New combo aims to revive immunotherapy in resistant cancers
NCT ID NCT07404332
First seen Jun 27, 2026 · Last updated Jun 27, 2026
Summary
This early-stage trial tests whether adding a chemotherapy drug (5-Azacitidine) to standard immunotherapy can help patients whose solid tumors have stopped responding to PD-1/PD-L1 inhibitors. About 35 adults with advanced or metastatic cancers will receive the combination to find the safest dose and check for early signs of tumor shrinkage. The goal is to see if this approach can overcome resistance to immunotherapy.
What this could mean
Our plain-language read of the trial. This is informational only, not medical advice or a prediction.
- Active substance
- 5-Azacitidine (a chemotherapy drug) combined with a PD-1/PD-L1 inhibitor (pembrolizumab, nivolumab, or cemiplimab)
- What this could lead to
- If it works, this could point toward a new treatment option for patients whose tumors no longer respond to standard immunotherapy.
- What could go wrong
- This is a very early Phase I trial with only 35 participants, so it is primarily testing safety and dosing. It is too soon to know if the combination will be effective, and there may be side effects from adding chemotherapy to immunotherapy.
This is an AI summary of the original study and may miss details. Read our disclaimer.
Study facts
What this study's own registry entry says, in plain language.
- Phase
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Phase 1
The first testing in people. Mainly checks safety and dose, usually in a small group.
- Participants
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About 35 people
The number the study aims to enrol. It can still change while the study runs.
- Started
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Feb 2026
- Expected to finish
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Feb 2031
An estimate. End dates often move.
- Lead sponsor
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Other sponsor
The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.
Who can take part
This study's own entry requirements. Only the study team can say for certain whether you qualify.
- Ages
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18 to 99 years
- Sex
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Anyone
- Healthy volunteers
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Not accepted
This study is not open to healthy volunteers. The entry requirements below say who it is open to.
Show the full entry requirements Hide the full entry requirements
Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.
Inclusion Criteria: * Written and voluntary informed consent. * At least 18 years of age or older. * Histologically and radiologically confirmed locally advanced or metastatic unresectable solid tumor malignancy for which PD-1 or PD-L1 therapy is already approved by the FDA. Locally advanced is defined as unresectable in the opinion of the treating physician. A repeat biopsy is required if previous biopsy tissue is unavailable. * At least one Response Evaluation Criteria in Solid Tumors (RECIST 1.1) - defined target lesion. * Eastern Cooperative Oncology Group (ECOG) performance status of 0 (fully active, able to carry on all pre-disease performance without restriction), 1 (restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, such as light housework or office work), or 2 (ambulatory and capable of self-care but unable to carry out any work activities, spending more than 50% of waking hours up and about). * Documented progression on PD1 or PD-L1 inhibitors. * Recovery from any acute toxicity associated with prior therapy to grade 1. * Renal function (creatinine level within normal institutional limit, or creatinine clearance \>15 mL/min/1.73 m2 for patients with creatinine levels above institutional normal, calculated using the Cockcroft-Gault formula). * Liver function (AST/ALT \<3.0 X institutional upper limit of normal OR \<5 X institutional upper limit of normal in cases of liver metastasis; total bilirubin ≤ 1.5 times upper limit of normal). * Adequate hematological lab values including: * Absolute Neutrophil Count (ANC) ≥ 1.0 X 109/L * Platelets ≥ 100X109/L * Hemoglobin ≥ 7.0 g/dL * Female subjects of childbearing potential and non-sterilized male subjects who intend to be sexually active during the study must agree to use a highly effective method of contraception from time of screening, throughout the whole duration of the drug treatment, and during the 6-month post-treatment washout period. * Patients may have previously received a hypomethylating agent, as long as it was not given in combination with ipilimumab. * Patients may have previously received ipilimumab but must have relapsed or progressed while on therapy. * Patients must have adequate archival tissue available for the purpose of downstream methylation status assessment, immunohistochemistry, RNA expression (10 slides at 5µM). If archival tissue is not available, a repeat biopsy is required. Exclusion Criteria: * Patients with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen. * Patients with active, untreated metastases in the central nervous system. * Patients who are pregnant or breastfeeding. * Patients who have an active infection. * Patients with significant hematologic, hepatic, and renal function impairment. * Patients who are being treated for any concurrent medical condition requiring the use of systemic steroids or history of long-term use of systemic steroids. * Patients who have a history of inflammatory bowel disease or a history of symptomatic autoimmune disease. * Patients who have had any major surgical procedure or significant traumatic injury within 28 days prior to study enrollment. * Patients who have received chemotherapy, immunosuppressive agents or any investigational drug within 28 days prior to starting the study drugs. * Patients who have any underlying medical condition which, in the treating physician's opinion, will make the administration of study drugs hazardous or obscure the interpretation of adverse events.
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Conditions
The condition(s) this trial relates to.
As listed by the trial registrant
The condition terms exactly as the trial's registrant entered them.
How to take part
Only the study team decides who joins. These are the ways to reach them.
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The places running it
1 site. The list below names each one and where it is.
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The official record
ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.
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A doctor treating you
A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.
Contacts and locations
Locations
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University of Iowa Health Care
RECRUITINGIowa City, Iowa, 52242, United States
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