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Chemotherapy and Vaccine Therapy Followed by Bone Marrow or Peripheral Stem Cell Transplantation and Interleukin-2 in Treating Patients With Recurrent or Refractory Brain Cancer

5 april 2013 uppdaterad av: Barbara Ann Karmanos Cancer Institute

Phase II Trial Of High Dose Cyclophosphamide, Cisplatin And Carmustine With Stem Cell Reconstitution Followed By Specific Cellular Therapy In Patients With Recurrent Or Refractory Brain Tumors

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with bone marrow or peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells. Vaccines made from a person's white blood cells and tumor cells may make the body build an immune response to kill tumor cells. Interleukin-2 may stimulate a person's white blood cells to kill tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy and vaccine therapy followed by bone marrow or peripheral stem cell transplantation and interleukin-2 in treating patients who have recurrent or refractory brain cancer.

Studieöversikt

Detaljerad beskrivning

OBJECTIVES:

  • Determine the effectiveness of induction paclitaxel and cyclophosphamide followed by autologous tumor cell vaccine and sargramostim (GM-CSF) followed by high-dose chemotherapy with cisplatin, cyclophosphamide, and carmustine, autologous bone marrow or peripheral blood stem cell transplantation, and interleukin-2 in patients with recurrent or refractory primary high-grade brain tumors.
  • Determine the safety and toxicity of this regimen in these patients.
  • Determine if a specific quantitative cellular response can be elicited in patients treated with this regimen.

OUTLINE: After partial surgical resection of tumor, patients receive induction chemotherapy comprising paclitaxel IV over 3 hours and cyclophosphamide IV over 1 hour on day 1. Patients also receive filgrastim (G-CSF) subcutaneously (SC) daily beginning on day 3 and continuing until peripheral blood stem cell (PBSC) or bone marrow collection is completed.

After the collection of PBSC or bone marrow, patients receive autologous tumor cell vaccine and sargramostim (GM-CSF) SC once every 2 weeks for up to 5 vaccinations. Two weeks after the last vaccination, patients undergo a second leukapheresis to collect lymphocytes.

After completion of the second leukapheresis, patients receive high-dose chemotherapy comprising cisplatin IV continuously over 24 hours on day -5, cyclophosphamide IV over 1 hour on days -5, -4, and -3, and carmustine IV over 2 hours on day -2. Patients undergo autologous bone marrow or PBSC transplantation on day 0. Patients receive G-CSF IV daily beginning on day 0 and continuing until blood counts recover.

Approximately 12 weeks after bone marrow or PBSC transplantation, patients receive autologous lymphocytes IV over 2-5 hours. Patients also receive interleukin-2 IV once every other day for 10 days.

Patients are followed at 18, 24, 36, 40, and 52 weeks.

PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study.

Studietyp

Interventionell

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Michigan
      • Detroit, Michigan, Förenta staterna, 48201-1379
        • Barbara Ann Karmanos Cancer Institute

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

Inte äldre än 65 år (Barn, Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

DISEASE CHARACTERISTICS:

  • Histologically confirmed active recurrent or refractory primary high-grade brain tumor

    • Tumor must be surgically accessible
  • Bidimensionally measurable disease by clinical exam, CT scan, or x-ray

    • Disease must be outside a previously irradiated field or have progressed or developed after radiotherapy
    • Previously treated metastatic bony lesions are not considered measurable
    • No previously irradiated metastatic disease site unless no response or clear progression on imaging

PATIENT CHARACTERISTICS:

Age:

  • 65 and under

Performance status:

  • CALGB 0-2

Life expectancy:

  • More than 3 months

Hematopoietic:

  • Absolute neutrophil count greater than 1,500/mm^3
  • Platelet count greater than 100,000/mm^3

Hepatic:

  • Liver function less than 2.5 times normal unless due to disease
  • No active hepatitis B or C

Renal:

  • Creatinine less than 1.5 mg/dL
  • Creatinine clearance greater than 60 mL/min

Cardiovascular:

  • Left ventricular ejection fraction greater than 50% by MUGA or 2-D echocardiogram
  • Electrocardiogram normal

Pulmonary:

  • FEV1 and DLCO greater than 50% predicted OR
  • Clearance by pulmonologist

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • HIV negative
  • No serious underlying co-morbid disease or other medical or psychiatric factor that would preclude study
  • Able to be weaned off steroids after surgery

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • Not specified

Chemotherapy:

  • Recovered from prior conventional chemotherapy

Endocrine therapy:

  • No concurrent steroid therapy for mass effect

Radiotherapy:

  • See Disease Characteristics
  • Recovered from prior conventional radiotherapy

Surgery:

  • See Disease Characteristics

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Studiestol: Esteban Abella, MD, Barbara Ann Karmanos Cancer Institute

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 augusti 1998

Primärt slutförande (Faktisk)

1 oktober 2004

Avslutad studie (Faktisk)

1 oktober 2004

Studieregistreringsdatum

Först inskickad

10 april 2001

Först inskickad som uppfyllde QC-kriterierna

2 april 2004

Första postat (Uppskatta)

5 april 2004

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

8 april 2013

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

5 april 2013

Senast verifierad

1 april 2013

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • CDR0000068559
  • P30CA022453 (U.S.S. NIH-anslag/kontrakt)
  • WSU-D-1654
  • WSU-07-92-98-P04-FB (Annan identifierare: Wayne State University - Human Investigation Committee)
  • NCI-G01-1937

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

Kliniska prövningar på aldesleukin

3
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