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Vaccine Therapy or Observation in Treating Patients With Nasopharyngeal Cancer at High Risk for Recurrence

This study is ongoing, but not recruiting participants.

Sponsored by: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00112541
  Purpose

RATIONALE: Vaccines made from peptides may help the body build an effective immune response to kill tumor cells. Sometimes, after treatment, the tumor may not need additional treatment until it progresses. In this case, observation may be sufficient.

PURPOSE: This phase I/II trial is studying the side effects of vaccine therapy and to see how well it works compared to observation in treating patients with nasopharyngeal cancer at high risk for recurrence after standard therapy.


Condition Intervention Phase
Head and Neck Cancer
Drug: LMP-2:340-349 peptide vaccine
Drug: LMP-2:419-427 peptide vaccine
Drug: incomplete Freund's adjuvant
Procedure: adjuvant therapy
Phase I
Phase II

MedlinePlus related topics:   Cancer    Head and Neck Cancer   

ChemIDplus related topics:   Freund's adjuvant    Montanide ISA 51   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Open Label
Official Title:   Phase I/II Trial of Latent Membrane Protein (LMP) - 2 Immunization for the Assessment of the Natural History and the Immunization-Induced Immunological Response in Patients at High Risk for Recurrence of Anaplastic Nasopharyngeal Cancer

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Response to MHC class I, HLA-A*-1101 restricted T cell epitopes of EBV encoded LMP-2 [ Designated as safety issue: No ]
  • Response to MHC class I, HLA-A*-2404 restricted T cell epitopes of EBV encoded LMP-2 [ Designated as safety issue: No ]
  • Positive immune response [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Safety [ Designated as safety issue: Yes ]
  • Clinical activity [ Designated as safety issue: No ]
  • Surrogate marker [ Designated as safety issue: No ]

Estimated Enrollment:   99
Study Start Date:   April 2005

Detailed Description:

OBJECTIVES:

Primary

  • Determine the efficacy of adjuvant vaccine therapy comprising either Epstein-Barr virus (EBV)-encoded latent membrane protein (LMP)-2: 340-349 peptide or EBV -encoded LMP-2: 419-427 peptide emulsified in Montanide ISA-51, in terms of inducing CD8+ T-cell responses, in patients with anaplastic nasopharyngeal carcinoma at high risk for recurrence.

Secondary

  • Determine the safety of these regimens in these patients.
  • Determine whether plasma anti-EBV titers parallel the natural history or treatment-induced history of this disease in these patients.
  • Determine whether plasma anti-EBV titers can be used as surrogate markers to monitor the efficacy of these regimens in these patients.

OUTLINE: Patients are assigned to 1 of 3 treatment groups according to HLA typing.

  • Group 1 (HLA-A*1101): Patients receive Epstein-Barr virus (EBV)-encoded latent membrane protein (LMP)-2: 340-349 peptide emulsified in Montanide ISA-51 subcutaneously (SC) once weekly in weeks 1-8.
  • Group 2 (HLA-A*2402)*: Patients receive EBV-encoded LMP-2: 419-427 peptide emulsified in Montanide ISA-51 SC once weekly in weeks 1-8.
  • Group 3 (non HLA-A*1101 and non HLA-A*2402): Patients undergo observation only for at least 12 weeks.

NOTE: *Patients who express both HLA-A*1101 and HLA-A*2402 are assigned to group 2.

In groups 1 and 2, treatment repeats every 12 weeks for 2 courses in the absence of disease progression or unacceptable toxicity. After course 2, immune response is assessed. Patients with no immune response undergo observation. Patients with an objective immune response may receive 2 additional courses of therapy for a maximum of 4 courses (approximately 1 year).

After completion of study treatment, patients are followed every 3 months for 1 year and then every 6 months for up to 4 years.

PROJECTED ACCRUAL: A total of 42-99 patients (14-33 per treatment group) will be accrued for this study within 3 years.

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed anaplastic nasopharyngeal carcinoma (NPC), meeting 1 of the following criteria at disease onset:

    • Advanced local disease (T3-T4, N0-N1, M0)
    • Nodal disease (T1-T2, N2-N3, M0)
    • Locoregional disease (T3-T4, N2-N3, M0)
    • Completely resected metastatic disease
  • Disease free by physical examination; ear, nose, and throat endoscopy; CT scan of abdomen, chest, neck, and nasal sinuses; and MRI of the head performed within the past 6 weeks

    • Disease controlled by standard surgery OR standard chemotherapy and radiotherapy

      • Completed standard therapy ≥ 3 months before study entry

        • Demonstrates evidence of local control with no histological or radiological evidence of recurrent disease
  • HLA-A*1101- or HLA-A*2042-positive disease* by high resolution molecular testing NOTE: *Patients who do not meet the above HLA typing criteria are assigned to the study observation group

PATIENT CHARACTERISTICS:

Age

  • Over 18

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • WBC ≥ 3,000/mm^3
  • Platelet count ≥ 90,000/mm^3

Hepatic

  • AST and ALT < 3 times normal
  • Bilirubin ≤ 1.6 mg/dL (< 3.0 mg/dL for patients with Gilbert's syndrome)
  • Hepatitis B surface antigen negative
  • Hepatitis C positivity allowed provided patients meet the above AST and ALT criteria

Renal

  • Creatinine ≤ 2.0 mg/dL

Immunologic

  • HIV negative
  • No known hypersensitivity to study agents
  • No known immunodeficiency disease
  • No active primary or secondary immunodeficiency
  • No autoimmune disease
  • No active systemic infection

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 1 month since prior systemic biologic therapy in the adjuvant or metastatic setting

Chemotherapy

  • See Disease Characteristics
  • At least 1 month since prior systemic chemotherapy in the adjuvant or metastatic setting

Endocrine therapy

  • No concurrent systemic steroid therapy

Radiotherapy

  • See Disease Characteristics

Surgery

  • See Disease Characteristics
  • At least 1 month since prior surgery for NPC

Other

  • Recovered from all prior therapy (alopecia allowed)
  • At least 1 month since other prior systemic therapy in the adjuvant or metastatic setting
  • More than 3 weeks since prior systemic therapy for NPC
  • No other concurrent systemic therapy for NPC
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00112541

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support    
      Bethesda, Maryland, United States, 20892-1182

Sponsors and Collaborators

Investigators
Principal Investigator:     Francesco M. Marincola, MD     NIH - Warren Grant Magnuson Clinical Center    
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site
 

Study ID Numbers:   CDR0000430681, NCI-04-CC-0118
First Received:   June 2, 2005
Last Updated:   July 23, 2008
ClinicalTrials.gov Identifier:   NCT00112541
Health Authority:   United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
stage III nasopharyngeal cancer  
stage IV nasopharyngeal cancer  

Study placed in the following topic categories:
Nasopharyngeal carcinoma
Otorhinolaryngologic Diseases
Otorhinolaryngologic Neoplasms
Head and Neck Neoplasms
Pharyngeal Neoplasms
Freund's Adjuvant
Stomatognathic Diseases
Pharyngeal Diseases
Nasopharyngeal Neoplasms
Recurrence

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Immunologic Factors
Physiological Effects of Drugs
Nasopharyngeal Diseases
Adjuvants, Immunologic
Pharmacologic Actions

ClinicalTrials.gov processed this record on September 05, 2008




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