Dose Escalation Study to Evaluate Safety and Tolerability of an Allogeneic Tumor Vaccine BIWB 2 in Patients With Advanced Malignant Melanoma

An Open-label, Multicenter, Controlled, Combined Parallel Group and Dose Escalation (0, 0.12, 1.2, 12.0 µg IL-2/10**8 Cells/24 Hours) Study, to Evaluate the Safety and Tolerability of an Allogeneic Tumor Vaccine BIWB 2 Containing Melanoma Cells Transfected With the Human IL-2 Gene in Patients With Advanced Malignant Melanoma

Evaluation of safety and tolerability of four intradermal injections given at two week intervals. In addition the efficacy of transferrinfection was determined by quantifying Interleukin 2 (IL-2), which was locally produced by the implanted, transfected allogenic melanoma cells at the injection sites. Further determination of tumor specific and clinical host responses induced or augmented by the treatment were determined.

Study Overview

• Status: Completed
• Conditions: Melanoma
• Intervention / Treatment: Biological: BIBW2 component B; Biological: BIBW2 component A

• Study Type: Interventional
• Enrollment (Actual): 49
• Phase: Phase 1

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Patients who fail to respond to conventional therapy or for whom conventional therapy is not available
• Metastatic melanoma (stage IV AJCC) which is surgically or medically incurable because of distant metastatic disease (i.e., a metastasis not in the same lymph node draining area as the primary malignant melanoma). Histologic confirmation of stage IV is required. Measurable disease that can be routinely assessed by physical examination and/or non-invasive radiological procedures
• Karnofsky performance status is at least 60% and life expectancy greater than 4 months
• Male or female, minimum age 18 years
• Written informed consent of the patient in accordance with good clinical practice and local legislation
• Availability of material for autologous Delayed Type Hypersensitivity (DTH) testing (material derived from autologous melanoma metastases and in-house preparation successful) is a requisite for entering the study
• Patients have to undergo biopsy of at least one metastasis before the first and after the last vaccination

Exclusion Criteria:

• Patient who have received any chemotherapy, corticosteroids, radiotherapy (stereotactic irradiation permitted), immunotherapy (e.g. Granulocyte Macrophage Colony Stimulating Factor, Granulocyte Colony Stimulating Factor) or any other investigational drugs in the 4 weeks prior to the first vaccination or prior to surgical removal of tumor specimens for DTH material preparation (patients are not permitted to receive such therapies 4 weeks prior to first cell inoculation except of tumor reductive surgery which are medically indicated)
• Patients with active intracranial metastases (CT/MRI) or choroidal melanoma
• Patients with active autoimmune disease
• Patients with organ allografts
• Patients with evidence of one or more of the following infections: HIV-1, HIV-2, Hepatitis B Virus, Hepatitis C Virus, Human T lymphotropic Virus-1
• Patients with active systemic infections or other major medical illness of the cardiovascular organ system [e.g. coronary heart disease (New York Heart Association class III or IV), history of clinically significant ventricular arrhythmias or angina], coagulation disorder, respiratory or nervous system disorder or with severe endocrinological disease
• Women of childbearing potential with a positive pregnancy test or without appropriate contraception (e.g. IUD [ Intra-Uterine Device], oral contraceptives) until at least 28 days after the last vaccination
• Lactating women
• Impaired renal or hepatic function (serum creatinine > 1.5 mg/dl or creatinine clearance < 75 ml/min). In amendments 1 and 3 serum creatinine levels were changed to 2.5 mg/dl and creatinine clearance was reduced to 30 ml/min

• Impaired hematologic function with:

  • White Blood Count (WBC) < 2500/mm**3 or
  • absolute lymphocyte count < 1500/mm**3 or
  • hemoglobin < 8 g/dl or
  • platelets < 100,000/mm**3
• Evidence for the existence or history of other malignant neoplasms (except adequately treated basal cell carcinoma and carcinoma in situ of the cervix)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: BIBW2 with IL-2 secreting cell line	Biological: BIBW2 component B; BIBW2 with IL-2 secreting cell line
Experimental: BIBW2 without IL-2 secreting cell line	Biological: BIBW2 component A; BIBW2 without IL-2 secreting cell line

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Occurrence of dose limiting toxicity (DLT)	up to 6 weeks
Number of patients with adverse events	up to 28 days after the last vaccination

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Grading of local reactions on a 4-point-scale		up to 28 days after the last vaccination
Number of patients with IL-2 transcripts in biopsies of injection sites		4-6 and 48 hours after first vaccination
Number of patients with delayed type hypersensitivity skin reaction	delayed type hypersensitivity testing	up to 28 days after the last vaccination
Number of antigen-positive cells in biopsies from metastatic lesions		up to 28 days after the last vaccination
Number of antigen-positive cells in the cellular infiltrate at the vaccination site		up to 28 days after the last vaccination
Number of patients with a positive reaction to Multitest Merieux	positive reaction: sum of all indurations of all existing reactions => 10 mm (male) or >= 5 mm (female)	up to day 14
Change in T cell proliferation as ratio of post-vaccination to pre-vaccination		up to 28 days after the last vaccination
Change in S-100 beta protein level in serum		up to 28 days after the last vaccination
Number of patients with clinical response	clinical response = complete and partial response	up to 28 days after the last vaccination
Change in interferon-gamma secretion as ratio of post-vaccination to pre-vaccination		up to 28 days after the last vaccination

Collaborators and Investigators

• Sponsor: Boehringer Ingelheim

Publications and helpful links

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start: August 1, 1998
• Primary Completion (Actual): February 1, 2001

Study Registration Dates

• First Submitted: July 29, 2014
• First Submitted That Met QC Criteria: July 29, 2014
• First Posted (Estimate): July 30, 2014

Study Record Updates

• Last Update Posted (Estimate): July 31, 2014
• Last Update Submitted That Met QC Criteria: July 30, 2014
• Last Verified: July 1, 2014

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms by Histologic Type; Neoplasms; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms, Nerve Tissue; Neuroendocrine Tumors; Nevi and Melanomas; Melanoma
• Other Study ID Numbers: 1155.2