Stereotactic Body Radiation Therapy and T-Cell Infusion in Treating Patients With Metastatic Kidney Cancer
Pilot Study of Local Tumor Irradiation With Autologous T-Cell Infusion for Metastatic Renal Cell Carcinoma
研究概览
地位
详细说明
PRIMARY OBJECTIVES:
I. Conduct a safety and feasibility study of stereotactic radiotherapy with autologous T-cell infusion for patients with metastatic renal cell carcinoma.
SECONDARY OBJECTIVES:
I. Determine the progression free survival at one year. II. Determine the overall survival at one year.
OUTLINE:
STEREOTACTIC BODY RADIATION THERAPY (SBRT): Patients undergo standard of care SBRT over 1-2 weeks according to tumor volume and location.
LYMPHODEPLETION: Beginning 3 weeks later, patients receive cyclophosphamide orally (PO) twice daily (BID) for 3 days.
REINFUSION OF PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMC): Within 3-14 days of completing lymphodepletion with cyclophosphamide, patients undergo autologous PBMC infusion.
After completion of study treatment, patients are followed up at 1 week, 4 weeks, and monthly thereafter.
研究类型
注册 (实际的)
阶段
- 阶段1
联系人和位置
学习地点
-
-
California
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Stanford、California、美国、94305
- Stanford University Hospitals and Clinics
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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
Inclusion Criteria:
- Histologically confirmed carcinoma of the kidney (clear-cell predominance)
- Have had at least 2 prior systemic treatments for renal cell carcinoma (RCC)
- Have at least 1 extracranial metastasis that is amenable to radiation and at least 1 other site of disease that is measurable by Response Evaluation Criteria in Solid Tumors (RECIST)
- Subjects must provide written informed consent prior to performance of study-specific procedures or assessments, and must be willing to comply with treatment and follow up
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2
- Absolute neutrophil count (ANC) >= 0.75 x 10^9/L
- Absolute lymphocyte count (ALC) >= 0.5 X 10^9/L
- Hemoglobin >= 8 g/dL
- Platelets >= 50 X 10^9/L
- Total bilirubin =< 3 X upper limit of normal (ULN)
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3 X ULN
- Serum creatinine =< 2.1 X ULN (or creatinine clearance of > 50 cc/min)
Exclusion Criteria:
History of other malignancies within 5 years prior to enrollment except for tumors with a negligible risk for metastasis or death, such as adequately controlled basal cell carcinoma, squamous-cell carcinoma of the skin, carcinoma in situ of the cervix, early-stage bladder cancer, or low-grade endometrial cancer
- Malignancies that have undergone a putative surgical cure (i.e., localized prostate cancer post-prostatectomy) within 5 years prior to enrollment may be discussed with the lead primary investigator
- History or clinical evidence of central nervous system (CNS) metastases or leptomeningeal carcinomatosis, except for individuals who have previously-treated CNS metastases, are asymptomatic, and have had no requirement for steroids or anti-seizure medication for more than 1 week within 6 months prior enrollment
- Presence of uncontrolled infection
- Evidence of active bleeding or bleeding diathesis; any medical condition requiring systemic anticoagulation (including anti-platelet agents)
- Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subject's safety, provision of informed consent, or compliance to procedures
- Pregnant and breastfeeding women are excluded; as well as women of child-bearing potential who are unwilling or unable to use an acceptable method of birth control (hormonal or barrier method of birth control; abstinence) to avoid pregnancy for the duration of the study
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 |
|---|---|
|
实验性的:Treatment (SBRT, autologous PBMC infusion)
SBRT: Patients undergo standard of care SBRT over 1-2 weeks according to tumor volume and location. LYMPHODEPLETION: Beginning 3 weeks later, patients receive cyclophosphamide PO BID for 3 days. REINFUSION OF PBMC: Within 3-14 days of completing lymphodepletion with cyclophosphamide , patients undergo autologous PBMC infusion. |
相关研究
给定采购订单
其他名称:
进行 SBRT
其他名称:
Undergo autologous PBMC infusion
其他名称:
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Frequency of treatment-related grade 3-5 toxicities, graded according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0
大体时间:Within 30 days after infusion of PBMCs
|
Adverse events will be tabulated by type and grade at each follow-up interval.
|
Within 30 days after infusion of PBMCs
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Overall survival (OS)
大体时间:1 year
|
The level of OS will be tabulated at each follow-up interval, and will be summarized using Kaplan-Meier curves and medians with 95% confidence intervals.
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1 year
|
|
Progression-free survival (PFS)
大体时间:The duration from SBRT treatment to documented disease progression or death, assessed at 1 year
|
The level of PFS will be tabulated at each follow-up interval.
The percentage of individuals free from disease progression will be computed with exact 95% confidence intervals.
PFS will be summarized using Kaplan-Meier curves and medians with 95% confidence intervals.
|
The duration from SBRT treatment to documented disease progression or death, assessed at 1 year
|
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Level of circulating tumor cells (CTCs)
大体时间:Up to 2 years
|
The correlations of CTCs and changes in signaling as measured by nano-immunoassay (NIA) to clinical response will be assessed.
NIA measurements for 20 protein isoforms will be analyzed.
Measurements will be analyzed as continuous variables for each sample.
The distribution of each isoform will be summarized with medians and interquartile ranges.
Quantile plot and box-Cox models will be used to determine whether to transform the data prior to analysis.
A protein isoform signature predictive of clinical response will be constructed using the Lasso R glmnet package.
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Up to 2 years
|
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Changes in signaling as measured by NIA
大体时间:Up to 2 years
|
The correlations of CTCs and changes in signaling as measured by NIA to clinical response will be assessed.
NIA measurements for 20 protein isoforms will be analyzed.
Measurements will be analyzed as continuous variables for each sample.
The distribution of each isoform will be summarized with medians and interquartile ranges.
Quantile plot and box-Cox models will be used to determine whether to transform the data prior to analysis.
A protein isoform signature predictive of clinical response will be constructed using the Lasso R glmnet package.
|
Up to 2 years
|
合作者和调查者
调查人员
- 首席研究员:Sandy Srinivas、Stanford University Hospitals and Clinics
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 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- RENAL0027 (其他标识符:Stanford University Hospitals and Clinics)
- P30CA124435 (美国 NIH 拨款/合同)
- NCI-2013-01688 (注册表标识符:CTRP (Clinical Trial Reporting Program))
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