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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2009-00159 | Registry Identifier | CTRP (Clinical Trials Reporting System) | |
| PCI-IRB-0607048 | |||
| CDR0000544402 | Registry Identifier | PDQ (Physician Data Query) |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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RATIONALE: Vaccines made from peptides may help the body build an effective immune response to kill tumor cells. Giving vaccine therapy together with GM-CSF, CpG 7909, and incomplete Freund's adjuvant may make a stronger immune response and kill more tumor cells.
PURPOSE: This clinical trial is studying the side effects and how well vaccine therapy works in treating patients with recurrent stage III or stage IV melanoma that cannot be removed by surgery.
OBJECTIVES:
OUTLINE: This is a pilot study.
Patients receive peptide vaccine comprising MART-1:27-35 peptide, gp100:209-217 (210M) peptide, and tyrosinase peptide with sargramostim (GM-CSF) and CpG 7909 emulsified in incomplete Freund's adjuvant subcutaneously on days 1 and 15. Treatment repeats every 28 days for up to 13 courses in the absence of disease progression or unacceptable toxicity.
Blood samples are collected at baseline, day 50-53, and day 91-94. Samples are examined by ELISPOT assay to measure lymphocyte immune response and by flow cytometry for biomarker quantification and T-cell response.
After completion of study treatment, patients are followed up periodically for at least 2 years.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Peptide Vaccine + GM-CSF + Pfizer 3512676 in-ISA Oil | Experimental | The water-in-oil emulsion will consist of peptide (100 mcg/0.1 mL), GM-CSF (80 mcg/0.16 mL using lyophilized 500 mcg/vial reconstituted with 1 mL of sterile water), Pfizer PF3512676 (0.6 mg/0.04 mL using 15mg/mL vial) and 0.20 mLl of sterile saline. Vaccination will be given subcutaneously rotating truncal sites in the vicinity of the four nodal drainage groups of the four extremities, on days 1 and 15 of each cycle (1 cycle = 28 days) for a maximum of 13 cycles (1 year). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Peptide vaccine | Biological | Multi-epitope peptide vaccine containing MART-1 (26-35, 27L), gp100 (209-217, 210M) and tyrosinase (368-376, 370D) peptides |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety | Number of grade 2 or greater allergic reactions (including generalized urticaria) or any grade 3 or greater adverse event | up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Immunologic response | Change in the circulating effector T-cells. | up to 94 days |
| Objective tumor regression | Change in tumor size will be performed at the end of cycle 2. |
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DISEASE CHARACTERISTICS:
Histologically confirmed melanoma meeting the following criteria:
Measurable disease as defined by the RECIST criteria
HLA-A2 positive
Prior brain metastases allowed provided adequate surgical or radiologic treatment for brain disease
PATIENT CHARACTERISTICS:
ECOG performance status 0 or 1
WBC ≥ 3,000/mm³
Lymphocytes ≥ 1,000/mm³
Platelet count ≥ 100,000/mm³
Creatinine ≤ 1.5 times upper limit of normal (ULN)
Bilirubin ≤ 1.5 times ULN
AST and ALT ≤ 2.5 times ULN
Lactic dehydrogenase ≤ 2.0 times ULN
aPTT < 40 seconds
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception for ≥ 1 week before, during, and for ≥ 2 weeks after completion of study therapy
No conditions of immunosuppression
Negative titers for antinuclear antibody (≤ 1/80) and antidouble stranded DNA (≤ 1/10)
No serious illnesses including, but not limited to, any of the following:
No serious cardiovascular disease including, but not limited to, any of the following:
HIV1 and 2 negative
HTLV-1 negative
Hepatitis B and C negative
No significant psychiatric disease, medical intervention, or other condition that, in the opinion of the principal investigator, would limit study compliance
No active infection within the past week, including unexplained fever (temperature > 38.1°C)
PRIOR CONCURRENT THERAPY:
Fully recovered from prior major surgery
More than 4 weeks since prior chemotherapy (6 weeks for mitomycin C or nitrosoureas), hormonal therapy, radiotherapy, or biological therapy
More than 1 week since prior antibiotics
More than 28 days since prior investigational agent
No prior vaccination with MART-1 (26-35, 27L), gp100 (209-217, 210M), and tyrosinase (368-376, 370D) peptides alone or in combination
More than 4 weeks since prior and no concurrent systemic immunosuppressive therapy, including steroids
More than 2 weeks since prior and no concurrent treatment with systemic steroids, including oral steroids, continuous use of topical steroid creams or ointments, or any inhaled steroids
No concurrent anticoagulants, except to keep an indwelling line patent
No other concurrent anticancer therapy, including chemotherapy, immunotherapy, radiotherapy, experimental programs, and/or surgery
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| Name | Affiliation | Role |
|---|---|---|
| Ahmad A. Tarhini, MD, MS | University of Pittsburgh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UPMC Cancer Centers | Pittsburgh | Pennsylvania | 15232 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22495394 | Result | Tarhini AA, Leng S, Moschos SJ, Yin Y, Sander C, Lin Y, Gooding WE, Kirkwood JM. Safety and immunogenicity of vaccination with MART-1 (26-35, 27L), gp100 (209-217, 210M), and tyrosinase (368-376, 370D) in adjuvant with PF-3512676 and GM-CSF in metastatic melanoma. J Immunother. 2012 May;35(4):359-66. doi: 10.1097/CJI.0b013e31825481fe. |
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| GM-CSF | Biological | 80 mcg/0.16 mL using lyophilized 500 mcg/vial reconstituted with 1 mL of sterile water given subcutaneously rotating truncal sites in the vicinity of the four nodal drainage groups of the four extremities, on days 1 and 15 of each cycle (1 cycle = 28 days) for a maximum of 13 cycles (1 year). |
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| PF3512676 | Biological | 0.6 mg/0.04 mL given subcutaneously rotating truncal sites in the vicinity of the four nodal drainage groups of the four extremities, on days 1 and 15 of each cycle (1 cycle = 28 days) for a maximum of 13 cycles (1 year). |
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| 2 months |
| Depigmentation evaluation | Change in cutaneous depigmentation using careful inspection of the skin of the torso by a Wood's lamp. | up to 2 years |
| ID | Term |
|---|---|
| D000098943 | Uveal Melanoma |
| 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 |
| D014604 | Uveal Neoplasms |
| D005134 | Eye Neoplasms |
| D009371 | Neoplasms by Site |
| D005128 | Eye Diseases |
| D014603 | Uveal Diseases |
| D012878 | Skin Neoplasms |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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| ID | Term |
|---|---|
| D000096202 | Protein Subunit Vaccines |
| D016178 | Granulocyte-Macrophage Colony-Stimulating Factor |
| C081222 | sargramostim |
| C483020 | ProMune |
| ID | Term |
|---|---|
| D022282 | Vaccines, Acellular |
| D022223 | Vaccines, Subunit |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
| D003115 | Colony-Stimulating Factors |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D016298 | Hematopoietic Cell Growth Factors |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
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