- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00019591
Vaccine Therapy With or Without Interleukin-2 in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer
A Phase I/II Trial of Vaccination With Mutant Ras Peptide-Pulsed Dendritic Cells in the Treatment of HLA A2.1 Positive Patients With Colorectal Cancer
RATIONALE: Vaccines may make the body build an immune response that will kill cancer cells. Combining vaccine therapy with interleukin-2 may kill more cancer cells.
PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy with or without interleukin-2 in treating patients who have locally advanced or metastatic colorectal cancer.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
OBJECTIVES:
- Determine the frequency of immunologic response in patients with locally advanced or metastatic colorectal cancer treated with ras peptide-pulsed dendritic cell vaccine with or without interleukin-2.
- Determine the tumor response and survival time in patients with metastatic colorectal cancer treated with vaccine plus interleukin-2.
- Determine the time to progression in patients with locally advanced colorectal cancer treated with adjuvant vaccine.
OUTLINE: Patients are assigned to 1 of 2 treatment groups according to extent of disease. Patients with prior locally advanced disease are assigned to treatment group A, while those with metastatic disease are assigned to treatment group B.
- Group A: Patients are vaccinated against influenza on day -6. Patients undergo collection of peripheral blood mononuclear cells (PBMC) on day -4. The PBMC are cultured with sargramostim (GM-CSF) and interleukin-4 for 5 days and CD40 ligand for 24 hours and then pulsed for 2 hours with the appropriate peptide to form a vaccine. Patients receive ras peptide-pulsed dendritic cell vaccine IV over 5 minutes on days 1, 15, 29, 43, and 57.
- Group B: Patients undergo collection of PBMC and receive vaccination as in group A. Patients also receive interleukin-2 subcutaneously on days 2-6 and 9-13.
Treatment in both groups repeats every 2 weeks for up to 5 vaccinations in the absence of disease progression or unacceptable toxicity.
Patients are followed on days 75, 90, 120, and 365.
PROJECTED ACCRUAL: A total of 500 patients will be accrued for this study within 3 years.
Type d'étude
Phase
- Phase 2
- La phase 1
Contacts et emplacements
Lieux d'étude
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Maryland
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Bethesda, Maryland, États-Unis, 20892-1182
- Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
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Tennessee
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Nashville, Tennessee, États-Unis, 37232-6838
- Vanderbilt-Ingram Cancer Center
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
DISEASE CHARACTERISTICS:
- Histologically confirmed locally advanced or metastatic colorectal cancer
- Metastatic disease must be radiologically proven
- HLA-A2-1 positive
- Locally advanced disease must have had prior resection or incomplete resection with poor prognosis
Locally advanced disease includes:
- Stage III or IV colon cancer (T4 or any T, N2-3, M0)
- Stage III or IV rectal cancer (T4 or T3, N1-3)
- Resectable or unresectable T4 disease after radiotherapy, chemotherapy, and/or surgery
- Absence of measurable disease but more than a 50% chance of recurrence
- Completely resected or locally advanced disease may have had conventional therapy completed within 1-12 months (surgery alone, with or without adjuvant chemotherapy and/or radiotherapy) prior to study entry
Metastatic disease patients must have bidimensionally measurable disease
- Bone lesions with well-demarcated borders allowed
- Lesions seen only on bone scan, pleural effusions, ascites, and changes in carcinoembryonic antigen are not considered measurable disease
PATIENT CHARACTERISTICS:
Age:
- Over 18
Performance status:
- ECOG 0-1
Life expectancy:
- Not specified
Hematopoietic:
- Lymphocyte count at least 470/mm^3
- Granulocyte count at least 1,000/mm^3
- Platelet count at least 100,000/mm^3
Hepatic:
- Bilirubin no greater than 2.0 mg/dL*
- SGOT no greater than 4 times upper limit of normal (ULN) (2.5 times ULN for adjuvant patients)*
- Albumin at least 3 g/dL
- No active viral hepatitis
- No evidence of chronic infection due to hepatitis C
- Hepatitis B surface antigen negative NOTE: *Unless due to metastatic disease
Renal:
- Creatinine no greater than 2.0 mg/dL
Cardiovascular:
- No history of cardiac failure, significant arrhythmias, or coronary artery disease (metastatic disease patients only)
Other:
- Not pregnant or nursing
- Fertile patients must use effective contraception
- HIV negative
- No prior malignancy with a 50% chance of recurrence within 5 years except nonmelanomatous skin cancer or carcinoma in situ of the cervix
- No medical or psychiatric condition that would preclude compliance
- No serious medical condition that would preclude apheresis
- No serious infection
- No uncontrolled thyroid disease (metastatic disease patients only)
- Patients with an allergy to eggs are allowed but are not vaccinated against influenza during study
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- No prior immunologic therapy directed at the cellular immune system
Chemotherapy:
- See Disease Characteristics
- Prior chemotherapy for metastatic disease allowed
- At least 4 weeks since prior chemotherapy
- No concurrent chemotherapy or anticipated need for chemotherapy for 2 months after vaccinations
Endocrine therapy:
- At least 4 weeks since prior supraphysiologic steroid therapy
Radiotherapy:
- See Disease Characteristics
- Prior radiotherapy for metastatic disease allowed
- No concurrent radiotherapy
Surgery:
- See Disease Characteristics
- Prior surgery for metastatic disease allowed
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
|---|
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Response rate every 3 months for up to a year after completion of study treatment
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Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: John E. Janik, MD, NCI - Metabolism Branch;MET
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Maladies du système digestif
- Tumeurs
- Tumeurs par site
- Tumeurs gastro-intestinales
- Tumeurs du système digestif
- Maladies gastro-intestinales
- Maladies du côlon
- Maladies intestinales
- Tumeurs intestinales
- Maladies rectales
- Tumeurs colorectales
- Agents anti-infectieux
- Agents antiviraux
- Agents anti-VIH
- Agents antirétroviraux
- Agents antinéoplasiques
- Aldesleukine
Autres numéros d'identification d'étude
- CDR0000066874
- NCI-99-C-0023L
- NCI-T98-0034
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