Vaccine Therapy in Treating Patients With Metastatic Prostate Cancer

March 19, 2013 updated by: Duke University

A Safety and Feasibility Study of Active Immunotherapy in Patients With Metastatic Prostate Carcinoma Using Autologous Dendritic Cells Pulsed With Antigen Encoded in Amplified Autologous Tumor RNA

RATIONALE: Vaccines made from a person's cancer cells may make the body build an immune response to kill prostate tumor cells.

PURPOSE: Phase I trial to study the effectiveness of vaccine therapy in treating patients who have metastatic prostate cancer.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

OBJECTIVES:

  • Determine the safety and feasibility of autologous dendritic cells transfected with autologous total tumor RNA in patients with metastatic prostate cancer.
  • Determine the presence, frequency, and activation status of tumor specific and prostate specific antigen (PSA) specific cellular immune responses in patients treated with this regimen.
  • Determine delayed-type hypersensitivity reactions to PSA protein and other recall antigens in patients before and after being treated with this regimen.
  • Determine clinical responses based on clinical and biochemical (PSA) response criteria in patients treated with this regimen.
  • Determine a platform for immunological treatment using dendritic-cell based tumor vaccines in these patients.

OUTLINE: This is a dose escalation study.

Tumor tissue and peripheral blood stem cells are collected from patients and cultured in vitro with sargramostim (GM-CSF) and interleukin-4 for 7 days to produce dendritic cells (DC). Patients receive autologous DC transfected with autologous prostate carcinoma RNA intradermally once weekly on weeks 0-3 for a total of 4 doses.

Cohorts of 3-6 patients receive escalating doses of DC until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity.

Patients are followed at weeks 6, 8, 10, and 12; every 3 months for 9 months; and then annually for 2 years.

PROJECTED ACCRUAL: A total of 18 patients will be accrued for this study within 20 months.

Study Type

Interventional

Enrollment (Actual)

3

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • North Carolina
      • Durham, North Carolina, United States, 27710
        • Duke Comprehensive Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

DISEASE CHARACTERISTICS:

  • Histologically confirmed metastatic adenocarcinoma of the prostate

    • Stage D1-3
    • Regional lymph node, bone, visceral, or soft tissue metastases
    • No transitional cell or small cell carcinoma
  • Testosterone less than 50 mg/L if prior treatment with luteinizing hormone releasing hormone (LHRH) analogues or estrogens
  • Evidence of androgen refractory disease after surgical castration and discontinuation of LHRH analogue therapy
  • No previously irradiated or new CNS metastases

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • Karnofsky 70-100%

Life expectancy:

  • More than 6 months

Hematopoietic:

  • WBC at least 3,000/mm^3
  • Hemoglobin at least 9 g/dL
  • Platelet count at least 100,000/mm^3

Hepatic:

  • Bilirubin less than 2.0 mg/dL
  • PT at least 11.3 seconds but no greater than 13.3 seconds
  • PTT at least 20.1 seconds but no greater than 32.9 seconds
  • No hepatic disease
  • No viral hepatitis

Renal:

  • Creatinine less than 2.5 mg/dL

Cardiovascular:

  • No New York Heart Association class III or IV heart disease

Pulmonary:

  • No asthma
  • No chronic obstructive pulmonary disease
  • No severe lung disease

Other:

  • No other medical illness or psychological impediment that would preclude study
  • No other concurrent malignancy except nonmelanoma skin cancer or controlled superficial bladder cancer
  • No active acute or chronic infection including symptomatic urinary tract infection
  • No autoimmune disease (e.g., inflammatory bowel disease, systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, scleroderma, or multiple sclerosis)
  • HIV negative
  • Adequate peripheral vein access

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • Prior biologic therapy allowed
  • No other concurrent immunotherapy

Chemotherapy:

  • Prior chemotherapy allowed
  • No concurrent chemotherapy

Endocrine therapy:

  • See Disease Characteristics
  • At least 4 weeks since prior non-steroidal hormonal therapy if increase in PSA while receiving non-steroidal hormonal therapy
  • At least 6 weeks since prior steroids
  • Concurrent LHRH analogues for gonadal androgen suppression allowed
  • No concurrent steroid therapy
  • No concurrent corticosteroids

Radiotherapy:

  • See Disease Characteristics
  • Prior palliative radiotherapy for bone metastases allowed
  • Prior prostatic radiotherapy allowed
  • At least 4 weeks since prior radiotherapy
  • At least 12 weeks since prior strontium chloride Sr 89
  • No concurrent radiotherapy

Surgery:

  • See Disease Characteristics

Other:

  • Recovered from prior therapy
  • No concurrent immunosuppressive agents (e.g., azathioprine or cyclosporine)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Duke University

Collaborators

National Cancer Institute (NCI)

Investigators

  • Study Chair: Johannes Vieweg, MD, Duke Cancer Institute

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2000

Study Completion (Actual)

March 1, 2003

Study Registration Dates

First Submitted

February 2, 2001

First Submitted That Met QC Criteria

July 29, 2003

First Posted (Estimate)

July 30, 2003

Study Record Updates

Last Update Posted (Estimate)

March 21, 2013

Last Update Submitted That Met QC Criteria

March 19, 2013

Last Verified

December 1, 2008

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 0759
  • DUMC-000759-00-4R1
  • DUMC-DORIS-99043
  • NCI-G00-1910
  • CDR0000068447 (Other Identifier: NCI)

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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