| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2013-02096 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| CDR0000067065 | |||
| NCI-T98-0081 | |||
| PPMC-IRB-99-9 | Other Identifier | Providence Portland Medical Center | |
| 99-9 | Other Identifier | Providence Portland Medical Center | |
| T98-0081 | Other Identifier | CTEP | |
| R21CA082614 | U.S. NIH Grant/Contract | View source |
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This randomized pilot phase II trial studies how well vaccine therapy works in treating human leukocyte antigen class 1 histocompatibility, A-2 (HLA-A2) positive patients with melanoma. Vaccines made from peptides may help the body build an effective immune response to kill tumor cells.
PRIMARY OBJECTIVES:
I. To define the toxicity of administration of gp100: 209-217 (210M) (gp100:209-217[210M] peptide vaccine) and the human papillomavirus (HPV) 16 E7(12-20) peptide (HPV16E7:12-20 peptide vaccine), with adjuvant Montanide ISA-51 (incomplete Freund's adjuvant), to patients who present with a primary melanoma > 1 mm thick.
II. To measure the T-cell response to the modified self-gp100: 209-217 (210M) peptide and the unmodified parental glycoprotein 100 (gp100) peptide.
III. To measure the T-cell response to the control human leukocyte antigen (HLA)-A2.1 restricted cytotoxic T-lymphocyte (CTL) epitope of papilloma virus HPV16E7:12-20.
IV. To determine whether analysis of antigen-specific T-cells using specific HLA-A2/peptide tetramers is an effective method for monitoring the immune response of patients undergoing peptide vaccination and to compare it to enzyme-linked immunosorbent spot (ELISPOT), limiting dilution analysis (LDA) and measurement of intracellular cytokine production (fastimmune).
V. To determine whether there is a difference between the induction of primary peptide-specific T-cell immune responses to the self gp100 peptide versus the foreign E7 peptide.
VI. To compare the immune response induced by vaccinating every 2 weeks for 6 months (a total of 13 vaccinations) vs. every 3 weeks for 6 months (a total of 9 vaccinations).
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM A: Patients receive gp100:209-217(210M) peptide vaccine and HPV16E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant subcutaneously (SC) every 2 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity.
ARM B: Patients receive gp100:209-217(210M) peptide vaccine and HPV16E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant SC every 3 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity.
In both arms, patients undergo sentinel lymph node biopsy approximately 10 days after the second vaccination. Patients with positive lymph nodes undergo complete lymph node dissection and resume vaccinations.
After completion of study treatment, patients are followed up every 3 months for 1 year, every 4 months for 1 year, every 6 months for 3 years, and then yearly thereafter.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| gp100:209-217(210M) + HPV 16 E7:12-20 (every 2 weeks) | Experimental | Patients receive gp100:209-217(210M) peptide vaccine and HPV 16 E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant SC every 2 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo laboratory biomarker analysis. |
|
| gp100:209-217(210M) + HPV 16 E7:12-20 (every 3 weeks) | Experimental | Patients receive gp100:209-217(210M) peptide vaccine and HPV 16 E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant SC every 3 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. Patients undergo laboratory biomarker analysis. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HPV 16 E7:12-20 | Biological | Given SC |
|
| Measure | Description | Time Frame |
|---|---|---|
| T Cell Immunity to gp100 Peptide and to E7 12-20 Papilloma Virus Peptide | Frequency measures obtained from each assay will be transformed to (common) logs for purposes of analysis. Repeated measures analyses will be performed on longitudinal data to assess patients' immune response profiles over time. Comparability of assay methods will be assessed with correlation analyses, regression analyses, standard parametric and nonparametric tests, and agreement methods. Pre- and post-immunization T-cell immunity to g209-2M peptide, to HPV16E7 peptide, and to a negative control HLA-A2 HIV peptide (pol) were assessed using HLA-A2/peptide tetramer-specific binding analysis. Within-subject analyses were performed to determine differences between pre- and postimmunization responses to the g209 -2M and HPV peptides and to the negative control HIV peptide after completion of 6 months of vaccination. Pre- versus postimmunization response differences were used as criterion measures in between-group (among subjects) analyses. | Baseline to 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Walter J. Urba, MD, PhD | Providence Cancer Center, Earle A. Chiles Research Institute, Robert W. Franz Cancer Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Providence Portland Medical Center | Portland | Oregon | 97213 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | gp100:209-217(210M)and HPV 16 E7:12-20 (Every 2 Weeks) | Patients receive gp100:209-217(210M) peptide vaccine and HPV 16 E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant SC every 2 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. HPV 16 E7:12-20 peptide vaccine: Given SC gp100:209-217(210M) peptide vaccine: Given SC laboratory biomarker analysis: Correlative studies |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| gp100:209-217(210M) | Biological | Given SC |
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| laboratory biomarker analysis | Other | Correlative studies |
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| FG001 | gp100:209-217(210M) and HPV 16 E7:12-20 (Every 3 Weeks) | Patients receive gp100:209-217(210M) peptide vaccine and HPV 16 E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant SC every 3 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. HPV 16 E7:12-20 peptide vaccine: Given SC gp100:209-217(210M) peptide vaccine: Given SC laboratory biomarker analysis: Correlative studies |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm A (Every 2 Weeks) | |
| BG001 | Arm B (Every 3 Weeks) | |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Gender | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | T Cell Immunity to gp100 Peptide and to E7 12-20 Papilloma Virus Peptide | Frequency measures obtained from each assay will be transformed to (common) logs for purposes of analysis. Repeated measures analyses will be performed on longitudinal data to assess patients' immune response profiles over time. Comparability of assay methods will be assessed with correlation analyses, regression analyses, standard parametric and nonparametric tests, and agreement methods. Pre- and post-immunization T-cell immunity to g209-2M peptide, to HPV16E7 peptide, and to a negative control HLA-A2 HIV peptide (pol) were assessed using HLA-A2/peptide tetramer-specific binding analysis. Within-subject analyses were performed to determine differences between pre- and postimmunization responses to the g209 -2M and HPV peptides and to the negative control HIV peptide after completion of 6 months of vaccination. Pre- versus postimmunization response differences were used as criterion measures in between-group (among subjects) analyses. | Patients were randomly assigned to two different vaccination schedules: group A received vaccinations every 2 weeks for 6 months (13 total injections), and group B received vaccinations every 3 weeks for 6 months (nine total vaccinations). | Posted | Mean | 90% Confidence Interval | % of CD8+ T cells | Baseline to 6 months |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Arm A (Every 2 Weeks) | Patients receive gp100:209-217(210M) peptide vaccine and HPV 16 E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant SC every 2 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. HPV 16 E7:12-20 peptide vaccine: Given SC gp100:209-217(210M) peptide vaccine: Given SC laboratory biomarker analysis: Correlative studies | 1 | 18 | 18 | 18 | ||
| EG001 | Arm B (Every 3 Weeks) | Patients receive gp100:209-217(210M) peptide vaccine and HPV 16 E7:12-20 peptide vaccine mixed with incomplete Freund's adjuvant SC every 3 weeks for 6 months. Treatment continues in the absence of disease progression or unacceptable toxicity. HPV 16 E7:12-20 peptide vaccine: Given SC gp100:209-217(210M) peptide vaccine: Given SC laboratory biomarker analysis: Correlative studies | 0 | 18 | 17 | 18 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| CVA | Nervous system disorders |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Injection Site Reaction | Skin and subcutaneous tissue disorders | Erythema/Induration/Ecchymosis |
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| Myalgia | Musculoskeletal and connective tissue disorders |
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| Anxiety | Nervous system disorders |
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| Pain | Musculoskeletal and connective tissue disorders | Headache/Back/Knee etc |
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| Fatigue | General disorders |
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| Neuropathy | Nervous system disorders |
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| Depression | Nervous system disorders |
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| Endocrine-Other | Endocrine disorders |
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| Nausea | Gastrointestinal disorders |
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| Constipation | Gastrointestinal disorders |
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| Arthralgia | Musculoskeletal and connective tissue disorders |
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| Chills | General disorders |
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| Edema | Vascular disorders |
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| Anorexia | Gastrointestinal disorders |
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| Dysguesia | Gastrointestinal disorders |
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| Diarrhea | Gastrointestinal disorders |
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| Alopecia | Skin and subcutaneous tissue disorders |
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| Vomiting | Gastrointestinal disorders |
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| Stomatitis | General disorders |
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| Dizziness | Nervous system disorders |
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| Insomnia | Nervous system disorders |
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| Fever | General disorders |
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| Cough | Respiratory, thoracic and mediastinal disorders |
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| Dyspnea | Respiratory, thoracic and mediastinal disorders |
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| Dry Mouth | Gastrointestinal disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Walter J. Urba, MD, PhD; Physician Director of Research | Providence Cancer Center, Earle A. Chiles Research Institute, Robert W. Franz Cancer Center | 503-215-5696 | Walter.Urba@providence.org |
| ID | Term |
|---|---|
| D008545 | Melanoma |
| ID | Term |
|---|---|
| D018358 | Neuroendocrine Tumors |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009380 | Neoplasms, Nerve Tissue |
| D018326 | Nevi and Melanomas |
| D012878 | Skin Neoplasms |
| D009371 | Neoplasms by Site |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| >=65 years |
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| Male |
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| Pre-Treatment % HPV16:E7 12-20-specific T cells |
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| Post-Treatment % HPV16:E7 12-20-specific T cells |
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Post versus Pre-Treatment %g209-2M-specific T-cells |
| No |
| Superiority or Other |
| t-test, 2 sided | 0.59 | Arm A Versus Arm B | No | Superiority or Other |