Vaccine Therapy in Treating Patients With Metastatic Melanoma

NCT ID: NCT00003224

Last Updated: 2014-11-20

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

1996-02-29

Brief Summary

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RATIONALE: Vaccines made from peptide 946 may make the body build an immune response to kill tumor cells. Combining these vaccines with proteins from the tetanus vaccine, and/or with either QS21 or Montanide ISA-51 may be an effective treatment for metastatic melanoma.

PURPOSE: Randomized phase I trial to study the effectiveness of vaccines made from peptide 946 with or without tetanus peptide, QS21, or Montanide ISA-51 in treating patients with metastatic melanoma that cannot be surgically removed or with melanoma that is likely to recur.

Detailed Description

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OBJECTIVES:

I. Determine the safety of peptide 946 melanoma vaccine (peptide 946), peptide 946 combined with tetanus peptide melanoma vaccine, or peptide 946-tetanus peptide conjugate in patients with high risk melanoma.

II. Determine the immunogenicity of peptide 946 melanoma vaccine (peptide 946), peptide 946 combined with tetanus peptide melanoma vaccine, or peptide 946-tetanus peptide conjugate in patients with high risk melanoma.

OUTLINE: This is a randomized, open-label study. Patients are randomized to 1 of 6 treatment arms: Arm I: Patients receive peptide 946 melanoma vaccine (peptide 946) emulsified with QS21 subcutaneously (SQ). Arm II: Patients receive peptide 946 emulsified with Montanide ISA-51 (ISA-51) SQ. Arm III: Patients receive peptide 946 combined with tetanus peptide melanoma vaccine (tetanus peptide) emulsified with QS21 SQ. Arm IV: Patients receive peptide 946 combined with tetanus peptide emulsified with ISA-51 SQ. Arm V: Patients receive peptide 946-tetanus peptide conjugate emulsified with QS21 SQ. Arm VI: Patients receive peptide 946-tetanus peptide conjugate emulsified with ISA-51 SQ. Initially, 4 patients are randomized to Arm I and 4 patients are randomized to Arm II. If no dose limiting toxicities are observed in these patients, then additional patients are randomized to arms III-VI. Patients in each arm receive vaccine on day 0 and at months 1, 2, 3, 6, 9, and 12. Patients are followed at 6 and 12 months.

PROJECTED ACCRUAL: A maximum of 36 patients will be accrued for this study.

Conditions

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Melanoma (Skin)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group 1: peptide 946 plus QS-21

100 mcg peptide gp100 \[280-288\] plus 0.2 ml (100 mcg) QS-21 vaccine adjuvant

Group Type EXPERIMENTAL

QS21

Intervention Type BIOLOGICAL

vaccine adjuvant

p946

Intervention Type BIOLOGICAL

This a nonamer peptide YLEPGPVTA from Gp100, used as a melanoma vaccine antigen.

Group 2. p946 plus IFA

100 mcg peptide gp100 \[280-288\] plus 0.5 ml IFA (Montanide ISA-51) vaccine adjuvant

Group Type EXPERIMENTAL

IFA (incomplete Freund's adjuvant)

Intervention Type BIOLOGICAL

Peptides emulsified in IFA.

p946

Intervention Type BIOLOGICAL

This a nonamer peptide YLEPGPVTA from Gp100, used as a melanoma vaccine antigen.

Group 3: p946 plus Tet-p plus QS-21

100 mcg peptide gp100 \[280-288\],190 mcg tetanus peptide, plus 0.2 ml (100 mcg) QS-21 vaccine adjuvant

Group Type EXPERIMENTAL

QS21

Intervention Type BIOLOGICAL

vaccine adjuvant

p946

Intervention Type BIOLOGICAL

This a nonamer peptide YLEPGPVTA from Gp100, used as a melanoma vaccine antigen.

Tet-p

Intervention Type BIOLOGICAL

modified form of the p2 peptide from tetanus toxoid, used as nonspecific epitope for helper T cells.

Group 4. p946, Tet-p plus IFA

100 mcg peptide gp100 \[280-288\], 190 mcg tetanus peptide, plus 0.5 ml IFA (Montanide ISA-51) vaccine adjuvant

Group Type EXPERIMENTAL

IFA (incomplete Freund's adjuvant)

Intervention Type BIOLOGICAL

Peptides emulsified in IFA.

p946

Intervention Type BIOLOGICAL

This a nonamer peptide YLEPGPVTA from Gp100, used as a melanoma vaccine antigen.

Tet-p

Intervention Type BIOLOGICAL

modified form of the p2 peptide from tetanus toxoid, used as nonspecific epitope for helper T cells.

Group 5: p946/Tet-p plus QS-21

282 mcg gp100 \[280-288\]/tetanus peptide conjugate, plus 0.2 ml (100 mcg) QS-21 vaccine adjuvant

Group Type EXPERIMENTAL

QS21

Intervention Type BIOLOGICAL

vaccine adjuvant

p946/tet-p

Intervention Type BIOLOGICAL

This peptide is a longer version of p946 (gp100 \[280-288\]) sythesized colinearly with the tetanus helper peptide (Tet-p)

Group 6. p946/Tet-p plus IFA

282 mcg gp100 \[280-288\]/tetanus peptide conjugate, plus 0.5 ml IFA (Montanide ISA-51) vaccine adjuvant

Group Type EXPERIMENTAL

IFA (incomplete Freund's adjuvant)

Intervention Type BIOLOGICAL

Peptides emulsified in IFA.

p946/tet-p

Intervention Type BIOLOGICAL

This peptide is a longer version of p946 (gp100 \[280-288\]) sythesized colinearly with the tetanus helper peptide (Tet-p)

Interventions

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QS21

vaccine adjuvant

Intervention Type BIOLOGICAL

IFA (incomplete Freund's adjuvant)

Peptides emulsified in IFA.

Intervention Type BIOLOGICAL

p946

This a nonamer peptide YLEPGPVTA from Gp100, used as a melanoma vaccine antigen.

Intervention Type BIOLOGICAL

p946/tet-p

This peptide is a longer version of p946 (gp100 \[280-288\]) sythesized colinearly with the tetanus helper peptide (Tet-p)

Intervention Type BIOLOGICAL

Tet-p

modified form of the p2 peptide from tetanus toxoid, used as nonspecific epitope for helper T cells.

Intervention Type BIOLOGICAL

Other Intervention Names

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Montanide ISA-51, from Seppic. peptide 946, gp100 [280-288], YLEPGPVTA peptide 946-tetanus peptide conjugate melanoma vaccine tetanus peptide melanoma vaccine

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed unresectable metastatic melanoma (AJCC stage III or IV) OR resected melanoma with high risk of recurrence or mortality (stage IIB and above)
* Age: 18 to 79
* Performance status: ECOG 0-2
* Life expectancy: Greater than 12 months
* Hematopoietic: Absolute neutrophil count greater than 1,000/mm3 Platelet count greater than 100,000/mm3 Hemoglobin greater than 9 g/dL
* Hepatic: AST and ALT no greater than 2.5 times upper limit of normal (ULN) Bilirubin no greater than 2.5 times ULN Alkaline phosphatase no greater than 2.5 times ULN
* Renal: Creatinine no greater than 1.5 times ULN

Exclusion Criteria

* patients currently receiving cytotoxic chemotherapy or who have received that therapy within the preceding 3 months
* known or suspected allergies to any component of the treatment vaccine
* unresectable tumor llikely to cause symptoms and for which therapy is anticipated within 3 months.
* receiving acute treatment for seriouis infection within 14 days.
* Patients with bulky disease, or with multiple brain metastases, but solitary brain metastases treated successfully with surgery or gamma knife may be eligible.
* Any of the following with 3 months:
* agentes with putative immunomodulating activity (except NSAIDs)
* allergy desensitizing injections
* other investigational agents
* interferons
* corticosteroids
* any growth factors
* prior melanoma vaccinations
* pregnancy or the possibility of becoming pregnant on study
* medical contraindication or potential problems in complying with the requirements of the protocol.
Minimum Eligible Age

18 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Virginia

OTHER

Sponsor Role lead

Responsible Party

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Craig L Slingluff, Jr

Professor of Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Craig L. Slingluff, MD

Role: STUDY_CHAIR

University of Virginia

Locations

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Cancer Center, University of Virginia HSC

Charlottesville, Virginia, United States

Site Status

Countries

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United States

References

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Slingluff CL Jr, Yamshchikov G, Neese P, Galavotti H, Eastham S, Engelhard VH, Kittlesen D, Deacon D, Hibbitts S, Grosh WW, Petroni G, Cohen R, Wiernasz C, Patterson JW, Conway BP, Ross WG. Phase I trial of a melanoma vaccine with gp100(280-288) peptide and tetanus helper peptide in adjuvant: immunologic and clinical outcomes. Clin Cancer Res. 2001 Oct;7(10):3012-24.

Reference Type RESULT
PMID: 11595689 (View on PubMed)

Other Identifiers

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NCI-H98-0010

Identifier Type: -

Identifier Source: secondary_id

6346

Identifier Type: -

Identifier Source: org_study_id