Adoptive Transfer of Specific Melanoma Antigens CD8+ T Cells in Metastatic Melanoma Patients: a Phase I/II Study

Study Overview
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Brief Summary
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This study evaluates the safety as well as the potential clinical efficacy of an adoptive transfer of CD8+ T cells, sorted with HLA-peptide multimers and specific for Melan-A and MELOE-1 melanoma antigens, to patients suffering from advanced metastatic melanoma (stages IIIc and IV).

Official Title
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Adoptive Transfer of CD8+ T Cells, Sorted With HLA-peptide Multimers and Specific for Melan-A and MELOE-1 Melanoma Antigens, to Metastatic Melanoma Patients. A Phase I/II, Non-randomized, Open Monocentric Study

Conditions
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Metastatic Melanoma

Intervention / Treatment
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* Biological: Melanoma antigens-specific CD8+ T lymphocytes


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male or female ≥ 18 and ≤ 75 years Patient expressing the HLA-A*0201 subtype of the human leukocyte antigen (HLA -A2) Patient with metastatic melanoma stage IIIc or IV (AJCC 2010) except brain metastases Tumor expressing the antigens Melan-A and MELOE-1 detected by RT-PCR Absence of cerebral metastases ECOG ≤ 1 or Karnofsky ≥ 80% Prior adjuvant melanoma treatment (before metastatic stage) authorized (anti- BRAF, anti-CTLA4, IFN, TIL... ) Disease measurable / evaluable within 28 days before the first administration of study treatment Negative viral serology (HIV 1/2, Ag p24 , HTLV 1/2 , hepatitis B and C, syphilis) Results of analysis: Hemoglobin ≥ 10 g / dl or ≥ 6.25 mmol / l Leukocytes ≥ 4000/μl Lymphocytes ≥ 1500/μl Platelets ≥ 80.000/μl Creatinine ≤ 2.5 N Total bilirubin ≤ 3 N AST and ALT ≤ 3 N without liver metastases; ≤ 5 N with liver metastases Negative pregnancy test for women of childbearing age Patient affiliated to a social security system Patient who has signed informed consent Exclusion Criteria: Brain metastases Ocular primitive melanoma Treatment of metastatic melanoma by more than two lines (chemotherapy , immunotherapy, targeted therapy or radiotherapy) or within 4 weeks before the inclusion Treatment with ipilimumab within 8 weeks before the inclusion Known allergy to albumin Contraindication to the use of vasopressors Positive viral serology for HIV 1/2 , Ag p24 , HTLV 1/2, hepatitis B or C, or syphilis Women who are pregnant, nursing or refusing to use contraceptives, women with no negative pregnancy test at baseline Presence of a second active cancer (with the exception of cervical cancer in situ or skin cancer other than melanoma) History of event or current event of a progressive or non-stabilized severe heart disease (congestive heart failure, coronary artery disease, uncontrolled hypertension, serious arrhythmias or ECG signs of previous myocardial infarction) Uncontrolled thyroid dysfunction Any serious acute or chronic illness (active infection requiring antibiotics, bleeding disorders or other condition requiring concomitant treatment not allowed in this study) History of chronic autoimmune disease (Addison's disease, multiple sclerosis, Graves' disease, rheumatoid arthritis, systemic lupus erythematosus, ... ) with the exception of patients with active vitiligo or a history of vitiligo History of uveitis and retinopathy associated with melanoma Adults under a legal protection regime (guardianship, trusteeship, sauvegarde de justice)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Autologous somatic cell therapy<br>Patients treated with melanoma antigens-specific CD8+ T lymphocytes followed by subcutaneous injections of Proleukin. | Biological: Melanoma antigens-specific CD8+ T lymphocytes<br>* The intervention uses an autologous somatic cell therapy medicinal product. It consists in the intravenous injection of melanoma antigens (Melan-A and MELOE-1) - specific CD8+ T lymphocytes followed by subcutaneous injections of Proleukin.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical and biological safety defined by the NCI (Common Toxicity Criteria - Version 4.0, may 2009, http:// ctep.cancer.gov) | Serious adverse effects of grade 3 and 4 will be considered to decide the suspension of inclusion | Until disease progression during the follow-up period of the study (12 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression-free survival |  | From the date of the first treatment until the date of the first documented progression or the date of death from any cause, whichever came first, assessed up to 2 years | 
| Overall survival |  | From the date of the first treatment until the date of death, assessed up to 2 years | 
| Overall tumor response (complete response, partial response, stable disease) evaluated according to Response Evaluation Criteria in Solid Tumor (RECIST) and immune-related Response Criteria (irRC) |  | At 12 months | 
| Duration of clinical responses defined as the time interval between the evaluation of the first objective response or stable disease and the first evaluation of disease progression |  | At 12 months | 
| Persistence of injected specific T cells evaluated by immunomonitoring |  | At 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Onco-dermatology, Adoptive transfer, Immunotherapy