Phase 2 study of the g209-2M melanoma peptide vaccine and low-dose interleukin-2 in advanced melanoma: Cancer and Leukemia Group B 509901

J Immunother. 2006 Jan-Feb;29(1):95-101. doi: 10.1097/01.cji.0000195295.74104.ad.

Abstract

High-dose interleukin-2 (IL-2) is the only approved immunologic therapy for advanced melanoma, but response rates are low and significant toxicities limit treatment to otherwise healthy patients. g209-2M is a nanopeptide engineered to mimic an epitope of the gp100 melanocyte differentiation protein that is recognized in a human leukocyte antigen (HLA)-restricted manner by melanoma tumor-infiltrating lymphocytes in some patients. Previous reports indicated that administration of the g209-2M peptide could induce g209-reactive circulating T cells in patients with melanoma and that the combination of g209-2M and high-dose IL-2 might be a more active treatment than high-dose IL-2 alone. Low-dose IL-2 is not active but has significant biologic effects, and because of a different toxicity profile, it can be offered to most patients. The primary objective of this cooperative group phase 2 study was to determine the activity of the combination of g209-2M and low-dose IL-2 in advanced melanoma. Twenty-six HLA appropriate patients with advanced melanoma received subcutaneous g209-2M peptide once every 3 weeks and subcutaneous IL-2 (5 million IU/m) daily for 5 days during the first and second weeks. Patients were monitored for tumor response, toxicity, and induction of g209-reactive circulating T cells. There were no objective responses. There were no toxic deaths and no grade 4 toxicities. More than half of the patients experienced some grade 2 toxicity and one quarter experienced grade 3 toxicity. There was no convincing evidence by enzyme-linked immunospot or tetramer analysis of induction of g209-reactive circulating T cells. The combination of g209-2M and low-dose IL-2 is safe and tolerable but inactive against advanced melanoma. Absence of evidence of immunization raises concerns for peptide-based immunization strategies with concurrent IL-2.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cancer Vaccines / administration & dosage*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Interleukin-2 / administration & dosage*
  • Leukocytes, Mononuclear / drug effects
  • Leukocytes, Mononuclear / immunology
  • Male
  • Melanoma / immunology
  • Melanoma / therapy*
  • Membrane Glycoproteins / immunology
  • Membrane Glycoproteins / therapeutic use*
  • Middle Aged
  • Neoplasm Recurrence, Local / therapy
  • Peptide Fragments / immunology
  • Peptide Fragments / therapeutic use*
  • Peptides
  • Skin Neoplasms / immunology
  • Skin Neoplasms / therapy*
  • gp100 Melanoma Antigen

Substances

  • Cancer Vaccines
  • Interleukin-2
  • Membrane Glycoproteins
  • PMEL protein, human
  • Peptide Fragments
  • Peptides
  • g209-2M melanoma peptide
  • gp100 Melanoma Antigen