A Pilot Trial of Therapeutic Vaccination With a Modified gp100 Melanoma Peptide (gp100:209-217(210M)), Montanide ISA 51, and KLH With Reconstitution After Chemotherapy to Induce Lymphopenia in Patients With Metastatic Melanoma
Data Collection
Melanoma+8
+ Neoplasms
+ Neoplasms by Histologic Type
Treatment Study
Summary
Study start date: July 1, 2004
Actual date on which the first participant was enrolled.OBJECTIVES: Primary * Determine the toxicity and immune effects of vaccination comprising modified gp100 peptide (gp100:209-217\[210M\]), Montanide ISA-51, and keyhole limpet hemocyanin followed by peripheral blood mononuclear cell reinfusion after treatment-induced lymphopenia with fludarabine in patients with unresectable or metastatic melanoma. * Determine the induction of antigen-specific T-cell responses in patients treated with this regimen. * Determine the kinetics and duration of immune response in patients treated with this regimen. * Compare the immunologic effects of this regimen in these patients with historical results. Secondary * Compare 2 different dosing schedules of fludarabine, in terms of induction of lymphopenia and granulocytopenia and on the induction of a specific immune response to this vaccine, in these patients. OUTLINE: This is a pilot, randomized study. Patients are randomized to 1 of 2 treatment arms. Within 2 weeks before the start of fludarabine, all patients undergo leukapheresis over 4-6 hours for the collection of peripheral blood mononuclear cells (PBMCs). * Arm I: Patients receive fludarabine IV over 30 minutes on days 1-5. * Arm II: Patients receive fludarabine as in arm I on days 1, 3, and 5. In both arms, patients receive autologous PBMCs IV over approximately 30 minutes on day 8 and vaccination comprising gp100:209-217(210M) peptide, Montanide ISA-51, and keyhole limpet hemocyanin subcutaneously on days 8, 22, 36, 50, and 64. Patients with stable or responding disease continue to receive vaccination on day 78 and then every 28-31 days for up to 1 year. Patients are followed every 3 months. PROJECTED ACCRUAL: A total of 20 patients (10 per treatment arm) will be accrued for this study within 2 years.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.20 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.Over 18 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: * Histologically or cytologically confirmed malignant melanoma * Metastatic or unresectable disease * Measurable disease * HLA-A2 positive * Received at least 1 prior immunotherapy and/or chemotherapy regimen for metastatic disease (first 6 patients only) * No known brain metastases unless previously treated with radiotherapy and/or surgery AND is stable for at least 1 month after treatment PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-2 OR * Karnofsky 60-100% Life expectancy * More than 3 months Hematopoietic * WBC ≥ 3,000/mm\^3 * Absolute neutrophil count ≥ 1,500/mm\^3 * Absolute lymphocyte count ≥ 500/mm\^3 * Platelet count ≥ 100,000/mm\^3 * Hemoglobin ≥ 10 g/dL (transfusions allowed) * Hematocrit ≥ 24% * No other active bleeding Hepatic * Bilirubin \< 2 times upper limit of normal (ULN) (unless due to Gilbert's disease) * AST and ALT \< 3 times ULN * Hepatitis B surface antigen negative * Hepatitis C antibody negative Renal * Creatinine \< 2 mg/dL * No uncontrolled hypercalcemia Cardiovascular * No uncontrolled symptomatic congestive heart failure * No unstable angina pectoris * No uncontrolled cardiac arrhythmia * No uncontrolled hypertension Pulmonary * No uncontrolled bronchospasm * No hemoptysis Immunologic * Negative serology for all of the following: * HIV-1 and HIV-2 * HTLV-1 and -2 * Syphilis * Rheumatoid factor \< 43 units/μL * Anti-nuclear antibody \< 11 units/μL * No history of multiple sclerosis, systemic lupus erythematosus, or myasthenia gravis * No primary or secondary immunodeficiency * No active infection * No allergy to seafood or shellfish that would preclude study participation Other * No active gastrointestinal bleeding * No uncontrolled hyperglycemia * No other medical or psychiatric condition or social situation that would preclude study compliance * No other uncontrolled illness * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception during and for 3-4 months after study participation PRIOR CONCURRENT THERAPY: Biologic therapy * See Disease Characteristics * No prior immunization with gp100:209-217(210M) peptide Chemotherapy * See Disease Characteristics * More than 3 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) Endocrine therapy * More than 2 weeks since prior steroid therapy except replacement steroids or inhaled steroids * No concurrent corticosteroids except replacement steroids * No concurrent dexamethasone Radiotherapy * See Disease Characteristics * More than 2 weeks since prior radiotherapy Surgery * See Disease Characteristics * Recovered from prior surgery Other * No other concurrent investigational agents * No other concurrent anticancer therapy
Study Plan
Find out more about all the medication administered in this study, their detailed description and what they involve.Study Objectives
Primary Objectives
Secondary Objectives
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location
Providence Cancer Center at Providence Portland Medical Center
Portland, United StatesSee the location