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Vaccine Therapy in Treating Patients With Stage IV Cutaneous Melanoma

Primary Purpose

Melanoma (Skin)

Status
Completed
Phase
Phase 1
Locations
Germany
Study Type
Interventional
Intervention
Autologous Dendritic Cells loaded with MAGE-A3, MelanA and Survivin
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 IV melanoma, recurrent melanoma

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed cutaneous* melanoma Stage IV Incurable by surgical resection Progressive disease after at least 1 standard chemotherapy or chemoimmunotherapy regimen (e.g., dacarbazine or cisplatin monotherapy) Unidimensionally or bidimensionally measurable disease by physical examination (e.g., cutaneous metastases) and/or noninvasive radiological procedures No active CNS metastases by CT scan or MRI Previously treated (e.g., excision of a single metastasis) CNS metastases are allowed provided there are no signs of active CNS metastases NOTE: *Metastatic melanoma with unidentified primary tumor allowed provided an ocular melanoma can be definitely excluded and origin from the skin is likely PATIENT CHARACTERISTICS: Age 18 and over 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 disorder Hepatic Bilirubin less than 2.0 mg/dL No evidence of hepatitis B or C infection Renal Creatinine less than 2.5 mg/dL Cardiovascular No clinically significant heart disease Pulmonary No respiratory disease Immunologic HIV-1 and HIV-2 negative HTLV-1 negative No active systemic infection No immunodeficiency disease No active autoimmune disease (e.g., lupus erythematosus, autoimmune thyroiditis or uveitis, multiple sclerosis, or inflammatory bowel disease) Vitiligo allowed Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 4 weeks after study participation Stable medical condition No other major serious illness No contraindication to leukapheresis No organic brain syndrome or significant psychiatric abnormality that would preclude study participation or follow-up No other active malignant neoplasm PRIOR CONCURRENT THERAPY: Biologic therapy More than 4 weeks since prior immunotherapy No other concurrent immunotherapy during and for 2 weeks after study participation Chemotherapy More than 4 weeks since prior systemic chemotherapy (6 weeks for nitrosoureas [e.g., fotemustine]) No concurrent chemotherapy during and for 2 weeks after study participation Endocrine therapy No concurrent corticosteroids during and for 2 weeks after study participation Radiotherapy More than 2 weeks since prior radiotherapy No prior radiotherapy to the spleen Concurrent palliative radiotherapy to selected metastases (e.g., due to pain or local complications such as compression) is allowed Surgery Recovered from prior surgery No prior splenectomy No prior organ allografts Concurrent surgical therapy to selected metastases (e.g., due to pain or local complications such as compression) is allowed Selected accessible metastases may be removed for tumor infiltrating lymphocyte assay or other immunomonitoring investigations (e.g., expression of tumor antigens and HLA molecules) Other No other concurrent investigational drug or paramedical substance during and for 2 weeks after study participation No concurrent participation in another clinical trial Concurrent palliative medication allowed (e.g., acetaminophen, indomethacin, or opiates)

Sites / Locations

  • Dermatologische Klinik mit Poliklinik - Universitaetsklinikum Erlangen

Outcomes

Primary Outcome Measures

Safety and tolerability at every visit
Overall survival as assessed by clinical staging (CT scan, positron emission tomography [PET]) every 3 months

Secondary Outcome Measures

Time to progression as assessed by clinical staging (CT scan, PET) every 3 months
Objective tumor response as assessed by clinical staging (CT scan, PET) every 3 months
Duration of response as assessed by clinical staging (CT scan, PET) every 3 months
Induction of antigen-specific immune responses as assessed by elispot and tetramer staining at every visit

Full Information

First Posted
December 10, 2003
Last Updated
May 11, 2015
Sponsor
University Hospital Erlangen
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1. Study Identification

Unique Protocol Identification Number
NCT00074230
Brief Title
Vaccine Therapy in Treating Patients With Stage IV Cutaneous Melanoma
Official Title
Vaccination of Stage IV Cutaneous Melanoma Patients With Mature, Autologous Monocyte-Derived Dendritic Cells Transfected With RNAs Encoding for Mage-3, MelanA, and Survivin Antigens
Study Type
Interventional

2. Study Status

Record Verification Date
May 2015
Overall Recruitment Status
Completed
Study Start Date
July 2003 (undefined)
Primary Completion Date
March 2014 (Actual)
Study Completion Date
March 2014 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Vaccines made from a person's dendritic cells and antigens may make the body build an immune response to kill tumor cells. PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy using autologous dendritic cells with antigens in treating patients who have stage IV cutaneous melanoma.
Detailed Description
OBJECTIVES: Primary Determine the safety and tolerability of vaccination with autologous monocyte-derived dendritic cells (DC) transfected with RNAs encoding Melan-A, MAGE-3, and survivin antigens in patients with stage IV cutaneous melanoma. Determine whether tumor antigen-specific T-cell responses are induced in patients treated with this vaccine. Determine whether simultaneous loading of DC with keyhole limpet hemocyanin (KLH) significantly enhances induction of the Melan-A, MAGE-3, and survivin antigens in these patients. Secondary Determine clinical antitumor activity (e.g., objective tumor response, time to tumor progression, progression-free interval, and overall survival) in patients treated with this vaccine. OUTLINE: This is an open-label, nonrandomized study. Phase I: Beginning 9-11 days before vaccination, patients undergo leukapheresis for collection of peripheral blood mononuclear cells (PBMCs). PBMCs are processed for the generation of dendritic cells (DC) to be used for vaccinations. PBMCs are transfected with RNAs encoding for Melan-A, MAGE-3, and survivin antigens. DC are pulsed with keyhole limpet hemocyanin (KLH) for some patients. Patients receive antigen-pulsed (with or without KLH) DC vaccination subcutaneously (SC) on days 1, 15, 43, and 71 in the absence of disease progression or unacceptable toxicity. Patients with stable or responding disease may proceed to the phase II portion of the study. Phase II: Patients undergo leukapheresis as in phase I on days 102, 354, and 690. Patients receive up to 6 additional booster vaccinations SC as in phase I on days 127, 185, 269, 356, 521, 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 IV melanoma, recurrent melanoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
82 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
Autologous Dendritic Cells loaded with MAGE-A3, MelanA and Survivin
Intervention Description
Within cohort 1 patients received the vaccine intradermally; in cohort 2 the route of Administration was intravenous Infusion, half of the patients had additional loading with RNA coding for EL-Selektin; in cohort 3 the vaccines was again infused intravenously, the cells were matured not with MCM.mimic as in cohort 1 and 2 but either with TriMix or MCM-mimic plus CD40L-RNA.
Primary Outcome Measure Information:
Title
Safety and tolerability at every visit
Time Frame
3 months
Title
Overall survival as assessed by clinical staging (CT scan, positron emission tomography [PET]) every 3 months
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Time to progression as assessed by clinical staging (CT scan, PET) every 3 months
Time Frame
3 months
Title
Objective tumor response as assessed by clinical staging (CT scan, PET) every 3 months
Time Frame
3 months
Title
Duration of response as assessed by clinical staging (CT scan, PET) every 3 months
Time Frame
3 months
Title
Induction of antigen-specific immune responses as assessed by elispot and tetramer staining at every visit
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed cutaneous* melanoma Stage IV Incurable by surgical resection Progressive disease after at least 1 standard chemotherapy or chemoimmunotherapy regimen (e.g., dacarbazine or cisplatin monotherapy) Unidimensionally or bidimensionally measurable disease by physical examination (e.g., cutaneous metastases) and/or noninvasive radiological procedures No active CNS metastases by CT scan or MRI Previously treated (e.g., excision of a single metastasis) CNS metastases are allowed provided there are no signs of active CNS metastases NOTE: *Metastatic melanoma with unidentified primary tumor allowed provided an ocular melanoma can be definitely excluded and origin from the skin is likely PATIENT CHARACTERISTICS: Age 18 and over 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 disorder Hepatic Bilirubin less than 2.0 mg/dL No evidence of hepatitis B or C infection Renal Creatinine less than 2.5 mg/dL Cardiovascular No clinically significant heart disease Pulmonary No respiratory disease Immunologic HIV-1 and HIV-2 negative HTLV-1 negative No active systemic infection No immunodeficiency disease No active autoimmune disease (e.g., lupus erythematosus, autoimmune thyroiditis or uveitis, multiple sclerosis, or inflammatory bowel disease) Vitiligo allowed Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for at least 4 weeks after study participation Stable medical condition No other major serious illness No contraindication to leukapheresis No organic brain syndrome or significant psychiatric abnormality that would preclude study participation or follow-up No other active malignant neoplasm PRIOR CONCURRENT THERAPY: Biologic therapy More than 4 weeks since prior immunotherapy No other concurrent immunotherapy during and for 2 weeks after study participation Chemotherapy More than 4 weeks since prior systemic chemotherapy (6 weeks for nitrosoureas [e.g., fotemustine]) No concurrent chemotherapy during and for 2 weeks after study participation Endocrine therapy No concurrent corticosteroids during and for 2 weeks after study participation Radiotherapy More than 2 weeks since prior radiotherapy No prior radiotherapy to the spleen Concurrent palliative radiotherapy to selected metastases (e.g., due to pain or local complications such as compression) is allowed Surgery Recovered from prior surgery No prior splenectomy No prior organ allografts Concurrent surgical therapy to selected metastases (e.g., due to pain or local complications such as compression) is allowed Selected accessible metastases may be removed for tumor infiltrating lymphocyte assay or other immunomonitoring investigations (e.g., expression of tumor antigens and HLA molecules) Other No other concurrent investigational drug or paramedical substance during and for 2 weeks after study participation No concurrent participation in another clinical trial Concurrent palliative medication allowed (e.g., acetaminophen, indomethacin, or opiates)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerold Schuler
Organizational Affiliation
Dermatologische Klinik MIT Poliklinik-Universitaetsklinikum Erlangen
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dermatologische Klinik mit Poliklinik - Universitaetsklinikum Erlangen
City
Erlangen
ZIP/Postal Code
D-91052
Country
Germany

12. IPD Sharing Statement

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Vaccine Therapy in Treating Patients With Stage IV Cutaneous Melanoma

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