Melanoma Vaccines: Differentiation Antigen Peptides (MART-1:27-35, Tyrosinase and Gp-100) as Immune Targets
18 Years
N/A
Both
Recurrent Melanoma, Stage IV Melanoma
Trial Information
Melanoma Vaccines: Differentiation Antigen Peptides (MART-1:27-35, Tyrosinase and Gp-100) as Immune Targets
PRIMARY OBJECTIVES:
I. Determine the immunological effects of immunization protocols utilizing MART-1:27-35
(MART-1:27-35 peptide vaccine), tyrosinase (tyrosinase peptide) or gp-100 (gp100 antigen)
peptides suspended in incomplete Freund's adjuvant (IFA) in the presence of two different
concentrations of sargramostim (GM-CSF).
II. Define the safety and toxicity profile of an immunization protocol utilizing varying
concentrations of MART-1:27-35, tyrosinase and gp-100 peptides suspended in IFA in the
presence of two different concentrations of GM-CSF.
III. Collect preliminary data on therapeutic efficacy as it relates to parameters of immune
function in patients with stage IV malignant melanoma.
OUTLINE: Patients are randomized to 1 of 3 treatment arms.
ARM I: Patients receive tyrosinase peptide, MART-1:27-35 peptide vaccine, and gp100 antigen
admixed in incomplete Freund's adjuvant subcutaneously (SC) on day 1 of weeks 0, 3, 6, 9,
12, and 24.
ARM II: Patients receive tyrosinase peptide, MART-1:27-35 peptide vaccine, and gp100 antigen
admixed in incomplete Freund's adjuvant SC and lower-dose sargramostim SC on day 1 of weeks
0, 3, 6, 9, 12, and 24.
ARM III: Patients receive tyrosinase peptide, MART-1:27-35 peptide vaccine, and gp100
antigen admixed in incomplete Freund's adjuvant SC and higher-dose sargramostim SC on day 1
of weeks 0, 3, 6, 9, 12, and 24.
In all arms, treatment may repeat every 3 months for up to 18 months in the absence of
disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up every 3 months for up to 3
years.
Inclusion Criteria:
- Human leukocyte antigen (HLA)-A2 positive
- Histologic proof of stage IV malignant melanoma with measurable disease
- Absolute neutrophil count (ANC) >= 1500
- Platelets (PLT) >= 100,000
- Alkaline phosphatase (Alk phos) =< 3 x upper limit of normal (ULN)
- Aspartate aminotransferase (AST) =< 3 x ULN
- Creatinine (Creat) =< 1.5 x ULN
- Hemoglobin (Hgb) > 9.0
- Ability to provide informed consent
- Willingness to return to a Mayo Clinic institution for follow-up
- Life expectancy >= 12 weeks
- Eastern Cooperative Oncology Group (ECOG) performance status 0, 1 or 2
Exclusion Criteria:
- Uncontrolled or current infection
- Prior immunization with differentiation antigen peptides
- Known standard therapy for the patient's disease that is potentially curative or
proven capable of extending life expectancy
- Any of the following prior therapies:
- Chemotherapy =< 4 weeks
- Mitomycin C/nitrosoureas =< 6 weeks
- Immunotherapy =<4 weeks
- Biologic therapy =< 4 weeks
- Radiation therapy =< 4 weeks
- Radiation to > 25% of bone marrow
- Failure to fully recover from effects of prior chemotherapy regardless of interval
since last treatment
- New York Heart Association classification III or IV
- Seizure disorder
- Any of the following:
- Pregnant women
- Nursing women
- Women of childbearing potential or their sexual partners who are unwilling to
employ adequate contraception (condoms, diaphragm, birth control pills,
injections, intrauterine device [IUD], surgical sterilization, subcutaneous
implants, or abstinence, etc.)
- Other concurrent chemotherapy, immunotherapy, or radiotherapy
- Active psychiatric disorder requiring medications (anti-psychotics)
- Known central nervous system metastases or carcinomatous meningitis
- History of other malignancy in last 5 years with the exception of basal cell or
squamous cell carcinoma of the skin treated with local resection only (it is
impossible to predict the effect of study treatment on other, potentially dormant
malignant diseases)
- Known immune deficiency (patients with known immune deficiencies will likely not be
able to mount an immune response to the study vaccine)
Type of Study:
Interventional
Study Design:
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Outcome Measure:
Changes in tumor antigen peptide specific immune responses
Outcome Description:
Plots of the percent changes in these factors from their pretreatment levels against time will be constructed.
Outcome Time Frame:
Baseline and 24 weeks
Safety Issue:
No
Principal Investigator
Svetomir Markovic
Investigator Role:
Principal Investigator
Investigator Affiliation:
Mayo Clinic
Authority:
United States: Food and Drug Administration
Study ID:
NCI-2012-02359
NCT ID:
NCT00006243
Start Date:
October 2000
Completion Date:
Related Keywords:
- Recurrent Melanoma
- Stage IV Melanoma
- Melanoma
Name | Location |
|---|---|
| Mayo Clinic | Rochester, Minnesota 55905 |
