Melanoma Patients Immunized With Natural DenDritic Cells (MIND-DC)
Primary Purpose
Melanoma (Skin)
Status
Active
Phase
Phase 3
Locations
Netherlands
Study Type
Interventional
Intervention
nDC vaccination
placebo injection
Sponsored by

About this trial
This is an interventional treatment trial for Melanoma (Skin)
Eligibility Criteria
Eligibility Criteria:
- at least 18 years of age.
- Histologically confirmed stage III cutaneous melanoma, classified as IIIB or IIIC disease (AJCC 2009). Patients with completely resected in-transit and/or satellite metastases and patients with unknown primary melanoma are allowed in this trial.
- Radical lymph node dissection involved site with complete resection or sentinel node procedure (in case of patients without RLND because of limited sentinel-node positive disease) of melanoma as documented on the operating report and pathology report with at least the minimal levels excised as stated in national guidelines.
- Radical lymph node dissection involved site with complete resection or sentinel node procedure (in case of patients without RLND because of limited sentinel-node positive disease) must be performed within 12 weeks prior to start of study.
- Recovered from definitive surgery (e.g. no uncontrolled wound infections or indwelling drains).
- Absence of distant metastases must be documented by a CT scan of the chest and abdomen (including pelvis) or a Positron Emission Tomography (PET) scan, the scan should have been performed within 6 weeks before surgery or after surgery prior to inclusion. In addition, a physical exam after surgery must be performed also excluding distant metastases.
- No clinical evidence for brain metastasis. If brain metastases are clinically suspected, a CT or Magnetic Resonance Imaging (MRI) scan of the brain must exclude brain metastases.
- World Health Organization (WHO) performance status of 0 or 1 at time of randomization.
- Adequate hematologic, renal and liver function as defined by laboratory values performed within 4 weeks of randomization.
- No second malignancy in the previous 5 years, with the exception of adequately treated carcinoma in-situ and basal or squamous cell carcinoma of the skin.
- No concomitant use of immunosuppressive drugs orally or intravenously. Topical and intranasal steroids are permitted.
- No uncontrolled infectious disease, i.e. negative testing for HIV, HBV, HCV and syphilis.
- No autoimmune disease such as, but not limited to, inflammatory bowel disease, multiple sclerosis, and lupus. Patients with type 1 diabetes mellitus, hypothyroidism after autoimmune thyroiditis and skin disorders are not excluded.
- No serious (bleeding and clotting) condition that may interfere with safe leukapheresis.
- No pregnant or lactating women.
- No Women Of Child-Bearing Potential (WOCBP) who are unwilling or unable to use an acceptable method to avoid pregnancy for up to 8 weeks after the last administration of the treatment. WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal [defined as amenorrhea > 12 consecutive months].
- Patients must have absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions must be discussed with the patient before registration in the trial.
- Expected adequacy of follow-up.
- Written informed consent.
Sites / Locations
- NKI-AvL
- VUmc
- Radboudumc
- ErasmusMC
- Isala klinieken
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
nDC vaccination arm
placebo arm
Arm Description
Patients in the nDC vaccination arm will receive a maximum of 3 cycles each consisting of 3 nDC injections intranodally (3-8x10^6 nDC).
Patients will receive a maximum of 3 cycles each consisting of 3 placebo injections intranodally.
Outcomes
Primary Outcome Measures
Recurrence-free survival rate
The primary objective of this study is to determine whether adjuvant nDC vaccination, after complete radical lymph node dissection or sentinel node procedure in stage IIIB and IIIC melanoma patients, improves 2-year RFS rate as compared to treatment with matching placebo. Defined as the percentage of patients who are alive and without recurrence of melanoma 2 years after randomization.
Secondary Outcome Measures
Recurrence-free survival
Median RFS duration will be assessed by physical examination and CT of the chest and abdomen every 3-12 months, or on clinical indication, during 5 years.
Overall survival
Tumor specific T-cell response
Quality of Life Questionnaires
Costs (direct and indirect) of treatment
QALY
A cost-effectiveness acceptability curve will be derived that is able to evaluate efficiency by using different tresholds (willingness to pay) for a QALY.
Adverse Events related to treatment
Full Information
NCT ID
NCT02993315
First Posted
November 23, 2016
Last Updated
March 11, 2021
Sponsor
Radboud University Medical Center
Collaborators
Dutch National Health Care Institute, ZonMw: The Netherlands Organisation for Health Research and Development
1. Study Identification
Unique Protocol Identification Number
NCT02993315
Brief Title
Melanoma Patients Immunized With Natural DenDritic Cells
Acronym
MIND-DC
Official Title
A Randomized, Double--Blind, Placebo-Controlled Phase III Study to Evaluate Active Immunization in Adjuvant Therapy of Patients With Stage IIIB and IIIC Melanoma With Natural Dendritic Cells Pulsed With Synthetic Peptides.
Study Type
Interventional
2. Study Status
Record Verification Date
February 2021
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 2016 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Radboud University Medical Center
Collaborators
Dutch National Health Care Institute, ZonMw: The Netherlands Organisation for Health Research and Development
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The aim of this study is to determine whether adjuvant treatment with nDC vaccination, after complete radical lymph node dissection or sentinel node procedure in stage IIIB and IIIC melanoma patients, improves recurrence-free survival (RFS) as compared to treatment with matching placebo.
Detailed Description
This is a phase 3, randomized, double-blind, interventional study of nDC vaccination versus placebo. Dendritic cell-based immunotherapy consists of antigen-loaded autologous DC that are administered to patients with the intention of inducing antigen-specific T and B cell responses and proved safe with minimal side effects. Natural DC (nDC) consist of plasmacytoid DC and myeloid DC. Subjects will be randomized 2:1 and stratified by stage of disease, adjuvant radiotherapy, BRAF mutation status, HLA-type and nDC production centre. The treatment will be continued for a maximum of 1.5 years or until recurrence of disease, unacceptable toxicity or withdrawal from the study.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Melanoma (Skin)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
210 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
nDC vaccination arm
Arm Type
Experimental
Arm Description
Patients in the nDC vaccination arm will receive a maximum of 3 cycles each consisting of 3 nDC injections intranodally (3-8x10^6 nDC).
Arm Title
placebo arm
Arm Type
Placebo Comparator
Arm Description
Patients will receive a maximum of 3 cycles each consisting of 3 placebo injections intranodally.
Intervention Type
Biological
Intervention Name(s)
nDC vaccination
Intervention Type
Biological
Intervention Name(s)
placebo injection
Primary Outcome Measure Information:
Title
Recurrence-free survival rate
Description
The primary objective of this study is to determine whether adjuvant nDC vaccination, after complete radical lymph node dissection or sentinel node procedure in stage IIIB and IIIC melanoma patients, improves 2-year RFS rate as compared to treatment with matching placebo. Defined as the percentage of patients who are alive and without recurrence of melanoma 2 years after randomization.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Recurrence-free survival
Description
Median RFS duration will be assessed by physical examination and CT of the chest and abdomen every 3-12 months, or on clinical indication, during 5 years.
Time Frame
2 years and 5 years
Title
Overall survival
Time Frame
2-years and median
Title
Tumor specific T-cell response
Time Frame
week 1, week 9, week 10, week 31, week 39, week 57, week 65, week 78, month 24, month 60
Title
Quality of Life Questionnaires
Time Frame
baseline, week 14, week 26, month 12, month 24, month 36, month 60
Title
Costs (direct and indirect) of treatment
Time Frame
2 years
Title
QALY
Description
A cost-effectiveness acceptability curve will be derived that is able to evaluate efficiency by using different tresholds (willingness to pay) for a QALY.
Time Frame
2 years
Title
Adverse Events related to treatment
Time Frame
1,5 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Eligibility Criteria:
at least 18 years of age.
Histologically confirmed stage III cutaneous melanoma, classified as IIIB or IIIC disease (AJCC 2009). Patients with completely resected in-transit and/or satellite metastases and patients with unknown primary melanoma are allowed in this trial.
Radical lymph node dissection involved site with complete resection or sentinel node procedure (in case of patients without RLND because of limited sentinel-node positive disease) of melanoma as documented on the operating report and pathology report with at least the minimal levels excised as stated in national guidelines.
Radical lymph node dissection involved site with complete resection or sentinel node procedure (in case of patients without RLND because of limited sentinel-node positive disease) must be performed within 12 weeks prior to start of study.
Recovered from definitive surgery (e.g. no uncontrolled wound infections or indwelling drains).
Absence of distant metastases must be documented by a CT scan of the chest and abdomen (including pelvis) or a Positron Emission Tomography (PET) scan, the scan should have been performed within 6 weeks before surgery or after surgery prior to inclusion. In addition, a physical exam after surgery must be performed also excluding distant metastases.
No clinical evidence for brain metastasis. If brain metastases are clinically suspected, a CT or Magnetic Resonance Imaging (MRI) scan of the brain must exclude brain metastases.
World Health Organization (WHO) performance status of 0 or 1 at time of randomization.
Adequate hematologic, renal and liver function as defined by laboratory values performed within 4 weeks of randomization.
No second malignancy in the previous 5 years, with the exception of adequately treated carcinoma in-situ and basal or squamous cell carcinoma of the skin.
No concomitant use of immunosuppressive drugs orally or intravenously. Topical and intranasal steroids are permitted.
No uncontrolled infectious disease, i.e. negative testing for HIV, HBV, HCV and syphilis.
No autoimmune disease such as, but not limited to, inflammatory bowel disease, multiple sclerosis, and lupus. Patients with type 1 diabetes mellitus, hypothyroidism after autoimmune thyroiditis and skin disorders are not excluded.
No serious (bleeding and clotting) condition that may interfere with safe leukapheresis.
No pregnant or lactating women.
No Women Of Child-Bearing Potential (WOCBP) who are unwilling or unable to use an acceptable method to avoid pregnancy for up to 8 weeks after the last administration of the treatment. WOCBP include any female who has experienced menarche and who has not undergone successful surgical sterilization (hysterectomy, bilateral tubal ligation or bilateral oophorectomy) or is not postmenopausal [defined as amenorrhea > 12 consecutive months].
Patients must have absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions must be discussed with the patient before registration in the trial.
Expected adequacy of follow-up.
Written informed consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jolanda de Vries, Prof. dr.
Organizational Affiliation
Radboud University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
NKI-AvL
City
Amsterdam
Country
Netherlands
Facility Name
VUmc
City
Amsterdam
Country
Netherlands
Facility Name
Radboudumc
City
Nijmegen
Country
Netherlands
Facility Name
ErasmusMC
City
Rotterdam
Country
Netherlands
Facility Name
Isala klinieken
City
Zwolle
Country
Netherlands
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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Melanoma Patients Immunized With Natural DenDritic Cells
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