examined separately. The estimand for this objective will be the number of patients with the objective's outcome measure coded as yes divided by the number of patients evaluable for this objective. Exact confidence interval of this proportion will also be calculated.

    Time frame: Up to 12 weeks

  2. Objective response rate

    Will evaluate objective response rate per Response Evaluation Criteria in Solid Tumors (RECIST) (version 1.1) by investigator assessment. This analysis will be conducted for each dose level examined separately. The estimand for this objective will be the number of patients demonstrating each RECIST category divided by the number of patients evaluable for this objective. The best response rate will be estimated by the number of patients who demonstrate partial response or complete response divided by the number of patients evaluable for this objective.

    Time frame: Up to 2 years

  3. Overall survival

    The probability of remaining alive as a function of time since enrollment will be calculated by the method of Kaplan and Meier (Kaplan EL and Meier P. Nonparametric estimation from incomplete observations. J Amer Statist Assoc, 457-481, 1958). The one year and two-year estimates will be reported for each dose group separately and for the aggregated evaluable population. There is no plan to conduct statistical comparisons between the dose groups.

    Time frame: From first dose of treatment to death due to any cause, assessed up to 2 years

  4. Progression free survival (PFS)

    The probability of remaining PFS-event free as a function of time since enrollment will be calculated by the method of Kaplan and Meier (Kaplan EL and Meier P. Nonparametric estimation from incomplete observations. J Amer Statist Assoc, 457-481, 1958). The one year and two-year estimates will be reported for each dose group separately and for the aggregated evaluable population. There is no plan to conduct statistical comparisons between the dose groups.

    Time frame: From start of treatment to time of progression or death whichever comes first, assessed up to 2 years

07

Study locations

1 site
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Nov 2026; primary completion for Nov 2029, 36 months later.

Of 186 non-industry phase 1 interventional studies under Melanoma, half reached primary completion within 52 months of starting (the median), counting those still running; a quarter within 33 and three quarters within 82. This study's planned 36 months is below that.

Counting every sponsor, half of 411 studies reached it within 49 months; a quarter within 31 and three quarters within 76.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 18, 2026
First posted
Sep 24, 2026
StartEst.
Nov 1, 2026
Primary completionEst.
Nov 1, 2029
CompletionEst.
Nov 1, 2030
Last update
Sep 24, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07838974
Responsible party
Sponsor
First posted
Sep 24, 2026
Start date
Nov 1, 2026 (estimated)
Primary completion
Nov 1, 2029 (estimated)
Completion
Nov 1, 2030 (estimated)
Last update
Sep 24, 2026

Study contacts

Fumito Ito
principal investigator · University of Southern California

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Interleukin 1 Receptor Antagonist Protein · Tocilizumab

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