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Vaccine Therapy With or Without Interleukin-2 in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer

2013年6月19日 更新者:National Cancer Institute (NCI)

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.

研究概览

详细说明

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.

研究类型

介入性

阶段

  • 阶段2
  • 阶段1

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Maryland
      • Bethesda、Maryland、美国、20892-1182
        • Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
    • Tennessee
      • Nashville、Tennessee、美国、37232-6838
        • Vanderbilt-Ingram Cancer Center

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

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

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗

研究衡量的是什么?

主要结果指标

结果测量
Response rate every 3 months for up to a year after completion of study treatment

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 学习椅:John E. Janik, MD、NCI - Metabolism Branch;MET

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

1999年3月1日

研究完成 (实际的)

2005年11月1日

研究注册日期

首次提交

2001年7月11日

首先提交符合 QC 标准的

2003年1月26日

首次发布 (估计)

2003年1月27日

研究记录更新

最后更新发布 (估计)

2013年6月20日

上次提交的符合 QC 标准的更新

2013年6月19日

最后验证

2005年11月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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