- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02320305
MART-1 Antigen With or Without TLR4 Agonist GLA-SE in Treating Patients With Stage II-IV Melanoma That Has Been Removed by Surgery
Peptide Vaccine With Glucopyranosyl Lipid A - Stable Oil-in-Water Emulsion (GLA-SE) for Patients With Resected Melanoma: A Pilot Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. Evaluate the immune response of each immunization regimen to determine an optimal regimen in terms of immune response to recommend for phase II testing.
SECONDARY OBJECTIVES:
I. Evaluate the adverse events profile of each immunization regimen.
TERTIARY OBJECTIVES:
I. Describe the immunological efficacy of the vaccine preparations as measured by the frequency and interferon (IFN) gamma production of peptide-specific cytotoxic T lymphocytes (CTL).
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients receive MART-1 antigen and TLR4 antagonist GLA-SE intramuscularly (IM) on day 1. Treatment repeats every 21 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.
ARM II: Patients receive MART-1 antigen IM on day 1. Treatment repeats every 21 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, stage II patients are followed up at 10 weeks and then at 6, 12, 18, and 24 months and stage III-IV patients are followed up at 3, 6, 9, 12, 15, 18, 21, and 24 months.
Study Type
Enrollment (Actual)
Phase
- Early Phase 1
Contacts and Locations
Study Locations
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Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Central pathology review submission; Note: this review for MART-1 positivity is mandatory prior to randomization to confirm eligibility
- Human leukocyte antigen (HLA)-A2-positive
- Histologic proof of stage II, III or IV melanoma that has been completely resected or completely treated with ablative therapy (ex: stereotactic body radiosurgery, radiofrequency ablation, cryoablation) with no current evidence of disease, as demonstrated by imaging within 2 months (stage III or stage IV; must be computed tomography [CT], magnetic resonance imaging [MRI], or positron emission tomography [PET]/CT) or 6 months (stage II; may be chest x-ray, CT, MRI, or PET/CT)
- Absolute neutrophil count (ANC) >= 1500 mL
- Hemoglobin (Hgb) > 10 g/dL
- Platelets (PLT) >= 50,000 mL
- Aspartate aminotransferase (AST) =< 3 x upper limit of normal (ULN)
- Alkaline phosphatase =< 3 x ULN
- Ability to provide informed consent
- Willingness to return to Mayo Clinic Rochester for follow-up
- Life expectancy >= 12 weeks
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2
- For women of childbearing potential, a negative serum pregnancy test =< 7 days prior to registration
- Willingness to provide mandatory blood samples for correlative research
Exclusion Criteria:
- Uncontrolled or current infection
- Known standard therapy for the patient's disease that is potentially curative or proven capable of extending life expectancy
- Known allergy to any of the vaccine or adjuvant components, including eggs
Any of the following prior therapies with interval since most recent treatment:
- Chemotherapy =< 4 weeks prior to registration
- Biologic or immunologic therapy =< 4 weeks prior to registration
- Radiation therapy =< 4 weeks prior to registration
- Failure to fully recover from side effects of prior therapy or surgery
Any of the following:
- Pregnant women
- Nursing women
- Women of childbearing potential or their sexual partners who are unwilling to employ adequate contraception (condoms, diaphragm, birth control pills, injections, intrauterine device [IUD], surgical sterilization, subcutaneous implants, or abstinence, etc.)
- Known immune deficiency, including human immunodeficiency virus (HIV) infection
- History of systemic autoimmune disease, as patients with ongoing autoimmunity may be at an increased risk of autoimmune toxicity from the study vaccine
- Current or recent (=< 4 weeks) use of immunosuppressive medications including systemic (inhaled, oral, or intravenous [IV]) corticosteroids; Note: use of corticosteroids in doses not exceeding those used for adrenal replacement is acceptable
- History of brain metastases; EXCEPTION: patients with a solitary brain metastasis that has been completely resected, and who have no ongoing central nervous system (CNS) symptoms and an MRI documenting no evidence of CNS disease at least 3 months after resection and within 30 days of registration, are eligible for treatment
- Other active malignancy =< 5 years prior to registration; EXCEPTIONS: non-melanotic skin cancer or carcinoma-in-situ of the cervix; NOTE: if there is a history of prior malignancy > 5 years prior to registration, the patient must not be receiving other cancer treatment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Arm I (MART-1 antigen and TLR4 antagonist GLA-SE)
Patients receive MART-1 antigen and TLR4 antagonist GLA-SE IM on day 1.
Treatment repeats every 21 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.
|
Correlative studies
Given IM
Other Names:
Given IM
Other Names:
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Experimental: Arm II (MART-1 antigen)
Patients receive MART-1 antigen IM on day 1.
Treatment repeats every 21 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.
|
Correlative studies
Given IM
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Immune response
Time Frame: Up to 24 months
|
A patient is considered to have achieved an immune response if there is a 2-fold or more increase from pre-treatment levels in the absolute number of vaccine peptide-specific (MART-1a-specific) CTL as measured by tetramer staining, or if the frequency of MART-1a-specific CTL is initially undetectable (< 0.05% of CD8 T cells) and becomes detectable during the vaccine treatment period.
The proportion of successes will be estimated and the exact binomial 95% confidence intervals for the true immune response rate will be calculated.
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Up to 24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Adverse event rate, graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0
Time Frame: Up to 24 months
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The maximum grade for each type of adverse event will be recorded for each patient, and frequency tables will be reviewed to determine patterns.
Additionally, the relationship of the adverse event(s) to the study treatment will be taken into consideration.
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Up to 24 months
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Immunological efficacy of the vaccine preparations against tumor antigen MART-1a will be described as a function of the vaccine immune adjuvant, as measured by the frequency and IFN gamma production of vaccine-peptide specific CTL
Time Frame: Up to 24 months
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Additional markers of immune activation will be described as a function of each vaccine preparation.
Each factor will be plotted against time.
Each graph will be visually inspected for trends across time.
The number of patients with at least a 2-fold change in the number of cells/plasma concentration or with a level that goes from undetectable to detectable after the 1st course will be determined.
The marker profile of those who derived an immune response and those who did not will be tabled to visually compare and contrast the pattern of marker-specific responses between these patient groups.
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Up to 24 months
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Collaborators and Investigators
Sponsor
Collaborators
Publications and helpful links
General Publications
- Kobayashi RH, Mandujano JF, Rehman SM, Kobayashi AL, Geng B, Atkinson TP, Melamed I, Turpel-Kantor E, Clodi E, Gupta S. Treatment of children with primary immunodeficiencies with a subcutaneous immunoglobulin 16.5% (cutaquig(R) [octanorm]). Immunotherapy. 2021 Jul;13(10):813-824. doi: 10.2217/imt-2021-0064. Epub 2021 May 6.
- Grewal EP, Erskine CL, Nevala WK, Allred JB, Strand CA, Kottschade LA, McWilliams RR, Dronca RS, Yakovich AJ, Markovic SN, Block MS. Peptide vaccine with glucopyranosyl lipid A-stable oil-in-water emulsion for patients with resected melanoma. Immunotherapy. 2020 Sep;12(13):983-995. doi: 10.2217/imt-2020-0085. Epub 2020 Aug 5.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MC1177 (Other Identifier: Mayo Clinic)
- P30CA015083 (U.S. NIH Grant/Contract)
- NCI-2014-02479 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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