Vaccine Therapy in Treating Patients With Advanced or Metastatic Cancer

September 4, 2014 updated by: Michael Morse, MD

A Phase I Study Of Active Immunotherapy With Autologous Dendritic Cells Infected With CEA-6D Expressing Fowlpox -Tricom In Patients With Advanced Or Metastatic Malignancies Expressing CEA

RATIONALE: Vaccines made from a person's white blood cells that have been treated in the laboratory may make the body build an immune response to kill tumor cells.

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

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

OBJECTIVES:

  • Determine the safety and feasibility of active immunotherapy comprising autologous dendritic cells infected with recombinant fowlpox-CEA-TRICOM vaccine in patients with advanced or metastatic malignancies expressing CEA.
  • Assess the CEA-specific immune response of patients treated with this regimen.
  • Assess, in a preliminary manner, the clinical response rate of patients treated with this regimen.

OUTLINE: This is a dose-escalation study.

Autologous dendritic cells (ADCs) are harvested and infected with fowlpox-CEA-TRICOM vaccine. Patients receive the infected ADCs intradermally and subcutaneously (SC) followed by ADCs mixed with CMV pp65 peptide and ADCs mixed with tetanus toxoid SC and intradermally on day 1. Treatment repeats every 3 weeks for a total of 4, 8, or 12 immunizations in the absence of unacceptable toxicity.

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

Patients are followed every 3 months for 1 year.

PROJECTED ACCRUAL: A total of 6-18 patients will be accrued for this study.

Study Type

Interventional

Enrollment (Actual)

14

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, 27705
        • 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

All

Description

DISEASE CHARACTERISTICS:

  • Histologically confirmed advanced or metastatic malignancy expressing CEA

    • Metastatic disease meeting one of the following criteria:

      • Measurable or nonmeasurable

      • History of metastases but no current evidence of disease, meeting one of the following criteria:

        • Unresectable peritoneal or lymph node metastases that cannot be detected by imaging

        • Treated or resected metastatic disease considered at high risk of recurrence (predicted 5-year disease-free survival of less than 50%)

          • Must have completed treatment that rendered no evidence of disease within the past year

  • CEA-expressing malignancy is defined by any of the following:

    • Immunohistochemical staining (at least 50% of the tumor has at least a moderate intensity of staining)
    • CEA level in peripheral blood greater than 2.5 µg/L
    • Tumor known to be universally CEA positive (e.g., colon and rectal cancer)
  • Received prior therapy with possible survival benefit or refused such therapy
  • Prior resection of brain metastases allowed provided no metastasis by CT scan or MRI of the brain within 1 month of enrollment

  • Hormone receptor status:

    • Not specified

PATIENT CHARACTERISTICS:

Age

  • 18 and over Sex
  • Male or female Menopausal status
  • Not specified Performance status
  • Karnofsky 70-100% Life expectancy
  • More than 6 months

Hematopoietic

  • WBC at least 3,000/mm^3
  • Absolute lymphocyte count at least 1,000/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin at least 9 g/dL (transfusion or epoetin alfa allowed) Hepatic
  • Bilirubin less than 2.0 mg/dL
  • SGOT/SGPT less than 1.5 times upper limit of normal
  • No active acute or chronic viral hepatitis
  • Hepatitis B surface antigen negative
  • Hepatitis C negative
  • No other hepatic disease that would preclude study entry

Renal

  • Creatinine less than 2.5 mg/dL
  • No active acute or chronic urinary tract infection

Cardiovascular

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

  • No history of autoimmune disease, including, but not limited to, the following:

    • Inflammatory bowel disease
    • Systemic lupus erythematosus
    • Rheumatoid arthritis
    • Ankylosing spondylitis
    • Scleroderma
    • Multiple sclerosis
  • No allergy to eggs or any component of study vaccine Other
  • No active acute or chronic infection
  • No concurrent serious acute or chronic illness that would preclude study entry
  • No other medical or psychological impediment that would preclude study entry
  • No other malignancy within the past 5 years except nonmelanoma skin cancer, controlled carcinoma in situ of the cervix, or controlled superficial bladder cancer
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 4 weeks since prior biologic therapy and recovered
  • No other concurrent immunotherapy

Chemotherapy

  • At least 4 weeks since prior chemotherapy and recovered
  • No concurrent chemotherapy

Endocrine therapy

  • At least 4 weeks since prior hormonal therapy and recovered
  • At least 6 weeks since prior steroids except steroids used as premedication for chemotherapy or for contrast-enhanced studies
  • No concurrent steroids

Radiotherapy

  • Prior palliative radiotherapy (including systemic radiolabeled compounds) for unstable or painful bone metastases in weight-bearing bones may be allowed
  • At least 4 weeks since prior radiotherapy and recovered
  • No concurrent radiotherapy

Surgery

  • Not specified

Other

  • At least 4 weeks since any other prior therapy (including experimental therapy) and recovered
  • No concurrent immunosuppressives (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
  • Allocation: NA
  • Interventional Model: SINGLE_GROUP
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: TRICOM-CEA(6D)
Subjects receiving TRICOM-CEA(6D)
Biological: TRICOM-CEA(6D)
dendritic cells loaded with TRICOM-CEA(6D)
Other Names:
  • recombinant fowlpox-CEA(6D)/TRICOM vaccine

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Safety
Time Frame: 12-36 weeks
The primary objective of this protocol is to determine the safety and feasibility of rF-CEA(6D)-TRICOM loaded DC in, subjects with metastatic, CEA expressing malignancies.
12-36 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Immune response
Time Frame: 12-36 weeks
The immune response to the injections of the TRICOM-CEA(6D) antigen loaded DC will be evaluated
12-36 weeks

Collaborators and Investigators

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

Sponsor

Michael Morse, MD

Collaborators

National Cancer Institute (NCI)

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

January 1, 2002

Primary Completion (Actual)

October 1, 2007

Study Completion (Actual)

October 1, 2007

Study Registration Dates

First Submitted

December 7, 2001

First Submitted That Met QC Criteria

January 26, 2003

First Posted (Estimate)

January 27, 2003

Study Record Updates

Last Update Posted (Estimate)

September 8, 2014

Last Update Submitted That Met QC Criteria

September 4, 2014

Last Verified

September 1, 2014

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2840 (Other Identifier: Duke IRB)
  • 1R21CA094523 (U.S. NIH Grant/Contract)
  • CDR0000069041

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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