Randomized Comparison of Three Schedules of Peptide Immunization in Patients With Stage II or III, or Completely Resected Metastatic Melanoma
- Compare the immunologic activity of three different schedules of peptide immunization
with gp100:209-217 (210M) or gp100:17-25 antigen and tyrosinase:368-376 (370D),
tyrosinase:240-251 (244S), tyrosinase:206-214 (closed to accrual 11/05/01), or
tyrosinase-related protein-1 (ORF3):1-9 peptide (closed to accrual 11/05/01) emulsified
in Montanide ISA-51 in patients with melanoma at high risk for recurrence.
- Compare the response rate to treatment with interleukin-2 (IL-2) after being immunized
with this regimen with the usual response rate to IL-2 in this patient population.
- Determine whether an exploratory cohort of HLA-A2-positive patients demonstrate
immunologic activity to immunization with 2 peptides emulsified together.
OUTLINE: This is a randomized study. Patients are stratified according to HLA type (A0201 vs
A1 vs A3 vs A24 vs A31). (HLA-A24 and HLA-A31 closed to accrual 11/05/01). Patients are
randomized to 1 of 3 treatment arms and are given an assigned vaccine, which is emulsified
in Montanide ISA-51.
- HLA typing:
- HLA-A2: gp100:209-217 (210M) and tyrosinase:368-376 (370D)
- HLA-A1: tyrosinase:240-251 (244S)
- HLA-A3: gp100:17-25
- HLA-A24: tyrosinase:206-214 (closed to accrual 11/05/01)
- HLA-A31: tyrosinase-related protein-1 (ORF3):1-9 (closed to accrual 11/05/01)
- Arm I: Patients receive assigned vaccine subcutaneously (SC) weekly for 10 weeks
followed by 3 weeks of no treatment.
- Arm II: Patients receive assigned vaccine SC on days 1, 22, 43, and 64.
- Arm III: Patients receive assigned vaccine SC on days 1-4, 22-25, 43-46, and 64-67.
Treatment in all arms repeats every 13 weeks for 4 courses in the absence of disease
progression or unacceptable toxicity.
After the completion of the randomized arms of HLA-A2 patients, additional HLA-A2 patients
receive immunization with gp100:209-217 (210M) and tyrosinase:368-376 (370D) emulsified in
Montanide ISA-51 SC once every 3 weeks for 4 courses.
Patients with progressive disease may receive interleukin-2 IV over 15 minutes every 8 hours
for up to 4 days. Treatment repeats every 10-14 days for at least 4 courses in the absence
of disease progression or unacceptable toxicity. Patients with stable disease or mixed or
partial response to treatment may receive additional courses every 2 months.
Patients are followed at 6 months.
PROJECTED ACCRUAL: A total of 324 patients (19-33 per arm for the HLA-A0201 stratum, 13-16
per arm for the other 4 strata, and 33 per the additional HLA-A2 cohort) will be accrued for
this study within 2 years. (HLA-A24 and HLA-A31 closed to accrual 11/05/01).
Allocation: Randomized, Primary Purpose: Treatment
Steven A. Rosenberg, MD, PhD
NCI - Surgery Branch
United States: Federal Government
|Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support||Bethesda, Maryland 20892-1182|