- ICH GCP
- Реестр клинических исследований США
- Клиническое испытание NCT00091143
Fludarabine Followed by Vaccine Therapy and White Blood Cell Infusions in Treating Patients With Unresectable or Metastatic Melanoma
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
RATIONALE: Drugs used in chemotherapy, such as fludarabine, work in different ways to stop tumor cells from dividing so they stop growing or die. Vaccines made from peptides may make the body build an immune response to kill tumor cells. Infusions of a person's white blood cells may be able to replace immune cells that were destroyed by chemotherapy. Combining fludarabine with vaccine therapy and white blood cell infusions may kill more tumor cells.
PURPOSE: This randomized phase I trial is studying the side effects of giving vaccine therapy together with fludarabine and white blood cell infusions and to see how well it works in treating patients with unresectable or metastatic melanoma.
Обзор исследования
Статус
Условия
Подробное описание
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.
Тип исследования
Регистрация (Ожидаемый)
Фаза
- Фаза 1
Контакты и местонахождение
Места учебы
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Oregon
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Portland, Oregon, Соединенные Штаты, 97213-2967
- Providence Cancer Center at Providence Portland Medical Center
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Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
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
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Уход
- Распределение: Рандомизированный
Что измеряет исследование?
Первичные показатели результатов
Мера результата |
|---|
|
Toxicity by clinical and laboratory observation at 1 month
|
|
Antigen-specific T-cell responses by tetramer analysis, ELISPOT, and cytokine flow cytometry periodically
|
Вторичные показатели результатов
Мера результата |
|---|
|
Compare 2 different dosing schedules of fludarabine in terms of lymphocyte recovery using a complete blood count periodically
|
|
Tumor regression by standard imaging at study completion
|
Соавторы и исследователи
Соавторы
Следователи
- Главный следователь: Walter J. Urba, MD, PhD, Providence Cancer Center, Earle A. Chiles Research Institute
Даты записи исследования
Изучение основных дат
Начало исследования
Первичное завершение (Действительный)
Завершение исследования (Действительный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Оценивать)
Обновления учебных записей
Последнее опубликованное обновление (Оценивать)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
- Новообразования по гистологическому типу
- Новообразования
- Нейроэктодермальные опухоли
- Новообразования, зародышевые клетки и эмбриональные
- Новообразования, нервная ткань
- Нейроэндокринные опухоли
- Невусы и меланомы
- Меланома
- Физиологические эффекты лекарств
- Молекулярные механизмы фармакологического действия
- Антиметаболиты, Противоопухолевые
- Антиметаболиты
- Противоопухолевые агенты
- Иммунодепрессанты
- Иммунологические факторы
- Адъюванты, Иммунологические
- Флударабин
- Флударабин фосфат
- Адъювант Фрейнда
- Гемоцианин замочной скважины-блюдечка
Другие идентификационные номера исследования
- CDR0000383908
- PPMC-IRB-02-99
- NCI-6361
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