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Vaccine Therapy in Treating Patients With Stage III or Stage IV Melanoma That Cannot Be Removed With Surgery

Randomized, Open Phase II Study of Immunization With the Recombinant MAGE-3 Protein Combined With Adjuvant AS02B or AS15 in Patients With Unresectable and Progressive Metastatic Cutaneous Melanoma

Status
UNKNOWN
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00086866
Enrollment
165
Registered
2004-07-12
Start date
2004-05-31
Completion date
Unknown
Last updated
2015-02-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Melanoma (Skin)

Keywords

stage III melanoma, stage IV melanoma, recurrent melanoma

Brief summary

RATIONALE: Vaccines may make the body build an immune response to kill tumor cells. PURPOSE: This randomized phase II trial is studying two different regimens of vaccine therapy and comparing them to see how well they work in treating patients with stage III or stage IV melanoma that cannot be removed with surgery.

Detailed description

OBJECTIVES: Primary * Compare the objective response rate (complete and partial response) in patients with unresectable stage III or stage IV M1a cutaneous melanoma immunized with vaccine comprising D1/3-MAGE-3-His fusion protein and SB-AS02B adjuvant vs SB-AS15 adjuvant. * Compare the activity of SB-AS02B adjuvant vs SB-AS15 adjuvant, in terms of maximizing the antigenicity of MAGE-3, in patients treated with these regimens. * Compare the rate of grade 3/4 vaccine-related toxicity in patients treated with these regimens. Secondary * Compare progression-free survival in patients treated with these regimens. OUTLINE: This is a randomized, open label, parallell-group, multicenter study. Patients are stratified according to disease stage (III in transit vs other stage III vs IV), presence of lesion ≥ 20 mm (yes vs no), and participating center. Patients are randomized to 1 of 2 treatment arms. * Induction therapy * Arm I: Patients receive immunization comprising D1/3-MAGE-3-His fusion protein and SB-AS02B adjuvant intramuscularly (IM) once weekly on weeks 1, 3, 5, 7, 9, and 11. * Arm II: Patients receive immunization comprising D1/3-MAGE-3-His fusion protein SB-AS15 adjuvant IM once weekly on weeks 1, 3, 5, 7, 9, and 11. Patients achieving a clinical complete response (CR), partial response (PR), stable disease (SD), or slow progressive disease (SPD) proceed to maintenance therapy. * Maintenance therapy: Patients in both arms receive immunization (according to their randomized arm) once weekly on weeks 15, 18, 21, 24, 27, 30, 34, 40, 46, and 52. Patients maintaining a CR, PR, or SD proceed to long-term treatment. * Long-term treatment: Beginning 3 months after completion of maintenance therapy, patients in both arms receive immunization (according to their randomized arm) once every 3 months for 4 courses and then once every 6 months for 4 courses. Treatment continues in both arms in the absence of disease progression that does not correspond to SPD status, unacceptable toxicity, or the diagnosis of an autoimmune disease. Patients are followed every 12 weeks. PROJECTED ACCRUAL: A total of 68 patients (34 patients per treatment arm) will be accrued for this study.

Interventions

BIOLOGICALSB-AS15 adjuvant

Sponsors

European Organisation for Research and Treatment of Cancer - EORTC
Lead SponsorNETWORK

Study design

Allocation
RANDOMIZED
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed cutaneous melanoma * Unresectable stage III OR stage IV M1a disease * Documented progressive disease within the past 12 weeks * Measurable disease * Skin, soft tissue, or lymph node metastasis allowed provided the disease is not amenable to curative treatment with surgery * Tumor must express the MAGE-3 gene by reverse transcription polymerase chain reaction analysis (more than 1% of the positive MAGE-3 control included in the assay) * No visceral metastases within the past 56 days by imaging PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-1 Life expectancy * Not specified Hematopoietic * Hemoglobin ≥ lower limit of normal (LLN) * WBC ≥ LLN * Lymphocyte count ≥ LLN * Platelet count ≥ LLN * No bleeding disorders Hepatic * Bilirubin ≤ upper limit of normal (ULN) * Lactic dehydrogenase ≤ ULN * AST and ALT ≤ 2 times ULN * PT and aPTT normal * Hepatitis B surface antigen negative (antibody test may be positive) * Hepatitis C antibody negative Renal * Creatinine ≤ ULN Cardiovascular * No clinically significant heart disease (CTC grade III or IV) Immunologic * No autoimmune disease (vitiligo allowed) * No anti-nuclear antibody titer ≥ 1/320 OR equal to 1/160 AND auto-antibodies directed against specific auto-antigens * No immunodeficiency * No active infection requiring antibiotic therapy * HIV negative Other * Not pregnant * Negative pregnancy test * Fertile patients must use effective contraception during and for 3 months after study participation * No other malignancy within the past 5 years except surgically cured basal cell or squamous cell skin cancer or carcinoma in situ of the cervix * No other serious acute or chronic illness requiring concurrent medications * No psychological, familial, sociological, or geographical condition that would preclude study compliance PRIOR CONCURRENT THERAPY: Biologic therapy * More than 8 weeks since prior adjuvant vaccine therapy * No prior vaccine therapy containing a MAGE-3 antigen * No prior vaccine therapy for metastatic melanoma * No concurrent immunomodulating agents (e.g., BCG) Chemotherapy * No prior systemic chemotherapy * No concurrent chemotherapy Endocrine therapy * No concurrent corticosteroids * Concurrent prednisone or equivalent allowed provided the dose is ≤ 40 mg/day and treatment duration is for no more than 3 weeks * Concurrent inhaled and topical steroids are allowed Radiotherapy * No prior radiotherapy to the spleen * No concurrent radiotherapy to \> 20% of all existing lesions (i.e., target lesions, non-target lesions, and nonmeasurable lesions) * Concurrent local low-dose (≤ 20 Grays) radiotherapy allowed Surgery * Recovered from prior surgery or biopsy * No prior organ allograft * No prior splenectomy * Concurrent surgery to a limited number of lesions allowed for patients with a complete response, partial response, or stable disease after at least 3 courses of study therapy Other * No prior systemic anticancer therapy * More than 4 weeks since prior isolated limb perfusion therapy * No other concurrent anticancer therapy * No other concurrent immunosuppressive agents

Design outcomes

Primary

MeasureTime frame
Response rate (complete response and partial response) as assessed by RECIST criteria
Vaccine-related toxicity as assessed by CTCAE v3

Secondary

MeasureTime frame
Rate of stabilization as assessed by RECIST criteria
Rate of mixed response as assessed by RECIST criteria
Rate of immune response
Progression-free survival

Countries

Belgium, France, Germany, Italy, Netherlands, Spain, United Kingdom

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026