Vaccine Therapy in Treating Patients With Metastatic Prostate Cancer
A PHASE I TRIAL OF RECOMBINANT VACCINIA VIRUS THAT EXPRESSES PSA IN PATIENTS WITH ADENOCARCINOMA OF THE PROSTATE
調査の概要
詳細な説明
OBJECTIVES:
I. Assess the toxicity associated with repeated vaccination with recombinant vaccinia virus expressing prostate-specific antigen (rV-PSA) in patients with metastatic adenocarcinoma of the prostate.
II. Determine the optimal dose of rV-PSA given at monthly intervals based on cellular and hormonal immunity.
III. Determine whether vaccination with rV-PSA is associated with anti-tumor activity.
IV. Determine whether granulocyte-macrophage colony-stimulating factor (GM-CSF) has an effect on cellular and humoral immunity different from rV-PSA, and whether the addition of GM-CSF has enhanced antitumor effect compared to rV-PSA alone.
OUTLINE: This is an open label, dose escalation study.
Patients in cohorts of 3-6 receive 3 vaccinations with rV-PSA at 4-week intervals (days 1, 29, 57, and 85) in the absence of disease progression or unacceptable toxicity. Response assessment is performed at eight weeks. Patients who discontinue therapy prior to eight weeks are considered unevaluable for response. If dose limiting toxicity is observed in 2 of 6 patients entered at a dose level, no further patients are entered at that level and the MTD is defined as the preceding dose level. Ten additional patients are treated at the MTD and receive granulocyte-macrophage colony-stimulating factor (GM-CSF) administered subcutaneously on day -1 through day 2 of each cycle. Patients who are HLA-A2 positive, have received all 3 rV-PSA vaccinations without unacceptable toxicity, and have been off study for at least 30 days due to disease progression may continue treatment with rV-PSA at the highest dose level and the addition of GM-CSF.
Patients are followed monthly for 6 months.
研究の種類
入学 (実際)
段階
- フェーズ 1
連絡先と場所
研究場所
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Massachusetts
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Boston、Massachusetts、アメリカ、02115
- Dana-Farber Cancer Institute
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Boston、Massachusetts、アメリカ、02115
- Brigham and Women's Hospital
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Boston、Massachusetts、アメリカ、02114
- Massachusetts General Hospital Cancer Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
DISEASE CHARACTERISTICS:
Histologically proven adenocarcinoma of the prostate with evidence of metastatic disease based on any of the following:
- Lymph node positive and PSA at least 10 ng/mL
- Bone scan positive and PSA at least 10 ng/mL
- PSA at least 2 ng/mL and rising following radical prostatectomy
- PSA at least 10 ng/mL following radiotherapy
- No symptomatic metastatic disease (bony pain)
PATIENT CHARACTERISTICS:
- Age: 18 and over
- Performance status: ECOG 0 or 1
- WBC greater than 2,000/mm3
- Platelet count greater than 100,000/mm3
- Bilirubin less than 2.0 mg/dL
- AST less than 4 times normal
- Creatinine less than 2.0 mg/dL
- Must be type HLA-A2 Prior vaccinia (smallpox) exposure required
- At least normal delayed type hypersensitivity to mumps and Candida
- At least normal CD4:CD8 ratio (greater than 1)
- At least normal lymphocyte proliferation testing (to Con A)
- At least normal immunoglobulin levels
- No evidence of altered immune responsiveness or autoimmune syndromes (e.g., scleroderma, systemic lupus erythematosus)
- No HIV antibody No prior splenectomy
- No known allergy to eggs
- No active extensive skin disorders (e.g, psoriasis, burns, impetigo, disseminated zoster)
- No other serious intercurrent illness
- No active infections unless cleared and at least 3 days since antibiotic therapy
No close contact for 2 weeks after each vaccination with the following people:
- Children less than 3 years old
- Pregnant women
- Individuals with eczema or skin conditions listed above
- Immunosuppressed individuals
PRIOR CONCURRENT THERAPY:
- No concurrent biologic therapy
- No prior chemotherapy for metastatic disease
- No prior hormone therapy for metastatic disease
- Neoadjuvant hormone therapy prior to prostatectomy or radiotherapy allowed
- No concurrent steroids or hormonal medications
- Prior radiotherapy allowed
- Prior surgery allowed
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:Arm I
atients in cohorts of 3-6 receive 3 vaccinations with rV-PSA at 4-week intervals (days 1, 29, 57, and 85) in the absence of disease progression or unacceptable toxicity.
Response assessment is performed at eight weeks.
Patients who discontinue therapy prior to eight weeks are considered unevaluable for response.
If dose limiting toxicity is observed in 2 of 6 patients entered at a dose level, no further patients are entered at that level and the MTD is defined as the preceding dose level.
Ten additional patients are treated at the MTD and receive granulocyte-macrophage colony-stimulating factor (GM-CSF) administered subcutaneously on day -1 through day 2 of each cycle.
Patients who are HLA-A2 positive, have received all 3 rV-PSA vaccinations without unacceptable toxicity, and have been off study for at least 30 days due to disease progression may continue treatment with rV-PSA at the highest dose level and the addition of GM-CSF.
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Eder JP Jr, Kantoff PW, Bubley GJ, et al.: A phase I trial of recombinant prostate specific antigen expressing vaccinia virus vaccine, PROSTVAC (rV-PSA) in advanced prostate cancer. [Abstract] Proceedings of the American Society of Clinical Oncology 18: A1692, 439, 1999.
- Eder JP Jr, Kantoff PW, Bubley GJ, et al.: A phase I trial of recombinant vaccinia virus, PROSTVAC that expresses prostate specific antigen (rV-PSA) as a vaccine in men with advanced prostate cancer. [Abstract] Proceedings of the American Society of Clinical Oncology 17: A1672, 434, 1998.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
前立腺がんの臨床試験
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