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Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma

Primary Purpose

Melanoma (Skin)

Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
recombinant CD40-ligand
therapeutic autologous dendritic cells
Sponsored by
University Hospital Erlangen
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Melanoma (Skin) focused on measuring stage III melanoma, stage IV melanoma, recurrent melanoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed stage III or IV cutaneous malignant melanoma HLA-A1 and/or HLA-A2 expression by serologic HLA typing HLA-A2.1 subtype must be confirmed by polymerase chain reaction on genomic DNA obtained from peripheral blood mononuclear cells No active CNS metastases by CT scan or MRI PATIENT CHARACTERISTICS: Age Over 18 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 disorders Hepatic Bilirubin less than 2.0 mg/dL Hepatitis B surface antigen negative Hepatitis C antibody negative Renal Creatinine less than 2.5 mg/dL Cardiovascular No clinically significant heart disease Pulmonary No clinically significant respiratory disease Immunologic No active systemic infection No immunodeficiency disease No evidence of HIV-1, HIV-2, or human T-cell lymphotropic virus-1 No active autoimmune disease including (but not limited to): Lupus erythematosus Autoimmune thyroiditis or uveitis Multiple sclerosis Inflammatory bowel disease Other Stable medical condition Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 1 month after study participation No organic brain syndrome or psychiatric illness that would preclude study compliance No other concurrent active malignancy No other concurrent serious illness that would preclude study treatment No contraindication to leukapheresis PRIOR CONCURRENT THERAPY: Biologic therapy More than 4 weeks since prior immunotherapy No other concurrent immunotherapy Chemotherapy More than 4 weeks since prior systemic chemotherapy (6 weeks for nitrosoureas) No concurrent chemotherapy Endocrine therapy No concurrent corticosteroids Radiotherapy More than 4 weeks since prior radiotherapy No prior radiotherapy to the spleen Concurrent palliative radiotherapy allowed Surgery Recovered from prior surgery No prior splenectomy No prior organ allograft Concurrent surgery on selected metastases (e.g., because of pain or local complications such as compression) allowed Other No other concurrent investigational drugs No concurrent participation in another clinical trial

Sites / Locations

  • Dermatologische Klinik mit Poliklinik - Universitaetsklinikum Erlangen

Outcomes

Primary Outcome Measures

Comparison of the efficacy of vaccination with vs without ex vivo CD40-ligand in terms of tumor-specific T-cell response
Safety
Tolerability

Secondary Outcome Measures

Tumor response
Recurrence rates

Full Information

First Posted
January 27, 2003
Last Updated
May 11, 2015
Sponsor
University Hospital Erlangen
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1. Study Identification

Unique Protocol Identification Number
NCT00053391
Brief Title
Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma
Official Title
Vaccination Of HLA-A1 And/Or -A2+ Stage III or IV Melanoma Patients With Tumor Peptide - Loaded Autologous Dendritic Cells That Are Generated In The Absence Or Presence Of CD40 Ligand
Study Type
Interventional

2. Study Status

Record Verification Date
May 2015
Overall Recruitment Status
Completed
Study Start Date
October 2002 (undefined)
Primary Completion Date
June 2005 (Actual)
Study Completion Date
June 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Hospital Erlangen

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Vaccines made from a person's white blood cells mixed with tumor proteins may make the body build an immune response to kill tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy in treating patients who have stage III or stage IV melanoma.
Detailed Description
OBJECTIVES: Compare the efficacy of vaccination with autologous dendritic cells pulsed with tumor and influenza antigen peptides treated with vs without ex vivo CD40-ligand, in terms of tumor-specific T-cell response, in patients with HLA-A1 and/or HLA-A2.1 positive stage III or IV melanoma. Determine the safety and tolerability of these vaccinations in these patients. Determine tumor response and recurrence rates in patients treated with these vaccinations. OUTLINE: This is an open-label non-randomized study. Phase I: Patients undergo leukapheresis for collection of peripheral blood mononuclear cells (PBMC). PBMC are cultured with sargramostim (GM-CSF) and interleukin-4 to generate dendritic cells (DCs) on day -9. DCs are pulsed separately with HLA-A1 and HLA-A2.1-restricted flu matrix peptides derived from melanoma-associated tumor antigens (MAGE-10.A2, Melan-A, MAGE-3, NY-ESO-1, gp100 antigen, and tyrosinase peptide). Half of the DCs are treated ex vivo with CD40-ligand. Patients receive the peptide-pulsed DC vaccinations subcutaneously (SC) on days 1, 14, 42, and 70 in the absence of disease progression. Patients who show tumor response (at least stable disease) at day 98 progress to phase II of the study. Phase II: Patients undergo leukapheresis as in phase I on days 102, 352, and 688. Patients receive up to 6 additional booster vaccinations SC as in phase I on days 126, 184, 268, 356, 520, 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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma (Skin)
Keywords
stage III melanoma, stage IV melanoma, recurrent melanoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
62 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
recombinant CD40-ligand
Intervention Type
Biological
Intervention Name(s)
therapeutic autologous dendritic cells
Primary Outcome Measure Information:
Title
Comparison of the efficacy of vaccination with vs without ex vivo CD40-ligand in terms of tumor-specific T-cell response
Title
Safety
Title
Tolerability
Secondary Outcome Measure Information:
Title
Tumor response
Title
Recurrence rates

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed stage III or IV cutaneous malignant melanoma HLA-A1 and/or HLA-A2 expression by serologic HLA typing HLA-A2.1 subtype must be confirmed by polymerase chain reaction on genomic DNA obtained from peripheral blood mononuclear cells No active CNS metastases by CT scan or MRI PATIENT CHARACTERISTICS: Age Over 18 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 disorders Hepatic Bilirubin less than 2.0 mg/dL Hepatitis B surface antigen negative Hepatitis C antibody negative Renal Creatinine less than 2.5 mg/dL Cardiovascular No clinically significant heart disease Pulmonary No clinically significant respiratory disease Immunologic No active systemic infection No immunodeficiency disease No evidence of HIV-1, HIV-2, or human T-cell lymphotropic virus-1 No active autoimmune disease including (but not limited to): Lupus erythematosus Autoimmune thyroiditis or uveitis Multiple sclerosis Inflammatory bowel disease Other Stable medical condition Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 1 month after study participation No organic brain syndrome or psychiatric illness that would preclude study compliance No other concurrent active malignancy No other concurrent serious illness that would preclude study treatment No contraindication to leukapheresis PRIOR CONCURRENT THERAPY: Biologic therapy More than 4 weeks since prior immunotherapy No other concurrent immunotherapy Chemotherapy More than 4 weeks since prior systemic chemotherapy (6 weeks for nitrosoureas) No concurrent chemotherapy Endocrine therapy No concurrent corticosteroids Radiotherapy More than 4 weeks since prior radiotherapy No prior radiotherapy to the spleen Concurrent palliative radiotherapy allowed Surgery Recovered from prior surgery No prior splenectomy No prior organ allograft Concurrent surgery on selected metastases (e.g., because of pain or local complications such as compression) allowed Other No other concurrent investigational drugs No concurrent participation in another clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerold Schuler
Organizational Affiliation
Dermatologische Klinik MIT Poliklinik-Universitaetsklinikum Erlangen
Official's Role
Study Chair
Facility Information:
Facility Name
Dermatologische Klinik mit Poliklinik - Universitaetsklinikum Erlangen
City
Erlangen
ZIP/Postal Code
D-91052
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
28422751
Citation
Gross S, Erdmann M, Haendle I, Voland S, Berger T, Schultz E, Strasser E, Dankerl P, Janka R, Schliep S, Heinzerling L, Sotlar K, Coulie P, Schuler G, Schuler-Thurner B. Twelve-year survival and immune correlates in dendritic cell-vaccinated melanoma patients. JCI Insight. 2017 Apr 20;2(8):e91438. doi: 10.1172/jci.insight.91438. eCollection 2017 Apr 20.
Results Reference
derived

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Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma

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