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Safety and Effectiveness of a Vaccine for Prostate Cancer That Uses Each Patients' Own Immune Cells.

2013년 1월 11일 업데이트: Robert Darnell, Rockefeller University

A Phase I/II Study of Autologous Dendritic Cells Pulsed With Apoptotic Tumor Cells (DC/LNCaP) Administered Subcutaneously to Prostate Cancer Patients.

The purpose of this study is to assess the safety and activity of a type of vaccine as immune therapy for prostate cancer. This vaccine will be made for each participant's own immune cells (called dendritic cells) obtained by blood donation. Dendritic cells are immune cells, whose role is to identify foreign antigens (bacteria, viruses, or tumor cells, for example) in the body and to activate other cells of the immune system to mount an attack on that foreign antigen. Each participant will be randomized into either Arm 1 (experimental treatment only) or Arm 2 (placebo first, then the experimental treatment). Participants will be given the vaccine and three boosters as an injection. After the placebo phase, each participant in Arm 2 will crossover to the treatment phase so that all participants will eventually receive the experimental treatment.

연구 개요

상세 설명

This is a Phase I/II dendritic cell vaccine study for patients with prostate cancer. Our laboratory has demonstrated that effective tumor immunity in humans is associated with, and likely mediated at least in part by tumor antigen-specific killer T cells (Albert et al., 1998a; Darnell, 1999; Darnell and Posner, 2003). Moreover, we have demonstrated that apoptotic material derived from dying tumor cells are a potent means of delivering antigen to DCs and subsequently triggering tumor antigen-specific T cell responses ex vivo (Albert et al., 1998a; Albert et al., 1998c). In this study, patients with 3 consecutive rises in PSA measured at least 2 week apart, after definite local therapy (prostatectomy or radiation) will be recruited. Peripheral blood monocytes will be collected by leukapheresis and dendritic cells will be generated in the Cleanroom in the Laboratory of Molecular Neuro-Oncology. These dendritic cells will be pulsed with apoptotic prostate cancer cells from a cell line (LNCaP), harvested, tested for certain release criteria, and then injected as vaccine. When patients are found to be eligible for the study, they will be randomized into either the experimental group or the placebo group for the purposes of comparing adverse events between groups only. Vaccine plus 3 boosters (or placebo) will be given, each two weeks apart. After the third booster, patients will be unblinded. Those receiving the vaccine will when enter the follow up phase which includes a post treatment leukapheresis. Those in the placebo group will cross over and receive the vaccine and boosters. The primary outcomes to be evaluated are toxicity and activity. Patients will be evaluated for both local and systemic toxicity. For activity, we measure both immunological and clinical responses to the vaccine, comparing measures taken before and after vaccination, combining patients in both arms.

연구 유형

중재적

등록 (실제)

24

단계

  • 2 단계
  • 1단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • New York
      • New York, New York, 미국, 10021
        • Rockefeller University Hospital

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

남성

설명

Inclusion Criteria:

Disease Characteristics

  • Histologically confirmed prostate carcinoma
  • Progressive, disease required, i.e.: elevated PSA documented to be rising on 3 occasions, either despite castrate testosterone levels (below 50 ng/dl), or after definitive local therapy (prostatectomy or radiation).

Prior/Concurrent Therapy

-Biologic therapy:

  • Recovered from toxicity of any prior therapy

    -Chemotherapy:

  • At least 4 weeks since chemotherapy -Endocrine evaluation/therapy
  • 3 rising PSA values at least 2 weeks apart
  • At least 2 weeks since concurrent corticosteroids (other than for replacement therapy for adrenal insufficiency)
  • Medical hormonal therapy to maintain castrate testosterone levels permitted

    -Radiotherapy:

  • At least 4 weeks since radiotherapy

    -Surgery:

  • Prior surgery allowed

Patient Characteristics

  • Age: 18 and over, able to give written informed consent. Individuals unable to provide informed consent must have consent provided by the legal guardian, or person designated by the subject to give consent on his behalf.
  • Performance status: Karnofsky 70-100%
  • Life expectancy: At least 1 year
  • Hematopoietic: obtained twice, once within 45 days prior to study entry, and again within 72 hours of study entry.
  • WBC greater than 3,800
  • Absolute neutrophils greater than 1,500
  • Absolute lymphocytes greater than 500
  • Platelets greater than 120,000
  • Hb at least 10 g/dl
  • Hepatic:

    --Bilirubin less than 2.0 mg/dl OR

    --SGOT less than 2 x ULN

  • Renal:

    • Creatinine no greater than 2.0 mg/dl OR
    • Creatinine clearance at least 40 ml/min
  • Rheumatologic:

    --ANA no greater than upper limit of normal, or ANA abnormal in absence of clinical signs of autoimmunity.

    • Rheumatoid factor (RF) no greater than upper limit of normal, or RF abnormal in absence of clinical signs of autoimmunity.
    • Anti-ds DNA no greater than upper limit of normal, or anti ds DNA abnormal in absence of clinical signs of autoimmunity.
  • Immunologic:
  • Influenza serology (assessment made at time of screening).
  • Assessment of DTH response to a standard anergy panel (to include candida, trichophyton and tetanus) or to a Multitest CMI (a disposable kit for DTH testing with standardized preloaded antigens).
  • Endocrine:

    --TSH, T3, and T4 no greater than upper limit of normal

  • Radiographic:

    • Baseline bone scan
    • Baseline CT or MRI of abdomen and pelvis

Exclusion Criteria:

Disease Characteristics -No active CNS metastases

Prior/Concurrent Therapy

  • Biologic therapy:

    • No prior autologous or allogeneic tumor vaccines
    • No concurrent other immunotherapy
  • Chemotherapy

    --Not previously treated with more than 2 chemotherapy regimens

    • No concurrent chemotherapy
  • Radiotherapy --No concurrent radiotherapy

Patient Characteristics -Cardiovascular: No NYHA class III/IV status No active angina, clinically significant cardiac arrythmia, recent (6 months) myocardial infarction

  • Pulmonary:

    --No severe debilitating pulmonary disease

  • Other:

    • No active infection requiring antibiotics
    • No active pain requiring chronic opioid analgesics.
    • Not HIV, hepatitis B or hepatitis C virus positive; anti-HIV, HbsAg and Hep C antibody negative
    • No history of hypersensitivity to vaccine components
    • No serious uncontrolled medical illness
    • No currently active second malignancy other than non-melanoma skin cancer (note: a patient is NOT considered to have currently active malignancy if they have completed therapy and are now considered by their physician to be at less than 30% risk for relapse)
    • No history of total lymph node irradiation
    • No history of vasculitis, including but not limited to systemic necrotizing vasculitides (polyarteritis nodosa group), hypersensitivity vasculitis, Wegener's granulomatosis.
    • No history of autoimmune disease.
    • No use of hydroxyurea within 45 days of study entry
    • No receipt of immune modulators or suppressors within 30 days prior to study entry, including but not limited to interferons and thalidomide. No active requirement for corticosteroids; prior use is acceptable.
    • No psychiatric illness or social condition that, in the opinion of the investigator, would interfere with adherence to study requirements.
    • No alcohol or drug use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 크로스오버 할당
  • 마스킹: 하나의

무기와 개입

참가자 그룹 / 팔
개입 / 치료
위약 비교기: Placebo
12 patients in the placebo Arm for 8 weeks followed by DC/LNCAP, DC/LNCaP-M1 and DC/KLH immunizations over 8 weeks.
Subcutaneous injection of vaccine vehicle only (5% DMSO in normal saline), followed by cross-over to Arm 1 design.
실험적: DC/LNCaP
12 patients, receiving DC/LNCaP, DC/LNCaP-M1 and DC/KLH immunizations over 8 weeks
Subcutaneous injection of DC/LNCaP, DC/LNCaP-M1, DC/KLH

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Adverse Event
기간: End of blinded phase (wk 9)
Occurrence of adverse events (AE) was compared between the placebo and vaccine groups during the blinded phase (the 1st 9 weeks). At the end of this phase, all were unblinded, and those who received placebo crossed over to now receive vaccine. All serious AEs and any other AEs that occurred 5 times or more are reported. The exact binomial test was used to compare the occurrence of each AE between groups.
End of blinded phase (wk 9)
Immunogenicity of the DC/LNCaP Vaccine. Pre- vs Post-vaccination Bulk T Cell Proliferation (3H Thymidine Incorporation) by Type of Antigen. The "Number" Indicated is the Median Difference of Post-Pre, of Each Antigen Group.
기간: pre- vs post-vaccination. Pre-vaccination T cells were collected at Wk 0 and post-vaccination T cells were collected at Wk 13
The difference between post minus pre-vaccination bulk T cell proliferation was calculated for each antigen.
pre- vs post-vaccination. Pre-vaccination T cells were collected at Wk 0 and post-vaccination T cells were collected at Wk 13

2차 결과 측정

결과 측정
측정값 설명
기간
Change in PSA Slope, Pre- vs Post-vaccination.
기간: pre- vs post- vaccination PSA slopes.
To model the evolution of PSA (in log-scale) during the three study phases (pre-vaccine, vaccine, and post-vaccine phases), a mixed linear spline model was used. Two knots (one at the start of the vaccine phase and the other at the start of the post-vaccine phase) were used to directly quantify the differences in slopes between each phase. To account for the heterogeneous treatment effect and the repeated measures structure, random effects are incorporated into the model. For the general model, random effects for the intercept, slope and the first knot were considered.
pre- vs post- vaccination PSA slopes.

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Robert B. Darnell, MD, PHD, Rockefeller University

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2002년 3월 1일

기본 완료 (실제)

2008년 11월 1일

연구 완료 (실제)

2008년 11월 1일

연구 등록 날짜

최초 제출

2006년 2월 7일

QC 기준을 충족하는 최초 제출

2006년 2월 7일

처음 게시됨 (추정)

2006년 2월 9일

연구 기록 업데이트

마지막 업데이트 게시됨 (추정)

2013년 1월 18일

QC 기준을 충족하는 마지막 업데이트 제출

2013년 1월 11일

마지막으로 확인됨

2013년 1월 1일

추가 정보

이 연구와 관련된 용어

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

전립선암에 대한 임상 시험

vaccine vehicle only에 대한 임상 시험

3
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