Intraocular Melanoma, Melanoma (Skin)
Conditions
Keywords
stage III melanoma, stage IV melanoma, recurrent melanoma, ciliary body and choroid melanoma, medium/large size, extraocular extension melanoma, iris melanoma, recurrent intraocular melanoma
Brief summary
RATIONALE: Vaccines may make the body build an immune response to kill tumor cells. PURPOSE: This randomized phase I/II trial is studying three different doses of a vaccine and comparing them to see how well they work in treating patients with stage IIIB, stage IIIC, or stage IV melanoma.
Detailed description
OBJECTIVES: * Determine the immune response in patients with stage IIIB, IIIC, or IV melanoma treated with vaccine comprising multiple synthetic melanoma peptides, Montanide ISA-51, and sargramostim (GM-CSF). OUTLINE: This is a randomized study. Patients are randomized to 1 of 3 treatment arms. * Arm I: Patients receive vaccine comprising low-dose multiple synthetic melanoma peptides, Montanide ISA-51, and sargramostim (GM-CSF) on days 1, 8, 15, 29, 36, and 43. * Arm II: Patients receive vaccine comprising medium-dose multiple synthetic melanoma peptides, Montanide ISA-51, and GM-CSF as in arm I. * Arm III: Patients receive vaccine comprising high-dose multiple synthetic melanoma peptides, Montanide ISA-51, and GM-CSF as in arm I. On day 22, the lymph node draining the vaccination site is removed to determine whether the immune system is responding to the vaccine. PROJECTED ACCRUAL: A maximum of 38 patients will be accrued for this study.
Interventions
Sponsors
National Cancer Institute (NCI)
University of Virginia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Diagnosis of stage IIIB, IIIC, or IV melanoma * HLA-DR1, -DR4, -DR11, -DR13, or -DR15 positive * Brain metastases allowed at the discretion of the principle investigator PATIENT CHARACTERISTICS: Age * 18 and over Performance status * ECOG 0-1 Life expectancy * Not specified Hematopoietic * Absolute neutrophil count \> 1,000/mm\^3 * Platelet count \> 100,000/mm \^3 * Hemoglobin \> 9 g/dL Hepatic * Liver function tests ≤ 2.5 times upper limit of normal (ULN) Renal * Creatinine ≤ 1.5 times ULN Cardiovascular * No New York Heart Association class III or IV heart disease Other * Prior diagnosis of other cancer allowed * Not pregnant or nursing * Weight ≥ 110 pounds * No uncontrolled diabetes PRIOR CONCURRENT THERAPY: Biologic therapy * More than 4 weeks since prior growth factors * More than 4 weeks since prior allergy shots * More than 12 weeks since prior melanoma vaccine therapy\* NOTE: \*Prior melanoma vaccine allowed only for patients with disease progression during or after administration of the vaccine * No prior vaccination with any of the peptides used in this study Chemotherapy * More than 4 weeks since prior chemotherapy Endocrine therapy * More than 4 weeks since prior steroids Radiotherapy * More than 4 weeks since prior radiotherapy Surgery * Not specified Other * More than 1 month since prior investigational drugs or therapies * No other concurrent investigational drugs or therapies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Safety: Dose-limiting toxicity | During study period | Toxicities measured by CTCAE. |
| Immunogenicity | day 22 | Melanoma peptide-specific helper T cell responses in the sentinel immunized node (SIN) on day 22. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Immune response in the blood | day 50 | Immune response measured in the blood, by proliferation assay, over time during the study. |
| DTH response | by day 85 | Delayed-type hypersensitivity response to tumor peptides |
| Clinical outcome | during the study | Clinical tumor response |
Countries
United States
Outcome results
None listed