Vaccination With Autologous Breast Cancer Cells Engineered to Secrete Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) in Metastatic Breast Cancer Patients
30 mars 2022 mis à jour par: Ana C Garrido-Castro, Dana-Farber Cancer Institute
A Phase I Trial of Vaccination With Autologous, Lethally Irradiated Breast Cancer Cells Engineered by Adenoviral Mediated Gene Transfer to Secrete Granulocyte-Macrophage Colony Stimulating Factor in Metastatic Breast Cancer Patients
The purpose of this trial is to test the safety of a vaccine made from a patient's own breast cancer cells, and determine if this vaccine will delay or stop the growth of the cancer.
The vaccine is made by genetically modifying a patient's own tumor cells to secrete granulocyte-macrophage colony-stimulating factor (GM-CSF) to activate the immune response.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
After the patient has given their consent to participate in the trial, a series of tests will be performed to determine if the patient is eligible.
These tests may take place up to 21 days before the surgery to remove a tumor sample or cancer-containing fluid, which will be used to create the vaccines.
The tumor cells or fluid is then brought to a special, certified laboratory where the vaccine is made.
Specially trained laboratory technicians then use a method known as adenoviral mediated gene transfer, which adds a new gene to the cancer cells.
This gene causes the cells to make GM-CSF, a powerful hormone that stimulates the immune system.
The cells are then given radiation so that they will not grow.
Participants will start receiving vaccine on day 1, 8, 15, 29, and then every two weeks until the supply of vaccine has run out.
The amount of the vaccine depends upon the total amount of cells that are obtained from the breast cancer tumor or fluid.
Each time the patient is vaccinated, they will be given injections that will be placed underneath the skin.
A different place will be used for each injection.
If there are enough cells from the patient's tumor sample, the patient will be given an injection of non-transduced irradiated cells (the gene was not added) .
These cells will help to measure how the patient's immune system is reacting to the tumor cells.
This is called Delayed-Type Hypersensitivity (DTH).
With vaccine #1 and #5, the patient will also receive a DTH injection.
Two to three days after the vaccine and DTH injection, skin biopsies will be taken of both sites.
At week 10 in the study treatment, or earlier if necessary, the patient will have a chest, abdomen, and pelvic CT scan to determine if the vaccine therapy has had an effect on their disease.
A brain MRI will be performed if there were any abnormalities on the first brain MRI or if new symptoms have developed.
Patients may participate in this study until one of the following happens: All vaccine created from the tumor has been given to the patient; the patient's disease worsens; the patient experiences an unacceptable and/or harmful side effect; the patient is unable to follow the study plan; or the patient's doctor feels it is no longer in the best interest of the patient to continue.
Type d'étude
Interventionnel
Inscription (Réel)
15
Phase
- La phase 1
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Massachusetts
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Boston, Massachusetts, États-Unis, 02115
- Dana-Farber Cancer Institute
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Boston, Massachusetts, États-Unis, 02115
- Brigham and Women's Hospital
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Histologically confirmed Stage IV breast cancer
- Prior banked malignant effusion or significant malignant effusion for tumor harvest or surgically-accessible tumor nodule of at least 2cm in greatest diameter by physical exam, magnetic resonance imaging (MRI) or computed tomography (CT) scan
- Must have received at least one prior regimen of chemotherapy for metastatic disease
- Patients with HER2 positive tumors must have received at least one prior trastuzumab-based therapy in the metastatic setting, and may not receive trastuzumab therapy and vaccine treatment concurrently
- Patients may receive concurrent bisphosphonate therapy and/or erythropoetin therapy at any point while on study
- ECOG performance status 0 or 1
- Estimated life expectancy of greater than or equal to 6 months
- 18 years of age or older
- Greater than 4 weeks from immunotherapy, or systemic glucocorticoid therapy
- Adequate recovery from drug-related toxicities from prior systemic therapies
- Adequate recovery from recent surgery and radiation therapy
- Greater than 6 months since bone marrow or peripheral blood stem cell transplant
Exclusion Criteria:
- Urgent need for cytotoxic chemotherapy, radiotherapy, or surgery in the next 60 days
- Uncontrolled active infection or illness
- Psychiatric illness/social situation that would limit study compliance
- Pregnant or nursing mothers
- Evidence of HIV infection
- Previous participation in an adenovirus-based trial
- Concurrent invasive malignancy
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Vaccin
Les vaccinations seront administrées les jours 1, 8, 15 et toutes les deux semaines par la suite jusqu'à épuisement des stocks de vaccins ou jusqu'à ce que le patient soit retiré de l'étude. Comme indiqué en 5.2.5, la dose de cellules vaccinales sera d'environ 1x10 7 , 4x10 6 , 1x10 6 ou 1x10 5 selon le rendement cellulaire final. |
Vaccine will be administered on days 1, 8, 15, 29 and then every 2 weeks until the supply of vaccine runs out
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Minimum Number of Vaccine Doses Created Using Participant Tumor Sample
Délai: Vaccine doses created and banked soon after registration, up to 8 days.
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Tumor samples were obtained via malignant effusion or a surgically accessible tumor nodule of 2 cm in greatest diameter.
Tumor cells were processed to single cell suspension and transduced with adenoviral vector encoding human Granulocyte-macrophage colony-stimulating factor (GM-CSF).
Then, the cells washed extensively and irradiated with 10,000 cGy.
Over the next 14 days, sterility cultures were tested for endotoxin and mycoplasma contamination.
Individual vaccine cell dose and number varied depending on the final cell yield from vaccine production.
The minimal dose was 1 x 10^5 cells and the maximal dose was 1 x 10^7 cells.
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Vaccine doses created and banked soon after registration, up to 8 days.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Nombre de participants avec des événements indésirables de grade 3 ou plus
Délai: Jusqu'à 58 mois
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Nombre de participants présentant des événements indésirables de grade 3 ou plus, évalués par les Critères de terminologie communs pour les événements indésirables (CTCAE) version 4.0.
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Jusqu'à 58 mois
|
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Number of Participants With RECIST Criteria Responses
Délai: Up to 14 Years
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Clinical outcomes as measured by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria.
For target lesions, complete response (CR) is complete disappearance of all target lesions and partial response (PR) is at least a 30% decrease in the sum of longest diameter (LD) of target lesions, taking as reference baseline sum LD.
Progressive disease (PD) is at least a 20% increase in sum LD of target lesions (smallest sum LD reference), new lesions, and/or unequivocal progression of existing non-target lesions.
Stable disease (SD) is defined as any condition not meeting the above criteria.
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Up to 14 Years
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Beth Overmoyer, MD, Dana-Farber Cancer Institute
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
1 janvier 2006
Achèvement primaire (Réel)
1 mai 2008
Achèvement de l'étude (Réel)
1 juin 2021
Dates d'inscription aux études
Première soumission
21 avril 2006
Première soumission répondant aux critères de contrôle qualité
21 avril 2006
Première publication (Estimation)
25 avril 2006
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
1 avril 2022
Dernière mise à jour soumise répondant aux critères de contrôle qualité
30 mars 2022
Dernière vérification
1 mars 2022
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 05-111
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