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Trial record 93 of 228 for:    yeast

Sargramostim, Vaccine Therapy, or Sargramostim and Vaccine Therapy in Preventing Disease Recurrence in Patients With Melanoma That Has Been Removed By Surgery

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ClinicalTrials.gov Identifier: NCT01989572
Recruitment Status : Completed
First Posted : November 21, 2013
Results First Posted : August 12, 2014
Last Update Posted : June 11, 2019
Sponsor:
Information provided by (Responsible Party):
National Cancer Institute (NCI)

Brief Summary:
This randomized phase III trial studies sargramostim or vaccine therapy alone to see how well they work compared to sargramostim and vaccine therapy together in preventing disease recurrence in patients with melanoma that has been removed by surgery. Sargramostim may stimulate the immune system in different ways and stop tumor cells from growing. Vaccines made from peptides may help the body build an effective immune response to kill tumor cells. It is not yet known whether yeast derived sargramostim and vaccine therapy are more effective alone or together in preventing recurrence of melanoma.

Condition or disease Intervention/treatment Phase
Iris Melanoma Medium/Large Size Posterior Uveal Melanoma Mucosal Melanoma Ocular Melanoma With Extraocular Extension Recurrent Melanoma Recurrent Uveal Melanoma Small Size Posterior Uveal Melanoma Stage IIA Cutaneous Melanoma AJCC v6 and v7 Stage IIA Uveal Melanoma AJCC v7 Stage IIB Cutaneous Melanoma AJCC v6 and v7 Stage IIB Uveal Melanoma AJCC v7 Stage IIC Cutaneous Melanoma AJCC v6 and v7 Stage IIIA Cutaneous Melanoma AJCC v7 Stage IIIA Uveal Melanoma AJCC v7 Stage IIIB Cutaneous Melanoma AJCC v7 Stage IIIB Uveal Melanoma AJCC v7 Stage IIIC Cutaneous Melanoma AJCC v7 Stage IIIC Uveal Melanoma AJCC v7 Stage IV Cutaneous Melanoma AJCC v6 and v7 Stage IV Uveal Melanoma AJCC v7 Other: Laboratory Biomarker Analysis Other: Placebo Biological: Sargramostim Biological: Tyrosinase Peptide Phase 3

  Show Detailed Description

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 815 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Prevention
Official Title: A Randomized, Placebo-Controlled Phase III Trial of Yeast Derived GM-CSF Versus Peptide Vaccination Versus GM-CSF Plus Peptide Vaccination Versus Placebo in Patients With "No Evidence of Disease" After Complete Surgical Resection of "Locally Advanced" and/or Stage IV Melanoma
Actual Study Start Date : February 23, 2000
Actual Primary Completion Date : October 8, 2012
Actual Study Completion Date : January 31, 2013


Arm Intervention/treatment
Experimental: Arm I (sargramostim, peptide vaccine)
Patients receive sargramostim SC on days 1-14 and peptide vaccine comprising tyrosinase, gp100 antigen, and MART-1 antigen mixed with either incomplete Freund's adjuvant or Montanide ISA-51 VG SC on days 1 and 15 (course 1) and day 1 (course 2 and subsequent courses).
Other: Laboratory Biomarker Analysis
Correlative studies

Biological: Sargramostim
Given SC
Other Names:
  • 23-L-Leucinecolony-Stimulating Factor 2
  • DRG-0012
  • Leukine
  • Prokine
  • rhu GM-CFS
  • Sagramostim
  • Sargramostatin

Biological: Tyrosinase Peptide
Given SC
Other Name: Tyrosinase Peptides

Experimental: Arm II (sargramostim placebo, peptide vaccine)
Patients receive sargramostim placebo SC on days 1-14 and peptide vaccine comprising tyrosinase, gp100 antigen, and MART-1 antigen mixed with either incomplete Freund's adjuvant or Montanide ISA-51 VG SC on days 1 and 15 (course 1) and day 1 (course 2 and subsequent courses).
Other: Laboratory Biomarker Analysis
Correlative studies

Other: Placebo
Given GM-CSF placebo SC
Other Names:
  • placebo therapy
  • PLCB
  • sham therapy

Biological: Tyrosinase Peptide
Given SC
Other Name: Tyrosinase Peptides

Experimental: Arm III (sargramostim, peptide placebo)
Patients receive sargramostim SC on days 1-14 and peptide placebo mixed with either incomplete Freund's adjuvant or Montanide ISA-51 VG SC on days 1 and 15 (course 1) and day 1 (course 2 and subsequent courses).
Other: Laboratory Biomarker Analysis
Correlative studies

Other: Placebo
Given peptide placebo SC
Other Names:
  • placebo therapy
  • PLCB
  • sham therapy

Biological: Sargramostim
Given SC
Other Names:
  • 23-L-Leucinecolony-Stimulating Factor 2
  • DRG-0012
  • Leukine
  • Prokine
  • rhu GM-CFS
  • Sagramostim
  • Sargramostatin

Placebo Comparator: Arm IV (placebo, peptide placebo)
Patients receive placebo SC on days 1-14 and peptide placebo on days 1 and 15 (course 1) and day 1 (course 2 and subsequent courses).
Other: Laboratory Biomarker Analysis
Correlative studies

Other: Placebo
Given GM-CSF placebo SC
Other Names:
  • placebo therapy
  • PLCB
  • sham therapy

Other: Placebo
Given peptide placebo SC
Other Names:
  • placebo therapy
  • PLCB
  • sham therapy

Experimental: Arm V (sargramostim)
Patients receive sargramostim SC on days 1-14.
Other: Laboratory Biomarker Analysis
Correlative studies

Biological: Sargramostim
Given SC
Other Names:
  • 23-L-Leucinecolony-Stimulating Factor 2
  • DRG-0012
  • Leukine
  • Prokine
  • rhu GM-CFS
  • Sagramostim
  • Sargramostatin

Placebo Comparator: Arm VI (sargramostim placebo)
Patients receive sargramostim placebo SC on days 1-14.
Other: Laboratory Biomarker Analysis
Correlative studies

Other: Placebo
Given GM-CSF placebo SC
Other Names:
  • placebo therapy
  • PLCB
  • sham therapy




Primary Outcome Measures :
  1. Overall Survival [ Time Frame: assessed every 3 months if patient is < 2 years from study entry and every 6 months if patient is 2-5 years from study entry, and annually if >5 years, up to year 15 ]
    Overall survival is defined as time from randomization to death from any cause.

  2. Recurrence Free Survival [ Time Frame: assessed every 3 months if patient is < 2 years from study entry and every 6 months if patient is 2-5 years from study entry, and annually if >5 years, up to year 15 ]
    Recurrence free survival is defined as time from randomization to first disease recurrence or death from any cause (whichever occur first), censoring cases without recurrence or death at the last date of known free of recurrence free survival events. Disease recurrence was determined based on positive cytology or biopsy in the presence of a single new lesion or the appearance of multiple lesions consistent with metastatic disease, or a positive brain CT or MRI scan or CSF cytology.


Secondary Outcome Measures :
  1. Overall Survival in Human Leukocyte Antigens-A2 (HLA-A2) Positive Patients [ Time Frame: assessed every 3 months if patient is < 2 years from study entry and every 6 months if patient is 2-5 years from study entry, and annually if >5 years,up to year 15 ]
    Overall survival is defined as time from randomization to death from any cause.

  2. Recurrence Free Survival in HLA-A2 Positive Patients [ Time Frame: assessed every 3 months if patient is < 2 years from study entry and every 6 months if patient is 2-5 years from study entry, and annually if >5 years, up to year 15 ]
    Recurrence free survival is defined as time from randomization to first disease recurrence or death from any cause (whichever occur first), censoring cases without recurrence or death at the last date of known free of recurrence free survival events. Disease recurrence was determined based on positive cytology or biopsy in the presence of a single new lesion or the appearance of multiple lesions consistent with metastatic disease, or a positive brain CT or MRI scan or CSF cytology.

  3. 5-year Overall Survival Rate [ Time Frame: assessed every 3 months if patient is < 2 years from study entry and every 6 months if patient is 2-5 years from study entry, and annually if >5 years, up to year 15 ]
    Overall survival is defined as time from randomization to death from any cause, and 5-year overall survival rate is estimated via Kaplan-Meier method.

  4. 5-year Recurrence Free Survival Rate [ Time Frame: assessed every 3 months if patient is < 2 years from study entry and every 6 months if patient is 2-5 years from study entry, and annually if >5 years, up to year 15 ]
    Recurrence free survival is defined as time from randomization to first disease recurrence or death from any cause (whichever occur first), censoring cases without recurrence or death at the last date of known free of recurrence free survival events, and 5-year overall survival rate is estimated via Kaplan-Meier method. Disease recurrence was determined based on positive cytology or biopsy in the presence of a single new lesion or the appearance of multiple lesions consistent with metastatic disease, or a positive brain CT or MRI scan or CSF cytology.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have HLA-A2 status known prior to randomization; typing may be obtained through a local laboratory facility or through a reference lab utilized by the initiating institution; if typing is not available through these means, it may be obtained from the University of Pittsburgh
  • All patients must have disease completely resected with one of the following in order to be eligible:

    • Completely resected disease
    • Any locoregional recurrence after prior adjuvant interferon or failure on S008
    • Any local recurrence of disease after adequate surgical excision of the original primary
    • Mucosal melanoma
    • Stage IV melanoma (cutaneous, ocular, mucosal, or unknown primary)
  • The following groups of patients may be entered onto this trial only if they are ineligible for S0008 or are, in the opinion of the managing physician, medically unfit to receive standard high-dose interferon:

    • Any clinically evident satellite or in-transit disease
    • Stage II disease with gross extracapsular extension
    • Recurrence in a previously resected nodal basin
    • Four or more involved lymph nodes or matted lymph nodes
    • Ulcerated primary melanoma and any involved lymph nodes

      • NOTE: Patients who are eligible for S0008 will be strongly encouraged to participate in that study in preference to this one
  • Patients must have been surgically rendered free of disease with negative margins on resected specimens; patients rendered free of disease by non-surgical means are not eligible
  • Patients must be randomized within 112 days (16 weeks) of surgical resection; if more than one surgical procedure is required to render the patient disease-free, all required surgeries must be accomplished within this 16 week time period
  • Patients must not have received any adjuvant treatment (chemotherapy, biotherapy, or limb perfusion) after the resection(s) that make(s) them eligible for this trial; one systemic treatment after a prior surgery is allowed, and must have been completed >= 8 weeks prior to randomization; (when chemotherapy and biotherapy are given together as one planned treatment [biochemotherapy], this counts as one regimen); NOTE: Previous radiation therapy, including after the resection, is allowed as long as 30 days elapse between the radiation and initiation of therapy
  • Prior treatment with GM-CSF or any peptides used in this protocol, is not allowed
  • Patients must have Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
  • Patients must not have an active infection requiring treatment with parenteral antibiotics
  • Patients must not have other significant medical, surgical, or psychiatric conditions or require any medication or treatment that may interfere with compliance on any of the E4697 treatment regimens
  • Patients must not have a diagnosis or evidence of organic brain syndrome or significant impairment of basal cognitive function or any psychiatric disorder that might preclude participation in the full protocol
  • Patients must be able to self-administer or arrange for administration of subcutaneous injections
  • Patients who have other current malignancies are not eligible
  • Patients with prior history at any time of any in situ cancer, lobular carcinoma of the breast in situ, cervical cancer in situ, atypical melanocytic hyperplasia or Clark I melanoma in situ are eligible; patients who meet this criteria must be disease-free at time of randomization
  • Patients with prior history of basal or squamous skin cancer are eligible; patients who meet this criteria must be disease-free at time of randomization
  • Patients who have had multiple primary melanomas are eligible
  • Patients with other malignancies are eligible if they have been continuously disease free for > 5 years prior to the time of randomization
  • Patients must not have autoimmune disorders, conditions of immunosuppression or treatment with systemic corticosteroids, including oral steroids (i.e., prednisone, dexamethasone), continuous use of topical steroid creams or ointments, or any steroid containing inhalers; replacement doses of steroids for patients with adrenal insufficiency are allowed; patients who discontinue use of these classes of medication for at least 2 weeks prior to randomization are eligible if, in the judgment of the treating physician, the patient is not likely to require these classes of drugs during the study
  • Women of childbearing potential must not be pregnant (negative beta human chorionic gonadotropin [bHCG] within 2 weeks prior to randomization) or breast-feeding
  • Women of childbearing potential and sexually active males must be counseled to use an accepted and effective method of contraception (including abstinence) while on treatment and for a period of 18 months after completing or discontinuing treatment
  • All patients must have brain computed tomography (CT) or magnetic resonance imaging (MRI), chest CT or chest x-ray (CXR), and abdominal (liver) CT or MRI within 4 weeks prior to randomization; positron emission tomography (PET) scans are also acceptable in place of CT, CXR and/or abdominal MRI if obtained within 4 weeks prior to randomization; patients with lesions on the lower extremity must also have pelvic imaging within this time period; this is also strongly recommended for patients with lesions on the lower trunk; PET scans are acceptable
  • Patients with resection of visceral disease must have imaging of the affected area/organ documenting disease-free status within 2 weeks prior to randomization
  • White blood cells (WBC) >= 3,000/mm?
  • Platelet count >= 100,000/mm?
  • Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 2 x institutional upper limit (IUL) of normal
  • Bilirubin =< 2 x IUL of normal
  • Serum creatinine =< 1.8 mg/dl
  • Alkaline phosphatase and lactate dehydrogenase (LDH) must be performed within 4 weeks prior to randomization; LDH must be normal; patients with abnormal alkaline phosphatase which is =< 1.25 times the institutional upper limit of normal who have a negative CT or MRI of the liver and negative bone scan or a negative PET scan are eligible
  • Patients with bone pain must have a bone scan within 4 weeks prior to randomization to document the absence of tumor

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01989572


  Show 148 Study Locations
Sponsors and Collaborators
National Cancer Institute (NCI)
Investigators
Layout table for investigator information
Principal Investigator: David H Lawson Eastern Cooperative Oncology Group

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT01989572     History of Changes
Obsolete Identifiers: NCT00005034
Other Study ID Numbers: NCI-2013-02101
NCI-2013-02101 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
CALGB 500101
U10CA021115 ( U.S. NIH Grant/Contract )
ECOG-4697
CDR0000067568
SWOG-E4697
9546
E4697 ( Other Identifier: Eastern Cooperative Oncology Group )
E4697 ( Other Identifier: CTEP )
First Posted: November 21, 2013    Key Record Dates
Results First Posted: August 12, 2014
Last Update Posted: June 11, 2019
Last Verified: May 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Additional relevant MeSH terms:
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Melanoma
Skin Neoplasms
Uveal Neoplasms
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Nerve Tissue
Nevi and Melanomas
Neoplasms by Site
Skin Diseases
Eye Neoplasms
Eye Diseases
Uveal Diseases
Vaccines
Sargramostim
Immunologic Factors
Physiological Effects of Drugs