Intensive Locoregional Chemoimmunotherapy, Intradermal Autologous Alpha-DC1 Vaccines, and Systemic Pembrolizumab for Advanced-Stage Ovarian Cancer
A Phase 2 Efficacy Trial of Intensive Locoregional Chemoimmunotherapy, Intradermal Autologous Alpha-DC1 Vaccines, and Systemic Pembrolizumab for Advanced-Stage Ovarian Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Kelsey Mitch, RN, BSN
- Phone Number: 4126412357
- Email: adamikka2@upmc.edu
Study Contact Backup
- Name: Lucia M Borrasso, RN, BSN
- Phone Number: 4126413304
- Email: borrlm@upmc.edu
Study Locations
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, United States, 15232
- UMPC Hillman Cancer Center
-
Principal Investigator:
- Robert Edwards, MD
-
Contact:
- Kelsey Mitch
- Phone Number: 4126412357
- Email: adamikka2@upmc.edu
-
Contact:
- Lucia M Borrasso
- Phone Number: 4126413304
- Email: borrlm@upmc.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Patients must have advanced stage (III-IV) epithelial carcinoma or carcinosarcoma of ovarian, tubal or peritoneal origin.
a. Histologic documentation of the original primary tumor is required via a pathology report.
- Patients must be eligible for cancer-related definitive therapy with neoadjuvant chemotherapy.
- Patients must be chemo-naive and receiving therapy in primary first-line neoadjuvant setting.
- Patients must have ECOG performance of 0-1.
- Patients must be reasonable candidate for interval debulking surgery as well as for IP platinum-based combination chemotherapy regimen, with no prior evidence of clinically significant intra-abdominal adhesions, persistent abdominal wall infections, renal disease or bowel obstruction.
- At least one lesion must be considered to be large enough for biopsy and resection to yield greater than 2 grams of tumor for tumor loading of αDC1's and immunoassays at the discretion of the treating investigator and/or surgeon.
- Patients must have measurable disease per iRECIST criteria.
- Sexually active fertile subjects and their partners must agree to use highly effective methods of contraception prior to study entry, during the course of the study, and for the following durations after the last dose of treatment (whichever is later). An additional contraceptive method, such as a barrier method (e.g., condom), is required. In addition, men must agree not to donate sperm and women must agree not to donate eggs (ova, oocyte) for the purpose of reproduction during these same periods.
Female subjects of childbearing potential must not be pregnant or breastfeeding at screening. Female subjects are considered to be of childbearing potential unless one of the following criteria is met:
a. Permanent sterilization (hysterectomy, bilateral salpingectomy, or bilateral oophorectomy) or documented postmenopausal status (defined as 12 months of amenorrhea in a woman > 45 years-of-age in the absence of other biological or physiological causes). Note: Documentation may include review of medical records, medical examination, or medical history interview by study site staff.
- Patients must be willing to undergo leukapheresis.
- Patients must be willing to adhere to protocol requirements.
Patients must have adequate:
Bone marrow function:
- Absolute neutrophil count (ANC) greater than or equal to 1,500/μL
- Platelets greater than or equal to 100,000/μL
- Hemoglobin greater than or equal to 8.0 g/dL
Renal function:
- Creatinine less than or equal to 1.5 x institutional upper limit normal (ULN)
Hepatic function:
- Bilirubin less than or equal to 1.5 x ULN
- SGOT and alkaline phosphatase less than or equal to 2.5 x ULN
- Patients who have signed informed consent and authorization permitting release of personal health information.
- Patients must be ≥ 18 years of age.
- Patient must be able to swallow oral medication and have no absorption related medical concern as deemed by the investigator.
Exclusion Criteria:
- Patients with sarcoma.
- Patients who have an active autoimmune disease (e.g., rheumatoid arthritis, systemic lupus erythematosus (SLE), ulcerative colitis, Crohn's Disease, multiple sclerosis (MS), ankylosing spondylitis).
- Patients with a known allergy to cisplatin or taxane chemotherapy. Patients with carboplatin allergy may be included if they tolerate a test dose of IV cisplatin given in monitored floor conditions. Patients who are allergic to paclitaxel can be alternatively treated with abraxane.
Patients being chronically treated with immunosuppressive drugs such as cyclosporin, adrenocorticotropic hormone (ACTH), or systemic corticosteroids.
a. Patients who received acute, low-dose systemic immunosuppressant medication or a one-time pulse dose of systemic immunosuppressant medication (e.g., 48 hours of corticosteroids for a contrast allergy) are eligible for the study after Principal Investigator confirmation has been obtained.
- Patients with a recognized immunodeficiency disease including cellular immunodeficiencies, hypogammaglobulinemia or dysgammaglobulinemia; patients who have acquired, hereditary, or congenital immunodeficiencies.
- Patients with uncontrolled diseases other than cancer will be excluded.
- Patients who have contraindications to the use of NSAID's like chronic renal failure, coronary artery disease, or bleeding ulcers.
- Patients who have contraindications to the use of interferon α-2b (Bioferon), including hypersensitivity to interferon-α or any component of the product, autoimmune hepatitis, and decompensated liver disease.
- Patients with tumors of low malignant potential, except ovarian pseudomyxoma or with no peritoneal disease.
- Patients with a history of other invasive malignancies, with the exception of non-melanoma skin cancer, are excluded if there is any evidence of other malignancy being present within the last five years. Patients are also excluded if their previous cancer treatment contraindicates this protocol therapy.
- Patients with previous pelvic radiation therapy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Safety Lead-in: Paclitaxel + Cisplatin + Bioferon + Rintatolimod + Pembrolizomab + Celecoxib
|
A chemotherapy for cancer patients that interferes structures that help move chromosomes during cell division, thus stabilizing these structures to prevents cancer cells from dividing and ultimately causing them to die. Dose: 175 mg/m^2 IV on D1 each cycle during neoadjuvant and adjuvant periods.
Other Names:
An alkylating agent that contains platinum, which binds to DNA in cancer cells, causing cross-links that prevent DNA replication and repair, leading to cell death, particularly in rapidly dividing cancer cells. Dose: 75 mg/m^2 IP / 1 hour on D1 of each cycle during neoadjuvant and adjuvant treatment periods.
Other Names:
Inhibits replication of a wide range of RNA and DNA viruses and exerts antiproliferative effects on malignant cells. It suppresses antibody formation through an effect on B-lymphocytes and inhibits onset of delayed hypersensitivity. Dose:6 milli on units/100 mL IP over 30-60 minutes on D2 of each cycle during neoadjuvant and adjuvant treatment. D1 during maintenance treatment periods.
Other Names:
A synthetic double-stranded RNA that selectively activates Toll-like Receptor 3 (TLR3), triggering antiviral and immunomodulatory responses, priming the immune system without causing excessive inflammation. Dose: 200 mg IP over 1-2 hours on D2 of each cycle during the neoadjuvant and adjuvant treatment periods. D1 during maintenance treatment periods
Other Names:
Humanized monoclonal antibody and a PD-1 inhibitor used in cancer immunotherapy that differs from chemotherapy as it does not directly kill cancer cells but stimulates the immune system, particularly T-cells, to recognize and attack cancer cells more effectively. Dose: 200 mg IV / 30 minutes on D2 of each cycle during neoadjuvant treatment period (none last neoadjuvant cycle), then optional on D2 for adjuvant treatment cycles, and on D1 of maintenance cycles
Other Names:
A COX-2 inhibitor in the class of nonsteroidal anti-inflammatory drugs (NSAIDs) that specifically target the cyclooxygenase-2 (COX-2) enzyme, which plays a key role in inflammation Dose: 200mg/day, orally twice a day for days 1-5 and once a day for days 6-21 of neoadjuvant and adjuvant treatment cycles, and then twice a day on D1 and once a day for days 2-21 for maintenance cycles
Other Names:
A surgical procedure designed to remove the majority of cancerous tumors when complete removal may not be feasible, with the goal of reducing tumor burden, making follow-up treatments like chemotherapy or radiation more effective. Surgery occurs in between the neoadjuvant and adjuvant treatment periods.
Other Names:
|
|
Experimental: Paclitaxel + Cisplatin + Bioferon + Rintatolimod + DC1 Vaccine + Pembrolizomab + Celecoxib
|
A chemotherapy for cancer patients that interferes structures that help move chromosomes during cell division, thus stabilizing these structures to prevents cancer cells from dividing and ultimately causing them to die. Dose: 175 mg/m^2 IV on D1 each cycle during neoadjuvant and adjuvant periods.
Other Names:
An alkylating agent that contains platinum, which binds to DNA in cancer cells, causing cross-links that prevent DNA replication and repair, leading to cell death, particularly in rapidly dividing cancer cells. Dose: 75 mg/m^2 IP / 1 hour on D1 of each cycle during neoadjuvant and adjuvant treatment periods.
Other Names:
Inhibits replication of a wide range of RNA and DNA viruses and exerts antiproliferative effects on malignant cells. It suppresses antibody formation through an effect on B-lymphocytes and inhibits onset of delayed hypersensitivity. Dose:6 milli on units/100 mL IP over 30-60 minutes on D2 of each cycle during neoadjuvant and adjuvant treatment. D1 during maintenance treatment periods.
Other Names:
A synthetic double-stranded RNA that selectively activates Toll-like Receptor 3 (TLR3), triggering antiviral and immunomodulatory responses, priming the immune system without causing excessive inflammation. Dose: 200 mg IP over 1-2 hours on D2 of each cycle during the neoadjuvant and adjuvant treatment periods. D1 during maintenance treatment periods
Other Names:
Humanized monoclonal antibody and a PD-1 inhibitor used in cancer immunotherapy that differs from chemotherapy as it does not directly kill cancer cells but stimulates the immune system, particularly T-cells, to recognize and attack cancer cells more effectively. Dose: 200 mg IV / 30 minutes on D2 of each cycle during neoadjuvant treatment period (none last neoadjuvant cycle), then optional on D2 for adjuvant treatment cycles, and on D1 of maintenance cycles
Other Names:
A COX-2 inhibitor in the class of nonsteroidal anti-inflammatory drugs (NSAIDs) that specifically target the cyclooxygenase-2 (COX-2) enzyme, which plays a key role in inflammation Dose: 200mg/day, orally twice a day for days 1-5 and once a day for days 6-21 of neoadjuvant and adjuvant treatment cycles, and then twice a day on D1 and once a day for days 2-21 for maintenance cycles
Other Names:
A surgical procedure designed to remove the majority of cancerous tumors when complete removal may not be feasible, with the goal of reducing tumor burden, making follow-up treatments like chemotherapy or radiation more effective. Surgery occurs in between the neoadjuvant and adjuvant treatment periods.
Other Names:
Autologous tumor-loaded alpha-DC1 vaccine is the new type of dendritic cell vaccine developed by our group, are the serum-free, clinically-applicable version of type-1 polarized DCs, combining a fully-mature phenotype and high expression of co-stimulatory molecules with an elevated, rather than exhausted, ability to produce IL-12p70. Dose: 6 million dendritic cells (reduced or omitted if insufficient vaccine material), ID injection on rotating sides of lower extremities on D2 each cycle during the neoadjuvant (not C1) and adjuvant treatment periods. D1 of each cycle during maintenance period. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Dose Limiting Toxicities (DLT)
Time Frame: Up to 2 months
|
Proportion of patients in the safety cohort (chemoimmunotherapy combined with the αDC1 vaccine) experiencing a dose-limiting toxicity (DLT).
A DLT will be any adverse event that is at least possibly related to the study treatment and prevents surgery or delays surgery by more than 4 weeks, or that prevents the initiation of the next cycle of treatment on schedule due to toxicity in the prior cycle.
The DLT period will be 2 cycles of treatment.
|
Up to 2 months
|
|
Complete Pathologic Response (pCR)
Time Frame: Up to 5 years
|
Percentage of patients who show no detectable cancer (cells) in tissue samples after neoadjuvant treatment as assessed at the time of the interval debulking procedure.
Per RECIST v1.1, Complete Response (CR): Disappearance of all target lesions.
Partial Response (PR): At least a 30% decrease in SLD compared to baseline, confirmed on a follow-up scan.
|
Up to 5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Treatment-related Adverse Events (AEs) and Serious Adverse Events (SAEs)
Time Frame: Up to 14 months
|
Number of patients who experience Adverse Events (AEs) and Serious Adverse Events (SAEs) least possibly related to treatment per CTCAE v 5.0.
|
Up to 14 months
|
|
12-month Progression-free Survival (PFS)
Time Frame: At 12 months
|
Percentage of patients without disease progression per iRECIST at 12 months post treatment initiation.
Per iRECIST, Progressive Disease (PD): At least a 20% increase in SLD from the nadir, with an absolute increase of ≥5 mm, or the appearance of any new lesion.
|
At 12 months
|
|
18-month Progression-free Survival (PFS)
Time Frame: At 18 months
|
Percentage of patients without disease progression per iRECIST at 18 months post treatment initiation.
Per iRECIST, Progressive Disease (PD): At least a 20% increase in SLD from the nadir, with an absolute increase of ≥5 mm, or the appearance of any new lesion.
|
At 18 months
|
|
Progression-free Survival (PFS)
Time Frame: Up to 5 years
|
Median time from treatment initiation when 50% of patients have disease progression (per RECIST v1.1) or have died from any cause, whichever occurs first.
Per RECIST v1.1, Progressive Disease (PD): At least a 20% increase in SLD from the nadir, with an absolute increase of ≥5 mm, or the appearance of any new lesion
|
Up to 5 years
|
|
Overall Survival (OS)
Time Frame: Up to 7 years
|
Median time from treatment initiation when 50% of patients have died from any cause.
|
Up to 7 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Robert Edwards, MD, UPMC Magee Womens Hospital
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Keywords
Additional Relevant MeSH Terms
- Urogenital Diseases
- Genital Diseases
- Endocrine System Diseases
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Genital Diseases, Female
- Endocrine Gland Neoplasms
- Ovarian Diseases
- Adnexal Diseases
- Genital Neoplasms, Female
- Gonadal Disorders
- Ovarian Neoplasms
- Peptides
- Amino Acids, Peptides, and Proteins
- Proteins
- Sulfur Compounds
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Surgical Procedures, Operative
- Azoles
- Hydrocarbons
- Cycloparaffins
- Hydrocarbons, Alicyclic
- Hydrocarbons, Cyclic
- Terpenes
- Biological Factors
- Hydrocarbons, Aromatic
- Amides
- Inorganic Chemicals
- Chlorine Compounds
- Nitrogen Compounds
- Taxoids
- Cyclodecanes
- Diterpenes
- Benzene Derivatives
- Intercellular Signaling Peptides and Proteins
- Platinum Compounds
- Benzenesulfonamides
- Sulfonamides
- Sulfones
- Cytokines
- Interferon Type I
- Interferons
- Pyrazoles
- Interferon-alpha
- Interferon alpha-2
- Celecoxib
- Paclitaxel
- Cisplatin
- poly(I).poly(c12,U)
- pembrolizumab
- taxane
- Cytoreduction Surgical Procedures
Other Study ID Numbers
Other Study ID Numbers
- HCC 25-166
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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