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Vaccine Therapy in Treating Patients With Stage IV Cutaneous Melanoma

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
PD Dr. med. univ. Beatrice Schuler-Thurner, University Hospital Erlangen
ClinicalTrials.gov Identifier:
NCT00074230
First received: December 10, 2003
Last updated: September 16, 2013
Last verified: September 2013
  Purpose

RATIONALE: Vaccines made from a person's dendritic cells and antigens may make the body build an immune response to kill tumor cells.

PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy using autologous dendritic cells with antigens in treating patients who have stage IV cutaneous melanoma.


Condition Intervention Phase
Melanoma (Skin)
Biological: MART-1 antigen
Biological: keyhole limpet hemocyanin
Biological: recombinant MAGE-3.1 antigen
Biological: survivin antigen
Biological: therapeutic autologous dendritic cells
Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Vaccination of Stage IV Cutaneous Melanoma Patients With Mature, Autologous Monocyte-Derived Dendritic Cells Transfected With RNAs Encoding for Mage-3, MelanA, and Survivin Antigens

Resource links provided by NLM:


Further study details as provided by University Hospital Erlangen:

Primary Outcome Measures:
  • Safety and tolerability at every visit [ Designated as safety issue: Yes ]
  • Overall survival as assessed by clinical staging (CT scan, positron emission tomography [PET]) every 3 months [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time to progression as assessed by clinical staging (CT scan, PET) every 3 months [ Designated as safety issue: No ]
  • Objective tumor response as assessed by clinical staging (CT scan, PET) every 3 months [ Designated as safety issue: No ]
  • Duration of response as assessed by clinical staging (CT scan, PET) every 3 months [ Designated as safety issue: No ]
  • Induction of antigen-specific immune responses as assessed by elispot and tetramer staining at every visit [ Designated as safety issue: No ]

Enrollment: 82
Study Start Date: July 2003
Estimated Study Completion Date: October 2014
Primary Completion Date: October 2012 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Determine the safety and tolerability of vaccination with autologous monocyte-derived dendritic cells (DC) transfected with RNAs encoding Melan-A, MAGE-3, and survivin antigens in patients with stage IV cutaneous melanoma.
  • Determine whether tumor antigen-specific T-cell responses are induced in patients treated with this vaccine.
  • Determine whether simultaneous loading of DC with keyhole limpet hemocyanin (KLH) significantly enhances induction of the Melan-A, MAGE-3, and survivin antigens in these patients.

Secondary

  • Determine clinical antitumor activity (e.g., objective tumor response, time to tumor progression, progression-free interval, and overall survival) in patients treated with this vaccine.

OUTLINE: This is an open-label, nonrandomized study.

  • Phase I: Beginning 9-11 days before vaccination, patients undergo leukapheresis for collection of peripheral blood mononuclear cells (PBMCs). PBMCs are processed for the generation of dendritic cells (DC) to be used for vaccinations. PBMCs are transfected with RNAs encoding for Melan-A, MAGE-3, and survivin antigens. DC are pulsed with keyhole limpet hemocyanin (KLH) for some patients.

Patients receive antigen-pulsed (with or without KLH) DC vaccination subcutaneously (SC) on days 1, 15, 43, and 71 in the absence of disease progression or unacceptable toxicity. Patients with stable or responding disease may proceed to the phase II portion of the study.

  • Phase II: Patients undergo leukapheresis as in phase I on days 102, 354, and 690. Patients receive up to 6 additional booster vaccinations SC as in phase I on days 127, 185, 269, 356, 521, and 692.

Patients are followed for 10 years.

PROJECTED ACCRUAL: A total of 8-30 patients will be accrued for this study within 6-12 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed cutaneous* melanoma

    • Stage IV
  • Incurable by surgical resection
  • Progressive disease after at least 1 standard chemotherapy or chemoimmunotherapy regimen (e.g., dacarbazine or cisplatin monotherapy)
  • Unidimensionally or bidimensionally measurable disease by physical examination (e.g., cutaneous metastases) and/or noninvasive radiological procedures
  • No active CNS metastases by CT scan or MRI

    • Previously treated (e.g., excision of a single metastasis) CNS metastases are allowed provided there are no signs of active CNS metastases NOTE: *Metastatic melanoma with unidentified primary tumor allowed provided an ocular melanoma can be definitely excluded and origin from the skin is likely

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • Karnofsky 60-100%

Life expectancy

  • At least 4 months

Hematopoietic

  • WBC greater than 2,500/mm^3
  • Neutrophil count greater than 1,000/mm^3
  • Lymphocyte count greater than 700/mm^3
  • Platelet count greater than 75,000/mm^3
  • Hemoglobin greater than 9 g/dL
  • No bleeding disorder

Hepatic

  • Bilirubin less than 2.0 mg/dL
  • No evidence of hepatitis B or C infection

Renal

  • Creatinine less than 2.5 mg/dL

Cardiovascular

  • No clinically significant heart disease

Pulmonary

  • No respiratory disease

Immunologic

  • HIV-1 and HIV-2 negative
  • HTLV-1 negative
  • No active systemic infection
  • No immunodeficiency disease
  • No active autoimmune disease (e.g., lupus erythematosus, autoimmune thyroiditis or uveitis, multiple sclerosis, or inflammatory bowel disease)

    • Vitiligo allowed

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for at least 4 weeks after study participation
  • Stable medical condition
  • No other major serious illness
  • No contraindication to leukapheresis
  • No organic brain syndrome or significant psychiatric abnormality that would preclude study participation or follow-up
  • No other active malignant neoplasm

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 4 weeks since prior immunotherapy
  • No other concurrent immunotherapy during and for 2 weeks after study participation

Chemotherapy

  • More than 4 weeks since prior systemic chemotherapy (6 weeks for nitrosoureas [e.g., fotemustine])
  • No concurrent chemotherapy during and for 2 weeks after study participation

Endocrine therapy

  • No concurrent corticosteroids during and for 2 weeks after study participation

Radiotherapy

  • More than 2 weeks since prior radiotherapy
  • No prior radiotherapy to the spleen
  • Concurrent palliative radiotherapy to selected metastases (e.g., due to pain or local complications such as compression) is allowed

Surgery

  • Recovered from prior surgery
  • No prior splenectomy
  • No prior organ allografts
  • Concurrent surgical therapy to selected metastases (e.g., due to pain or local complications such as compression) is allowed

    • Selected accessible metastases may be removed for tumor infiltrating lymphocyte assay or other immunomonitoring investigations (e.g., expression of tumor antigens and HLA molecules)

Other

  • No other concurrent investigational drug or paramedical substance during and for 2 weeks after study participation
  • No concurrent participation in another clinical trial
  • Concurrent palliative medication allowed (e.g., acetaminophen, indomethacin, or opiates)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00074230

Locations
Germany
Dermatologische Klinik mit Poliklinik - Universitaetsklinikum Erlangen
Erlangen, Germany, D-91052
Sponsors and Collaborators
University Hospital Erlangen
Investigators
Principal Investigator: Gerold Schuler Dermatologische Klinik MIT Poliklinik-Universitaetsklinikum Erlangen
  More Information

No publications provided

Responsible Party: PD Dr. med. univ. Beatrice Schuler-Thurner, Principal Investigator, University Hospital Erlangen
ClinicalTrials.gov Identifier: NCT00074230     History of Changes
Other Study ID Numbers: ERLANGEN-DERMA-ER-DC-06, CDR0000343699, EU-20317
Study First Received: December 10, 2003
Last Updated: September 16, 2013
Health Authority: Germany: Paul Ehrlich Institut, Langen

Keywords provided by University Hospital Erlangen:
stage IV melanoma
recurrent melanoma

Additional relevant MeSH terms:
Melanoma
Neoplasms
Neoplasms by Histologic Type
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Neuroectodermal Tumors
Neuroendocrine Tumors
Nevi and Melanomas
Keyhole-limpet hemocyanin
Adjuvants, Immunologic
Immunologic Factors
Pharmacologic Actions
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on November 25, 2014