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Trial registered on ANZCTR
Registration number
ACTRN12611001136998
Ethics application status
Approved
Date submitted
28/10/2011
Date registered
31/10/2011
Date last updated
17/01/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Combination therapy with chemotherapy and immune therapy for metastatic melanoma. Protocol: GPH 11/14.
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Scientific title
Evaluation of chemotherapy followed by multivalent dendritic cell vaccines and Ipilimumab for Stage IV metastatic melanoma.
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Secondary ID [1]
273274
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Metastatic melanoma
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Condition category
Condition code
Cancer
279225
279225
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0
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Malignant melanoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will receive 3 intravenous infusions of Fotemustine 100mg/m2/week for three weeks followed by 3 intradermal vaccinations with 3-6x106 mature, autologous DC treated with tumour lysate (2ug of protein per ml) and immune adjuvants (Zometa, OK432, and KRN7000) at 2 weekly intervals. The participant will then receive four intravenous infusions of Ipilimumab at 3mg/kg per dose at three weekly intervals, concurrently with further DC vaccination. After completion of Ipilimumab, patients will then receive at least four further DC vaccinations at fortnightly intervals until study completion or disease progression.
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Intervention code [1]
269617
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Treatment: Other
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Overall Response (OR) and Time To Progression (TTP) rates will be measured via CT-PET scan in accordance with RESIST Criteria Guidelines. A CT scan of Head (at baseline but only repeated if initially positive or clinically indicated), Chest, Abdomen and Pelvis will be performed Pre-Treatment, D44 and D163. Participants will undergo monthly clinical review for disease progression and autoimmune side effects after D163. Restaging CT and MRI scans will be done every three months or with the development of new symptoms suggestive of disease progression, whichever is earlier.
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Assessment method [1]
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Timepoint [1]
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3 year follow-up following End of Treatment
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Primary outcome [2]
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Response rates with the present sequential therapy compared to historical, published studies with Ipilimumab alone or Ipilimumab+ peptide vaccines
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Assessment method [2]
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Timepoint [2]
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3 year follow-up following End of Treatment
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Secondary outcome [1]
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Laboratory correlates immune response to melanoma
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Assessment method [1]
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Timepoint [1]
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3 year follow-up following End of Treatment
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Eligibility
Key inclusion criteria
1) Patients with metastatic stage IV metastatic melanoma and measurable disease as defined by the most recently published RECIST criteria.
2) Written informed consent
3) ECOG performance status 0, 1 or 2
4) Subject judged to be able to safely undergo leukapheresis
5) Age greater than or equal to 16 years.
6) Life expectancy estimated to be greater than 4 months
7) Availability of tumour sample or an alternative source of tumour antigen
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Minimum age
16
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) Any concurrent therapy with possible activity against the patient’s malignancy (local radiotherapy on lesions not essential for study evaluation is allowed)
2) Concurrent therapy with any agent known to have immune modulating activity
3) Any therapy with possible activity against the patient’s malignancy in the month preceding administration of first dose of study therapy
4) Patient unable to undergo leukapheresis due to serious co-existing medical conditions (particularly cardiac or cardiovascular) or for other reasons
5) ECOG > 2
6) Pregnant or breast feeding or at risk for becoming pregnant within 3 months of enrolment
7) HIV, Hepatitis B or Hepatitis C positive
8) Patients with history of autoimmune disease affecting the liver, gastrointestinal tract (e.g. ulcerative colitis or Crohn's disease), neurological system (including Guillaine Barre Syndrome and Myasthenia Gravis) and autoimmune pituitary or adrenal disease.
9) Active CNS disease requiring steroids
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants who meet the eligibility criteria will be enrolled in a sequential, nonrandomized procedure.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The accrual of subjects is not randomized.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
Open label Phase I study to determine the overall response rates to sequential therapy with chemotherapy followed by vaccine therapy and Ipilimumab in patients with previously untreated stage IV metastatic melanoma.
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Phase
Phase 1 / Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
6/11/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
284106
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Charities/Societies/Foundations
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Name [1]
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Gallipoli Medical Research Foundation
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Address [1]
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Greenslopes Private Hospital
Newdegate Street
GREENSLOPES QLD 4120
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Country [1]
284106
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Australia
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Primary sponsor type
Individual
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Name
Andrew Nicol
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Address
Suite 14, Greenslopes Specialist Centre, Newdegate Street,
GREENSLOPES QLD 4120
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Country
Australia
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Secondary sponsor category [1]
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Charities/Societies/Foundations
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Name [1]
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Gallipoli Medical Research Foundation
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Address [1]
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Greenslopes Private Hospital
Newdegate Street
GREENSLOPES QLD 4120
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Country [1]
269068
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
272056
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Greenslopes Research and Ethics Committee
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Ethics committee address [1]
272056
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Ethics Secretary Greenslopes Private Hospital Newdegate street GREENSLOPES, QLD 4120
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Ethics committee country [1]
272056
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Australia
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Date submitted for ethics approval [1]
272056
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08/03/2011
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Approval date [1]
272056
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09/08/2011
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Ethics approval number [1]
272056
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11/14
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Ethics committee name [2]
272058
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University of Queensland Medical Research Ethics Committee
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Ethics committee address [2]
272058
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Human Ethics Research and Innovation Division Cumbrae-Stewart Building (#72) Research Road BRISBANE, QLD 4072
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Ethics committee country [2]
272058
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Australia
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Date submitted for ethics approval [2]
272058
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21/06/2011
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Approval date [2]
272058
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14/09/2011
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Ethics approval number [2]
272058
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2011000695
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Summary
Brief summary
This study involves treatment with a standard chemotherapy for melanoma in combination with immune therapy. Fotemustine is a chemotherapy drug that is approved for use in metastatic melanoma. It has been shown to produce responses in 15 % of patients. Other benefits include delaying the onset of metastases to the brain, with its major side effects including nausea and vomiting (generally well controlled with current anti-nausea treatments) and low blood counts that could lead to a risk of bleeding and/or infections. The main aim of the study is to determine the number of patients who respond to successive treatment with chemotherapy followed by vaccine therapy and Ipilimumab in patients with previously untreated stage IV metastatic melanoma. It is planned to include 50 patients with stage IV metastatic melanoma in this study over a 3 year period. Who is it for? You may be eligible for this study if you have metastatic stage IV metastatic melanoma, provide written informed consent , an ECOG performance status of 0, 1 or 2, are deemed by your physician to be able to safely undergo leukapheresis, are aged greater than or equal to 16 years, have a life expectancy estimated to be greater than 4 months, and are able to provide a tumour sample or an alternative source of tumour antigen – as arranged by your treating hospital or facility. Trial Details: There are two components to the immune therapy that the patients will receive. One is treatment with a vaccine comprised of the patients’ own Dendritic Cells (immune system boosters, also known as DC’s), treated in the laboratory with their own tumour (autologous melanoma), plus a number of agents known to help stimulate the immune system. Previous studies have shown response rates (meaning melanoma shrinkage) in 10-25 % of cases at best. The overall survival benefits have not been assessed in large numbers of patients. However in a small trial of 11 patients receiving vaccines similar to (but not identical to) the vaccine being used in this study, 3 remain alive 5 years after study enrolment. The second component of the immune therapy is an antibody (Ipilimumab) that unblocks the protective mechanisms that normally operate to prevent the immune system recognising and damaging one’s own body. With this protective mechanism in place, it is very difficult for vaccines to boost the immune system to recognise and kill the melanoma. Ipilimumab has been shown to prolong survival in patients with metastatic melanoma who have previously failed chemotherapy. Of patients previously treated with chemotherapy and then treated with Ipilimumab, 44% were still alive one year after starting Ipilimumab treatment. In comparison of the patients who did not receive Ipilimumab only 25% were still alive after one year. By combining a vaccine with Ipilimumab, it is expected that the boosted immune system (resulting from the vaccines) will not be prevented from recognising and killing the melanoma.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
33313
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Country
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Phone
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Fax
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Email
33313
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Contact person for public queries
Name
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Mr. Ben Evans
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Address
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Gallipoli Medical Research Foundation
Greenslopes Private Hospital
Newdegate Street
GREENSLOPES QLD 4120
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Country
16560
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Australia
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Phone
16560
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+61 7 3394 7284
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Fax
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+61 7 3394 7767
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Andrew Nicol
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Address
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Suite 14, Greenslopes Specialist Centre
Newdegate Street,
GREENSLOPES QLD 4120
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Country
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Australia
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Phone
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+61 7 3324 1233
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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