Vaccine Therapy With High-Dose Interleukin-2 in Treating Patients With Metastatic Melanoma

NCT ID: NCT00003568

Last Updated: 2013-06-26

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Study Classification: INTERVENTIONAL
• Study Start Date: 1998-11-30
• Study Completion Date: 2005-12-31

Brief Summary

RATIONALE: Vaccines may make the body build an immune response that will kill tumor cells. Interleukin-2 may stimulate a person's white blood cells to kill melanoma cells.

PURPOSE: Randomized phase II trial to study the effectiveness of vaccine therapy with interleukin-2 in treating patients with metastatic melanoma.

Detailed Description

OBJECTIVES:

• Define the antitumor activity of gp100:209-217 (210M), a melanoma peptide derived from gp100 mixed with Montanide ISA-51, in combination with high-dose interleukin-2 (IL-2) administered by various schedules in patients with advanced melanoma.
• Examine the effect of the addition of gp100:209-217 (210M) peptide vaccine to high-dose IL-2 on the toxicity of the treatment in these patients.
• Define the induction of T-cell responses to gp100:209-217 (210M) peptide and its gp100 (parent) protein by ELISA with interferon gamma production or CTL precursor frequencies in these patients after the initial course of treatment.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior therapy (adjuvant interferon vs chemotherapy for advanced disease vs both vs none), ECOG performance status (0 vs 1), and number of organ sites involved (1 vs more than 1). Patients are randomized into 1 of 3 treatment arms. (Arm III closed to accrual as of 11/30/1998.)

• Arm I: Patients receive vaccination comprising gp100:209-217 (210M) peptide mixed with Montanide ISA-51 subcutaneously on days 1, 22, 43, and 64. Patients also receive high-dose interleukin-2 (IL-2) IV over 15 minutes every 8 hours on days 2-6 and 16-20.
• Arm II: Patients receive vaccination as in arm I on days 1, 22, 43, and 64. Patients also receive high-dose IL-2 as in arm I on days 44-48 and 60-64. Patients who demonstrate rapid visible disease progression during the initial 4 weeks of therapy while maintaining good performance status may begin high-dose IL-2 on day 23.
• Arm III (closed to accrual as of 11/30/1998): Patients receive vaccination as in arm I on day 1 and then high-dose IL-2 as in arm I on day 2. Patients with nonhematologic toxicity may only receive vaccination on weeks 4, 7, and 10. Other patients may also receive IL-2 beginning on day 2 of each treatment week (4, 7, and 10) for up to 14 doses.

Patients in each arm may receive up to a total of 3 courses of treatment.

Patients are followed until death.

PROJECTED ACCRUAL: Approximately 90 patients (25 patients for arms I and II and 40 patients for arm III [arm III closed to accrual as of 11/30/1998]) will be accrued for this study within 12-18 months.

Conditions

Melanoma (Skin)

Study Design

• Allocation Method: RANDOMIZED
• Primary Study Purpose: TREATMENT

Interventions

aldesleukin

Intervention Type: BIOLOGICAL

gp100 antigen

Intervention Type: BIOLOGICAL

incomplete Freund's adjuvant

Intervention Type: BIOLOGICAL

Eligibility Criteria

Inclusion Criteria

DISEASE CHARACTERISTICS:

• Histologically confirmed clearly progressive metastatic or unresectable melanoma
• Must be HLA-A2.1 positive
• Measurable disease
• No active brain metastases, leptomeningeal disease, or seizure disorder

• More than 4 months since prior definitive therapy (surgery or radiotherapy) for brain metastases and must not have evidence of disease on brain CT scan or MRI
• No ascites or pleural effusions

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• ECOG 0-1 OR
• Karnofsky 80-100%

Life expectancy:

• Not specified

Hematopoietic:

• WBC at least 3,500/mm^3
• Platelet count at least 100,000/mm^3
• Hemoglobin at least 9 g/dL

Hepatic:

• Bilirubin no greater than 2.0 mg/dL

Renal:

• Creatinine no greater than 1.5 mg/dL OR
• Creatinine clearance at least 60 mL/min

Cardiovascular:

• No congestive heart failure
• No symptoms of coronary artery disease
• No serious cardiac arrhythmias
• No evidence of prior myocardial infarction on EKG
• Normal cardiac stress test required for all patients over 40 years

Pulmonary:

• FEV_1 greater than 2.0 liters or at least 75% of predicted
• No chronic obstructive pulmonary disease

Other:

• HIV negative
• No significant systemic infection
• No contraindication to use of pressor agents
• No history of major psychiatric illness
• No other major illness that would significantly increase the risk of immunotherapy
• No other active malignancy except surgically cured nonmelanoma skin cancer or carcinoma in situ or stage I carcinoma of the cervix
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No prior interleukin-2
• At least 4 weeks since prior vaccine therapy or other cytokine therapy

Chemotherapy:

• One prior chemotherapy regimen allowed
• At least 4 weeks since prior chemotherapy (6 weeks for carmustine or lomustine) and recovered

Endocrine therapy:

• No concurrent steroids

Radiotherapy:

• See Disease Characteristics
• No prior radiotherapy to areas of measurable disease unless there has been clearly progressive disease in this site or there is measurable disease outside of areas of prior radiation
• At least 2 weeks since prior radiotherapy for local control or palliative therapy and recovered

Surgery:

• See Disease Characteristics
• Recovered from prior major surgery
• No prior organ allografts

Other:

• No antihypertensive therapy within 24 hours prior to interleukin-2

• Minimum Eligible Age: 16 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: collaborator

University of Illinois at Chicago

OTHER

Sponsor Role: lead

Principal Investigators

David M. Gustin, MD

Role: STUDY_CHAIR

University of Illinois at Chicago

Locations

City of Hope Comprehensive Cancer Center

Duarte, California, United States

University of Illinois at Chicago Health Sciences Center

Chicago, Illinois, United States

Loyola University Medical Center

Maywood, Illinois, United States

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, United States

Comprehensive Cancer Center at Our Lady of Mercy Medical CenterOur

The Bronx, New York, United States

University of Pittsburgh Cancer Institute

Pittsburgh, Pennsylvania, United States

Vanderbilt University Medical Center

Nashville, Tennessee, United States

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Countries

United States

Other Identifiers

CDR0000066634

Identifier Type: REGISTRY

Identifier Source: secondary_id

NCI-T98-0027

Identifier Type: -

Identifier Source: secondary_id

CWG-UIC-T98-0027

Identifier Type: -

Identifier Source: org_study_id