Immunotherapy of HLA-A2 Positive Stage III/IV Melanoma Patients

Immune therapy with tumor antigenic peptides is generally quite well tolerated. However, immune activation is often only weak or even undetectable, and clinical responses (supposedly corresponding to protective immunity) are unfortunately infrequent. Further progress is required to improve the vaccines, with the goal to increase the strength of immune activation.

The tumor antigenic peptides Melan-A/Mart-1 (EAA and ELA) and Tyrosinase (YMD) are combined with two drugs in this study, both of which are known to enhance immune responses: first, CpG 7909 oligodeoxynucleotides, and second, Montanide ISA-51.

• Group 1: vaccination with Melan-A analog peptide + CpG and Montanide adjuvants;
• Group 2: vaccination with Melan-A natural peptide + CpG and Montanide adjuvants;
• Group 3 : vaccination with Melan-A natural and Tyrosinase peptides + CpG and Montanide adjuvants;
• Group 4 : vaccination with Melan-A analog and Tyrosinase peptides + CpG and Montanide adjuvants.

Inclusion criteria

• Histologically confirmed stage III or stage IV melanoma
• Tumor expression of Melan-A +/- Tyrosinase
• Human leukocyte antigen-A2 (HLA-A2) positive

Exclusion criteria

• Clinically significant heart disease
• Serious illnesses, eg, serious infections requiring antibiotics, bleeding disorders or uncontrolled peptic ulcer, or seizure or central nervous system disorders
• History of immunodeficiency disease or autoimmune disease
• Coagulation or bleeding disorders