Lymphocyte Therapy in Treating Patients With Kidney Cancer
Adjuvant Autolymphocyte Therapy (ALT) For Patients With Non-Metastatic Renal Cell Carcinoma
RATIONALE: Treating a person's lymphocytes with interleukin-2 and monoclonal antibody may help them kill more cancer cells when they are put back in the body.
PURPOSE: This phase II trial is studying how well lymphocyte therapy works in treating patients with stage III or stage IV kidney cancer.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Evaluate the ability of autologous lymphocyte therapy (ALT) given as adjuvant therapy following nephrectomy and/or complete surgical resection of any metastatic disease to delay or prevent metastatic recurrence in patients with high-risk renal cell carcinoma.
- Determine the incidence of tumor recurrence and the survival of these patients treated with this regimen.
- Determine the toxicity/morbidity of this regimen in these patients.
- Explore the relationship between clinical response and in vitro autologous lymphocyte characteristics, including lytic activity, cytokine production, response to cytokines, and phenotypic profile in these patients treated with this regimen.
- Assess patient immune status before, during, and after therapy.
OUTLINE: Patients are stratified according to postnephrectomy interval (less than 3 months vs more than 3 months), extent of lymph node involvement (N1 vs N2-N3), interleukin-1 concentration in initial autologous lymphocyte culture (less than 500 pg/mL vs greater than 500 pg/mL), and prenephrectomy treatment.
Mononuclear cells are collected by apheresis on day 1 and cultured with interleukin-2 and monoclonal antibody OKT3. After cellular production, the autologous lymphocytes are reinfused over at least 30 minutes. Treatment repeats monthly for 6 months and then every 3 months for 6 months in the absence of unacceptable toxicity.
Patients are followed every 3 months for 1 year, every 6 months for 1 year, and then annually for 5 years.
PROJECTED ACCRUAL: A total of 10-90 patients will accrued for this study within 3 years.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Wisconsin
-
Milwaukee, Wisconsin, United States, 53201-2901
- Vince Lombardi Cancer Clinic at Aurora St. Luke's Medical Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
- Histologically documented and completely resected stage III or stage IV renal cell carcinoma, clinically staged within 2 months prior to initiation of therapy
- No evidence of nephrotic syndrome
PATIENT CHARACTERISTICS:
Age:
- Over 16
Performance status:
- ECOG 0-2
Hematopoietic:
- WBC at least 3,000/mm^3
- Granulocyte count at least 1,500/mm^3
- Platelet count 50,000/mm3 to 500,000/mm^3
- Hemoglobin at least 10 g/dL
- No hematologic abnormalities
Hepatic:
- PT no greater than 1.5 times control
- PTT less than 1.5 times control
- Hepatitis B surface antigen negative
Renal:
- Creatinine no greater than 4.0 mg/dL
- Calcium no greater than 12 mg/dL
- No symptomatic hypercalcemia
Cardiovascular:
No uncontrolled or severe cardiac disease, e.g.:
- No myocardial infarction within 6 months
- No congestive heart failure
Other:
- HIV negative
- No significant organ dysfunction
- No other serious medical illness that would limit life expectancy
- No significant CNS disease including uncontrolled or untreated psychiatric or seizure disorders
- No uncontrolled bacterial, viral, or fungal infection
- No active peptic or duodenal ulcer
- Adequate peripheral venous access required
- No prior malignancy within past 5 years except inactive nonmelanoma skin cancer or carcinoma in situ of the cervix
- Not pregnant
- Negative pregnancy test
PRIOR CONCURRENT THERAPY:
- No other concurrent postnephrectomy adjuvant therapy
Biologic therapy:
- No concurrent immunotherapy
Chemotherapy:
- No concurrent chemotherapy
Endocrine therapy:
- More than 1 week since prior corticosteroids (except as inhalation therapy for respiratory ailments or replacement for adrenal insufficiency)
No concurrent therapy with the following:
- Estrogens (except as postmenopausal replacement therapy)
- Androgens
- Progestins
- Antiestrogens
- Antiandrogens
- LHRH analogues or antagonists
- Other hormones
Radiotherapy:
- Not specified
Surgery:
- See Disease Characteristics
- No prior solid organ allograft
- More than 3 weeks since major surgery, including nephrectomy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
|---|
|
Survival as measured by Kaplan-Meier method at 5 years
|
|
Onset of recurrence as measured by Kaplan-Meier method at 5 years
|
|
Safety as measured by NCI Common Toxicity Criteria at completion of study
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: John P. Hanson, MD, St. Luke's Medical Center
Study record dates
Study Major Dates
Study Start
Study Start
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Urologic Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Kidney Diseases
- Urologic Diseases
- Adenocarcinoma
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Kidney Neoplasms
- Carcinoma, Renal Cell
- Physiological Effects of Drugs
- Anti-Infective Agents
- Antiviral Agents
- Anti-HIV Agents
- Anti-Retroviral Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Aldesleukin
- Muromonab-CD3
Other Study ID Numbers
Other Study ID Numbers
- CDR0000063744
- STLMC-BRM-9401
- NCI-V94-0514
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