Adjuvant Therapy of Pegylated Interferon- 2b Plus Melanoma Peptide Vaccine



Status:Active, not recruiting
Conditions:Skin Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:5/7/2016
Start Date:March 2009

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An Exploratory Study of Adjuvant Therapy of Pegylated Interferon-Alfa 2b Plus Melanoma Peptide Vaccine in Patients With Resected, Intermediate-Thickness, Node-Negative Melanoma

The goal of this clinical research study is to find the best dosing schedule of a combined
treatment of PEG Intron® (pegylated Interferon-alfa 2b) plus a peptide vaccine (gp100) that
may help improve immune response in patients that had Stage II or Stage III melanoma and are
free of the disease. The safety and tolerability of this drug combination will also be
studied. Researchers also want to collect long-term follow-up information.

The Study Drugs:

Pegylated Interferon alfa-2b is a protein made by the human immune system that helps to
fight viral infections and regulate cell function.

Gp100 is a protein that is found on melanoma cells. In laboratory studies, the gp100 vaccine
has been shown to stimulate the immune system to "recognize" and kill melanoma cells that
have gp100 on their cell surfaces.

Evaluation of Immune cell response to vaccine:

Blood (about 3-1/2 tablespoons) will be drawn on Weeks 4, 7,10,13,16,19, and 22 for tests to
check the response of your immune system to the vaccine, before each injection. These tests
are for research purposes only and will not be used to make decisions about your medical
care.

Parts of the Study:

There are 2 parts to this study, an Induction Phase and a Maintenance Phase. The Induction
Phase treatment is the first course of treatment used to stimulate ("turn on") an
immune-cell response to fight cancer and to learn the body's response to the treatment. The
Maintenance Phase treatment is continued therapy and is used to maintain the immune-cell
response and to help keep the disease in remission.

Study Groups:

If participant is found to be eligible to take part in this study, they will be randomly
assigned (as in the roll of dice) to 1 of 3 treatment groups. Participant will have an equal
chance of being assigned to one of each of the groups. Participants in each group will
receive the same dose levels of pegylated Interferon alfa-2b and gp100. The difference
between each group will be the dosing schedule of pegylated Interferon alfa-2b.

Every week, participant will give themselves the pegylated Interferon alfa-2b either in the
clinic or at home, and the gp100 will be given to participant every 3 weeks by the research
nurse in the clinic. Participant will be shown how to give yourself Pegylated Interferon
alfa-2b at home.

Pegylated Interferon alfa-2b will be given immediately after the GP-100 Peptide Vaccine
injection.

Participants in Group 1 will take pegylated Interferon alfa-2b at a certain dose level once
a week for 4 weeks (in the Induction Phase), followed by once a week for 20 weeks in the
Maintenance Phase (when the drug will be taken at a lower dose level than during Induction).

Participants in Group 2 will take pegylated Interferon alfa-2b at a certain dose level once
a week for 8 weeks (in the Induction Phase), followed by once a week for 16 weeks in the
Maintenance Phase (when the drug will be taken at a lower dose level than during Induction).

Participants in Group 3 will take pegylated Interferon alfa-2b at a certain dose level once
a week for 12 weeks (in the Induction Phase), followed by once a week for 12 weeks in the
Maintenance Phase (when the drug will be taken at a lower dose level than during Induction).

Study Treatment:

Participant will take pegylated Interferon alfa-2b as an injection just under their skin.
Participant will receive gp100 as an injection just under their skin once every 3 weeks.

On Week 1, PEG-Intron will be given right after GP-100 Peptide Vaccine injection in the
clinic. Participant will be observed for at least 30 minutes after both GP-100 Peptide
Vaccine and PEG-Intron Injections.

On Weeks 4, 7, 10, 13, 16, 19, and 22 (+/- 1 day, not counting institutional holidays),
GP-100 peptide will be given in the clinic. Participant will be observed for at least 30
minutes after GP-100 Peptide Vaccine injection. Participant should give the PEG-Intron to
themselves within 24 hours of GP-100 Peptide Vaccine injection. The injection of gp100 will
be given in two separate areas of participant's limbs, such as in an upper arm or thigh. It
will be given in the same area each time.

Length of Study:

Participant will remain on this study for up to 25 weeks, unless the disease comes out of
remission or they experience intolerable side effects.

End-of-Treatment Visit:

At the end of study treatment (approximately 3 weeks after the last injection of gp100),
participant will have the following tests:

- Participant will have a review of their general health and any medical problems they
may be having.

- Participant will have a physical exam, including measurement of their vital signs.

- Blood (about 1 tablespoon) will be drawn for routine tests.

- Participant will have the leukapheresis repeated.

- Participant will have a CT scan of chest, stomach, and pelvis, and they will have an
MRI or CT scan of the brain.

While participant is on this study no steroids will be allowed while on treatment.

This is an investigational study. Pegylated Interferon alfa-2b is FDA approved and
commercially available for the treatment of chronic hepatitis C. Gp100 is not FDA approved
or commercially available. At this time, the combination use of pegylated Interferon alfa-2b
plus gp100 is being used for research purposes only in this study.

Up to 30 participants will take part in this study. All will be enrolled at MD Anderson.

Inclusion Criteria:

1. Patients must be free of disease after surgical resection for AJCC stage II or III
(N1a) melanoma (T2b, T3a, T3b, T4a, T4b and N1a or N2a). Diagnosis must be confirmed
by the Pathology Department of MD Anderson Cancer Center.

2. Patients must be HLA-A0201 positive.

3. Patients must be fully recovered from surgery, for at least one month, but not more
than 90 days after surgery and before study entry.

4. Patients must have no other malignancies. Patients with prior history of any in situ
cancer, lobular carcinoma of the breast in situ, cervical cancer in situ, atypical
melanocytic hyperplasia or Clark I melanoma in situ or basal or squamous skin cancer
are eligible. Patients with other malignancies are eligible, if they have been
continuously disease-free for 5 years prior to the time of study entry.

5. Patients must be >/= 18 years of age.

6. Patients must give signed written informed consent.

7. Women of childbearing potential (WOCBP) must not be pregnant (negative urine HCG
within 2 weeks of treatment) or lactating. A WOCBP has not undergone a hysterectomy
or who has not been naturally postmenopausal for at least 24 consecutive months
(i.e., who has had menses at any time in the preceding 24 consecutive months).

8. Women of childbearing potential and sexually active males must be counseled to use an
accepted and effective method of contraception (including abstinence) while on
treatment and for a period of 3 months after completing or discontinuing treatment.
Simultaneous use of two contraceptive methods such as, IUD or condom and
contraceptive jelly is considered the accepted method of contraception.

9. Patients must have ECOG performance status 0 or 1.

10. Patients must have WBC >/= 3,000/mm3, platelet count >/= 100,000/mm3, and hemoglobin
>/= 9 g/dL or 5.6 mmole/L obtained within 2 weeks of study entry.

11. Patients must have AST, ALT, LDH, alkaline phosphatase, and bilirubin within
institutional upper limit (IUL) of normal and serum creatinine < 2.0 mg/dl or < 140
micromol/L all obtained within 2 weeks of study entry. Patients with Gilbert's
Disease may have bilirubin
12. Patients must have a CT of chest, abdomen, pelvis, and a MRI or CT scan of the brain
performed within 4 weeks of study entry.

Exclusion Criteria:

1. Patients with clinical, radiological/laboratory or pathological evidence of
incompletely resected melanoma or any distant metastatic disease.

2. Patients with autoimmune disorders or receiving immunosuppressive therapy including
chemotherapy, steroids or methotrexate.

3. Patients requiring consistent use of antihistamines or non-steroidal
anti-inflammatory drugs.

4. Patients with a history of active ischemic heart disease or cerebro-vascular disease,
congestive heart failure (NYHA class >2) or anginal syndrome requiring ongoing
medical treatment.

5. Patients have a diagnosis or evidence of organic brain syndrome or significant
impairment of basal cognitive function or any psychiatric disorder that might
preclude participation in the protocol. Any questionable patients will be reviewed by
the investigator or attending physician.

6. Patients having prior radiotherapy, chemotherapy or any immunotherapy including,
tumor vaccines, interferon, interleukins, levamisole or other biologic response
modifiers for any type of cancer.

7. Patients with a history of CNS demyelinating, inflammatory disease or hereditary or
acquired grade 2 or higher peripheral neuropathy.

8. Patients with any other significant medical or surgical condition or psychiatric
disorder, which includes any serious psychiatric illness that has not been adequately
controlled despite intervention (with our without medication) with known history of
HIV or hepatitis infection may interfere with the completion of this trial or with
the evaluation of safety and efficacy of the study compound.

9. Patients with thyroid dysfunction not responsive to therapy.

10. Patients with pre-existing psychiatric condition including, but not limited to: a.
History of severe depression, including the following: 1) Hospitalization for
depression 2) Electroconvulsive therapy for depression 3) Depression that resulted in
a prolonged absence from work and/or significant disruption of daily functions. b.
Suicidal or homicidal ideation and/or suicidal or homicidal attempt. c. History of
severe psychiatric disorders (eg. psychosis, post-traumatic stress disorder or
mania). d. Past history or current use of lithium and/or antipsychotic drugs.
We found this trial at
1
site
1515 Holcombe Blvd
Houston, Texas 77030
 713-792-2121
University of Texas M.D. Anderson Cancer Center The mission of The University of Texas MD...
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mi
from
Houston, TX
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