Melanoma (Skin)
Conditions
Keywords
recurrent melanoma, stage III melanoma, stage IV melanoma
Brief summary
RATIONALE: Vaccines made from a patient's dendritic cells and tumor cells may make the body build an immune response to kill tumor cells. PURPOSE: This phase I trial is studying the side effects and best dose of vaccine therapy in treating patients with stage III or stage IV melanoma.
Detailed description
OBJECTIVES: Primary * Determine the dose-limiting toxicity and the maximum tolerated dose of autologous dendritic cells pulsed with autologous tumor cell lysate in patients with stage III or IV melanoma. * Determine the safety and tolerability of this therapy in these patients. Secondary * Determine the immune response, in terms of the type and degree of T-cell proliferation and delayed-type hypersensitivity responses, in patients treated with this therapy. OUTLINE: This is a dose-escalation, pilot study. Patients undergo leukapheresis for the collection of peripheral blood mononuclear cells (PBMC) on days -9, 19, and 47. Autologous dendritic cells (DC) are prepared from autologous PBMC exposed to sargramostim (GM-CSF), interleukin-4, and tumor necrosis factor alpha and pulsed with autologous tumor cell lysate. Patients receive autologous tumor cell lysate-pulsed DC IV over 5-10 minutes on days 0, 28, and 56. Cohorts of 3-6 patients receive escalating doses of autologous tumor cell lysate-pulsed DC until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose at which 33% of all patients experience dose-limiting toxicity. Patients are followed at day 84 and then every 3 months thereafter. PROJECTED ACCRUAL: A total of 3-20 patients will be accrued for this study within 3-20 months.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
DISEASE CHARACTERISTICS: * Histologically confirmed melanoma * Stage III (lymph node or in-transit metastases) or IV (systemic metastases) disease * Patients with relapsed disease OR who failed prior immunotherapy or chemotherapy are eligible (but trial not restricted to relapsed or refractory disease) * Tumor tissue available and properly stored for lysate preparation PATIENT CHARACTERISTICS: Age * 18 and over Performance status * Karnofsky 60-100% Life expectancy * At least 12 weeks Hematopoietic * Absolute neutrophil count ≥ 1,000/mm\^3 * Platelet count ≥ 75,000/mm\^3 Hepatic * AST ≤ 2 times upper limit of normal (ULN) (3 times ULN for liver metastases) * Bilirubin ≤ 2 times ULN * Hepatitis B surface antigen negative * Hepatitis C negative Renal * Creatinine ≤ 2.0 times ULN Immunologic * No active infection * No history of autoimmune disease, including any of the following: * Inflammatory bowel disease * Systemic lupus erythematosus * Scleroderma * Rheumatoid arthritis * Multiple sclerosis * No allergy to aminoglycosides or streptomycin * HIV negative Other * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No significant comorbid illness * No other malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix PRIOR CONCURRENT THERAPY: Biologic therapy * See Disease Characteristics * At least 10 days since prior immunotherapy Chemotherapy * See Disease Characteristics Endocrine therapy * At least 6 weeks since prior steroid therapy * No concurrent corticosteroids Radiotherapy * At least 10 days since prior radiotherapy * No concurrent radiotherapy Surgery * At least 10 days since prior surgery * Prior diagnostic or palliative surgery allowed provided the patient has fully recovered Other * No concurrent immunosuppressive or potentially immunosuppressive therapy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Ex Vivo Matured Dendritic Cell Therapy in Patients with Melanoma | 2005-2006 |
Countries
United States