Vaccine Therapy With or Without Imiquimod in Treating Patients Who Have Undergone Surgery for Stage II, Stage III, or Stage IV Melanoma

This study has been completed.
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Craig L Slingluff, Jr, University of Virginia Identifier:
First received: July 8, 2005
Last updated: December 18, 2014
Last verified: December 2014

RATIONALE: Vaccines made from peptides may help the body build an effective immune response to kill tumor cells. Biological therapies, such as imiquimod, may stimulate the immune system in different ways and stop tumor cells from growing. Giving vaccine therapy together with imiquimod after surgery may help the body kill any remaining tumor cells.

PURPOSE: This randomized phase I trial is studying the side effects and best way to give vaccine therapy with or without imiquimod in treating patients who have undergone surgery for stage II, stage III, or stage IV melanoma.

Condition Intervention Phase
Melanoma (Skin)
Biological: incomplete Freund's adjuvant
Biological: multi-epitope melanoma peptide vaccine
Biological: sargramostim
Biological: tetanus toxoid helper peptide
Drug: dimethyl sulfoxide
Drug: imiquimod
Procedure: adjuvant therapy
Phase 1

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: Evaluation of Different Adjuvants for the Transdermal Administration of a Peptide-Based Vaccine in Participants With High-Risk Melanoma

Resource links provided by NLM:

Further study details as provided by University of Virginia:

Primary Outcome Measures:
  • Safety if less than 33% of patients experience a dose-limiting at day 22 [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Immune response by Elispot assay at day 22 [ Designated as safety issue: No ]

Study Start Date: November 2004
Primary Completion Date: November 2007 (Final data collection date for primary outcome measure)
Detailed Description:


  • Determine the safety of adjuvant transdermal vaccine therapy comprising multi-epitope melanoma peptides (MP), tetanus toxoid helper peptide (TET), and sargramostim (GM-CSF) in combination with Montanide ISA-51 or dimethyl sulfoxide with or without imiquimod in patients who have undergone surgical resection for stage II-IV melanoma.
  • Determine, preliminarily, the immunogenicity of these regimens in these patients.
  • Correlate, preliminarily, transdermal administration of these vaccines with the recruitment and maturation of epidermal Langerhans cells in these patients.
  • Determine, preliminarily, the effects of timing of subsequent vaccine therapy comprising MP, TET, and GM-CSF emulsified in Montanide ISA-51, administered intradermally and subcutaneously, on the persistence of immune response in these patients.

OUTLINE: This is a randomized, open-label study. Patients are randomized to 1 of 4 treatment arms.

  • Arm I: Patients receive vaccine therapy comprising multi-epitope melanoma peptides (MP), tetanus toxoid helper peptide (TET), and sargramostim (GM-CSF) emulsified in Montanide ISA-51 transdermally (TD) on days 1, 8, and 15. Patients then receive the vaccine intradermally (ID) and subcutaneously (SC) on days 29, 50, 71, 92, 113, and 134.
  • Arm II: Patients receive vaccine therapy as in arm I. Patients also receive imiquimod topically on days 0, 7, and 14.
  • Arm III: Patients receive vaccine therapy comprising MP, TET, GM-CSF, and dimethyl sulfoxide TD on days 1, 8, and 15. Patients then receive vaccine therapy comprising MP, TET, and GM-CSF emulsified in Montanide ISA-51 ID and SC on days 29, 50, 71, 92, 113, and 134.
  • Arm IV: Patients receive vaccine therapy as in arm III and imiquimod as in arm II.

In all arms, treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed at 3 and 5 weeks and then at disease progression.

PROJECTED ACCRUAL: A maximum of 26 patients (approximately 6 per treatment arm) will be accrued for this study within approximately 2 years.


Ages Eligible for Study:   12 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No


  • Histologically or cytologically confirmed melanoma

    • Stage II-IV disease
  • Has undergone surgical resection within the past 12 months

    • No clinical or radiological evidence of disease after surgical resection
    • Must have ≥ 1 undissected axillary and/or inguinal lymph node basin
  • HLA-A1, -A2, or -A3 positive
  • Ineligible for OR refused interferon



  • 12 and over

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified


  • Absolute neutrophil count > 1,000/mm^3
  • Platelet count > 100,000/mm^3
  • Hemoglobin > 9 g/dL


  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • Bilirubin ≤ 2.5 times ULN
  • Lactic dehydrogenase ≤ 1.5 times ULN
  • Alkaline phosphatase ≤ 2.5 times ULN
  • Hepatitis C negative


  • Creatinine ≤ 1.5 times ULN


  • No New York Heart Association class III or IV heart disease


  • HIV negative
  • No known or suspected allergy to any component of the study vaccines
  • No autoimmune disorder with visceral involvement
  • No prior active autoimmune disorder requiring cytotoxic or immunosuppressive therapy
  • The following immunologic conditions are allowed:

    • Laboratory evidence of autoimmune disease (e.g., positive anti-nuclear antibody titer) without symptoms
    • Clinical evidence of vitiligo
    • Other forms of depigmenting illness
    • Mild arthritis requiring non-steroidal anti-inflammatory drugs


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Weight ≥ 110 lbs
  • No uncontrolled diabetes

    • Hemoglobin A1C < 7% (for patients with diabetes)
  • No medical contraindication or potential problem that would preclude study compliance
  • No known active addiction to alcohol or drugs
  • No recent (within the past year) or ongoing illicit IV drug use


Biologic therapy

  • Prior vaccinations that resulted in recurrent disease during or after vaccine administration allowed provided the last vaccination was administered more than 12 weeks ago
  • Prior multi-epitope melanoma peptide vaccine that resulted in a negative immune response allowed
  • More than 4 weeks since prior and no concurrent interferon (e.g., Intron-A®), interleukins (e.g., Proleukin®), or growth factors (e.g., Procrit®, Aranesp®, or Neulasta®)
  • More than 4 weeks since prior and no concurrent allergy desensitization injections
  • No influenza vaccine for at least 2 weeks before or after study vaccine administration


  • More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas [e.g., carmustine or lomustine])
  • No concurrent chemotherapy, including nitrosoureas

Endocrine therapy

  • More than 4 weeks since prior and no concurrent oral or parenteral corticosteroids (e.g., prednisone)
  • No prior or concurrent inhaled steroids (e.g., Advair®, Flovent®, Azmacort®)
  • Concurrent topical corticosteroids allowed


  • More than 4 weeks since prior and no concurrent radiotherapy
  • Prior stereotactic radiosurgery allowed provided it was completed within the past 12 months


  • See Disease Characteristics
  • More than 4 weeks since prior surgical resection of metastatic lesion(s)
  • No concurrent surgery requiring general anesthesia


  • More than 4 weeks since prior and no other concurrent investigational agents
  • More than 30 days since prior and no concurrent participation in another clinical study
  • No other concurrent immunosuppressive 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 identifier: NCT00118313

United States, Virginia
University of Virginia Cancer Center
Charlottesville, Virginia, United States, 22908
Sponsors and Collaborators
Craig L Slingluff, Jr
National Cancer Institute (NCI)
Principal Investigator: Craig L. Slingluff, MD University of Virginia
  More Information

Additional Information:
No publications provided

Responsible Party: Craig L Slingluff, Jr, Professor, Department of Surgery, University of Virginia Identifier: NCT00118313     History of Changes
Other Study ID Numbers: 11490, UVACC-MEL-45, UVACC-34204
Study First Received: July 8, 2005
Last Updated: December 18, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Virginia:
stage II melanoma
stage III melanoma
stage IV melanoma

Additional relevant MeSH terms:
Neoplasms by Histologic Type
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Neuroectodermal Tumors
Neuroendocrine Tumors
Nevi and Melanomas
Dimethyl Sulfoxide
Freund's Adjuvant
Adjuvants, Immunologic
Antineoplastic Agents
Cryoprotective Agents
Free Radical Scavengers
Immunologic Factors
Interferon Inducers
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Protective Agents
Therapeutic Uses processed this record on October 08, 2015