Evaluation of a New Anti-cancer Immunotherapy in Patients With Non-operable and Progressing Metastatic Cutaneous Melanoma

In this study, patients were to receive a maximum of 24 doses of recNY-ESO-1 + AS15 ASCI
according four cycles over a period of four years. An active follow-phase (up to five years
after registration into the study) was planned for all patients.

As of Amendment 3, there will no longer be an active follow-up of patients after
discontinuation or completion of the treatment. The study will end 30 days after the last
dose will be administered.

In addition, no more biological samples will be collected for protocol research purposes. For
each biological sample already collected in the scope of this study and not tested yet,
testing will not be performed by default, except if a scientific rationale remains relevant.

Blood sampling for safety monitoring as per protocol will continue.

Inclusion Criteria:

- Male or female patient with histologically proven, measurable metastatic cutaneous
melanoma, and with documented progressive disease within the 12 weeks before the first
administration of study treatment.

- Written informed consent for NY-ESO-1 expression screening and gene profiling on
resected tumor tissue and for the complete study has been obtained from the patient
prior to shipment of the sample for expression testing and prior to the performance of
any other protocol-specific procedure.

- Patient is >= 18 years of age at the time of signature of the informed consent.

- The patient's tumor shows expression of NY-ESO-1, as determined by real-time
quantitative reverse transcription polymerase chain reaction (RT-PCR) analysis or any
updated technique on fresh tissue sample(s).

- Eastern Cooperative Oncology Group performance status of 0 or 1.

- The patient has normal organ functions as shown by all of the following:

- Hemoglobin ≥ 12 g/dL

- Absolute leukocytes count ≥ 3.0 x 1000000000/L

- Absolute lymphocytes count ≥ 1.0 x 1000000000/L

- Platelets ≥ 100 x 1000000000/L

- Serum creatinine ≤ Upper Limit of Normal (ULN)

- Serum total bilirubin ≤ 1.5 x ULN (except for patients with Gilbert's syndrome
for whom the limit is 2 x ULN)

- Lactate dehydrogenase ≤ ULN

- Aspartate aminotransferase ≤ 2 × ULN

- Alanine aminotransferase ≤ 2 × ULN

These tests must be done no more than 3 weeks before the first ASCI administration.

- Female patients of non-childbearing potential may be enrolled in the study.

- Female patient of childbearing potential may be enrolled in the study, if the patient:

- has practiced adequate contraception for 30 days prior to first ASCI
administration, and

- has a negative pregnancy test at the specified study visits, and

- has agreed to continue adequate contraception during the entire treatment period
and for 2 months after completion of the ASCI administration series.

- In the view of the investigator, the patient can and will comply with the requirements
of this protocol.

Exclusion Criteria:

- The patient has at any time received systemic chemotherapy, biochemotherapy, small
molecules or nti-CTLA-4 monoclonal antibody for metastatic disease.

- The patient is scheduled to receive any other anticancer treatments than those
specified in the protocol, including but not limited to (bio-) chemotherapeutic,
immunomodulating agents and radiotherapy.

- The patient received any cancer immunotherapy containing a NY-ESO-1 antigen or any
cancer immunotherapy for his/her metastatic disease.

- The patient requires concomitant treatment with systemic corticosteroids, or any other
immunosuppressive agents.

- Use of any investigational or non-registered product other than the ASCI within 30
days preceding the first ASCI administration, or planned use during the study period.

- The patient has (had) previous or concomitant malignancies at other sites, except
effectively treated non-melanoma skin cancers or carcinoma in situ of the cervix or
effectively treated malignancy that has been in remission for over 5 years and is
highly likely to have been cured.

- The patient has an allergy to any component of the study investigational product or
has a history of previous allergic reactions to vaccinations.

- The patient has an autoimmune disease such as, but not limited to, multiple sclerosis,
lupus, and inflammatory bowel disease. Patients with vitiligo are not excluded.

- The patient has a family history of congenital or hereditary immunodeficiency.

- The patient is known to be positive for the Human Immunodeficiency Virus.

- The patient has an uncontrolled bleeding disorder.

- The patient has a family history of congenital or hereditary immunodeficiency.

- The patient has psychiatric or addictive disorders that may compromise his/her ability
to give informed consent, or to comply with the trial procedures.

- The patient has concurrent severe medical problems, unrelated to the malignancy, that
would significantly limit full compliance with the study or expose the patient to
unacceptable risk.

- For female patients: the patient is pregnant or lactating.