- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01212887
Treated Blood Cells, Cyclophosphamide, Fludarabine Phosphate, and Aldesleukin in Treating Patients With Cancer
A Cancer Research UK Phase I Trial of Adoptive Transfer of Autologous Tumor Antigen-Specific T Cells With Preconditioning Chemotherapy and Intravenous IL2 in Patients With Advanced CEA Positive Tumors
RATIONALE: Placing a gene into T cells may improve the body's ability to recognize cancer cells and build an immune response to fight cancer. Drugs used in chemotherapy, such as cyclophosphamide and fludarabine phosphate, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Biological therapies, such as aldesleukin, may stimulate the immune system in different ways and stop cancer cells from growing. Giving specially treated T cells together with cyclophosphamide, fludarabine phosphate, and aldesleukin may kill more tumor cells.
PURPOSE: This phase I clinical trial is studying the side effects and best dose of treated T cells when given together with cyclophosphamide, fludarabine phosphate, and aldesleukin in treating patients with cancer.
Study Overview
Status
Conditions
Detailed Description
OBJECTIVES:
Primary
- To evaluate the feasibility of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes in combination with preconditioning chemotherapy comprising cyclophosphamide and fludarabine phosphate plus aldesleukin in patients with CEA-positive tumors.
- To assess the toxicity of this regimen in these patients.
- To determine the dose of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes required to give optimal survival of these cells in the circulation (recommended phase II dose).
Secondary
- To assess whether MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes isolated from the circulation are functional.
- To determine the preliminary tumor response to MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes.
- To evaluate the safety of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes.
OUTLINE: This is a phase I, dose-escalation study of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes.
Patients undergo leukapheresis 7-14 days before study therapy begins. Cells are then transduced with a retrovirus vector and expanded to produce MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes.
Patients receive preconditioning chemotherapy comprising fludarabine phosphate IV over 15 minutes on days -5 to -1 or cyclophosphamide IV over 1 hour on days -7 to -6 and fludarabine phosphate IV over 15 minutes on days -5 to -1. They receive MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes IV over 30 minutes on day 0. Patients also receive high-dose aldesleukin IV over 15 minutes every 8 hours for up to 12 doses beginning on day 0, in the absence of disease progression or unacceptable toxicity. If there is evidence of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes survival, patients may receive additional high-dose aldesleukin.
Patients undergo blood sample collection periodically for pharmacokinetic and pharmacodynamic studies. Some patients may undergo a tumor biopsy.
After completion of study treatment, patients are followed up every 2 weeks for 6 weeks, every 4 weeks for 6 months, every 3 months for 1 year, and then every 6 months thereafter.
Peer Reviewed and Funded or Endorsed by Cancer Research UK
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
-
-
England
-
Manchester, England, United Kingdom, M20 4BX
- Christie Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Histologically confirmed malignancy
- Metastatic or unresectable disease
- Standard curative or palliative measures do not exist, are no longer effective, have been completed, or have been refused
- CEA-positive tumor (either by immunohistochemistry or as demonstrated by elevated CEA > 50 μg/L)
- No primary brain tumor or brain metastases
PATIENT CHARACTERISTICS:
- WHO performance status 0-1
- Life expectancy ≥ 3 months
- Hemoglobin ≥ 10 g/dL
- Platelet count ≥ 100 x 10^9/L
- Neutrophil count ≥ 2.0 x 10^9/L
- Lymphocyte count ≥ 1.0 x 10^9/L
- Serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
- ALT/AST ≤ 5 times ULN
- Alkaline phosphatase ≤ 5 times ULN
- Calculated creatinine clearance OR isotope clearance measurement ≥ 50 mL/min
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception 4 weeks prior to, during, and for 6 months after completion of study therapy (male patients must use barrier-method contraception)
- LVEF ≥ 50% on MUGA scan (for patients receiving cyclophosphamide)
- ECG and exercise ECG (or stress ECHO) normal (may be abnormal but not clinically significant)
- Urine dipstick normal (may be abnormal but not clinically significant)
- No medical high risk due to nonmalignant systemic disease including active uncontrolled infection
- No known serologically positive hepatitis B, hepatitis C, HIV, or HTLV
- No history of autoimmune disease
- No inflammatory bowel disease
- No concurrent congestive heart failure or prior history of NYHA class III-IV cardiac disease
- No concurrent malignancies originating from other primary sites, except for adequately treated cone-biopsied carcinoma in situ of the cervix uteri or basal cell or squamous cell carcinoma of the skin
- No other condition that, in the investigator's opinion, would make the patient an unsuitable candidate for the clinical trial
PRIOR CONCURRENT THERAPY:
- At least 30 days since prior and no concurrent participation in another clinical trial
- At least 4 weeks since prior and no concurrent radiotherapy (except for palliative reasons [i.e., control of bone pain])
- At least 4 weeks since prior and no concurrent endocrine therapy, immunotherapy, or chemotherapy (6 weeks for nitrosoureas and mitomycin C)
- No toxic manifestations of previous treatment, except for alopecia or certain grade 1 toxicities that, in the opinion of the investigator and CRUK (Cancer Research UK), would exclude the patient (e.g., grade 1 neuropathy or grade 1 fatigue)
- No prior major thoracic and/or abdominal surgery from which the patient has not yet recovered
- No prior bone marrow transplant or extensive radiotherapy to > 25% of bone marrow
- No concurrent systemic steroids or other immunosuppressive therapy
- No other concurrent anticancer therapy or investigational drugs
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
Percentage of patients (goal is 50%) who are evaluable for MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes survival
|
Adverse event according to CTCAE version 3 criteria
|
Dose of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes that gives the highest frequency in the circulation as measured by the primary assays (recommended phase II dose)
|
Secondary Outcome Measures
Outcome Measure |
---|
Presence of cells with a functional chimeric immune receptor on bCEA binding assay
|
Partial response or complete response on CT scans at 6, 12, 24, and 52 weeks as defined by RECIST criteria
|
Long-term follow up for insertional mutagenesis
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Robert E. Hawkins, MD, The Christie NHS Foundation Trust
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study 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
Keywords
- stage IV breast cancer
- recurrent breast cancer
- recurrent non-small cell lung cancer
- extensive stage small cell lung cancer
- recurrent small cell lung cancer
- stage IIIA non-small cell lung cancer
- stage IIIB non-small cell lung cancer
- stage IV non-small cell lung cancer
- unspecified adult solid tumor, protocol specific
- stage IV colon cancer
- recurrent colon cancer
- recurrent rectal cancer
- recurrent pancreatic cancer
- stage IV ovarian epithelial cancer
- recurrent ovarian epithelial cancer
- stage IIIC breast cancer
- stage IIIB rectal cancer
- stage IIIC rectal cancer
- stage IV pancreatic cancer
- stage IV gastric cancer
- recurrent gastric cancer
- stage IIIA ovarian epithelial cancer
- stage IIIB ovarian epithelial cancer
- stage IIIC ovarian epithelial cancer
- recurrent ovarian germ cell tumor
- stage IV ovarian germ cell tumor
- stage III pancreatic cancer
- stage IIIA ovarian germ cell tumor
- stage IIIB ovarian germ cell tumor
- stage IIIC ovarian germ cell tumor
- stage IIIA colon cancer
- stage IIIA rectal cancer
- stage IIIB colon cancer
- stage IIIC colon cancer
- stage IVB colon cancer
- stage IVA rectal cancer
- stage IVB rectal cancer
Additional Relevant MeSH Terms
- Digestive System Diseases
- Skin Diseases
- Respiratory Tract Diseases
- Neoplasms
- Lung Diseases
- Neoplasms by Site
- Endocrine System Diseases
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Gastrointestinal Diseases
- Stomach Diseases
- Endocrine Gland Neoplasms
- Breast Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Pancreatic Diseases
- Stomach Neoplasms
- Breast Neoplasms
- Lung Neoplasms
- Pancreatic Neoplasms
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Anti-HIV Agents
- Anti-Retroviral Agents
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Aldesleukin
- Cyclophosphamide
- Fludarabine
- Fludarabine phosphate
Other Study ID Numbers
- CDR0000685060
- CRUK-PH1/105
- CRUK-MFEz
- EUDRACT-2005-004085-16
- EU-21070
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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