Active Specific Intranodal Immunotherapy With a Recombinant Vaccinia Virus Expressing Three Melanoma Associated Epitopes and Two Costimulatory Molecules, Followed by Immunization With Synthetic Melanoma Associated Epitopes. A Phase I/II Trial in Patients With Stages IIb to IV Melanoma
The investigators have conducted a phase I/II clinical trial based on the intradermal
administration to stage III/IV melanoma patients of a recombinant vaccinia virus encoding
tumor associated antigens and costimulatory epitopes for the priming of immune responses,
followed by boosts with corresponding synthetic peptides (Zajac P et al in Human Gene Ther
2003). Specific cytotoxic T cells could be induced in a majority of patients following
priming, but sustained responsiveness could not be maintained by peptide boosting on a long
term basis. Emerging evidence supports the notion that expansion of specific T cells
requires trafficking of antigen presenting cells loaded with specific determinants to
lymphatic nodes, as induced, among others, by pro-inflammatory stimuli. Therefore, we now
adopt the intranodal injection of the immunogenic formulations. As for the former melanoma
active specific immunotherapy trial, GM-CSF is used as a supporting cytokine. The epitopes
considered are expressed, either all or some of them, in over 90% of the melanomas in
Western countries; namely, we immunize with Mart-1/Melan-A epitope 27-35, Gp-100 epitope
280-288 and tyrosinase epitope 1-9. As a consequence, HLA-A2 positivity is mandatory for
inclusion in the trial. The 2 costimulatory molecules expressed by cells infected with our
replication-incompetent recombinant vaccinia virus are B7.1 (CD80) and B7.2 (CD86).
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Safety evaluation
Michel Adamina, M.D.
Principal Investigator
University Hospital, Basel, Switzerland
Switzerland: Swissmedic
GT1999017/05.050
NCT00116597
November 2002
December 2008
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