A Multipeptide Vaccine Plus Toll-Like Receptor Agonists in Melanoma Patients (MEL58)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
UVA Human Immune Therapy Center
Oncovir, Inc.
Information provided by (Responsible Party):
University of Virginia
ClinicalTrials.gov Identifier:
NCT01585350
First received: April 24, 2012
Last updated: June 16, 2014
Last verified: June 2014
  Purpose

The purpose of this study is to learn the effects an experimental vaccine (MELITAC 12.1) combined with other substances called lipopolysaccharide (LPS; endotoxin), polyICLC, and Montanide ISA-51. The LPS, polyICLC, and Montanide ISA-51 are included with the vaccine to test whether they have an effect on the MELITAC 12.1 vaccine. The study will also look at whether the experimental vaccine and these drugs cause any changes to the immune system.


Condition Intervention Phase
Melanoma
Biological: MELITAC 12.1 + Montanide ISA-51 + lipopolysaccharide (LPS)
Biological: MELITAC 12.1 + Montanide ISA-51 + polyICLC
Phase 1

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Multipeptide Vaccine Plus Toll-Like Receptor Agonists in Melanoma Patients, With Evaluation of the Injection Site Microenvironment

Resource links provided by NLM:


Further study details as provided by University of Virginia:

Primary Outcome Measures:
  • Safety, with measures of adverse events, locally and systemically [ Time Frame: over 6 months ] [ Designated as safety issue: Yes ]
  • CD8+ and CD4+ peptide-reactive T cell responses among lymphocytes in the peripheral blood and in sentinel immunized nodes (SIN) [ Time Frame: over 6 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Toll-like receptor signaling in the replicate immunization site [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
  • CCR and integrin expression on vaccine induced T cells in the peripheral blood and at the replicate immunization site [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
  • Th1, Th2, and Th17 profiles of T cells in the vaccination site and SIN as measured by cytokine expression (IFNγ, IL-2, TNFα, IL-4, IL-5, IL-10, IL-17, IL-23), and nuclear expression of transcription factors (T-bet, GATA3, RORγt) by immunohistochemistry. [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
  • Chemokines CXCL9, 10, and 11; CCL19, CCL21, CXCL12, CXCL13 in the vaccine site microenvironment [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
  • Markers of activation, regulation, and apoptosis on CD4 and CD8 T cells in the vaccine site and SIN: CD69, Ki67, FoxP3, and TUNEL staining [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
  • Homing receptors expressed by antigen-reactive (tetramer-positive) T cells induced by vaccination, in the circulation and SIN [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
  • MyD88 expression in the VSME and SIN [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
  • Regulatory processes in the immunization site and SIN [ Time Frame: over 6 months ] [ Designated as safety issue: No ]
    • Regulatory T cells (CD4+CD25hi FoxP3+)
    • Myeloid suppressor cells
    • Indole-amine dioxygenase
    • PD-1, B7-H1
    • IL-10 and IL-12 expression by dendritic cells (DC)


Estimated Enrollment: 51
Study Start Date: October 2012
Estimated Primary Completion Date: October 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Cohort 1

Vaccines will be administered subcutaneously, intradermally or transdermally in one skin location that is rotated to different sites on an extremity clinically uninvolved with melanoma.

Vaccines will be administered on days 1, 8, 15, 36, 57, and 78.

Biological: MELITAC 12.1 + Montanide ISA-51 + lipopolysaccharide (LPS)

Cohort 1 will be divided into three sub-groups and will receive:

  • Group 1a: MELITAC 12.1 + lipopolysaccharide (LPS)
  • Group 1b: MELITAC 12.1 + lipopolysaccharide (LPS) + Montanide adjuvant with vaccination #1
  • Group 1c: MELITAC 12.1 + lipopolysaccharide (LPS) adjuvant + Montanide adjuvant with all vaccinations
Experimental: Cohort 2

Vaccines will be administered subcutaneously, intradermally or transdermally in one skin location that is rotated to different sites on an extremity clinically uninvolved with melanoma.

Vaccines will be administered on days 1, 8, 15, 36, 57, and 78.

Biological: MELITAC 12.1 + Montanide ISA-51 + polyICLC

Cohort 2 will be divided into three sub-groups and will receive:

  • Group 2a: MELITAC 12.1 + polyICLC adjuvant
  • Group 2b: MELITAC 12.1 + polyICLC adjuvant + Montanide adjuvant with vaccination #1
  • Group 2c: MELITAC 12.1 + polyICLC adjuvant + Montanide adjuvant with all vaccinations

  Show Detailed Description

  Eligibility

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

Inclusion Criteria:

  • Histologically or cytologically proven melanoma that meets one of the following two criteria:

    • Stage IIB-IV melanoma rendered clinically free of disease by surgery, other therapy, or spontaneous remission within 6 months prior to registration.
    • Stage III or IV melanoma with disease. Patients may be eligible if there are definite or equivocal findings of persistent or metastatic disease as long as those findings do not meet RECIST criteria for measurable disease.
  • Patients with brain metastases may be eligible if all of the following are true:

    • The total number of brain metastases ever is less than or equal to 3.
    • The brain metastases have been completely removed by surgery or have been treated completely by stereotactic radiotherapy. Stereotactic radiotherapy, such as gamma knife, can be used up to 1 week prior to study entry.
    • There has been no evident growth of any brain metastasis since treatment.
    • No treated brain metastasis is greater than 2 cm in diameter at the time of protocol entry.
  • Patients must have at least two intact axillary and/or inguinal lymph node basins.
  • All patients must have:

    • ECOG performance status of 0 or 1.
    • Ability and willingness to give informed consent.
  • Laboratory parameters as follows:

    • HLA-A1, A2, A3, -A11, or -A31
    • ANC > 1000/mm3
    • Platelets > 100,000/mm3
    • Hgb ≥ 9 g/dL
    • AST and ALT ≤ 2.5 x upper limits of normal (ULN)
    • Bilirubin ≤ 2.5 x ULN
    • Alkaline Phosphatase ≤ 2.5 x ULN
    • Creatinine ≤ 1.5 x ULN
    • HIV negative
    • Hepatitis C negative
    • HGBA1C level of < 7%

Exclusion Criteria:

  • Patients who have had brain metastases, unless they meet inclusion criteria
  • Patients who are currently receiving systemic cytotoxic chemotherapy, radiation, or other experimental therapy, or who have received this therapy within the preceding 4 weeks. Gamma knife or stereotactic radiosurgery may be administered within the prior 4 weeks, but must not be administered less than one week prior to study enrollment. Patients who are currently receiving nitrosoureas or who have received this therapy within the preceding 6 weeks.
  • Patients with clinically detectable melanoma deemed likely by the investigator to require intervention during the first 12 weeks of the study that would require premature discontinuation.
  • Patients with known or suspected allergies to any component of the vaccine.
  • Patients receiving the following medications at study entry or within the preceding 4 weeks are excluded:

    • Agents with putative immunomodulating activity (with the exception of non-steroidal anti-inflammatory agents and topical steroids
    • Allergy desensitization injections.
    • Systemic corticosteroids, administered parenterally or orally. Inhaled steroids (e.g. Advair®, Flovent®, Azmacort®) are not permitted. Topical corticosteroids are acceptable, including steroids with very low solubility administered nasally for local effects only (e.g. Nasonex®).
    • Any growth factors (e.g. GM-CSF, G-CSF, erythropoietin).
    • Interferon therapy.
    • Interleukin-2 or other interleukins.
    • Toll-like receptor agonists, including imiquimod or resiquimod.
  • Prior melanoma vaccinations may be an exclusion criterion in some circumstances:

    • Patients who have recurred or progressed either after or during administration of a melanoma vaccine may be eligible to enroll 12 weeks following their last vaccination.
    • Patients may have been vaccinated previously with peptide vaccines (except that they may not have been vaccinated with peptides included in MELITAC 12.1 or MELITAC 12.6)
    • Patients may have been vaccinated with protein, DNA, or cell-based vaccines that include the proteins from which these peptides are derived.
  • Other investigational drugs or investigational therapy if the patient is currently taking those drugs/therapy, or if they have received the drugs/therapy within 1 month.
  • Pregnancy or the possibility of becoming pregnant during vaccine administration. Women must also not be breast feeding.
  • Patients in whom there is a medical contraindication or potential problem in complying with the requirements of the protocol, in the opinion of the investigator.
  • Patients classified as having Class III or IV heart disease according to the New York Heart Association
  • Body weight < 110 lbs
  • No active or prior autoimmune disorders requiring cytotoxic or immunosuppressive therapy, or autoimmune disorders with visceral involvement. The following will not be exclusionary:

    • The presence of laboratory evidence of autoimmune disease (e.g. positive ANA titer) without associated symptoms
    • Clinical evidence of vitiligo
    • Other forms of depigmenting illness
    • Mild arthritis requiring NSAID medications or no medical therapy
  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: NCT01585350

Locations
United States, Virginia
University of Virginia
Charlottesville, Virginia, United States, 22908
Sponsors and Collaborators
University of Virginia
UVA Human Immune Therapy Center
Oncovir, Inc.
Investigators
Principal Investigator: Craig L Slingluff, MD University of Virginia
  More Information

No publications provided

Responsible Party: University of Virginia
ClinicalTrials.gov Identifier: NCT01585350     History of Changes
Other Study ID Numbers: 15781
Study First Received: April 24, 2012
Last Updated: June 16, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Virginia:
melanoma
peptide vaccine
polyICLC
lipopolysaccharide (LPS)
immunotherapy

Additional relevant MeSH terms:
Melanoma
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas
Freund's Adjuvant
Poly ICLC
Adjuvants, Immunologic
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions
Interferon Inducers

ClinicalTrials.gov processed this record on September 18, 2014