Immunization With gp100 Protein Vaccine in Treating Patients With Metastatic Melanoma

Phase 2CompletedNCT00072085

National Cancer Institute (NCI)

Overview

RATIONALE: Vaccines may make the body build an immune response to kill tumor cells. PURPOSE: This randomized phase II trial is studying immunization using two different gp100 protein vaccines to compare how well they work in treating patients with metastatic melanoma.

OBJECTIVES: Primary * Compare the clinical response in patients with metastatic melanoma immunized with recombinant gp100 protein (184V) emulsified in Montanide ISA-51 with or without gp100:209-217 (210M) peptide. Secondary * Compare the toxicity profile of these immunizations in these patients. OUTLINE: This is a randomized study. Patients are assigned to 1 of 2 cohorts according to HLA-A2\*0201 status. Patients assigned to cohort 1 are then randomized to 1 of 2 treatment arms. * Cohort 1 (HLA-A2\*0201-positive patients): Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive immunization comprising recombinant gp100 protein (184V) emulsified in Montanide ISA-51 subcutaneously (SC) on days 1, 22, 43, and 64 (1 course). * Arm II: Patients receive immunization comprising recombinant gp100 protein (184V) and gp100:209-217 (210M) peptide emulsified in Montanide ISA-51 SC on days 1, 22, 43, and 64 (1 course). * Cohort 2 (HLA-A2\*0201-negative patients): Patients receive immunization as in cohort 1, arm I. In both cohorts, treatment continues in the absence of rapid disease progression or unacceptable toxicity. In both cohorts, patients are evaluated 3-4 weeks after the fourth immunization. Patients achieving stable disease or a partial response receive retreatment according to their assigned cohort. Patients with progressive disease who are eligible for interleukin-2 (IL-2) receive retreatment according to their assigned cohort AND high-dose IL-2 IV over 15 minutes 3 times daily on days 2-5, 23-26, 44-47, and 65-68 (1 course). Patients receive up to 3 retreatment courses. Patients achieving a complete response (CR) receive 1 retreatment course beyond CR. Patients with progressive disease who are ineligible for IL-2 administration are removed from the study. PROJECTED ACCRUAL: A total of 45-75 patients (30-50 for cohort 1 \[15-25 per treatment arm\] and 15-25 for cohort 2) will be accrued for this study within 3 years.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Conditions

Melanoma (Skin)

Interventions

aldesleukinBIOLOGICAL

gp100 antigenBIOLOGICAL

incomplete Freund's adjuvantBIOLOGICAL

Eligibility

Sex: ALLMin age: 16 Years

Medical Language ↔ Plain English

DISEASE CHARACTERISTICS: * Diagnosis of metastatic melanoma * Measurable disease * Progressive disease during or after prior standard treatment with or without interleukin-2 PATIENT CHARACTERISTICS: Age * 16 and over Performance status * ECOG 0-2 Life expectancy * More than 6 months Hematopoietic * WBC at least 3,000/mm\^3 * Platelet count at least 90,000/mm\^3 * Lymphocyte count greater than 500/mm\^3 Hepatic * Bilirubin no greater than 2.0 mg/dL (less than 3.0 mg/dL for patients with Gilbert's syndrome) * ALT and AST less than 3 times normal * Hepatitis B surface antigen negative Renal * Creatinine no greater than 2.0 mg/dL Cardiovascular * No symptomatic cardiac disease Immunologic * No active systemic infection * No autoimmune disease * No known immunodeficiency disease * No known hypersensitivity to study agents * No form of primary or secondary immunodeficiency * No opportunistic infection * HIV negative Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy * See Disease Characteristics * No prior gp100 peptide vaccine Chemotherapy * More than 6 weeks since prior nitrosoureas Endocrine therapy * No concurrent systemic steroid therapy Radiotherapy * Not specified Surgery * Prior recent (within the past 3 weeks) minor surgical procedures allowed Other * Recovered from prior therapy (toxicity no greater than grade 1) * More than 3 weeks since prior systemic anticancer therapy * No other concurrent systemic anticancer therapy

Locations (2)

Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support

Bethesda, Maryland, United States

NCI - Center for Cancer Research

Bethesda, Maryland, United States

Data from ClinicalTrials.gov

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