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A Phase I Study of Recombinant Vaccinia Virus That Expresses Prostate Specific Antigen in Adult Patients With Adenocarcinoma of the Prostate

3 de marzo de 2008 actualizado por: National Cancer Institute (NCI)
This trial will evaluate, in patients with metastatic prostate cancer, the tolerability, toxicities, efficacy, and immunologic effects of repeated vaccinations with a recombinant vaccinia virus that contains the Prostate Specific Antigen gene (PROSTVAC).

Descripción general del estudio

Estado

Terminado

Intervención / Tratamiento

Descripción detallada

This trial will evaluate, in patients with metastatic prostate cancer, the tolerability, toxicities, efficacy, and immunologic effects of repeated vaccinations with a recombinant vaccinia virus that contains the Prostate Specific Antigen gene (PROSTVAC). Patients with PSA-expressing adenocarcinoma of the prostate will be evaluated for eligibility that includes a history of prior vaccinia (as vaccine against smallpox) and immunocompetence. We completed a phase I trial investigating the use of rV-CEA in adenocarcinomas of the GI tract, lung and breast. The toxicities encountered are local reactions to the vaccine. We did not encounter any myelosuppression or systemic autoimmune reaction. We would like to evaluate four doses to ensure safety and to decide a best biological dose. Six patients will receive 2.65 x 10(5) PFU and 2.65 x 10(6) PFU of vaccine by scarification. Because higher doses cannot be achieved by scarification, six patients will receive 2.65 x 10(7) PFU and 2.65 x 10(8) PFU subcutaneously. We plan to give three vaccinations at four week intervals. All six patients treated in each dose level must be evaluable for 4 weeks before enrolling patients at the higher dose level. No intrapatient escalation is planned. Toxicity, tumor response, and humoral and cellular immunity factors will be monitored. Optional lymphapheresis will be done on patients that are HLA A2. Once we determined the best biological dose, we would like to accrue an additional 6 patients to that level.

Tipo de estudio

Intervencionista

Inscripción

75

Fase

  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • Maryland
      • Bethesda, Maryland, Estados Unidos, 20892
        • National Cancer Institute (NCI)

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Niño
  • Adulto
  • Adulto Mayor

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

DISEASE CHARACTERISTICS:

Histologically confirmed adenocarcinoma of the prostate as follows: Unresectable and/or incurable tumor AND Tumor progression after at least 1 prior hormonal manipulation (i.e., LHRH agonist/flutamide or orchiectomy). LHRH agonist may by continued concurrently with protocol therapy.

New bone or soft tissue lesions OR Serum PSA that has risen on 3 successive evaluations at least 1 week apart during and/or after hormonal therapy. If PSA is below 4 ng/mL, measurable disease with positive immunohistochemical stain for PSA is required.

No history of allergy to eggs.

No history of or active CNS metastases.

Symptomatic spinal or other bony metastasis should be irradiated prior to entry.

Bi-dimensionally measurable disease not required.

PRIOR/CONCURRENT THERAPY:

Biologic Therapy:

No concurrent Biologic Therapy.

Must fully recover from prior Biologic Therapy.

Chemotherapy:

At least 4 weeks since prior chemotherapy and fully recovered.

No more than 1 prior chemotherapy regimen.

No concurrent chemotherapy.

Endocrine Therapy:

See Disease Characteristics.

At least 4 weeks since prior hormonal therapy and fully recovered.

No concurrent steroids.

Radiotherapy:

At least 4 weeks since prior radiation therapy and fully recovered.

No prior radiotherapy to more than 50% of nodal groups.

No concurrent radiotherapy.

Surgery:

At least 4 weeks since prior surgery, with surgical scar healed.

No prior splenectomy.

PATIENT CHARACTERISTICS:

Age: Over 18.

Performance status: Zubrod (ECOG) 0-2.

Hematopoietic:

Absolute granulocyte count greater than 2,000/mm(3);

Platelet count greater than 100,000/mm(3);

Hemoglobin greater than 8.0 g/dL.

Hepatic:

Bilirubin less than 1.6 mg/dL;

AST and ALT less than 4 times normal.

Renal: Creatinine less than 1.6 mg/dL.

Immunologic:

Prior vaccinia (for smallpox immunization) required, with proof of vaccination as follows: Detectable anti-vaccinia antibodies, Physician certification of prior vaccination, Patient recollection or appropriate vaccination-site scar sufficient in patients over age 25, Delayed-type hypersensitivity skin testing (to mumps, Candida, and Trichophyton antigens) normal Quantitative immunoglobulins normal.

No evidence of immunocompromise, i.e.:

No HIV antibody;

No eczema or atopic dermatitis;

No autoimmune neutropenia, thrombocytopenia, or hemolytic anemia;

No systemic lupus erythematosus, Sjogren syndrome, or scleroderma;

No myasthenia gravis;

No Goodpasture syndrome;

No Addison's disease, Hashimoto's thyroiditis, or active Graves' disease;

No other autoimmune disease or diagnosis of altered immune function.

OTHER:

No active case or history of extensive psoriasis, severe acneiform rash, impetigo, varicella zoster, burns, or other traumatic or pruritic skin condition.

No active infection requiring antibiotics (including chronic suppressive therapy). At least 3 days since antibiotic therapy.

No history of seizures, encephalitis, or multiple sclerosis.

No other serious intercurrent illness.

Able to avoid close contact with the following individuals for at least 2 weeks after vaccination (i.e., no such individuals as household members and no care-giving responsibilities for such individuals): Children under age 3, Pregnant women, Individuals with eczema or skin conditions defined above, Leukemia or lymphoma patients, HIV-positive individuals, Patients receiving immunosuppressive therapy, Any other immunosuppressed individuals.

No prior malignancy unless curatively treated and patient has been in remission for at least 2 years (excluding squamous cell or basal cell carcinoma of the skin or carcinoma in situ of the cervix).

Able and willing to travel to the NIH, NCI-NMOB, or the Lombardi Cancer Center at Georgetown University for treatment and follow-up.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de marzo de 1994

Finalización del estudio

1 de marzo de 2000

Fechas de registro del estudio

Enviado por primera vez

3 de noviembre de 1999

Primero enviado que cumplió con los criterios de control de calidad

9 de diciembre de 2002

Publicado por primera vez (Estimar)

10 de diciembre de 2002

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

4 de marzo de 2008

Última actualización enviada que cumplió con los criterios de control de calidad

3 de marzo de 2008

Última verificación

1 de marzo de 2000

Más información

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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