A Phase I Trial of a Recombinant Human hsp110-gp100 Chaperone Complex Vaccine for Advanced Stage IIIB/C or IV Melanoma
Inclusion Criteria:
- Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
- Absolute neutrophil count (ANC) > 1500/uL
- Platelets >= 120,000/uL
- Total bilirubin =< 1.5 mg/dL
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 1.5 x upper
limit of normal (ULN)
- Serum creatinine =< 1.5 mg/dL (if > 1.5 mg/dL, then creatinine clearance should be >
60 mL/min)
- Blood urea nitrogen (BUN) =< 1.5 x ULN
- Have measurable disease per Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
criteria or physical exam
- An anticipated overall survival of at least 6 months
- Patients of child-bearing potential must agree to use acceptable contraceptive
methods (e.g., double barrier) during treatment
- Patient or legal representative must understand the investigational nature of this
study and sign an Independent Ethics Committee/Institutional Review Board approved
written informed consent form prior to receiving any study related procedure
- Patients must have undergone/undergo testing for BRAF V600 mutation status
- Patients must have documented, clinically measurable 7th edition American Joint
Committee on Cancer (AJCC) stage IIIB/C (bulky nodal and/or in transit disease) or
stage IV (distant metastatic) melanoma; patients with brain metastases that have been
appropriately treated with surgical resection and/or radiation are eligible for
inclusion if they meet the performance status and life expectancy criteria; patients
who are BRAF V600E mutation positive need to have failed, refused, or be ineligible
for at least 2 lines of therapy (vemurafenib plus one other regimen)
- Stage IIIB/C patients must have refused, be ineligible for, or have failed at least
one standard of care regional therapy (isolated limb perfusion or infusion) or one
non-vaccine based systemic therapy (such as, high dose interleukin (IL)-2,
dacarbazine/temozolomide, vemurafenib, ipilimumab, or participation in a clinical
trial); stage IV patients must have refused, be ineligible for, or have failed at
least one non-vaccine based systemic therapy (such as, high dose IL-2,
dacarbazine/temozolomide, vemurafenib, ipilimumab, or participation in a clinical
trial)
- Stage IV patients must have refused, be ineligible for, or have failed at least one
non-vaccine based systemic therapy (such as, high dose interleukin [IL]-2,
dacarbazine/temozolomide, ipilimumab, or participation in a clinical trial); patients
who are BRAF V600E mutation positive need to have failed, refused, or be ineligible
for at least 2 lines of therapy (vemurafenib plus one other regimen)
Exclusion Criteria:
- Pregnant or nursing female patients
- Unwilling or unable to follow protocol requirements
- Any condition which in the Investigator's opinion deems the patient an unsuitable
candidate to receive study drug
- Received an investigational agent within 30 days prior to enrollment
- Melanoma specific systemic therapy within 30 days of enrollment
- A history of AJCC stage IIIB/C or stage IV melanoma but no current clinical evidence
of metastatic disease
- Known immunosuppressed conditions or active immunosuppressive therapy such as organ
transplantation (including bone marrow transplant), high dose steroids, or human
immunodeficiency virus (HIV); although a documented negative HIV test is not
mandatory for enrollment, patients felt to have a high clinical suspicion for HIV
will need to test negative prior to enrollment; use of topicals or eye drops
containing steroids is acceptable; inhaled steroids are excluded
- Known autoimmune conditions including but not limited to rheumatoid arthritis,
multiple sclerosis, lupus, scleroderma, sarcoidosis, vitiligo, inflammatory bowel
disease, idiopathic thrombocytopenia purpura, Graves' disease, or Hashimoto's
thyroiditis
- Previous history of splenectomy or whole spleen radiation
- Systemic immunoglobin therapy within the last 30 days
- Previous history of anaphylaxis or severe allergic reaction to hsp110, gp100, other
vaccines, or unknown allergens
- Previous or active non-melanoma malignancies (excluding non-melanoma skin cancer or
carcinoma in situ of the cervix) diagnosed/treated within the last 5 years
- Active uncontrolled bacterial, viral, or fungal infection until these conditions are
corrected or controlled
- Concomitant systemic treatment with anti-histamine or non-steroidal anti-inflammatory
drugs; specific cyclooxygenase (COX)-2 inhibitors are permitted