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Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma That Cannot Be Removed With Surgery

Primary Purpose

Melanoma (Skin)

Status
Unknown status
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
D1/3-MAGE-3-His fusion protein
SB-AS02B adjuvant
SB-AS15 adjuvant
Sponsored by
European Organisation for Research and Treatment of Cancer - EORTC
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 cutaneous melanoma Unresectable stage III OR stage IV M1a disease Documented progressive disease within the past 12 weeks Measurable disease Skin, soft tissue, or lymph node metastasis allowed provided the disease is not amenable to curative treatment with surgery Tumor must express the MAGE-3 gene by reverse transcription polymerase chain reaction analysis (more than 1% of the positive MAGE-3 control included in the assay) No visceral metastases within the past 56 days by imaging PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic Hemoglobin ≥ lower limit of normal (LLN) WBC ≥ LLN Lymphocyte count ≥ LLN Platelet count ≥ LLN No bleeding disorders Hepatic Bilirubin ≤ upper limit of normal (ULN) Lactic dehydrogenase ≤ ULN AST and ALT ≤ 2 times ULN PT and aPTT normal Hepatitis B surface antigen negative (antibody test may be positive) Hepatitis C antibody negative Renal Creatinine ≤ ULN Cardiovascular No clinically significant heart disease (CTC grade III or IV) Immunologic No autoimmune disease (vitiligo allowed) No anti-nuclear antibody titer ≥ 1/320 OR equal to 1/160 AND auto-antibodies directed against specific auto-antigens No immunodeficiency No active infection requiring antibiotic therapy HIV negative Other Not pregnant Negative pregnancy test Fertile patients must use effective contraception during and for 3 months after study participation No other malignancy within the past 5 years except surgically cured basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No other serious acute or chronic illness requiring concurrent medications No psychological, familial, sociological, or geographical condition that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy More than 8 weeks since prior adjuvant vaccine therapy No prior vaccine therapy containing a MAGE-3 antigen No prior vaccine therapy for metastatic melanoma No concurrent immunomodulating agents (e.g., BCG) Chemotherapy No prior systemic chemotherapy No concurrent chemotherapy Endocrine therapy No concurrent corticosteroids Concurrent prednisone or equivalent allowed provided the dose is ≤ 40 mg/day and treatment duration is for no more than 3 weeks Concurrent inhaled and topical steroids are allowed Radiotherapy No prior radiotherapy to the spleen No concurrent radiotherapy to > 20% of all existing lesions (i.e., target lesions, non-target lesions, and nonmeasurable lesions) Concurrent local low-dose (≤ 20 Grays) radiotherapy allowed Surgery Recovered from prior surgery or biopsy No prior organ allograft No prior splenectomy Concurrent surgery to a limited number of lesions allowed for patients with a complete response, partial response, or stable disease after at least 3 courses of study therapy Other No prior systemic anticancer therapy More than 4 weeks since prior isolated limb perfusion therapy No other concurrent anticancer therapy No other concurrent immunosuppressive agents

Sites / Locations

  • Institut Jules Bordet
  • Hopital Universitaire Erasme
  • Clinique Sainte-Marguerite
  • Centre Hospitalier Regional et Universitaire de Lille
  • Hopital St. Eloi
  • CHR Hotel Dieu
  • Institut Curie Hopital
  • Institut Gustave Roussy
  • Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
  • Klinikum der Stadt Mannheim
  • Universitaets - Kinderklinik Wuerzburg
  • Centro di Riferimento Oncologico - Aviano
  • Istituto Nazionale per lo Studio e la Cura dei Tumori
  • Azienda Ospedaliera di Padova
  • Universita di Siena
  • Leiden University Medical Center
  • Daniel Den Hoed Cancer Center at Erasmus Medical Center
  • Hospital Clinic de Barcelona
  • Hospital Universitario 12 de Octubre
  • Saint Bartholomew's Hospital
  • Christie Hospital NHS Trust

Outcomes

Primary Outcome Measures

Response rate (complete response and partial response) as assessed by RECIST criteria
Vaccine-related toxicity as assessed by CTCAE v3

Secondary Outcome Measures

Rate of stabilization as assessed by RECIST criteria
Rate of mixed response as assessed by RECIST criteria
Rate of immune response
Progression-free survival

Full Information

First Posted
July 8, 2004
Last Updated
February 9, 2015
Sponsor
European Organisation for Research and Treatment of Cancer - EORTC
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1. Study Identification

Unique Protocol Identification Number
NCT00086866
Brief Title
Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma That Cannot Be Removed With Surgery
Official Title
Randomized, Open Phase II Study of Immunization With the Recombinant MAGE-3 Protein Combined With Adjuvant AS02B or AS15 in Patients With Unresectable and Progressive Metastatic Cutaneous Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2015
Overall Recruitment Status
Unknown status
Study Start Date
May 2004 (undefined)
Primary Completion Date
January 2007 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
European Organisation for Research and Treatment of Cancer - EORTC

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Vaccines may make the body build an immune response to kill tumor cells. PURPOSE: This randomized phase II trial is studying two different regimens of vaccine therapy and comparing them to see how well they work in treating patients with stage III or stage IV melanoma that cannot be removed with surgery.
Detailed Description
OBJECTIVES: Primary Compare the objective response rate (complete and partial response) in patients with unresectable stage III or stage IV M1a cutaneous melanoma immunized with vaccine comprising D1/3-MAGE-3-His fusion protein and SB-AS02B adjuvant vs SB-AS15 adjuvant. Compare the activity of SB-AS02B adjuvant vs SB-AS15 adjuvant, in terms of maximizing the antigenicity of MAGE-3, in patients treated with these regimens. Compare the rate of grade 3/4 vaccine-related toxicity in patients treated with these regimens. Secondary Compare progression-free survival in patients treated with these regimens. OUTLINE: This is a randomized, open label, parallell-group, multicenter study. Patients are stratified according to disease stage (III in transit vs other stage III vs IV), presence of lesion ≥ 20 mm (yes vs no), and participating center. Patients are randomized to 1 of 2 treatment arms. Induction therapy Arm I: Patients receive immunization comprising D1/3-MAGE-3-His fusion protein and SB-AS02B adjuvant intramuscularly (IM) once weekly on weeks 1, 3, 5, 7, 9, and 11. Arm II: Patients receive immunization comprising D1/3-MAGE-3-His fusion protein SB-AS15 adjuvant IM once weekly on weeks 1, 3, 5, 7, 9, and 11. Patients achieving a clinical complete response (CR), partial response (PR), stable disease (SD), or slow progressive disease (SPD) proceed to maintenance therapy. Maintenance therapy: Patients in both arms receive immunization (according to their randomized arm) once weekly on weeks 15, 18, 21, 24, 27, 30, 34, 40, 46, and 52. Patients maintaining a CR, PR, or SD proceed to long-term treatment. Long-term treatment: Beginning 3 months after completion of maintenance therapy, patients in both arms receive immunization (according to their randomized arm) once every 3 months for 4 courses and then once every 6 months for 4 courses. Treatment continues in both arms in the absence of disease progression that does not correspond to SPD status, unacceptable toxicity, or the diagnosis of an autoimmune disease. Patients are followed every 12 weeks. PROJECTED ACCRUAL: A total of 68 patients (34 patients per treatment arm) will be accrued for this study.

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 2
Masking
None (Open Label)
Allocation
Randomized
Enrollment
165 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
D1/3-MAGE-3-His fusion protein
Intervention Type
Biological
Intervention Name(s)
SB-AS02B adjuvant
Intervention Type
Biological
Intervention Name(s)
SB-AS15 adjuvant
Primary Outcome Measure Information:
Title
Response rate (complete response and partial response) as assessed by RECIST criteria
Title
Vaccine-related toxicity as assessed by CTCAE v3
Secondary Outcome Measure Information:
Title
Rate of stabilization as assessed by RECIST criteria
Title
Rate of mixed response as assessed by RECIST criteria
Title
Rate of immune response
Title
Progression-free survival

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed cutaneous melanoma Unresectable stage III OR stage IV M1a disease Documented progressive disease within the past 12 weeks Measurable disease Skin, soft tissue, or lymph node metastasis allowed provided the disease is not amenable to curative treatment with surgery Tumor must express the MAGE-3 gene by reverse transcription polymerase chain reaction analysis (more than 1% of the positive MAGE-3 control included in the assay) No visceral metastases within the past 56 days by imaging PATIENT CHARACTERISTICS: Age 18 and over Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic Hemoglobin ≥ lower limit of normal (LLN) WBC ≥ LLN Lymphocyte count ≥ LLN Platelet count ≥ LLN No bleeding disorders Hepatic Bilirubin ≤ upper limit of normal (ULN) Lactic dehydrogenase ≤ ULN AST and ALT ≤ 2 times ULN PT and aPTT normal Hepatitis B surface antigen negative (antibody test may be positive) Hepatitis C antibody negative Renal Creatinine ≤ ULN Cardiovascular No clinically significant heart disease (CTC grade III or IV) Immunologic No autoimmune disease (vitiligo allowed) No anti-nuclear antibody titer ≥ 1/320 OR equal to 1/160 AND auto-antibodies directed against specific auto-antigens No immunodeficiency No active infection requiring antibiotic therapy HIV negative Other Not pregnant Negative pregnancy test Fertile patients must use effective contraception during and for 3 months after study participation No other malignancy within the past 5 years except surgically cured basal cell or squamous cell skin cancer or carcinoma in situ of the cervix No other serious acute or chronic illness requiring concurrent medications No psychological, familial, sociological, or geographical condition that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy More than 8 weeks since prior adjuvant vaccine therapy No prior vaccine therapy containing a MAGE-3 antigen No prior vaccine therapy for metastatic melanoma No concurrent immunomodulating agents (e.g., BCG) Chemotherapy No prior systemic chemotherapy No concurrent chemotherapy Endocrine therapy No concurrent corticosteroids Concurrent prednisone or equivalent allowed provided the dose is ≤ 40 mg/day and treatment duration is for no more than 3 weeks Concurrent inhaled and topical steroids are allowed Radiotherapy No prior radiotherapy to the spleen No concurrent radiotherapy to > 20% of all existing lesions (i.e., target lesions, non-target lesions, and nonmeasurable lesions) Concurrent local low-dose (≤ 20 Grays) radiotherapy allowed Surgery Recovered from prior surgery or biopsy No prior organ allograft No prior splenectomy Concurrent surgery to a limited number of lesions allowed for patients with a complete response, partial response, or stable disease after at least 3 courses of study therapy Other No prior systemic anticancer therapy More than 4 weeks since prior isolated limb perfusion therapy No other concurrent anticancer therapy No other concurrent immunosuppressive agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Willem H. J. Kruit, MD, PhD
Organizational Affiliation
Daniel Den Hoed Cancer Center at Erasmus Medical Center
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Cornelis J. A. Punt, MD, PhD
Organizational Affiliation
Universitair Medisch Centrum St. Radboud - Nijmegen
Official's Role
Study Chair
Facility Information:
Facility Name
Institut Jules Bordet
City
Brussels
ZIP/Postal Code
1000
Country
Belgium
Facility Name
Hopital Universitaire Erasme
City
Brussels
ZIP/Postal Code
1070
Country
Belgium
Facility Name
Clinique Sainte-Marguerite
City
Hyeres
ZIP/Postal Code
83400
Country
France
Facility Name
Centre Hospitalier Regional et Universitaire de Lille
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
Hopital St. Eloi
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
CHR Hotel Dieu
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
Institut Curie Hopital
City
Paris
ZIP/Postal Code
75248
Country
France
Facility Name
Institut Gustave Roussy
City
Villejuif
ZIP/Postal Code
F-94805
Country
France
Facility Name
Charite - Universitaetsmedizin Berlin - Campus Benjamin Franklin
City
Berlin
ZIP/Postal Code
D-12200
Country
Germany
Facility Name
Klinikum der Stadt Mannheim
City
Mannheim
ZIP/Postal Code
D-68135
Country
Germany
Facility Name
Universitaets - Kinderklinik Wuerzburg
City
Wuerzburg
ZIP/Postal Code
D-97080
Country
Germany
Facility Name
Centro di Riferimento Oncologico - Aviano
City
Aviano
ZIP/Postal Code
33081
Country
Italy
Facility Name
Istituto Nazionale per lo Studio e la Cura dei Tumori
City
Naples
ZIP/Postal Code
80131
Country
Italy
Facility Name
Azienda Ospedaliera di Padova
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Universita di Siena
City
Siena
ZIP/Postal Code
53100
Country
Italy
Facility Name
Leiden University Medical Center
City
Leiden
ZIP/Postal Code
2300 RC
Country
Netherlands
Facility Name
Daniel Den Hoed Cancer Center at Erasmus Medical Center
City
Rotterdam
ZIP/Postal Code
3008 AE
Country
Netherlands
Facility Name
Hospital Clinic de Barcelona
City
Barcelona
ZIP/Postal Code
08036
Country
Spain
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Facility Name
Saint Bartholomew's Hospital
City
London
State/Province
England
ZIP/Postal Code
EC1A 7BE
Country
United Kingdom
Facility Name
Christie Hospital NHS Trust
City
Manchester
State/Province
England
ZIP/Postal Code
M20 4BX
Country
United Kingdom

12. IPD Sharing Statement

Citations:
Citation
Kruit WH, Suciu S, Dreno B, et al.: Immunization with recombinant MAGE-A3 protein combined with adjuvant systems AS15 or AS02B in patients with unresectable and progressive metastatic cutaneous melanoma: A randomized open-label phase II study of the EORTC Melanoma Group (16032- 18031). [Abstract] J Clin Oncol 26 (Suppl 15): A-9065, 2008.
Results Reference
result
Citation
Louahed J, Gruselle O, Gaulis S, et al.: Expression of defined genes identified by pretreatment tumor profiling: association with clinical responses to the GSK MAGE- A3 immunotherapeutic in metastatic melanoma patients (EORTC 16032-18031). [Abstract] J Clin Oncol 26 (Suppl 15): A-9045, 2008.
Results Reference
result
PubMed Identifier
23715572
Citation
Kruit WH, Suciu S, Dreno B, Mortier L, Robert C, Chiarion-Sileni V, Maio M, Testori A, Dorval T, Grob JJ, Becker JC, Spatz A, Eggermont AM, Louahed J, Lehmann FF, Brichard VG, Keilholz U. Selection of immunostimulant AS15 for active immunization with MAGE-A3 protein: results of a randomized phase II study of the European Organisation for Research and Treatment of Cancer Melanoma Group in Metastatic Melanoma. J Clin Oncol. 2013 Jul 1;31(19):2413-20. doi: 10.1200/JCO.2012.43.7111. Epub 2013 May 28.
Results Reference
derived
PubMed Identifier
23715562
Citation
Ulloa-Montoya F, Louahed J, Dizier B, Gruselle O, Spiessens B, Lehmann FF, Suciu S, Kruit WH, Eggermont AM, Vansteenkiste J, Brichard VG. Predictive gene signature in MAGE-A3 antigen-specific cancer immunotherapy. J Clin Oncol. 2013 Jul 1;31(19):2388-95. doi: 10.1200/JCO.2012.44.3762. Epub 2013 May 28.
Results Reference
derived

Learn more about this trial

Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma That Cannot Be Removed With Surgery

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