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.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
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.
Tipo di studio
Tipo di studio
Fase
Fase
- Fase 2
- Fase 1
Contatti e Sedi
Luoghi di studio
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Maryland
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Bethesda, Maryland, Stati Uniti, 20892-1182
- Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
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Tennessee
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Nashville, Tennessee, Stati Uniti, 37232-6838
- Vanderbilt-Ingram Cancer Center
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
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Response rate every 3 months for up to a year after completion of study treatment
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Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Cattedra di studio: John E. Janik, MD, NCI - Metabolism Branch;MET
Studiare le date dei record
Studia le date principali
Inizio studio
Inizio studio
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Stima)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Malattie dell'apparato digerente
- Neoplasie
- Neoplasie per sede
- Neoplasie gastrointestinali
- Neoplasie dell'apparato digerente
- Malattie gastrointestinali
- Malattie del colon
- Malattie intestinali
- Neoplasie intestinali
- Malattie del retto
- Neoplasie colorettali
- Agenti antinfettivi
- Agenti antivirali
- Agenti anti-HIV
- Agenti antiretrovirali
- Agenti antineoplastici
- Aldesleukin
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- CDR0000066874
- NCI-99-C-0023L
- NCI-T98-0034
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