Stage IV Melanoma Clinical Trial
Official title:
Phase I Study Using Autologous Ex Vivo-Activated (X-ACT) Lymph Node Lymphocytes as Adoptive Immunotherapy in Advanced Malignant Melanoma Patients
This phase I trial studies the safety and best dose of ex-vivo activated lymph node lymphocytes (X-ACT) as well as how well the immune system responds to X-ACT treatment in participants with stage IIIC-IV melanoma. X-ACT treatment involves removing a participant's lymph node(s) close to a melanoma tumor. These lymph nodes contain special kind of cells (called T cells) which can be activated (getting the cells to start up certain responses in the immune system) outside of the body in an approved laboratory. The activated T cells are then injected back into the same participant using an i.v. to help the participant's immune system to target melanoma. The participant will undergo regular blood testing to determine whether the X-ACT treatment has resulted in changes to the immune system and also whether the T cells which were given back to the patient persist in the blood stream over time. In addition, the effect of the X-ACT treatment on the growth or shrinkage of the participant's melanoma will be measured.
PRIMARY OBJECTIVES:
I. Assess the safety and toxicity profile of repeated infusions of ex-vivo activated
tumor-draining lymphocytes (X-ACT) in participants with advanced melanoma.
SECONDARY OBJECTIVES:
I. Assess the feasibility of multiple infusions of X-ACT. II. Assess the effect of dose and
schedule on immunologic parameters using two novel biomarkers.
III. Observe the clinical outcomes of participants receiving X-ACT therapy.
OUTLINE: This is a dose-escalation study.
STEP 1: Participants undergo lymph node biopsy for collection of at least one
melanoma-draining lymph node (MDLN). MDLN cells will then be cryopreserved into aliquots
until they are needed to generate an activated T cell culture.
STEP 2: Cryopreserved lymph node cells are thawed and then undergo activation with
anti-cluster of differentiation (CD)3/anti-CD28 microbeads. The cultures then undergo
expansion over 14-18 days in the presence of recombinant human interleukin-2 and
anti-vascular endothelial growth factor antibody. The activated X-ACT cells are then
transferred i.v. into the same participant from which they were derived with no additional
therapy.
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