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| Sponsor: | University of Virginia |
|---|---|
| Information provided by: | University of Virginia |
| ClinicalTrials.gov Identifier: | NCT00977145 |
Purpose
The goals of this study are to evaluate 1) the safety of administration of intratumoral interferon gamma with a peptide-based vaccine, in patients with melanoma and 2) the biological effects of the vaccine. These include an examination of changes within the tumor following vaccination and the evaluation of T cell responses to the vaccine both in the blood and at the sight of tumor.
| Condition | Intervention |
|---|---|
|
Melanoma |
Biological: A combination of intratumoral IFN-gamma plus systemic vaccination with MELITAC 12.1 |
| Study Type: | Interventional |
| Study Design: | Treatment, Open Label, Single Group Assignment, Safety/Efficacy Study |
| Official Title: | Evaluation of the Safety and Immunogenicity of Intratumoral Injection of Interferon Gamma During Vaccination in Patients With Subcutaneous or Cutaneous Metastases of Melanoma |
| Estimated Enrollment: | 14 |
| Study Start Date: | November 2009 |
| Estimated Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
Vaccine regimen: The vaccines will be administered in two treatment cycles. During cycle one, three vaccines will be administered over a 3-week period on days 1, 8, 15. During cycle two, three vaccines will be administered over a 9-week period on days 24, 43, 64. All participants will receive 12-MP (100 mcg each peptide) plus Peptide-tet (Peptide-tet; 200 mcg) administered in Montanide ISA-51 VG adjuvant. The vaccine will be administered subcutaneously (1 ml) and intradermally (1ml) at a single vaccination site.
Intratumoral Interferon regimen: On day 22, patients will have one or more tumor sites injected with 0.5-2 million IU of IFN-gamma each, with a maximum dose of 2 million IU of IFN-gamma administered per patient. The number of lesions that are injected will be dependent on the availability and size of the lesions.
Melanoma vaccines have been associated with major regressions in a small percentage of patients with advanced measurable disease. This provides proof-of-principle of the potential for clinical benefit with melanoma vaccines however, the current response rate is low. Thus, there is a critical need for additional new therapies for melanoma, both for adjuvant therapy of high-risk resected melanoma and for therapy of patients who are not candidates for, or fail, other therapies in the setting of advanced disease.
It is generally agreed that one mechanism to improve the immunologic outcomes of vaccine therapy is to optimize T cell trafficking to the tumor site. CXCR3 is the chemokine receptor on T cells which directs them to sites of inflammation by following the chemokine gradient. The ligands for CXCR3 (CXCL9 (MIG), CXCL10 (IP-10) and CXCL11 (I-TAC)) are known to be induced by interferon gamma. This protocol proposes administering a peptide vaccine to activate tumor antigen-specific CD8+ T cells expressing CXCR3, followed by intratumoral interferon gamma to increase CXCR3 ligands (CXCL9-11) at the tumor site and recruit the CXCR3+ T cells.
The primary goals of the proposed work are to assess the safety of the combination of peptide vaccine and intratumoral interferon gamma and to assess the immunologic outcomes at the tumor site.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients must have adequate cutaneous or subcutaneous metastases of melanoma readily accessible for biopsy to provide a minimum of 0.3 cm3 of tissue per biopsy (approximately 0.85 cm by 0.85 cm x 0.85 cm or five 2mm core biopsies) at each time point. Additionally, at least one of the subcutaneous or cutaneous metastases must be accessible to intratumoral IFN-gamma administration. Several scenarios may fulfill the tumor burden requirement. For example, a patient may have one large lesion from which core biopsies can be taken for the first and second biopsy time points and then the entire lesion excised for the final tissue sample. Alternatively, a patient may have three lesions, each ≥0.3 cm3, and these lesions would be excised sequentially as biopsies 1, 2 and 3. Other combinations are acceptable.
The intent is to limit this study to patients with cutaneous or subcutaneous melanoma metastasis rather than lymph node metastasis. There may be cases where a subcutaneous nodule cannot be definitively characterized as a non-nodal metastasis at the start of the trial - these patients may be included.
Participants who have had brain metastases may be eligible in selected circumstances:
Patients with less than or equal to 3 metastases may eligible as long as the following 3 criteria are true:
Patients with greater than 3 metastases may be eligible if the above 3 criteria are met and if at least one year has elapsed since the last treatment.
All participants must have:
Laboratory parameters - The following laboratory parameters will be required for all participants. If a lab value appears to be an error or a result of a transient or treatable condition, the investigator will use his/her clinical judgment to decide if the test may be repeated. The requirements for inclusion are as follows:
Hepatic:
Renal
o Creatinine ≤ 1.5 x ULN
Serology (within 6 months of study entry)
Exclusion Criteria:
Patients receiving the following medications at study entry or within the preceding 4 weeks are excluded:
Prior melanoma vaccinations may be an exclusion criterion in some circumstances:
Participants must not have had prior autoimmune disorders requiring cytotoxic or immunosuppressive therapy, or autoimmune disorders with visceral involvement. Participants with an active autoimmune disorder requiring these therapies are also excluded. The following will not be exclusionary:
Contacts and Locations| Contact: Mary (Jonni) Thoma, BSN | 434-982-6714 | mjh4a@hscmail.mcc.virginia.edu |
| Contact: Alison Gaucher, BS | agg5a@hscmail.mcc.virginia.edu |
| United States, Virginia | |
| University of Virginia | Recruiting |
| Charlottesville, Virginia, United States, 22908 | |
| Principal Investigator: Craig L. Slingluff, M.D. | |
| Principal Investigator: | Craig L. Slingluff, M.D. | University of Virginia |
More Information
| Responsible Party: | University of Virginia Health System, Department of Surgery, Human Immune Therapy Center ( Dr. Craig L. Slingluff, Jr., M.D., Professor of Surgery, Principal Investigator ) |
| Study ID Numbers: | 14215 |
| Study First Received: | September 14, 2009 |
| Last Updated: | November 17, 2009 |
| ClinicalTrials.gov Identifier: | NCT00977145 History of Changes |
| Health Authority: | United States: Food and Drug Administration |
|
melanoma peptide vaccine interferon gamma immunotherapy |
|
Anti-Infective Agents Neoplasms by Histologic Type Interferon Type II Antineoplastic Agents Neoplasms, Nerve Tissue Interferons Antiviral Agents Pharmacologic Actions |
Melanoma Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms Therapeutic Uses Neoplasms, Germ Cell and Embryonal Nevi and Melanomas Interferon-gamma, Recombinant |