Immunological effects of local low-dose immunotherapy in early stage melanoma patients
| ISRCTN | ISRCTN63321797 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN63321797 |
| Protocol serial number | 03.199 |
| Sponsor | VU University Medical Center |
| Funder | Fritz Ahlqvist Foundation |
- Submission date
- 18/07/2016
- Registration date
- 22/07/2016
- Last edited
- 25/09/2017
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Cancer
Plain English summary of protocol
Background and study aims
Melanoma is a type of skin cancer that is able to spread to other organs in the body. The most common sign of the disease is a new mole appearing or a change in appearance of an existing mole. At the moment, there isn’t a widely used treatment option for early stage melanoma patients after they have had their initial therapy that will help prevent the cancer reoccurring. Indeed, the disease coming back remains the biggest challenge in the management of early stage melanoma. This study is investigating the use of stimulators of the immune system, namely unmethylated CpG type-B oligodeoxynucleotide (CpG type B) and Granulocyte/Macrophage-Colony Stimulating Factor (GM-CSF). The researchers want to know whether these substances can improve the immune response in order to fight the melanoma.
Who can participate?
Adults diagnosed with melanoma
What does the study involve?
Participants are randomly allocated to one of five groups. Those in group 1 are given an injection of CpG type B seven days at the tumour excision site (that is the site where the tumour is about to be removed) before undergoing a sentinel node biopsy (an operation that determines whether a cancer has spread beyond the original tumour into the lymphatic system). Those in group 2 are given an injection of CpG type B at the tumour excision site seven days and two days before the sentinel node biopsy. Those in group 3 are given an injection of CpG type B and GM-CSF at the tumour excision site seven days and two days before the sentinel node biopsy. Those in group 4 are given an injection of saline at the tumour excision site seven days before the sentinel node biopsy. Those in group 5 are given an injection of saline at the tumour excision site seven days and two days before the sentinel node biopsy. All participants are followed up two days after the biopsy and again after seven days to assess their immune response.
What are the possible benefits and risks of participating?
A possible benefit of participating in this trial might be that the immune system can effectively fight the melanoma cells that remain in the body after surgery. The side effects of these treatments are mild (symptoms of fever may occur) and are often easy to control.
Where is the study run from?
VU University Medical Center (Netherlands)
When is the study starting and how long is it expected to run for?
August 2003 to July 2017
Who is funding the study?
Fritz Ahlqvist Foundation
Who is the main contact?
Professor Tanja de Gruijl
Contact information
Scientific
VU University medical center – Cancer Center Amsterdam
Room CCA2.44
De Boelelaan 1117
Amsterdam
1081 HV
Netherlands
 ORCID ID |
0000-0003-1464-8978 |
|---|
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Single-center single-blinded randomized and placebo (saline) controlled phase-II clinical trial |
| Secondary study design | |
| Study type | Participant information sheet |
| Scientific title | Immune response in the sentinel node in melanoma patients after the pre-operative administration of immune modulators GM-CSF and / or CpG 7909 |
| Study objectives | It is expected that local administration of CpG 7909 around the primary tumor site in melanoma patients will result in an increased size of the sentinel lymph node (SLN) and we expect to see higher frequencies and activations states of DC and T cells due to the production of Th-1 type cytokines (IL-12, IL-2, IFN-γ, IFN-α). The researchers also expect to see an increase in specific cytotoxic T-cells under the influence of both CpG 7909 and GM-CSF in the tumor positive SLN since CpG and GM-CSF can probably enhance the response against specific tumor antigens more effectively when tumor cells are present in the lymph nodes. |
| Ethics approval(s) | Institutional Review Board of the VU University Medical Centre, 16/03/2004, ref: IRB00002991 |
| Health condition(s) or problem(s) studied | Clinical stage I-II melanoma |
| Intervention | There are three treatment arms and two saline (placebo) controlled arms. Treatment arm 1: Intradermal injection at the tumor excision site with 8 mg CpG-B (PF-3512676, formerly named CPG 7909, Coley Pharmaceutical Group, Wellesley, MA) 7 days prior to the sentinel node biopsy. Treatment arm 2: Intradermal injection at the tumor excision site with 1 mg CpG-B, 7 and 2 days prior to the sentinel node biopsy. Treatment arm 3: Intradermal injection at the tumor excision site with 1 mg CpG-B and 100µg GM-CSF (Leukine®, Berlex Laboratories Inc. Montville, NJ) 7 and 2 days prior to the sentinel node biopsy. Placebo arm 1: Intradermal injection at the tumor excision site with saline (0.9% NaCl) 7 days prior to the sentinel node biopsy. Placebo arm 2: Intradermal injection at the tumor excision site with saline (0.9% NaCl) 7 and 2 days prior to the sentinel node biopsy. All patients are followed up at day 7 and day 14 (after the sentinel node biopsy). |
| Intervention type | Drug |
| Phase | Phase II |
| Drug / device / biological / vaccine name(s) | 1. Unmethylated CpG type-B oligodeoxynucleotide; PF-3512676 (cpg7909) 2. Granulocyte/Macrophage-Colony Stimulating Factor; Leukine |
| Primary outcome measure(s) |
Immune status in the sentinel lymph node (SLN), specifically DC activation state and melanoma antigen specific T cells, measured using flow cytometry, interferon (IFN) gamma Elispot and tetramer analysis on immune cells that are harvested from the SLN at the day of the biopsy. . |
| Key secondary outcome measure(s) |
Systemic anti melanoma activity measured using flow cytometry, IFN gamma Elispot and tetramer analysis on peripheral mononuclear blood cells from day -7, 0 and 14 (day 0 is the day of the SLN biopsy). |
| Completion date | 01/07/2017 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Sex | All |
| Target sample size at registration | 52 |
| Key inclusion criteria | Patients with histologically proven primary melanoma, who are eligible for a SLN biopsy. |
| Key exclusion criteria | 1. Treated with chemotherapy or immunotherapy in the last ten years 2. Autoimmune diseases 3. Congenital or acquired immunodeficiency 4. Use of immunosuppressive medications |
| Date of first enrolment | 01/06/2004 |
| Date of final enrolment | 30/06/2007 |
Locations
Countries of recruitment
- Netherlands
Study participating centre
Amsterdam
1081 HV
Netherlands
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 15/05/2007 | Yes | No | |
| Results article | results | 15/07/2008 | Yes | No | |
| Results article | results | 01/05/2015 | Yes | No | |
| Results article | results | 01/04/2016 | Yes | No | |
| Participant information sheet | Participant information sheet | 11/11/2025 | 11/11/2025 | No | Yes |
Editorial Notes
25/09/2017: Internal review.
04/08/2016: Added publications and changed ethics approval date from 16/03/2016 to 16/03/2004
