Vaccine Therapy in Treating Patients With Epstein-Barr Virus-Related Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed malignancy of a type typically associated with Epstein-Barr virus (EBV) latent infection meeting the following criteria:

  • The presence of EBV within the malignant cells has been demonstrated by immunohistochemistry for viral antigens or by EBER (EBV early RNA) in situ hybridization

• Patients in remission from disease or with disease for which no standard treatment is appropriate, as defined by 1 of the following groups:

  • Have achieved a continuing complete response (CR) or unconfirmed CR
  • Residual masses at the site of treated disease that are not progressing (i.e., stable disease) and for which no standard therapy is recognized
  • Residual or recurrent disease that is low-volume and causing minimal or no symptoms and for which no standard therapy is recognized

• Completed standard therapy for malignancy ≥ 12 weeks before trial entry

  • No more than 1 course of chemotherapy as treatment for EBV+ malignancy
• No ongoing toxic manifestations of prior treatment, except alopecia or certain grade 1 toxicities at the discretion of the investigator and Cancer Research UK
• No patients with active EBV+ cancer for whom evidence-based active treatment is available and likely to be offered to prolong life or relieve symptoms within 14 weeks of the first vaccination

PATIENT CHARACTERISTICS:

• WHO performance status 0 or 1
• Life expectancy ≥ 4 months

• Lymphocyte count must satisfy 1 of the following criteria:

  • Greater than lower limit of the reference range in the investigator site
  • Greater than or equal to 0.5 x 10^9/L AND recovery from nadir of lymphocyte numbers following primary treatment for EBV+ malignancy, judged by no successive rises in lymphocyte count measured up to 3 successive occasions 3 weeks apart
• Hemoglobin > 10.0 g/dL
• Absolute neutrophil count ≥ 1.5 x 10^9/L
• Platelet count ≥ 100 x 10^9/L
• Serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
• Serum alkaline phosphatase < 1.5 times ULN
• ALT and/or AST < 1.5 times ULN
• Calculated creatinine clearance > 50 mL/min (uncorrected value) OR isotope clearance measurement > 50 mL/min
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during study and for 6 months after completion of study treatment
• No known chronic active infection with hepatitis B, hepatitis C, or HIV
• No history of anaphylaxis or severe allergy to vaccinations
• No allergy to eggs or egg products
• No ongoing active infection
• No known splenic dysfunction
• No concurrent active autoimmune disease
• No prior NYHA class III or IV cardiac disease or concurrent congestive heart failure
• No concurrent active skin diseases requiring therapy (i.e., psoriasis, eczema)
• No other condition that, in the Investigator's opinion, would make the patient not a good candidate for this clinical trial

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No prior myeloablative therapy followed by an autologous or allogeneic hematopoietic stem cell transplant
• More than 12 weeks since prior and no concurrent chemotherapy or radiotherapy
• No splenectomy or splenic irradiation

• No concurrent immunosuppressive medication, including corticosteroids

  • Long-term prophylactic use of inhaled corticosteroids allowed
• No major thoracic and/or abdominal surgery within the past 4 weeks from which the patient has not yet recovered
• No other concurrent anticancer or investigational drugs