GRN-1201 is a novel HLA-A*02-restricted multiple-peptide, therapeutic cancer vaccine, being
developed by GreenPeptide for the treatment of melanoma because it can induce immune
responses against tumor associated antigens (TAAs), particularly cytotoxic T cell (CTL)
responses. Granulocyte-macrophage-colony-stimulating-factor (GM-CSF) (Leukine®,
SanofiAventis) will be administered in combination with GRN-1201 as an immuno-adjuvant
In contrast to advanced melanoma, treatment options in the adjuvant setting are limited.
Surgical resection is the primary treatment of Stage IIb, IIc, and III melanoma patients. The
rate of disease recurrence in patients with American Joint Committee on Cancer (AJCC) TNM
Stage II (T2-4N0M0) and Stage III (TanyN+M0) disease ranges between 20 -60%, with 5-year
overall survival between 45 - 70%. Thus, safe and effective treatment options to reduce the
risk of recurrence are much needed. Considering their generally safe nature, peptide-based
cancer vaccines would be ideal to address this unmet medical need. Patients with Stage IIb,
IIc or III melanoma are, in general, healthy following local therapy. They are anticipated to
maintain an immune system uncompromised by chemotherapy or disease burden. Further, they may
have already developed immune response to TAAs targeted by GRN-1201, which may increase the
probability of developing effective immune responses. It is conceivable that the combination
of peptide vaccines with an immune checkpoint inhibitor, especially with a PD-1 pathway
inhibitor, could enhance the efficacy of immunotherapy without increasing toxicity. Studies
evaluating the combination of a melanoma vaccine with nivolumab in advanced melanoma [14] and
resected high-risk metastatic melanoma patients [15] reported encouraging clinical outcome.
The pre-clinical data suggest that GRN-1201 may have anti-tumor activity in the adjuvant
setting or may enhance activity of other drugs such as checkpoint inhibitors in the adjuvant
or metastatic disease setting, by enhancing immune responses against TAAs.
Inclusion Criteria:
- Males and females ≥18 years of age (at the time consent is obtained);
- Provide written informed consent for study participation, approved by the appropriate
institutional review board (IRB), and be willing and able to cooperate with all
aspects of the protocol;
- Resected, histologically proven, cutaneous melanoma determined to be Stage IIb, IIc,
or III; according to the American Joint Commission of Cancer Staging, 7th edition
- Human leukocyte antigen (HLA)-A*02+ by serology by an ASHI accredited laboratory;
- Eastern Cooperative Oncology Group (ECOG) performance status of 0;
- Female subjects must have a negative serum human chorionic gonadotropic (hCG) test
(pregnancy test not required for subjects with bilateral oophorectomy and/or
hysterectomy or for those subjects who are >1 year post-menopausal); and
- All female and male subjects of reproductive potential must agree to use an effective
method of contraception, as determined by the Investigator, during and for 3 months
after the last dose of study drug.
Exclusion Criteria:
- Inadequate hematologic or biologic function as determined by the following laboratory
tests:
- Hemoglobin <10 g/dL,
- Platelet count <100,000/µL,
- Leukocyte count <3000/µL,
- Lymphocyte count <1000/µL,
- Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) >2 × upper limit of
normal (ULN),
- Total bilirubin >ULN: Subjects with Gilbert's syndrome are allowed if total bilirubin
is <3.0 mg/dL and direct bilirubin is ≤ULN,
- Serum creatinine >ULN, or Prothrombin time (PT) or international normalized ratio
(INR) >1.5 × ULN or activated partial thromboplastin time (aPTT) > 1.5 × ULN
- Greater than 3 months since melanoma resection;
- Have known fungal, bacterial, and/or viral infection, including human immunodeficiency
virus (HIV) or hepatitis virus (B or C);
- Active immunosuppressive therapy associated with: Organ or allogeneic hematopoietic
stem cell transplant, High-dose steroids, such as daily steroid doses in excess of 20
mg/day of prednisone (Note: Use of intra-articular or topical corticosteroids or eye
drops containing corticosteroids is acceptable.), or Inhaled corticosteroids;
- Known history of autoimmune conditions including, but not limited to: rheumatoid
arthritis, multiple sclerosis, lupus erythematosus, scleroderma, sarcoidosis,
inflammatory bowel disease, idiopathic thrombocytopenia purpura, Graves' disease, or
Hashimoto's thyroiditis;
- Current requirement for anti-coagulation therapy that prolongs PT or aPTT 7. History
of prior malignancy except: Curatively treated non-melanoma skin cancer; Solid tumor
treated curatively >5 years previously without evidence of recurrence; or History of
other malignancy that in the Investigator's opinion would not affect the determination
of study treatment effect (e.g., superficial bladder cancer, or carcinoma in situ of
the prostate, cervix, or breast);
- Non-healed wound;
- Prior adjuvant therapy for current melanoma diagnosis;
- History of any clinically significant cardiovascular disorder (i.e., symptoms above
Class II per New York Heart Association [NYHA] Functional Classification);
- History of serious allergic reaction to yeast or yeast-derived products, including
known or suspected hypersensitivity reaction to sargramostim;
- Pregnant, breastfeeding, or planning to become pregnant during the study;
- Received any other investigational therapy within 28 days of Day 1; or
- Any concurrent medical condition that, in the opinion of the Investigator, would
complicate or compromise compliance with the study or the well-being of the subject
