Vaccine Therapy and Sargramostim in Treating Patients With Stage IV Malignant Melanoma

NCT ID: NCT00006243

Last Updated: 2013-01-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-10-31

Brief Summary

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This randomized pilot clinical trial studies vaccine therapy and sargramostim in treating patients with stage IV malignant melanoma. Vaccines made from melanoma peptides or antigens may help the body build an effective immune response to kill tumor cells. Colony-stimulating factors, such as sargramostim, increase the number of white blood cells and platelets found in bone marrow or peripheral blood. Giving vaccine therapy together with sargramostim may be an effective treatment for malignant melanoma

Detailed Description

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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.

Conditions

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Recurrent Melanoma Stage IV Melanoma

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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Arm I (vaccine therapy)

Patients receive tyrosinase peptide, MART-1:27-35 peptide vaccine, and gp100 antigen admixed in incomplete Freund's adjuvant SC on day 1 of weeks 0, 3, 6, 9, 12, and 24.

Group Type EXPERIMENTAL

tyrosinase peptide

Intervention Type BIOLOGICAL

Given SC

MART-1:27-35 peptide vaccine

Intervention Type BIOLOGICAL

Given SC

gp100 antigen

Intervention Type BIOLOGICAL

Given SC

incomplete Freund's adjuvant

Intervention Type BIOLOGICAL

Given SC

laboratory biomarker analysis

Intervention Type OTHER

Correlative studies

Arm II (vaccine therapy and lower-dose sargramostim)

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.

Group Type EXPERIMENTAL

tyrosinase peptide

Intervention Type BIOLOGICAL

Given SC

MART-1:27-35 peptide vaccine

Intervention Type BIOLOGICAL

Given SC

gp100 antigen

Intervention Type BIOLOGICAL

Given SC

incomplete Freund's adjuvant

Intervention Type BIOLOGICAL

Given SC

sargramostim

Intervention Type BIOLOGICAL

Given SC

laboratory biomarker analysis

Intervention Type OTHER

Correlative studies

Arm III (vaccine therapy and higher-dose sargramostim)

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.

Group Type EXPERIMENTAL

tyrosinase peptide

Intervention Type BIOLOGICAL

Given SC

MART-1:27-35 peptide vaccine

Intervention Type BIOLOGICAL

Given SC

gp100 antigen

Intervention Type BIOLOGICAL

Given SC

incomplete Freund's adjuvant

Intervention Type BIOLOGICAL

Given SC

sargramostim

Intervention Type BIOLOGICAL

Given SC

laboratory biomarker analysis

Intervention Type OTHER

Correlative studies

Interventions

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tyrosinase peptide

Given SC

Intervention Type BIOLOGICAL

MART-1:27-35 peptide vaccine

Given SC

Intervention Type BIOLOGICAL

gp100 antigen

Given SC

Intervention Type BIOLOGICAL

incomplete Freund's adjuvant

Given SC

Intervention Type BIOLOGICAL

sargramostim

Given SC

Intervention Type BIOLOGICAL

laboratory biomarker analysis

Correlative studies

Intervention Type OTHER

Other Intervention Names

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TYRP gp100 IFA ISA-51 Montanide ISA 51 GM-CSF Leukine Prokine

Eligibility Criteria

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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)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Svetomir Markovic

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic

Rochester, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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MC9973

Identifier Type: -

Identifier Source: secondary_id

CDR0000068171

Identifier Type: REGISTRY

Identifier Source: secondary_id

NCI-2012-02359

Identifier Type: -

Identifier Source: org_study_id

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