Patient case: 73-year-old male with melanoma; genetic feature: tumor cells negative for PD-L1 expression

Clinical trial: Trial for the Evaluation of the Effect of Systemic Low-dose Interleukin-2 (IL-2) on the Immunogenicity of a Vaccine Comprising Synthetic Melanoma Peptides Administered With Granulocyte-macrophage Colony-stimulating Factor (GM-CSF)-In-Adjuvant, in Patients With High Risk Melanoma

Summary: This clinical pilot study will test the hypothesis that systemic low-dose IL-2 therapy significantly enhances the immunologic efficacy of a vaccine comprising melanoma peptides plus GM-CSF-in-adjuvant.


Eligibility: Inclusion Criteria:
  -  Patients who have been diagnosed, by cytologic or histologic examination, with AJCC stage IIB, stage III or resected stage IV melanoma.
  -  Patients with up to 2 brain metastases less than or equal to 2 cm that have been surgically removed or treated successfully with the gamma-knife are eligible. Surgical resections must have been performed within 6 months prior to entry.
  -  All patients must have:
  1. ECOG performance status 0-1, and,
  2. Ability and willingness to give informed consent.
  -  Laboratory parameters as follows:
  -  HLA-A1, A2 or A3 (+)
  -  gp100 (+) and/or tyrosinase (+) tumor cells
  -  ANC > 1000/mm3, and Platelets > 100,000 and Hgb > 9
  -  Hepatic: AST and ALT up to 2.5 x upper limits of normal (ULN), Bilirubin up to 2.5 x ULN, Alkaline phosphatase up to 2.5 x ULN
  -  Renal: Creatinine up to 1.5 x ULN
  -  Serology: HIV negative, Hepatitis C negative
  Exclusion criteria:
  -  Patients who are currently receiving cytotoxic Chemotherapy or radiation or who have received that therapy within the preceding 4 weeks.
  -  Patients with known or suspected allergies to any component of the vaccine.
  -  Patients receiving the following medications at study entry or within the preceding 30 days are excluded:
  -  Agents with putative immunomodulating activity (with the exception of non-steroidal anti-inflammatory agents)
  -  Allergy desensitization injections
  -  Corticosteroids, administered parenterally or orally - topical corticosteroids are acceptable
  -  Any growth factors, Interleukin 2, Interferon alfa.
  -  Prior melanoma vaccinations will not be an exclusion criteria if given more than 8 weeks previously, but will be recorded, and data analysis will take this into account.
  -  Other investigational drugs or investigational therapy also will not necessarily be an exclusion criteria, but will similarly be recorded and taken into account during data analysis.
  -  Pregnancy or the possibility of becoming pregnant during vaccine administration.
  -  Female patients of child-bearing potential must have a negative pregnancy test (urinary or serum beta-HCG) prior to administration of the first vaccine dose.
  -  Males and females must agree, in the consent form, to use effective birth control methods during the course of vaccination.
  -  This is consistent with existing standards of practice for vaccine and chemotherapy protocols.
  -  Patients in whom there is a medical contraindication or potential problem in complying with the requirements of the protocol, in the opinion of the investigator.
  -  Patients classified according to the New York Heart Association classification system as having Class II, III or IV heart disease.
  -  Patients with active connective tissue disease requiring medication, or other severe autoimmune disease.
  -  Patients who are actively hyperthyroid.
  -  Patients with uncontrolled diabetes.

Relevance to patient case: not relevant