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Gene Therapy and Chemotherapy in Treating Patients With Advanced Solid Tumors or Non-Hodgkin's Lymphoma
This study has been completed.
Study NCT00003567   Information provided by National Cancer Institute (NCI)
First Received: November 1, 1999   Last Updated: June 9, 2009   History of Changes

November 1, 1999
June 9, 2009
May 1999
January 2007   (final data collection date for primary outcome measure)
Gene transfer expression measured at days 28, 56, 84, and 112, and then every 3 months for 1 year [ Designated as safety issue: No ]
Gene transfer expression measured at days 28, 56, 84, and 112, and then every 3 months for 1 year
Complete list of historical versions of study NCT00003567 on ClinicalTrials.gov Archive Site
 
 
 
Gene Therapy and Chemotherapy in Treating Patients With Advanced Solid Tumors or Non-Hodgkin's Lymphoma
Mutant MGMT Gene Transfer Into Human Hematopoietic Progenitors to Protect Hematopoiesis During O6-Benzylguanine (BG, NSC 637037) and Carmustine Followed by Temozolomide Therapy of Advanced Solid Tumors

RATIONALE: Gene therapy may improve the body's ability to fight cancer or make the cancer more sensitive to chemotherapy. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die.

PURPOSE: This phase I trial is studying the side effects and best dose of gene therapy together with chemotherapy in treating patients with advanced solid tumors or non-Hodgkin's lymphoma.

OBJECTIVES:

  • Evaluate the feasibility of introducing and expressing mutant MGMT-G156A cDNA in hematopoietic progenitors taken from patients with advanced solid tumors (including gliomas) or non-Hodgkin's lymphoma using a safety modified retroviral vector MFG.
  • Determine the toxicity associated with reinfusion of ex vivo-transduced hematopoietic stem cells into these patients, including the detection of replication competent retrovirus.
  • Evaluate the feasibility of identifying mutant MGMT-G156A-transduced and O6-benzylguanine (BG)- and temzolomide-resistant hematopoietic and stromal progenitors from the bone marrow of these patients.
  • Evaluate the feasibility of in vivo enrichment of the transduced hematopoietic progenitors in patients treated with BG and temzolomide.
  • Evaluate the toxicity of this regimen in these patients.
  • Determine the antitumor effect of this regimen in these patients.

OUTLINE: This is a dose-escalation study of CD34 stem cells and carmustine.

After a negative bone marrow sampling, patients receive sargramostim (GM-CSF) and filgrastim (G-CSF) subcutaneously (SC) once daily on days 1-5 (or G-CSF twice daily alone for 4-5 days). Peripheral blood progenitor cells are collected 24 hours after the last dose of growth factor injection on day 5 and also on day 6, if necessary. The CD34 positive stem cells are then infected by the retroviral mutant MGMT-G156A ex vivo.

Patients receive O6-benzylguanine (BG) IV over 1 hour followed by carmustine IV over 1 hour every 6 weeks for 5 courses, assuming recovery of peripheral blood counts. Approximately 72 hours after the end of the first course of chemotherapy, patients receive reinfusion of retrovirally-transduced hematopoietic stem cells over 5-10 minutes. Four weeks after the completion of BG and carmustine, patients receive BG IV over 1 hour followed by temozolomide IV over 1 hour every 4 weeks for up to 5 courses, in the absence of hematologic toxicity. Patients with responding disease may continue to receive BG and temzolomide in the absence of disease progression or unacceptable toxicity provided other phase II studies indicate the safety of more than 5 courses.

Cohorts of 3-6 patients receive escalating numbers of CD34 stem cells targeted for retroviral infection and escalating doses of carmustine.

Patients are followed monthly for 2 months, every 4 months for 8 months, and then every 6 months thereafter.

PROJECTED ACCRUAL: A total of 12-18 patients will be accrued for this study.

Phase I
Interventional
Treatment
  • Brain and Central Nervous System Tumors
  • Lymphoma
  • Unspecified Adult Solid Tumor, Protocol Specific
  • Biological: filgrastim
  • Biological: sargramostim
  • Biological: therapeutic autologous lymphocytes
  • Drug: O6-benzylguanine
  • Drug: carmustine
  • Drug: temozolomide
  • Procedure: in vitro-treated peripheral blood stem cell transplantation
 
 

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Completed
18
 
January 2007   (final data collection date for primary outcome measure)

DISEASE CHARACTERISTICS:

  • One of the following histologically confirmed diseases for which no curative surgical, radiotherapy, or chemotherapy programs are available and standard therapy offers, at best, a modest clinical benefit

    • Solid tumors
    • Gliomas
    • Non-Hodgkin's lymphoma
  • Primary and metastatic CNS malignancies are eligible
  • Evaluable or measurable disease
  • CD34 count at least 2.0 cells/μL
  • No bone marrow involvement

    • Histologically negative bone marrow biopsy

PATIENT CHARACTERISTICS:

Age:

  • 18 to 70

Performance status:

  • ECOG 0-2

Life expectancy:

  • At least 12 weeks

Hematopoietic:

  • Absolute neutrophil count at least 1,500/mm^3
  • Platelet count at least 100,000/mm^3
  • Hemoglobin at least 8.5 g/dL

Hepatic:

  • Bilirubin no greater than 1.5 mg/dL
  • AST and ALT less than 2.5 times normal
  • Prothrombin time less than 1.2 times normal

Renal:

  • Creatinine no greater than 2.0 mg/dL

Cardiovascular:

  • No acute cardiac disease by EKG

Pulmonary:

  • No symptomatic pulmonary disease

Other:

  • HIV negative
  • No other severe comorbid conditions
  • Not pregnant or nursing
  • Fertile patients must use effective contraception during and for 2 months after study completion

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • See Chemotherapy
  • No prior hematopoietic stem cell transplantation

Chemotherapy:

  • No prior high-dose chemotherapy
  • Prior adjuvant chemotherapy allowed

Endocrine therapy:

  • Not specified

Radiotherapy:

  • No prior radiotherapy to 25% or more of bone marrow

Surgery:

  • Not specified

Other:

  • At least 4 weeks since prior myelosuppressive therapy
Both
18 Years to 70 Years
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00003567
 
CDR0000066633, CASE-CWRU-2Y97, NCI-T97-0060, CASE-2Y97
Case Comprehensive Cancer Center
National Cancer Institute (NCI)
Study Chair: Stanton L. Gerson, MD Case Comprehensive Cancer Center
National Cancer Institute (NCI)
March 2007

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP