Vaccine Therapy and GM-CSF With or Without Low-Dose Aldesleukin in Treating Patients With Stage II, Stage III, or Stage IV Melanoma
- Conditions
- Melanoma (Skin)
- Interventions
- Biological: MART-1 antigenBiological: IL-2Biological: gp100 antigenBiological: GM-CSFBiological: MART-1a peptide
- Registration Number
- NCT00470015
- Lead Sponsor
- Mayo Clinic
- Brief Summary
RATIONALE: Vaccines made from peptides may help the body build an effective immune response to kill tumor cells. Colony-stimulating factors, such as GM-CSF, may increase the number of immune cells found in bone marrow or peripheral blood. Aldesleukin may stimulate the white blood cells to kill tumor cells. Giving vaccine and different doses of GM-CSF mixed in incomplete Freund's adjuvant, with or without aldesleukin, may kill more tumor cells.
PURPOSE: This phase I trial is studying the side effects and how well giving vaccine therapy together with GM-CSF, with or without low-dose aldesleukin, works in treating patients with stage II, stage III, or stage IV melanoma.
- Detailed Description
OBJECTIVES:
* Determine the safety and toxicity profile of peptide vaccine comprising MART-1 antigen, gp100 antigen, and survivin antigen in combination with sargramostim (GM-CSF) emulsified in incomplete Freund's adjuvant (IFA) with or without low-dose aldesleukin in patients with stage II-IV melanoma.
* Determine the immunologic effects of two different doses of GM-CSF coemulsified with melanoma peptides in IFA in these patients.
* Determine the immunological effects of low-dose aldesleukin therapy administered after peptide immunization in these patients.
* Collect preliminary data on the impact of the vaccine on clinical outcomes in these patients.
OUTLINE: This is a pilot study. Patients are stratified according to disease stage (II vs III or IV). Patients are sequentially enrolled into 1 of 4 different dose schedules.
* Dose schedule 1: Patients receive gp100 antigen, MART-1 antigen, survivin antigen, and sargramostim (GM-CSF) emulsified in incomplete Freund's adjuvant (peptide vaccine) subcutaneously (SC) on day 1. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
* Dose schedule 2: Patients receive peptide vaccine as in group 1. Patients also receive low-dose aldesleukin SC twice daily on days 7-20. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
* Dose schedule 3: Patients receive peptide vaccine as in group 1 except with a higher dose of GM-CSF. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
* Dose schedule 4: Patients receive peptide vaccine as in group 1 except with a higher dose of GM-CSF. Patients also receive low-dose aldesleukin SC twice daily on days 7-20. Treatment repeats every 21 days for 4 courses in the absence of disease progression or unacceptable toxicity.
Cohorts of 5 patients receive treatment at subsequent dose schedule until the maximum tolerated dose schedule (MTDS) is determined. The MTDS is defined as the dose schedule preceding that at which 2 of 5 patients experience dose-limiting toxicity within the first course.
After completion of study therapy, patients are followed every 3 months for up to 2 years.
PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 20
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description MART1 Analog, gp100 and Survivin MART-1 antigen - MART1 Analog, gp100 and Survivin GM-CSF - MART1 Analog, gp100 and Survivin MART-1a peptide - MART1 Analog, gp100 and Survivin IL-2 - MART1 Analog, gp100 and Survivin gp100 antigen -
- Primary Outcome Measures
Name Time Method Percent changes in peptide vaccine-specific immune responses (tetramer frequencies) from pretreatment levels 12 weeks Number and severity of hematologic and nonhematologic toxicities observed at each dose level 12 weeks
- Secondary Outcome Measures
Name Time Method Delayed-type hypersensitivity positivity 12 weeks Time to treatment failure 12 weeks Time to progression 24 months Maximum percent change in CD4, CD8, CD14, CD19, and C20 levels from preimmunization levels 12 weeks
Trial Locations
- Locations (1)
Mayo Clinic
🇺🇸Rochester, Minnesota, United States