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Phase I/II Randomized Study of Adjuvant Vaccine Therapy Comprising Multi-Epitope Melanoma Peptides in Combination With Either Multi-Epitope Melanoma Helper Peptides or Tetanus Toxoid Helper Peptide Emulsified in Montanide ISA-51 With Versus Without Cyclophosphamide in Patients With Resected Stage IIB-IV Melanoma
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Trial Contact Information Registry Information
Alternate Title
Vaccine Therapy With or Without Cyclophosphamide in Treating Patients Who Have Undergone Surgery for Stage II, Stage III, or Stage IV Melanoma
Basic Trial Information
Phase | Type | Status | Age | Protocol IDs |
---|
Phase II, Phase I | Treatment | Closed | 18 and over | UVACC-HIC-11491 Mel 44, UVACC-34104, UVACC-MEL-44, UVACC-GCRC-CLS013, UVACC-HITC-02620, MDA-2005-0070, NCT00118274 |
Objectives Primary - Determine the safety of adjuvant vaccine therapy comprising multi-epitope melanoma peptides (MP) and multi-epitope melanoma helper peptides (MHP) emulsified in Montanide ISA-51 in patients with resected stage IIB-IV melanoma.
- Determine the safety of administering cyclophosphamide before vaccination in these patients.
- Compare the magnitude of immune response against vaccination comprising MP in combination with either MHP or tetanus toxoid helper peptide (TET) emulsified in Montanide ISA-51 with vs without cyclophosphamide in these patients.
Secondary - Compare the response rate and persistence of immune responses in patients treated with these regimens.
- Compare the magnitude of immune response against vaccination comprising TET or MHP with vs without cyclophosphamide in these patients.
- Compare the response rate and persistence of immune response against vaccination comprising TET or MHP with vs without cyclophosphamide in these patients.
- Determine the delayed-type hypersensitivity response to the peptide components of these vaccines in these patients.
- Compare, preliminarily, disease-free survival of patients treated with these regimens.
Entry Criteria Disease Characteristics:
Prior/Concurrent Therapy:
Biologic therapy - No prior vaccination with any of the synthetic peptides used in this study
- Prior vaccinations (containing agents other than the synthetic peptides used in this study) that resulted in recurrent disease during or after vaccine administration allowed provided the last vaccination was administered more than 12 weeks ago
- More than 4 weeks since prior and no concurrent interferon (e.g., Intron-A®), interleukins (e.g., Proleukin®), or growth factors (e.g., Procrit®, Aranesp®, or Neulasta®)
- More than 4 weeks since prior and no concurrent allergy desensitization injections
- No influenza vaccines for at least 2 weeks before or after study vaccine administration
Chemotherapy - More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas)
- No concurrent chemotherapy, including nitrosoureas
Endocrine therapy - More than 4 weeks since prior and no concurrent oral or parenteral corticosteroids
- No prior or concurrent inhaled steroids (e.g., Advair®, Flovent®, or Azmacort®)
- Prior or concurrent topical corticosteroids allowed
Radiotherapy - See Disease Characteristics
- More than 4 weeks since other prior and no concurrent radiotherapy
Surgery - See Disease Characteristics
Other - More than 4 weeks since prior and no other concurrent investigational agents
- More than 30 days since prior and no concurrent participation in another clinical study
Patient Characteristics:
Age Performance status Life expectancy Hematopoietic - Absolute neutrophil count > 1,000/mm3
- Platelet count > 100,000/mm3
- Hemoglobin > 9 g/dL
Hepatic - AST and ALT ≤ 2.5 times upper limit of normal
(ULN)
- Bilirubin ≤ 2.5 times ULN
- Lactic dehydrogenase ≤ 1.5 times ULN
- Alkaline phosphatase ≤ 2.5 times ULN
- Hepatitis C negative
Renal - Creatinine ≤ 1.5 times ULN
Cardiovascular - No New York Heart Association class III or IV heart disease
Immunologic - HIV negative
- No known or suspected allergy to any component of the study vaccines
- No autoimmune disorder with visceral involvement
- No prior or active autoimmune disorder requiring cytotoxic or immunosuppressive therapy
- The following immunologic conditions are allowed:
- Laboratory evidence of autoimmune disease (e.g., positive anti-nuclear antibody titer) without symptoms
- Clinical evidence of vitiligo
- Other forms of depigmenting illness
- Mild arthritis requiring non-steroidal anti-inflammatory drugs
Other - Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- Weight ≥ 110 lbs
- No uncontrolled diabetes
- No medical contraindication or potential problem that would preclude study compliance
- No other malignancy except squamous cell or basal cell skin cancer without known metastasis, carcinoma in situ of the breast (ductal or lobular) or cervix, or other successfully treated cancer without distant metastasis with no evidence of recurrence or metastasis for > 5 years
- No known active addiction to alcohol or drugs
- No recent (within the past year) or ongoing illicit IV drug use
Expected Enrollment 173A total of 173 patients will be accrued for this study within 2 years. Outcomes Primary Outcome(s)Safety if less than 33% of patients experience a dose-limiting toxicity up to week 52
Secondary Outcome(s)Immunogenicity by Elispot assay up to week 52
Outline This is a randomized, open-label, multicenter study. Patients are stratified according to HLA-type (HLA-A1 positive vs HLA-A2 positive, HLA-A1 negative, or -A3 negative vs HLA-A3 positive, or -A1 negative) and participating center (University of Virginia [UVA] vs non-UVA). Patients are randomized to 1 of 4 treatment arms. - Arm I: Patients receive vaccine comprising multi-epitope melanoma peptides (MP) and tetanus toxoid helper peptide emulsified in Montanide ISA-51 intradermally (ID) and subcutaneously (SC) on days 1, 8, 15, 29, 36, 43, 85, 183, 274, and 365.
- Arm II: Patients receive cyclophosphamide IV over 30-60 minutes on day -4. Patients then receive vaccine as in arm I.
- Arm III: Patients receive vaccine comprising MP and multi-epitope melanoma helper peptides emulsified in Montanide ISA-51 ID and SC on days 1, 8, 15, 29, 36, 43, 85, 183, 274, and 365.
- Arm IV: Patients receive cyclophosphamide as in arm II. Patients then receive vaccine as in arm III.
Treatment in all arms continues in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed every 6 months for 2 years and then annually thereafter.
Trial Contact Information
Trial Lead Organizations University of Virginia Cancer Center | | | Craig Slingluff, MD, Principal investigator | | | |
Registry Information | | Official Title | | A Multicenter Trial to Evaluate the Effects of Administration of Cyclophosphamide and Melanoma-Derived Helper Peptides on the Immunogenicity of a Class I MHC-Restricted Peptide-Based Vaccine in Participants with Resected Melanoma | | Trial Start Date | | 2005-03-03 | | Trial Completion Date | | 2010-02-01 (estimated) | | Registered in ClinicalTrials.gov | | NCT00118274 | | Date Submitted to PDQ | | 2005-04-29 | | Information Last Verified | | 2008-11-06 | | NCI Grant/Contract Number | | CA44579 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |
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