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CP-675,206 (CTLA4-Blocking Monoclonal Antibody) Combined With Dendritic Cell Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma That Cannot Be Removed With Surgery
This study is ongoing, but not recruiting participants.
First Received: September 7, 2004   Last Updated: February 6, 2009   History of Changes
Sponsored by: Jonsson Comprehensive Cancer Center
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00090896
  Purpose

RATIONALE: Biological therapies, such as CP-675,206, work in different ways to stimulate the immune system and stop tumor cells from growing. Vaccines may make the body build an immune response to kill tumor cells. Combining CP-675,206 with vaccine therapy may cause a stronger immune response and kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of CP-675,206 when given with vaccine therapy in treating patients with stage III or stage IV melanoma that cannot be removed with surgery.


Condition Intervention Phase
Melanoma (Skin)
Biological: MART-1 antigen
Biological: ipilimumab
Biological: therapeutic autologous dendritic cells
Phase I

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: A Phase I, Open Label, Study To Evaluate The Safety And Immune Function Effects Of CP-675,206 In Combination With MART-1 Peptide-Pulsed Dendritic Cells In Patients With Advanced Melanoma

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Estimated Enrollment: 21
Study Start Date: April 2004
Detailed Description:

OBJECTIVES:

Primary

  • Determine the safety and maximum tolerated dose of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (CTLA4-blocking monoclonal antibody; CP-675,206) administered with autologous dendritic cells pulsed with MART-1 antigen in patients with unresectable stage III or stage IV melanoma.
  • Determine the biological activity and immune effects of this regimen in these patients.

Secondary

  • Correlate CTLA4 genotype with safety of this regimen and/or immune response in these patients.
  • Determine, preliminarily, the efficacy of this regimen, in terms of clinical benefit rate, in these patients.

OUTLINE: This is an open-label, dose-escalation study of anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (CTLA4-blocking monoclonal antibody; CP-675,206).

Patients receive CP-675,206 IV on days 0, 28, 60, and 90 and autologous dendritic cells pulsed with MART-1 antigen intradermally on days 0, 14, and 28. After day 120, patients with stable or responding disease may receive additional doses of CP-675,206 monthly in the absence of disease progression or unacceptable toxicity

Cohorts of 3-6 patients receive escalating doses of CP-675,206 until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed every 3 months.

PROJECTED ACCRUAL: A total of 3-21 patients will be accrued for this study within 3-10 months.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed cutaneous or mucosal melanoma, meeting criteria for 1 of the following:

    • Unresectable stage III disease (locally relapsed unresectable, in-transit lesions, or unresectable draining nodes)
    • Stage IV disease, metastatic to 1 of the following sites:

      • Skin, subcutaneous tissues, or distant lymph nodes
      • Lung
      • Other visceral sites with lactic dehydrogenase ≤ 2 times upper limit of normal (unless due to liver stasis)
  • De novo metastatic disease allowed provided patient refused any standard or approved stage-appropriate therapy for melanoma
  • Measurable disease
  • HLA-A2.1 positive (HLA-A*0201 by molecular subtyping)
  • MART-1-expressing tumor by reverse transcription polymerase chain reaction or immunohistochemistry
  • No symptomatic brain metastases and/or progression of CNS metastases within the past 4 weeks

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Performance status

  • ECOG 0-1 OR
  • Karnofsky 70-100%

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • See Disease Characteristics
  • No chronic hepatitis B or C

Renal

  • Not specified

Pulmonary

  • No asthma

Gastrointestinal

  • No inflammatory bowel disease
  • No celiac disease
  • No history of chronic colitis or other chronic gastrointestinal conditions associated with diarrhea or bleeding

Immunologic

  • HIV negative
  • No active chronic inflammatory or autoimmune disease, including any of the following:

    • Psoriasis
    • Rheumatoid arthritis
    • Multiple sclerosis
    • Hashimoto's thyroiditis
    • Addison's disease
    • Graves' disease
    • Systemic lupus erythematosus
  • No active infection OR fever over 100° F within the past 3 days
  • No allergy to study drugs

Other

  • Not pregnant
  • Negative pregnancy test
  • Fertile patients must use effective barrier contraception during and for 3 months after study participation
  • No symptomatic seizures
  • No other medical problem that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • More than 30 days since prior immunotherapy for metastatic, relapsed, or primary melanoma
  • No prior melanoma immunotherapy containing MART-1 antigen
  • No prior anti-T-cell therapy
  • No prior anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody (CP-675,206)

Chemotherapy

  • More than 30 days since prior chemotherapy for metastatic, relapsed, or primary melanoma

Endocrine therapy

  • More than 4 weeks since prior corticosteroids

Radiotherapy

  • More than 30 days since prior radiotherapy for metastatic, relapsed, or primary melanoma

Surgery

  • More than 30 days since prior surgery for metastatic, relapsed, or primary melanoma
  • No organ allografts requiring long-term immune suppressive therapy

Other

  • More than 30 days since other prior therapy for metastatic, relapsed, or primary melanoma
  • More than 14 days since prior anti-infective therapy
  • More than 4 weeks since prior immune suppressive therapy (e.g., cyclosporine)
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00090896

Locations
United States, California
Jonsson Comprehensive Cancer Center at UCLA
Los Angeles, California, United States, 90095-1781
Sponsors and Collaborators
Jonsson Comprehensive Cancer Center
Investigators
Study Chair: Antoni Ribas, MD Jonsson Comprehensive Cancer Center
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000380840, UCLA-0312023, PFIZER-NRA3670003
Study First Received: September 7, 2004
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00090896     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
recurrent melanoma
stage III melanoma
stage IV melanoma

Study placed in the following topic categories:
Antibodies, Monoclonal
Neuroectodermal Tumors
Antibodies
Nevus, Pigmented
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Nevus
Cytotoxic T-lymphocyte antigen 4
Recurrence
Immunoglobulins
Neuroendocrine Tumors
Melanoma

Additional relevant MeSH terms:
Neuroectodermal Tumors
Neoplasms
Neoplasms by Histologic Type
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Nevi and Melanomas
Neuroendocrine Tumors
Melanoma

ClinicalTrials.gov processed this record on September 03, 2009