mRNA Electroporated Autologous Dendritic Cells for Stage III/IV Melanoma (DC-MEL)
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Purpose
This is an open label, 2-arm, 1-stage, randomized controlled phase II study in patients with AJCC stage IIIB/C & -IV melanoma. At baseline tumor assessment (using total body FDG-PET/CT), patients should be free from measurable tumor lesions (according to RECISTv1.1 definitions) following prior local therapy (e.g. following surgical resection, isolated limb perfusion, radiofrequency ablation, cryotherapy, radiotherapy, electrochemotherapy, …). Patients should not have symptomatic non-measurable tumor lesions (e.g. bone metastasis, or pleural effusion), and lesions treated by prior local therapy should be free from progression. Patients should not have received any prior systemic therapy (non-experimental or experimental).
| Condition | Intervention | Phase |
|---|---|---|
|
Malignant Melanoma Stage III Malignant Melanoma Stage IV |
Biological: Dendritic cell therapy |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Randomized Controlled Phase II Clinical Trial on mRNA Electroporated Autologous Dendritic Cells for Stage III/IV Melanoma Patients Who Are Disease-free Following the Local Treatment of Macrometastases |
- 1-year disease free survival percentage [ Time Frame: 1-year following recruitment date ] [ Designated as safety issue: No ]Patients will be evaluated 52 weeks following randomization for their melanoma disease status (= macro-metastases present or absent)
- safety [ Time Frame: continuous during the study (52weeks after start) ] [ Designated as safety issue: Yes ]Patients will be followed continuous during their study participation for adverse events
| Estimated Enrollment: | 88 |
| Study Start Date: | October 2012 |
| Estimated Study Completion Date: | September 2016 |
| Estimated Primary Completion Date: | September 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm A dendritic cell therapy
Arm-A, patients will receive Dendritic Cell therapy during one year following randomization.
|
Biological: Dendritic cell therapy
Dendritic cell therapy IV and ID
|
|
Experimental: Arm B Dendritic cell therapy
Arm-B, patients will initiate Dendritic Cell therapy only after documented recurrence of the melanoma that cannot be salvaged by local therapy.
|
Biological: Dendritic cell therapy
Dendritic cell therapy IV and ID
|
Detailed Description:
This is an open label, 2-arm, 1-stage, randomized controlled phase II study in patients with AJCC stage IIIB/C & -IV melanoma. At baseline tumor assessment (using total body FDG-PET/CT), patients should be free from measurable tumor lesions (according to RECISTv1.1 definitions) following prior local therapy (e.g. following surgical resection, isolated limb perfusion, radiofrequency ablation, cryotherapy, radiotherapy, electrochemotherapy, …). Patients should not have symptomatic non-measurable tumor lesions (e.g. bone metastasis, or pleural effusion), and lesions treated by prior local therapy should be free from progression. Patients should not have received any prior systemic therapy (non-experimental or experimental).
- Patients will be randomized between two treatment arms (Arm-A and -B). In study Arm-A, patients will receive DC-administrations during one year following randomization. Salvage treatment by local therapies will be allowed during the study treatment in Arm-A. In study Arm-B, patients will initiate DC-administrations only after documented recurrence of the melanoma that cannot be salvaged by local therapy.
- The primary endpoint of this clinical trial is to determine the rate (%) of patients who are free from macrometastases (: measurable tumor lesions and symptomatic non-measurable tumor lesions) at 1-year (= 52 weeks) after randomization.
Patients treated on Arm-B will serve as a contemporary control-arm to help interpreting the outcome of patients treated in Arm-A. By design (phase II) this trial will not be powered to statistically prove a predefined difference between the two study arms (this would require a phase III design). Patients treated in Arm-B will be able to initiate immunotherapy with autologous DC at the time of recurrence that can not be salvaged by local therapy. Documentation of the anti-tumor activity and survival following DC-treatment at recurrence in Arm-B patients will be a secondary objective of this clinical trial.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Able and willing to give written informed consent
- Histological documentation of AJCC stage III or stage IV melanoma
- melanoma (melanoma originating in the choroid, iris or ciliar body are not eligible)
- baseline tumor assessment by whole-body FDG-PET/CT, patients should be free from measurable tumor lesions (RECIST (v1.1)), and free from symptomatic non-measurable tumor lesions
- Prior local treatment of primary and metastatic tumor lesions is allowed . Treated tumor lesions should be free from progression at baseline assessment
- Normal organ function and normal hematological parameters;laboratory parameters should be within normal range, except following laboratory parameters:HEMOGLOBIN ≥ 10 G/DL; GRANULOCYTES ≥ 1,500/µL; LYMPHOCYTES ≥ 1000/µL; PLATELETS ≥ 100,000/µL; SERUM CREATININ ≤ 2.0 MG/DL; SERUM BILIRUBIN ≤ 2.0 MG/DL; AST AND ALT ≤ 2 X THE NORMAL UPPER LIMITS; LDH ≤ 1,5X NORMAL UPPER LIMIT; CRP ≤ 1,5X NORMAL UPPER LIMIT; PROTHROMBIN TIME (PT) INTERNATIONAL NORMALIZED RATIO (INR) AND PARTIAL THROMBOPLASTIN TIME (PTT) WITHIN NORMAL LIMITS
- Negative serology for HCV, and HIV; absence of active infection with HBV, and Syphilis; If positive results for HepB or Syphilis indicate immunity and are not indicative of active infection, the patient can enter the study.
- Adequate venous access(to undergo leukapheresis)
- No prior systemic therapy for melanoma
- Full recovery from all prior therapies. A period of 4 weeks following major surgery, radiation therapy, or ILP, or any other major invasive procedure is required
- Baseline WHO performance status of 0 or 1
- Male and female patients ≥ 18 years
- No need for uninterrupted therapeutic anticoagulation
- No prior history of a serious autoimmune disorder
- No concomitant medication with immune suppressive drugs
- Women of childbearing potential must be using an adequate method of contraception to avoid pregnancy throughout the study and for up to 8 weeks after the study in such a manner that the risk of pregnancy is minimized.
Exclusion Criteria:
- Evidence of immunodeficiency or autoimmune disease requiring medical treatment (e.g. corticosteroids or other immunosuppressive drugs).Vitiligo is not an exclusion criterion
- Any serious acute or chronic illnesses (e.g. heart disease NYHA Class III or IV,renal-,liver- or pulmonary insufficiency) or other conditions requiring concurrent medications not allowed during this study (e.g. active chronic infections requiring antibiotics)
- History of malignancy. Curatively treated cervical carcinoma in situ,or squamous-,or basal cell carcinoma of the skin, or subjects who have been treated and recurrence-free of other malignancies for more than 5 years following the diagnosis are eligible
- Inability to undergo FDG-PET/CT, or MRI examination
- Mental impairment that may compromise the ability to give informed consent and comply with the requirements of the study
- Participation in any other clinical trial involving another investigational agent within 4 weeks prior to enrollment
- Subject is pregnant (positive serum beta-HCG test at screening) or is currently breast-feeding, anticipates becoming pregnant/impregnating their partner during the study or within 6 months after study participation, or subject does not agree to follow acceptable methods of birth control, to avoid conception during the study and for at least 6 months after receiving the last dose of study treatment
- Current alcohol dependence or drug abuse
- Known hypersensitivity to the study treatment
- Legal incapacity or limited legal capacity
- Presence of any psychological, familial, sociological, or geographical condition potentially hampering compliance with the study protocol and follow-up schedule.
- Signs and symptoms suggestive of transmissible spongiform encephalopathy,or family members who suffer(ed) from such.
Contacts and Locations| Contact: Bart Neyns, Phd, Md | 0032(0)2 477 64 15 | bart.neyns@uzbrussel.be |
| Contact: Sofie Wilgenhof, Md | 0032 2 477 5447 | sofie.wilgenhof@vub.ac.be |
| Belgium | |
| UZ Brussel | Recruiting |
| Brussel, Belgium, 1090 | |
| Contact: Bart Neyns, Phd,Md +32 2 477 ext 54 47 bart.neyns@uzbrussel.be | |
| Principal Investigator: Bart Neyns, Phd,Md | |
| Principal Investigator: | Bart Neyns, Phd Md | UZ Brussel |
More Information
No publications provided
| Responsible Party: | Bart Neyns, Head of devision (Medical Oncology), Universitair Ziekenhuis Brussel |
| ClinicalTrials.gov Identifier: | NCT01676779 History of Changes |
| Other Study ID Numbers: | DC-MEL |
| Study First Received: | August 21, 2012 |
| Last Updated: | April 30, 2013 |
| Health Authority: | Belgium: Federal Agency for Medicinal Products and Health Products |
Keywords provided by Universitair Ziekenhuis Brussel:
|
melanoma no evidence of disease resection macro-metastases |
Additional relevant MeSH terms:
|
Melanoma Neuroendocrine Tumors Neuroectodermal Tumors Neoplasms, Germ Cell and Embryonal |
Neoplasms by Histologic Type Neoplasms Neoplasms, Nerve Tissue Nevi and Melanomas |
ClinicalTrials.gov processed this record on May 23, 2013