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
研究概览
详细说明
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.
研究类型
注册 (实际的)
阶段
- 阶段1
联系人和位置
学习地点
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Massachusetts
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Boston、Massachusetts、美国、02115
- Dana-Farber Cancer Institute
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Boston、Massachusetts、美国、02115
- Brigham and Women's Hospital
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Boston、Massachusetts、美国、02114
- Massachusetts General Hospital Cancer Center
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:不适用
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的: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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合作者和调查者
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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