A Randomized Phase II Trial of Multi-Epitope Vaccination With Melanoma Peptides For Cytotoxic T Cells And Helper T Cells For Patients With Metastatic Melanoma
OBJECTIVES:
- Compare the cytotoxic T-cell response to each of 12 melanoma peptides restricted by
Human Leukocyte Antigen (HLA)-A1, -A2, or -A3 in patients with metastatic melanoma
vaccinated with or without these 12 melanoma peptides and with or without helper
peptides.
- Compare the helper T-cell response to each of 6 melanoma helper peptides restricted by
HLA-DR molecules in patients treated with these vaccinations.
- Determine whether the addition of 6 melanoma helper peptides to a vaccine containing
multiple class I Major histocompatibility complex (MHC)-restricted peptides augments
T-cell responses to the class I restricted peptides in these patients.
- Determine, preliminarily, whether booster vaccination maintains immune response in
patients treated with these vaccinations.
- Compare the rates of clinical response and survival in patients treated with these
vaccinations.
- Determine, preliminarily, whether cellular immune response correlates with clinical
response and survival rates in patients treated with these vaccinations.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to HLA
type (HLA-A1 vs HLA-A2 vs HLA-A1 and -A2 vs HLA-A3) and planned sentinel immunized node
biopsy (yes vs no). Patients are randomized to 1 of 4 treatment arms.
- Arm I: Patients receive 2 injections of multi-epitope peptide vaccine comprising 12
melanoma peptides restricted by Class I MHC (12MP) emulsified with sargramostim
(Granulocyte-macrophage colony-stimulating factor, GM-CSF) and Montanide ISA-51 or
Montanide ISA-51 VG (ISA-51) intradermally (ID) and subcutaneously (SC) on day 1 of
weeks 1-3 and 1 injection at the primary site only on day 1 of weeks 5-7.
- Arm II: Patients receive 2 injections of multi-epitope peptide vaccine comprising 12MP
and 1 tetanus helper peptide emulsified with GM-CSF and ISA-51 ID and SC on day 1 of
weeks 1-3 and 1 injection at the primary site only on day 1 of weeks 5-7.
- Arm III (closed to accrual as of 5/19/08): Patients receive 2 injections of
multi-epitope peptide vaccine comprising 12MP and 6 melanoma helper peptides (6HP)
emulsified with GM-CSF and ISA-51 ID and SC on day 1 of weeks 1-3 and 1 injection at
the primary site only on day 1 of weeks 5-7.
- Arm IV: Patients receive 2 injections of multi-epitope peptide vaccine comprising 6HP
emulsified with GM-CSF and ISA-51 ID and SC on day 1 of weeks 1-3 and 1 injection at
the primary site only on day 1 of weeks 5-7.
In all arms, patients continue therapy in the absence of unacceptable toxicity or disease
progression necessitating other urgent therapy.
Patients are evaluated at 8 and 12 weeks. Beginning 2-3 weeks after the week-12 evaluation,
patients with no evidence of disease progression may receive booster vaccinations according
to their randomized treatment arm. Patients receive booster vaccination ID and SC once
weekly for 3 weeks. Treatment repeats every 9 weeks for 1 course, every 12 weeks for 2
courses, and then every 24 weeks for 2 courses OR for up to 2 years (whichever comes first)
provided the patient does not require an urgent change in therapy.
After completion of study treatment, patients are followed every 6 months for 2 years and
then for survival for 5 years from study randomization.
ACTUAL ACCRUAL: A total of 175 patients were accrued for this study during March 2005 and
January 2009.
Interventional
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Cytotoxic T-cell Lymphocytes (CTL) Response Rate
Assessment of CTL response was based on a fold-increase in T cell response measure by interferon-gamma ELIspot assay.
Immune response was assessed at pre-registrtion, in weeks 1, 3, 5, 7, 8
No
Craig L. Slingluff, MD
Study Chair
University of Virginia
United States: Federal Government
CDR0000335055
NCT00071981
March 2005
January 2014
Name | Location |
---|---|
Mayo Clinic - Jacksonville | Jacksonville, Florida 32224 |
Mayo Clinic Cancer Center | Rochester, Minnesota 55905 |
CCOP - Christiana Care Health Services | Wilmington, Delaware 19899 |
CCOP - Carle Cancer Center | Urbana, Illinois 61801 |
CCOP - Metro-Minnesota | Saint Louis Park, Minnesota 55416 |
CCOP - Northern New Jersey | Hackensack, New Jersey 07601 |
Rush-Copley Cancer Care Center | Aurora, Illinois 60507 |
Joliet Oncology-Hematology Associates, Limited - West | Joliet, Illinois 60435 |
Carle Cancer Center at Carle Foundation Hospital | Urbana, Illinois 61801 |
Saint Anthony Memorial Health Centers | Michigan City, Indiana 46360 |
Bronson Methodist Hospital | Kalamazoo, Michigan 49007 |
West Michigan Cancer Center | Kalamazoo, Michigan 49007-3731 |
Borgess Medical Center | Kalamazooaa, Michigan 49001 |
Fairview Ridges Hospital | Burnsville, Minnesota 55337 |
Mercy and Unity Cancer Center at Mercy Hospital | Coon Rapids, Minnesota 55433 |
Fairview Southdale Hospital | Edina, Minnesota 55435 |
Mercy and Unity Cancer Center at Unity Hospital | Fridley, Minnesota 55432 |
Minnesota Oncology Hematology, PA - Maplewood | Maplewood, Minnesota 55109 |
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital | Minneapolis, Minnesota 55407 |
Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center | Robbinsdale, Minnesota 55422-2900 |
St. Francis Cancer Center at St. Francis Medical Center | Shakopee, Minnesota 55379 |
Park Nicollet Cancer Center | St. Louis Park, Minnesota 55416 |
United Hospital | St. Paul, Minnesota 55102 |
Ridgeview Medical Center | Waconia, Minnesota 55387 |
Minnesota Oncology Hematology, PA - Woodbury | Woodbury, Minnesota 55125 |
Case Comprehensive Cancer Center | Cleveland, Ohio 44106-5065 |
Sanford Cancer Center at Sanford USD Medical Center | Sioux Falls, South Dakota 57117-5039 |
Medical X-Ray Center, PC | Sioux Falls, South Dakota 57105 |
Avera Cancer Institute | Sioux Falls, South Dakota 57105 |
University of Wisconsin Paul P. Carbone Comprehensive Cancer Center | Madison, Wisconsin 53792-6164 |
Marshfield Clinic - Marshfield Center | Marshfield, Wisconsin 54449 |
Marshfield Clinic - Indianhead Center | Rice Lake, Wisconsin 54868 |
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Baltimore, Maryland 21231-2410 |
Veterans Affairs Medical Center - Palo Alto | Palo Alto, California 94304 |
McCreery Cancer Center at Ottumwa Regional | Ottumwa, Iowa 52501 |
Indiana University Melvin and Bren Simon Cancer Center | Indianapolis, Indiana 46202-5289 |
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School | New Brunswick, New Jersey 08903 |
Gundersen Lutheran Center for Cancer and Blood | La Crosse, Wisconsin 54601 |
Robert H. Lurie Comprehensive Cancer Center at Northwestern University | Chicago, Illinois 60611 |
Morgan Cancer Center at Lehigh Valley Hospital - Cedar Crest | Allentown, Pennsylvania 18105 |
Fox Chase Cancer Center - Philadelphia | Philadelphia, Pennsylvania 19111-2497 |
Hematology Oncology Associates - Skokie | Skokie, Illinois 60076 |
UPMC Cancer Centers | Pittsburgh, Pennsylvania 15232 |
Hematology and Oncology Associates | Chicago, Illinois 60611 |
Midwest Center for Hematology/Oncology | Joliet, Illinois 60432 |
North Shore Oncology and Hematology Associates, Limited - Libertyville | Libertyville, Illinois 60048 |
Cancer Institute of New Jersey at Cooper - Voorhees | Voorhees, New Jersey 08043 |
St. Mary Regional Cancer Center | Langhorne, Pennsylvania 19047 |
Stanford Cancer Center | Stanford, California 94305-5824 |
Tunnell Cancer Center at Beebe Medical Center | Lewes, Delaware 19958 |
University of Miami Sylvester Comprehensive Cancer Center - Miami | Miami, Florida 33136 |
Cancer Care and Hematology Specialists of Chicagoland - Niles | Niles, Illinois 60714 |
William N. Wishard Memorial Hospital | Indianapolis, Indiana 46202 |
Greater Baltimore Medical Center Cancer Center | Baltimore, Maryland 21204 |
Union Hospital Cancer Program at Union Hospital | Elkton MD, Maryland 21921 |
Christ Hospital Cancer Center | Cincinnati, Ohio 45219 |
Center for Cancer Treatment & Prevention at Sacred Heart Hospital | Eau Claire, Wisconsin 54701 |
Marshfield Clinic Cancer Care at Regional Cancer Center | Eau Claire, Wisconsin 54701 |
Saint Joseph's Hospital | Marshfield, Wisconsin 54449 |
Marshfield Clinic - Lakeland Center | Minocqua, Wisconsin 54548 |
Ministry Medical Group at Saint Mary's Hospital | Rhinelander, Wisconsin 54501 |
Saint Michael's Hospital Cancer Center | Stevens Point, Wisconsin 54481 |
Marshfield Clinic - Wausau Center | Wausau, Wisconsin 54401 |
Marshfield Clinic - Weston Center | Weston, Wisconsin 54476 |
Marshfield Clinic - Wisconsin Rapids Center | Wisconsin Rapids, Wisconsin 54494 |