- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00028496
Vaccine Therapy With or Without Sargramostim in Treating Patients With Advanced or Metastatic Cancer
Phase I Study of a Recombinant Fowl Pox Vaccine rF-CEA (6D)/TRICOM Alone or With GM-CSF in Patients With Advanced CEA Expressing Adenocarinomas
Study Overview
Status
Conditions
- Ovarian Endometrioid Adenocarcinoma
- Adenocarcinoma of the Pancreas
- Recurrent Pancreatic Cancer
- Stage III Pancreatic Cancer
- Stage IV Pancreatic Cancer
- Male Breast Cancer
- Stage IV Breast Cancer
- Stage IIIA Breast Cancer
- Stage IIIB Breast Cancer
- Recurrent Breast Cancer
- Stage IV Colon Cancer
- Stage IV Rectal Cancer
- Stage IV Gastric Cancer
- Recurrent Colon Cancer
- Recurrent Rectal Cancer
- Stage II Pancreatic Cancer
- Recurrent Gastric Cancer
- Recurrent Salivary Gland Cancer
- Adenocarcinoma of the Rectum
- Advanced Adult Primary Liver Cancer
- Recurrent Adult Primary Liver Cancer
- Recurrent Gallbladder Cancer
- Stage III Colon Cancer
- Stage III Gastric Cancer
- Stage III Rectal Cancer
- Unresectable Gallbladder Cancer
- Adult Primary Hepatocellular Carcinoma
- Stage III Salivary Gland Cancer
- Stage IV Salivary Gland Cancer
- Diffuse Adenocarcinoma of the Stomach
- Intestinal Adenocarcinoma of the Stomach
- Mixed Adenocarcinoma of the Stomach
- Cholangiocarcinoma of the Gallbladder
- Adenocarcinoma of the Colon
- Recurrent Malignant Testicular Germ Cell Tumor
- Stage II Malignant Testicular Germ Cell Tumor
- Stage III Malignant Testicular Germ Cell Tumor
- Salivary Gland Adenocarcinoma
- Thyroid Gland Medullary Carcinoma
- Adenocarcinoma of the Gallbladder
- Paget Disease of the Breast With Intraductal Carcinoma
- Paget Disease of the Breast With Invasive Ductal Carcinoma
Detailed Description
PRIMARY OBJECTIVES:
I. Determine the toxicity of recombinant fowlpox-CEA-TRICOM vaccine with or without sargramostim (GM-CSF) or recombinant fowlpox-GM-CSF in patients with advanced or metastatic CEA-expressing adenocarcinomas.
II. Determine the CEA-specific T-cell precursor frequency in patients treated with these regimens.
III. Assess the immunogenicity of GM-CSF in patients treated with these regimens.
IV. Determine the inflammatory response and cytokine expression at the vaccination site in these patients 48 hours after vaccination.
V. Correlate telomere length of leukocytes with prior cytotoxic therapies and immunologic response in patients treated with these regimens.
OUTLINE: This is a dose-escalation study. The first three cohorts of 3-12 patients receive escalating doses of recombinant fowlpox-CEA-TRICOM vaccine (fCEA-TRI) until the maximum tolerated dose (MTD) is determined.
The MTD is defined as the dose preceding that at which 2 of 6 patients or 3 of 12 patients experience dose-limiting toxicity. fCEA-TRI is administered intradermally every 2 weeks for 4 doses and then every 2 months thereafter (beginning on day 56) in the absence of disease progression or unacceptable toxicity.
The fourth and fifth cohorts of 6 patients receive fCEA-TRI at the MTD in the same manner as the first three cohorts combined with escalating doses of sargramostim (GM-CSF). GM-CSF is administered subcutaneously once daily beginning on the day of each vaccination and continuing for a total of 4 days.
The sixth through eighth cohorts of 6 patients receive fCEA-TRI at the MTD in the same manner as the first three cohorts combined with escalating doses of recombinant fowlpox-GM-CSF (rF-GM-CSF). rF-GM-CSF is administered in the same manner as GM-CSF.
Patients are followed every month for 4 months.
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19111-2497
- Fox Chase Cancer Center
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Histologically confirmed adenocarcinoma that failed standard curative options and for which no standard palliative options are required within the next 8weeks
- Advanced or metastatic disease
- Recurrent or unresectable disease
- Microscopic metastatic disease confirmed by surgical exploration allowed
- CEA expression by immunohistochemistry
- Circulating CEA greater than 5 ng/mL
HLA phenotyping required
- HLA phenotyping must be repeated for patients who have undergone allogeneic bone marrow transplantation
No clinically symptomatic brain metastases
- Patients with brain metastases who have completed palliative radiotherapy and have discontinued steroids are eligible
Hormone receptor status:
- Not specified
- Male or female
- Performance status - ECOG 0-1
- WBC at least 3,000/mm^3
- Platelet count at least 100,000/mm^3
- Bilirubin less than 1.5 times upper limit of normal (ULN)
- AST and ALT less than 3 times ULN
- PT and PTT less than 1.5 times ULN (unless therapeutically anticoagulated)
- Creatinine less than 1.5 mg/dL
- Creatinine clearance greater than 60 mL/min
- Proteinuria or hematuria less than +2 on urinalysis*
- Urine protein less than 1,000 mg/24-hour collection, if proteinuria greater than +1
- No frequent vomiting or severe anorexia
- No more than 10% weight loss within the past 3 months
- No inflammatory bowel disease, Crohn's disease, ulcerative colitis, or active diverticulitis
- No uncontrolled seizure disorders
- No encephalitis
- No multiple sclerosis
- No allergy to eggs
- No HIV-associated opportunistic infection
No autoimmune diseases, including the following:
- Systemic lupus erythematosus
- Sjögren's syndrome
- Scleroderma
- Myasthenia gravis
- Goodpasture syndrome
- Addison's disease
- Hashimoto's thyroiditis
- Graves' disease
- Antinuclear antibody positive status allowed if no evidence of an autoimmune disease
No direct contact of vaccination site with the following persons for at least 72 hours after each vaccination:
- Children under 1 year of age
- Pregnant women
- Individuals with eczema or other open skin condition
- Immunocompromised individuals
- No other concurrent serious medical illness that would preclude study entry
- No other malignancy within the past 2 years except excised basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception for at least 1 month before (female patients only), during, and for at least 3 months after study participation
- See Disease Characteristics
- No prior CEA-directed active immunotherapy
- Prior CEA-directed antibody therapy allowed
- At least 4 weeks since prior immunotherapy and recovered
- No other concurrent antineoplastic biologic therapy or immunotherapy
- At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
- No concurrent antineoplastic chemotherapy
- See Disease Characteristics
- No concurrent antineoplastic hormonal therapy
- No concurrent systemic steroids (inhaled steroids allowed)
- Concurrent systemic mineralocorticoids (e.g., megestrol for appetite stimulation or fludrocortisone) allowed
- Concurrent birth control pills allowed
- See Disease Characteristics
- At least 4 weeks since prior radiotherapy and recovered
- No prior radiotherapy to more than 50% of all nodal groups
- See Disease Characteristics
- Recovered from prior surgery
- No prior splenectomy
- Concurrent non-steroidal anti-inflammatory drugs allowed
- No other concurrent anti-cancer therapy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment (vaccine therapy, sargramostim, vaccine adjuvant)
The first three cohorts of 3-12 patients receive escalating doses of recombinant fowlpox-CEA-TRICOM vaccine (fCEA-TRI) until the maximum tolerated dose (MTD) is determined. fCEA-TRI is administered intradermally every 2 weeks for 4 doses and then every 2 months thereafter (beginning on day 56) in the absence of disease progression or unacceptable toxicity. The fourth and fifth cohorts of 6 patients receive fCEA-TRI at the MTD in the same manner as the first three cohorts combined with escalating doses of sargramostim (GM-CSF). GM-CSF is administered subcutaneously once daily beginning on the day of each vaccination and continuing for a total of 4 days. The sixth through eighth cohorts of 6 patients receive fCEA-TRI at the MTD in the same manner as the first three cohorts combined with escalating doses of recombinant fowlpox-GM-CSF (rF-GM-CSF). |
Given subcutaneously
Other Names:
Given intradermally
Other Names:
Given intradermally
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Maximum tolerated dose of recombinant fowlpox-CEA(6D)/TRICOM vaccine determined by dose-limiting toxicities graded according to NCI Common Toxicity Criteria, version 2.0
Time Frame: 56 days
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56 days
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- Skin Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Uterine Neoplasms
- Genital Neoplasms, Female
- Endocrine System Diseases
- Disease Attributes
- Ovarian Diseases
- Adnexal Diseases
- Gonadal Disorders
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Stomach Diseases
- Endocrine Gland Neoplasms
- Genital Neoplasms, Male
- Testicular Diseases
- Liver Diseases
- Head and Neck Neoplasms
- Stomatognathic Diseases
- Mouth Diseases
- Neuroectodermal Tumors
- Neoplasms, Nerve Tissue
- Colonic Diseases
- Intestinal Diseases
- Intestinal Neoplasms
- Rectal Diseases
- Colorectal Neoplasms
- Gallbladder Diseases
- Biliary Tract Diseases
- Pancreatic Diseases
- Neuroendocrine Tumors
- Carcinoma in Situ
- Ovarian Neoplasms
- Endometrial Neoplasms
- Salivary Gland Diseases
- Carcinoma, Neuroendocrine
- Mouth Neoplasms
- Biliary Tract Neoplasms
- Neoplasms, Ductal, Lobular, and Medullary
- Breast Carcinoma In Situ
- Stomach Neoplasms
- Neoplasms, Germ Cell and Embryonal
- Testicular Neoplasms
- Breast Neoplasms
- Carcinoma
- Carcinoma, Hepatocellular
- Recurrence
- Adenocarcinoma
- Rectal Neoplasms
- Pancreatic Neoplasms
- Cholangiocarcinoma
- Liver Neoplasms
- Carcinoma, Endometrioid
- Colonic Neoplasms
- Breast Diseases
- Breast Neoplasms, Male
- Salivary Gland Neoplasms
- Gallbladder Neoplasms
- Carcinoma, Ductal
- Carcinoma, Intraductal, Noninfiltrating
- Carcinoma, Medullary
- Paget's Disease, Mammary
- Physiological Effects of Drugs
- Anti-Infective Agents
- Antineoplastic Agents
- Immunologic Factors
- Anti-Bacterial Agents
- Antiprotozoal Agents
- Antiparasitic Agents
- Vaccines
- Metronidazole
- Sargramostim
- Molgramostim
Other Study ID Numbers
- NCI-2012-02433
- FCCC-01016
- CDR0000069093 (Registry Identifier: PDQ (Physician Data Query))
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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