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Ipilimumab With or Without Vaccine Therapy in Treating Patients With Previously Treated Stage IV Melanoma

Primary Purpose

Melanoma (Skin)

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
gp100:209-217(210M) peptide vaccine
gp100:280-288(288V) peptide vaccine
incomplete Freund's adjuvant
ipilimumab
Sponsored by
Bristol-Myers Squibb
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

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

DISEASE CHARACTERISTICS: Histologically confirmed stage IV melanoma HLA-A*0201 positive disease Previously treated metastatic disease Clinically evaluable and measurable disease No mucosal or ocular melanoma No evidence of active brain metastases PATIENT CHARACTERISTICS: ECOG performance status 0-2 WBC ≥ 2,500/mm³ Absolute neutrophil count ≥ 1,000/mm³ Absolute lymphocyte count ≥ 500/mm³ Platelet count ≥ 75,000/mm³ Hemoglobin ≥ 9 g/dL Creatinine < 2.5 mg/dL AST ≤ 2 times upper limit of normal (ULN) (5 times ULN if liver metastases are present) Bilirubin normal (< 3.0 mg/dL if Gilbert's syndrome is present) Hepatitis B surface antigen negative HIV negativity No hepatitis C virus antibodies Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No other prior malignancy except for any of the following: Adequately treated basal cell or squamous cell skin cancer Superficial bladder cancer Carcinoma in situ of the cervix Any other cancer from which patient has been disease free for > 5 years No active immune-mediated disease requiring active therapy with any form of steroid or immunosuppressive therapy No documented history of any of the following: Inflammatory bowel disease Regional enteritis Connective tissue disorders, such as systemic lupus erythematosus Rheumatoid arthritis Immune-mediated inflammatory eye disease Sjögren's syndrome Inflammatory neurologic disorder, such as multiple sclerosis Any immune-mediated disease that can cause life-threatening symptoms or severe organ/tissue damage, in the opinion of the principal investigator History of vitiligo or immune-mediated thyroiditis allowed Skin rashes associated with previous therapy allowed provided patient has recovered from treatment-related toxicity to < grade 1 No active infection No systemic hypersensitivity to any of the study drugs History of local reactions (e.g., delayed hypersensitivity or glaucomatous reactions) to Montanide ISA-51 allowed No underlying medical condition that, in the opinion of the investigator, would preclude study treatment PRIOR CONCURRENT THERAPY: At least 3 weeks since prior systemic treatment (6 weeks for nitrosoureas) and recovered No prior ipilimumab or gp100 vaccines More than 4 weeks since prior steroids No concurrent systemic or topical corticosteroids or immunosuppressive agents (e.g., cyclosporine or chemotherapy agents), including steroid enemas, inhaled steroids, or steroid eye drops Hormone-replacement therapy allowed

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Clinical response

    Secondary Outcome Measures

    Safety and toxicity
    Immunologic response
    Response rate
    Overall survival

    Full Information

    First Posted
    July 26, 2006
    Last Updated
    May 14, 2013
    Sponsor
    Bristol-Myers Squibb
    Collaborators
    National Cancer Institute (NCI)
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00357461
    Brief Title
    Ipilimumab With or Without Vaccine Therapy in Treating Patients With Previously Treated Stage IV Melanoma
    Official Title
    A Randomized Phase II Study of Fixed Dose Ipilimumab (MDX-010) 10 mg/kg Given Alone or in Combination With Two gp100 Peptides Emulsified With Montanide ISA-51 VG for Previously Treated HLA-A * 0201 Positive Subjects With Stage IV Melanoma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2013
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    May 2006 (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Bristol-Myers Squibb
    Collaborators
    National Cancer Institute (NCI)

    4. Oversight

    5. Study Description

    Brief Summary
    RATIONALE: Monoclonal antibodies, such as ipilimumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Vaccines made from gp100 peptides may help the body build an effective immune response to kill tumor cells. Giving ipilimumab together with vaccine therapy may be an effective treatment for melanoma. PURPOSE: This randomized phase II trial is studying ipilimumab and vaccine therapy to see how well they work compared to ipilimumab alone in treating patients with previously treated stage IV melanoma.
    Detailed Description
    OBJECTIVES: Primary Compare the impact of ipilimumab with vs without gp100 peptides emulsified with Montanide ISA-51 on clinical response in patients with previously treated, HLA-A*0201 positive stage IV melanoma. Secondary Compare the safety/toxicity profile of these regimens in these patients. Determine the immunologic response, as measured by in vitro assays using peripheral blood samples, in patients treated with these regimens. Determine the response rate after a re-induction regimen for patients who have relapsed after initial response. Determine overall survival. OUTLINE: This is a randomized, open-label study. Patients are stratified according to ECOG performance status (0 vs 1 or 2) and metastases (M1a vs M1 b or M1c). Patients are randomized to 1 of 2 treatment arms. Induction phase: Arm I: Patients receive ipilimumab IV over 90 minutes on day 1. Arm II: Patients receive ipilimumab as in arm I. Patients also receive gp100 peptides emulsified in Montanide ISA-51 subcutaneously (SC) on day 1. In both arms, treatment repeats every 3 weeks for 4 courses in the absence of disease progression or unacceptable toxicity. Patients achieving stable disease or better for 12 weeks after 4 courses proceed to maintenance phase. Maintenance phase: Arm I: Patients receive ipilimumab IV over 90 minutes on day 1. Arm II: Patients receive ipilimumab IV as in arm I and gp100 peptides emulsified in Montanide ISA-51 SC on day 1. Treatment in both arms begins in approximately week 21 and repeats every 3 months for 8 courses in the absence of disease progression or unacceptable toxicity. Patients who relapse or progress while on maintenance phase undergo re-induction comprising 4 courses of treatment with ipilimumab with or without gp100 peptides emulsified in Montanide ISA-51 as in induction phase. Patients achieving responding disease (complete response, partial response, or stable disease) for 12 weeks after re-induction proceed to the maintenance phase as above for up to 8 courses of treatment. After completion of study treatment, patients are evaluated for 3 weeks after the last treatment, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter. PROJECTED ACCRUAL: A total of 94 patients 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 IV melanoma, recurrent melanoma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Intervention Type
    Biological
    Intervention Name(s)
    gp100:209-217(210M) peptide vaccine
    Intervention Type
    Biological
    Intervention Name(s)
    gp100:280-288(288V) peptide vaccine
    Intervention Type
    Biological
    Intervention Name(s)
    incomplete Freund's adjuvant
    Intervention Type
    Biological
    Intervention Name(s)
    ipilimumab
    Primary Outcome Measure Information:
    Title
    Clinical response
    Secondary Outcome Measure Information:
    Title
    Safety and toxicity
    Title
    Immunologic response
    Title
    Response rate
    Title
    Overall survival

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    16 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    DISEASE CHARACTERISTICS: Histologically confirmed stage IV melanoma HLA-A*0201 positive disease Previously treated metastatic disease Clinically evaluable and measurable disease No mucosal or ocular melanoma No evidence of active brain metastases PATIENT CHARACTERISTICS: ECOG performance status 0-2 WBC ≥ 2,500/mm³ Absolute neutrophil count ≥ 1,000/mm³ Absolute lymphocyte count ≥ 500/mm³ Platelet count ≥ 75,000/mm³ Hemoglobin ≥ 9 g/dL Creatinine < 2.5 mg/dL AST ≤ 2 times upper limit of normal (ULN) (5 times ULN if liver metastases are present) Bilirubin normal (< 3.0 mg/dL if Gilbert's syndrome is present) Hepatitis B surface antigen negative HIV negativity No hepatitis C virus antibodies Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No other prior malignancy except for any of the following: Adequately treated basal cell or squamous cell skin cancer Superficial bladder cancer Carcinoma in situ of the cervix Any other cancer from which patient has been disease free for > 5 years No active immune-mediated disease requiring active therapy with any form of steroid or immunosuppressive therapy No documented history of any of the following: Inflammatory bowel disease Regional enteritis Connective tissue disorders, such as systemic lupus erythematosus Rheumatoid arthritis Immune-mediated inflammatory eye disease Sjögren's syndrome Inflammatory neurologic disorder, such as multiple sclerosis Any immune-mediated disease that can cause life-threatening symptoms or severe organ/tissue damage, in the opinion of the principal investigator History of vitiligo or immune-mediated thyroiditis allowed Skin rashes associated with previous therapy allowed provided patient has recovered from treatment-related toxicity to < grade 1 No active infection No systemic hypersensitivity to any of the study drugs History of local reactions (e.g., delayed hypersensitivity or glaucomatous reactions) to Montanide ISA-51 allowed No underlying medical condition that, in the opinion of the investigator, would preclude study treatment PRIOR CONCURRENT THERAPY: At least 3 weeks since prior systemic treatment (6 weeks for nitrosoureas) and recovered No prior ipilimumab or gp100 vaccines More than 4 weeks since prior steroids No concurrent systemic or topical corticosteroids or immunosuppressive agents (e.g., cyclosporine or chemotherapy agents), including steroid enemas, inhaled steroids, or steroid eye drops Hormone-replacement therapy allowed
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Steven A. Rosenberg, MD, PhD
    Organizational Affiliation
    NCI - Surgery Branch
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    17982122
    Citation
    Downey SG, Klapper JA, Smith FO, Yang JC, Sherry RM, Royal RE, Kammula US, Hughes MS, Allen TE, Levy CL, Yellin M, Nichol G, White DE, Steinberg SM, Rosenberg SA. Prognostic factors related to clinical response in patients with metastatic melanoma treated by CTL-associated antigen-4 blockade. Clin Cancer Res. 2007 Nov 15;13(22 Pt 1):6681-8. doi: 10.1158/1078-0432.CCR-07-0187. Epub 2007 Nov 2.
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    Ipilimumab With or Without Vaccine Therapy in Treating Patients With Previously Treated Stage IV Melanoma

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