A Randomized Phase II Study of Immunization Against Melanoma Comparing Autologous Dendritic Cells Pulsed With gp100 Peptide to Autologous Dendritic Cells Fused With Autologous Tumor Cells
autologous dendritic cell-tumor fusion vaccine
+ gp100 antigen
+ therapeutic autologous dendritic cells
Melanoma+5
+ Neoplasias
+ Neoplasias de Células Germinales y Embrionarias
Estudio de Tratamiento
Resumen
Fecha de inicio: 1 de marzo de 2004
Fecha en la que se inscribió al primer participante.OBJECTIVES: Primary * Compare the tumor-specific immune response, in terms of the number of gp100-specific cytotoxic T-lymphocytes, T-cell production of interferon gamma, or T-cell proliferation in response to in vitro exposure to gp100 and tumor lysate, in patients with stage III or IV melanoma treated with autologous dendritic cells (DC) pulsed with gp100 antigen vs autologous DC fused with autologous tumor cells. Secondary * Compare the safety and toxicity of these regimens in these patients. * Compare the therapeutic effect of these regimens in these patients. OUTLINE: This is a randomized study. Patients are randomized to 1 of 2 treatment arms. All patients undergo leukapheresis. Peripheral blood mononuclear cells are cultured to generate dendritic cells (DC). * Arm I: Patients undergo surgical harvesting of tumor cells for subsequent fusion. Patients receive vaccination comprising DC fused with autologous tumor cells subcutaneously on day 1. Treatment repeats every 21 days for 3 courses. Patients who achieve a partial (PR) or complete response (CR) may receive an additional 3 courses. * Arm II: Patients receive vaccination comprising DC pulsed with gp100 antigen IV on day 1. Treatment repeats every 21 days for 6 courses. Patients who achieve a PR or CR may receive an additional 6 courses. In both arms, patients are followed monthly for 6 months. PROJECTED ACCRUAL: A total of 40 patients (20 per treatment arm) will be accrued for this study.
Protocolo
Esta sección proporciona detalles del plan del estudio, incluyendo cómo está diseñado y qué se está evaluando.Se reclutarán 40 pacientes
Número total de participantes que el ensayo clínico espera reclutar.Estudio de Tratamiento
Elegibilidad
Los investigadores buscan pacientes que cumplan ciertos criterios, conocidos como criterios de elegibilidad: estado general de salud o tratamientos previos.Cualquier sexo
Sexo biológico de los participantes elegibles para inscribirse.Voluntarios sanos no permitidos
Indica si personas sanas, sin la condición que se estudia, pueden participar.Condiciones
Patología
Criterios
DISEASE CHARACTERISTICS: * Histologically confirmed cutaneous melanoma * Stage III or IV disease * Recurrent or de novo stage III disease allowed if disease is unresectable and no definitive treatment is available * gp100- and HLA-A201-positive * Surgically accessible tumor, defined by 1 of the following: * Pulmonary lesions approachable by thoracoscopic procedure * Skin or superficial soft tissue or lymph node lesions amenable to resection under local anesthesia * Malignant ascites or pleural effusion * Measurable disease in addition to surgically accessible tumor \> 2.0 cm * No CNS metastases * No mucosal or ocular melanoma PATIENT CHARACTERISTICS: Age * Any age Performance status * ECOG 0-1 Life expectancy * More than 3 months Hematopoietic * WBC \> 3,000/mm\^3 * Platelet count \> 75,000/mm\^3 Hepatic * Bilirubin \< 2.0 mg/dL Renal * Creatinine \< 2.0 mg/dL Immunologic * No active infection requiring treatment * No clinically significant autoimmune disorder * No immune deficiency disorder * HIV negative Other * Antecubital vein accessible for leukapheresis * No other malignancy within the past 5 years except nonmelanoma skin cancer or squamous cell carcinoma in situ of the cervix * No pre-existing comorbid disease that would preclude study compliance * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective barrier contraception PRIOR CONCURRENT THERAPY: Biologic therapy * No prior melanoma vaccine therapy * More than 6 weeks since prior immunotherapy Chemotherapy * No prior chemotherapy for metastatic melanoma Endocrine therapy * No concurrent corticosteroids Radiotherapy * More than 6 weeks since prior radiotherapy Surgery * Not specified Other * No concurrent systemic immunosuppressive therapy
Plan de Estudio
Conoce todos los tratamientos administrados en este estudio, su descripción detallada y en qué consisten.2 grupos de intervención están designados en este estudio
0% de probabilidad de ser asignado al grupo placebo
Grupos de Tratamiento
Grupo I
ExperimentalGrupo II
ExperimentalObjetivos del Estudio
Objetivos Primarios
Centros del Estudio
Estos son los hospitales, clínicas o centros de investigación donde se lleva a cabo el estudio. Puedes encontrar la ubicación más cercana a ti y su estado de reclutamiento.Este estudio tiene 3 ubicaciones
Beth Israel Deaconess Medical Center
Boston, United StatesMassachusetts General Hospital
Boston, United States