An Open Label Phase I Study to Eval the Safety and Tolerability of a Vaccine (GI-6207) Consisting of Whole, Heat-killed Recombinant Saccharomyces Cerevisiae (Yeast) Genetically Modified to Express CEA Protein in Adults With Metastatic CEA-expressing ...

This study has been completed.
Sponsor:
Information provided by:
National Institutes of Health Clinical Center (CC)
ClinicalTrials.gov Identifier:
NCT00924092
First received: June 17, 2009
Last updated: May 21, 2014
Last verified: May 2014
  Purpose

Objectives:

  • To find out the maximum tolerated dose of the GI-6207 vaccine (the highest dose that does not cause unacceptable side effects), and to evaluate any side effects.
  • To see if GI-6207 has any effect on patients tumors.
  • To learn how the vaccine causes immune responses against the cancer.

Eligibility:

  • Patients 18 years of age and older who have been diagnosed with a cancer that has not responded to standard treatments. Patients must not be allergic to yeast or yeast products.

Design:

  • Initial physical examination, blood and tissue sampling, computed tomography (CT) scan, and skin test to determine eligibility for the procedure.
  • Treatment with GI-6027 in seven 14-day cycles as follows:
  • Vaccine administered on days 1, 15, 29, 43, 57, 71, and 85.
  • Vaccine given at four sites around the body: right and left chest area below the armpit, and right and left upper thigh in the pelvic region. (These areas drain into parts of your body that contain large numbers of lymph nodes. The lymph nodes contain immune cells that may be activated by the vaccine to target cancer cells.)
  • Clinic visits for physical examinations to check vital signs, take additional blood and urine samples, and perform other tests needed for the study.
  • After day 85 (about 3 months), patients will continue to receive vaccine monthly (or every 28 days) as long as the vaccine is not producing harmful effects or side effects and the cancer is either stable or reducing. Patients who do well on the vaccine may continue to receive it for as long as it is available.

Condition Intervention Phase
Prostate Cancer
Breast Cancer
Lung Cancer
Colorectal Cancer
Head and Neck Cancer
Biological: GI-6207 [Recombinant Saccharomyces Cerevisia
Drug: (Yeast CEA Vaccine)(GI-6207[Recombinant Sarrcharomyces Cerevusua-CEA (610D)])
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Open Label Phase I Study to Evaluate the Safety and Tolerability of Vaccine (GI-6207) Consisting of Whole, Heat-Killed Recombinant Saccharomyces Cerevisiae Genetically Modified to Express CEA Protein in Adults With Metastatic CEA-Expressing Carcinoma

Resource links provided by NLM:


Further study details as provided by National Institutes of Health Clinical Center (CC):

Primary Outcome Measures:
  • To determine the safety and tolerability of escalating doses of a heated-killed yeast-based vaccine that targets tumors that express CEA.

Secondary Outcome Measures:
  • To evaluate CD4 and CD8 immunologic response. To evaluate humoral immune response to yeast antigen. To evaluate evidence of clinical benefit such as PFS, OR, & amp; decreases in circulating tumor cells & amp; tumor markers.

Enrollment: 25
Study Start Date: March 2009
Study Completion Date: August 2012
Intervention Details:
    Biological: GI-6207 [Recombinant Saccharomyces Cerevisia
    N/A
    Drug: (Yeast CEA Vaccine)(GI-6207[Recombinant Sarrcharomyces Cerevusua-CEA (610D)])
    N/A
  Show Detailed Description

  Eligibility

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

A. Histologically confirmed carcinoma by the NIH Laboratory of Pathology that has been shown to express CEA (either a CEA serum level > 5 microg/L or a tumor that stains positive for CEA in > 20% of a tumor block).

B. Completed or had disease progression on at least one prior line of disease-appropriate therapy for metastatic disease, or not be a candidate for therapy of proven efficacy for their disease.

C. 18 years of age or greater.

D. Must have metastatic disease that is measurable or non-measurable but evaluable (e.g., pleural effusion or present on bone scan).

E. Ability to understand and the willingness to sign a written informed consent document.

F. ECOG performance status of 0 2 (Karnofsky greater than or equal to 50).

G. Serum creatinine less than or equal to 1.5 times upper limit of normal OR creatinine clearance on a 24-h urine collection of greater than or equal to 60 mL/min.

H. ALT and AST less than or equal to 2.5 times the upper limits of normal.

I. Total bilirubin less than or equal to 1.5 times upper limit of normal OR in patients with Gilbert s syndrome, a total bilirubin less than or equal to 3.0.

J. Recovered completely from any reversible toxicity associated with recent therapy. Typically this is 3 4 weeks for patients who most recently received cytotoxic therapy, except for the nitrosoureas and mitomycin C for which 6 weeks is needed for recovery. There should be a minimum of 2 weeks from any prior chemotherapy, immunotherapy and/or radiation.

K. Hematological eligibility parameters (within 16 days of starting therapy):

  • Granulocyte count greater than or equal to 1,500/mm(3)
  • Platelet count greater than or equal to 100,000/mm(3)

L. Prior immune therapy (e.g. related vaccinia and fowlpox vaccines or antigen-specific peptides) is allowed.

M. Men and women must agree to use effective birth control or abstinence during and for a period of 4 months after the last vaccination therapy.

N. Patients with prostate cancer must continue to receive GnRH agonist therapy (unless orchiectomy has been done).

O. Patients must be negative for yeast allergy skin test.

P. Patients must have baseline pulse oximetry greater than 90% on room air.

INCLUSION CRITERIA (EXTENSION PHASE: 10 ADDITIONAL PATIENTS AT HIGHEST TESTED DOSE/MTD):

Eligibility: Same as with the dose escalation phase with the following exceptions:

  • Patients must be HLA-A2, A3, or A24 positive for immunologic monitoring.
  • ECOG PS equal to 0 1.

EXCLUSION CRITERIA:

A. Patients should have no evidence of immune dysfunction as listed below.

  • Human immunodeficiency virus positivity due to the potential for decreased immune response to the vaccine.
  • Active autoimmune diseases requiring treatment or a history of autoimmune disease that might be stimulated by vaccine treatment. This requirement is due to the potential risks of exacerbating autoimmunity. Patients with endocrine autoimmune disease that is controlled by replacement therapy, including thyroid disease and adrenal disease; or those with vitiligo, may be enrolled.
  • Concurrent use of systemic steroids, except for physiologic doses for systemic steroid replacement or local (topical, nasal, or inhaled) steroid use. Limited doses of systemic steroids to prevent IV contrast, allergic reaction, or anaphylaxis (in patients who have known contrast allergies) are allowed.

B. History of allergy or untoward reaction to yeast-based products (any hypersensitivity to yeast-based products will be excluded).

C. Pregnant or breast-feeding women.

E. Serious intercurrent medical illness which would interfere with the ability of the patient to carry out the treatment program, including, but not limited to, inflammatory bowel disease, Crohn's disease, ulcerative colitis, or active diverticulitis.

F. Untreated brain metastases (or local treatment of brain metastases within the last 6 months) due to the poor prognosis of these patients and difficulty ascertaining the cause of neurologic toxicities.

G. Concurrent chemotherapy. An exception is to allow for patients on the extension phase only with breast cancer who are receiving trastuzumab to continue therapy with trastuzumab while receiving the vaccine treatment.

K. Chronic hepatitis infection, including B and C, because of potential immune impairment.

L. Patients requiring continuous tricyclic antidepressant therapy should be excluded due to the interference with the yeast skin test in creating false negative test results.

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00924092

Locations
United States, Maryland
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, United States, 20892
Sponsors and Collaborators
Investigators
Principal Investigator: Ravi A Madan, M.D. National Cancer Institute (NCI)
  More Information

Publications:
ClinicalTrials.gov Identifier: NCT00924092     History of Changes
Obsolete Identifiers: NCT00887016
Other Study ID Numbers: 090101, 09-C-0101
Study First Received: June 17, 2009
Last Updated: May 21, 2014
Health Authority: United States: Federal Government

Keywords provided by National Institutes of Health Clinical Center (CC):
Immunotherapy
Lung Cancer
Colorectal Cancer
Head and Neck Cancer
Prostate
Breast Cancer

Additional relevant MeSH terms:
Head and Neck Neoplasms
Lung Neoplasms
Prostatic Neoplasms
Colorectal Neoplasms
Breast Neoplasms
Neoplasms by Site
Neoplasms
Respiratory Tract Neoplasms
Thoracic Neoplasms
Lung Diseases
Respiratory Tract Diseases
Genital Neoplasms, Male
Urogenital Neoplasms
Genital Diseases, Male
Prostatic Diseases
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Breast Diseases
Skin Diseases

ClinicalTrials.gov processed this record on September 16, 2014