Phase II Trial of FANG™ Autologous Tumor Cell Vaccine in Advanced Melanoma
This is a Phase I open-label trial of FANG autologous tumor cell vaccine in inpatients with
stages IIIc and IV melanoma. Patients will receive FANG™ autologous tumor vaccine once
every 4 weeks for up to 12 doses via intradermal injection as long as sufficient material is
available. All patients with successful harvest for a minimum of 5 (1 x 10e7 cells /
injection) monthly injections will be entered into the study. Patients in whom insufficient
tissue (<5 doses) is collected or whose vaccine fails manufacturing release criteria will
not receive vaccine. The patients will be managed in an outpatient setting. Hematologic
function, liver enzymes, renal function and electrolytes will be monitored by once weekly
assessment during Cycle 1. Immune response (defined as production of interferon-gamma and
granzyme from CD8+ T cells in response to autologous tumor antigens as evaluated in the
ELISPOT assay) and secondary immunologic endpoints including, but not limited to, PBMC
counts, phenotyping of blood lymphocyte subsets (T cell subsets including CD4, CD8 and Treg
cells, NK cells, etc), and Fox P3+ cells will be monitored at baseline, months 2, 3, 4, end
of treatment, and at response follow up visits. (Note that in some instances IFN secretion
and granule exocytosis are uncoupled. Therefore the direct measurement of granzyme B (gzB)
secretion by ELISPOT provides a more direct readout for antigen-specific granule exocytosis
and cytotoxicity. For clinical efficiency it may be important to detect both IFN-gamma
secretion and gzB exocytosis.) Intratumoral immune response including CD4, CD8 and Treg
cells, NK cells, MHC I, MHC II, and Fox P3+ cells will be monitored at baseline and at month
2 and month 4. If tissue is available, biopsy one month following end of treatment or at
progression will be likewise be obtained for immune phenotype analysis.
Treatment will be continued until progressive disease however, insofar as some patients in
our early vaccine trials had increased survival despite initial tumor progression, if early
progression is noted without clinically significant symptomatic change, particularly at the
2 month evaluation, patient will continue on protocol after review with the PI. Each
investigator will assess disease response (complete response [irCR], partial response
[irPR], stable disease [irSD], and progressive disease [irPD]) using IRC criteria (Wolchok,
Hoos et al. 2009) as well as RECIST criteria for measurable/detectable disease. If ≥ Grade
2 toxicity by NCI Common Toxicity Criteria (excluding Grade 2 fever less than 24 hours and
Grade 3 injection site reaction) develops related to study treatment the vaccine dose will
be reduced by 50% and continued on a monthly basis.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Immune Responses to FANG
To evaluate and correlate blood and intratumoral immune responses to FANG™ vaccine in patients with melanoma.
Actively monitored for one year then quarterly for 3 years
No
Minal Barve, MD
Principal Investigator
Mary Crowley Cancer Research Center
United States: Food and Drug Administration
CL-PTL 114
NCT01453361
October 2011
December 2013
Name | Location |
---|---|
Mary Crowley Cancer Research Centers | Dallas, Texas 75201 |