Dendritic Cell Vaccination for Patients With Acute Myeloid Leukemia in Remission (CCRG 05-001)

This study has been completed.
Sponsor:
Information provided by:
University Hospital, Antwerp
ClinicalTrials.gov Identifier:
NCT00834002
First received: January 30, 2009
Last updated: February 5, 2010
Last verified: August 2009
  Purpose

RATIONALE: Vaccines made from a patient's white blood cells (dendritic cells) and a specific leukemia antigen (Wilms tumor antigen-1) may induce an effective immune response to kill residual leukemic cells and/or prevent leukemia relapse.

PURPOSE: This phase I/II trial is studying the feasibility, safety and efficacy of intradermal mRNA-transfected dendritic cell vaccination therapy in patients with acute myeloid leukemia.


Condition Intervention Phase
Acute Myeloid Leukemia (AML)
Biological: injection of antigen-loaded cultured dendritic cells
Phase 1

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Wilms Tumor Gene (WT1) mRNA-transfected Autologous Dendritic Cell Vaccination for Patients With Acute Myeloid Leukemia (AML): a Phase I Trial

Resource links provided by NLM:


Further study details as provided by University Hospital, Antwerp:

Primary Outcome Measures:
  • acute toxicity of intradermal injections of WT1 mRNA-electroporated autologous dendritic cells [ Designated as safety issue: Yes ]
  • feasibility to generate functional DC vaccines from leukapheresis material from AML patient in remission [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • T cell immunogenicity of WT1 mRNA-loaded dendritic cell vaccines in AML patients in remission [ Designated as safety issue: No ]

Enrollment: 10
Study Start Date: March 2005
Study Completion Date: December 2008
Primary Completion Date: November 2007 (Final data collection date for primary outcome measure)
Intervention Details:
    Biological: injection of antigen-loaded cultured dendritic cells
    intradermal injection of WT1-RNA-electroporated autologous dendritic cell vaccine (therapeutic cell vaccine)
Detailed Description:

Autologous dendritic cell (DC) vaccination is a promising strategy for adjuvant cancer therapy in the setting of minimal residual disease (MRD). We performed a phase I/II trial in patients with acute myeloid leukemia (AML) where patients received intradermal injections of autologous DC loaded with mRNA coding for the Wilms' tumor protein (WT1). WT1 is highly overexpressed in leukemia and the level of WT1 RNA in peripheral blood is a useful biomarker for molecular diagnosis en follow-up in the MRD setting. We want to prospectively monitor WT1 RNA expression in the peripheral blood of vaccinated and non-vaccinated AML patients in order to evaluate its predictive value as a biomarker for relapse and to assess the clinical efficacy of DC vaccination in acute myeloid leukemia patients. We believe, on the basis of already available evidence, that the use of WT1 both as a target for immunotherapy as well as a biomarker not holds promise to assess the efficacy of new experimental therapeutic interventions such as DC vaccination.

  Eligibility

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

Inclusion Criteria:

  1. Tumor type: Acute Myeloid Leukemia (AML) according to the WHO criteria (ea at least 20% blasts in the marrow). All FAB subtypes except M3. Patients with Myelodysplastic Syndrome, category of Refractory Anemia with Excess Blasts (RAEB): RAEB I (WHO: medullary blast count ≤ 10% and a peripheral blast count ≤ 5%) and RAEB II (WHO: medullary blast count > 10% and/or > 5% peripheral blasts) can be included in the study in absence of other non-experimental treatment modalities.
  2. Extent of disease: remission (partial or complete) or smouldering course. Complete remission (CR) is defined as no blasts in the peripheral blood and no more than 5% blasts in the bone marrow. This definition is related to the hematological remission if it is not specified. Partial remission (PR) is defined as a decrease of at least 50% in the percentage of blasts to 5 to 25% in the bone marrow aspirate. Smouldering course is defined as a relatively low marrow blast count and slowly progressive disease.
  3. Overexpression of WT1 RNA (>50 copies of WT1 per 1000 copies ABL in bone marrow or >2 copy/1000 copies ABL in peripheral blood) as assessed by quantitative RT-PCR at the time of presentation.
  4. Prior treatments : Patients must have received at least one prior antileukemic chemotherapeutic regimen and must be more than 1 month past the last treatment and/or 6 months past allogeneic/autologous stem cell transplantation.
  5. Age: ≥ 18 years
  6. High risk of relapse because of (and/or)

    • Age > 60 years (if <60 y, no sibling allotransplant donor available)
    • Poor risk cytogenetic or molecular markers at presentation
    • Hyperleukocytosis at presentation
    • Second complete remission after relapse
  7. Performance status: WHO PS grade 0-1 (Appendix B)
  8. Objectively assessable parameters of life expectancy: more than 3 months
  9. Prior and concomitant associated diseases allowed with the exception of underlying autoimmune disease and positive serology for HIV/HBV/HCV
  10. No concomitant use of immunosuppressive drugs
  11. Adequate renal and liver function, i.e. creatinin and bilirubin = 1.2 times the upper limit of normal
  12. Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial
  13. Women of child-bearing potential should use adequate contraception prior to study entry and for the duration of study participation

Exclusion Criteria:

  1. Subjects with concurrent additional malignancy (with exception of Non-melanoma skin cancers and carcinoma in situ of the cervix)
  2. Subjects who are pregnant
  3. Subjects who have sensitivity to drugs that provide local anesthesia
  4. Age < 18 years
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00834002

Locations
Belgium
Antwerp University Hospital/Center for Cellular Therapy and Regenerative Medicine
Edegem, Belgium, 2650
Sponsors and Collaborators
University Hospital, Antwerp
Investigators
Study Director: Zwi Berneman, MD, PHD University Hospital, Antwerp
Principal Investigator: Ann Van de Velde, MD University Hospital, Antwerp
Principal Investigator: Viggo FI Van Tendeloo, PhD University Hospital, Antwerp
  More Information

No publications provided

Responsible Party: Prof dr Zwi Berneman, University Hospital Antwerp
ClinicalTrials.gov Identifier: NCT00834002     History of Changes
Other Study ID Numbers: EC 5/6/29
Study First Received: January 30, 2009
Last Updated: February 5, 2010
Health Authority: Belgium: The Federal Public Service (FPS) Health, Food Chain Safety and Environment

Keywords provided by University Hospital, Antwerp:
AML in remission

Additional relevant MeSH terms:
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Leukemia
Neoplasms by Histologic Type
Neoplasms

ClinicalTrials.gov processed this record on September 16, 2014