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Gene-Modified Cancer Cells in Treating Patients With B-Cell Chronic Lymphocytic Leukemia
This study is ongoing, but not recruiting participants.
Study NCT00609076   Information provided by National Cancer Institute (NCI)
First Received: January 30, 2008   Last Updated: February 6, 2009   History of Changes

January 30, 2008
February 6, 2009
July 2002
December 2022   (final data collection date for primary outcome measure)
Qualitative and quantitative toxicity [ Designated as safety issue: Yes ]
Same as current
Complete list of historical versions of study NCT00609076 on ClinicalTrials.gov Archive Site
  • Determination of immunologic efficacy [ Designated as safety issue: No ]
  • Antitumor effects [ Designated as safety issue: No ]
Same as current
 
Gene-Modified Cancer Cells in Treating Patients With B-Cell Chronic Lymphocytic Leukemia
TREATMENT OF CHRONIC LYMPHOCYTIC B-LEUKEMIA (B-CLL) WITH HUMAN IL-2 GENE MODIFIED AND HUMAN CD40 LIGAND-EXPRESSING AUTOLOGOUS TUMOR CELLS

RATIONALE: Vaccines made from a patient's gene-modified cancer cells may help the body build an effective immune response to kill cancer cells.

PURPOSE: This phase I trial is studying the side effects and best dose of gene-modified cancer cells and to see how well it works in treating patients with B-cell chronic lymphocytic leukemia.

OBJECTIVES:

  • To determine the safety of autologous malignant B cells from patients with chronic lymphocytic leukemia (B-CLL), which have been modified ex vivo to secrete human interleukin-2 (hIL-2) and to express human CD40 ligand (hCD40L).
  • To determine whether major histocompatability complex-restricted or unrestricted antitumor immune responses are induced by subcutaneous injections of B-CLL cells, which have been modified ex vivo to secrete hIL-2 and to express hCD40L.
  • To obtain preliminary data on the antitumor effects of this treatment regimen.

OUTLINE: This is a dose-escalation study of CD40-ligand-expressing B-cell chronic lymphocytic leukemia (B-CLL) cells.

Patients undergo peripheral blood and/or leukapheresis for collection of B-CLL cells. B-CLL cells are isolated and transduced by the human interleukin-2 (IL-2) adenoviral vector and stimulated with CD40-ligand for the production of CD40-ligand-expressing and IL-2 gene-modified autologous tumor cells.

Patients receive CD40-ligand-expressing and IL-2 gene-modified autologous tumor cell vaccine subcutaneously (SC) once weekly in weeks 1, 2, and 3. Patients with stable or responding disease receive 3 additional injections on weeks 4, 6, and 8 in the absence of disease progression or unacceptable toxicity.

After a 3-4 week rest, patients are re-evaluated for toxicity and response. Patients with disease regression after the administration of 6 injections, may receive additional vaccinations once weekly at 2-week intervals.

Blood samples are collected once weekly for 10 weeks, in week 12, monthly for 1 year, and annually thereafter for 15 years for immune analysis. Samples are analyzed for immune response by numeric and phenotypical characterization of circulating leukocyte sub-populations, including analysis of CD4+, CD8+ and CD25+ T-lymphocytes, and CD16+ and CD56+ NK cells; the number of precursors reacting against autologous B-CLL cells using IFN-gamma ELISPOT assay; and the presence of immunoglobulins against autologous B-CLL cells in plasma. Tumor response is analyzed via bone marrow samples and skin punch biopsies.

After completion of study treatment, patients are followed monthly for 1 year, and then annually for 15 years.

Phase I
Interventional
Treatment
Leukemia
  • Biological: autologous tumor cell vaccine
  • Other: immunoenzyme technique
  • Other: laboratory biomarker analysis
  • Procedure: biopsy
 
 

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Active, not recruiting
21
 
December 2022   (final data collection date for primary outcome measure)

DISEASE CHARACTERISTICS:

  • Diagnosis of B-cell chronic lymphocytic leukemia

    • No Richter's transformation (e.g., aggressive non-Hodgkin lymphoma)
  • Measurable or nonmeasurable disease
  • Untreated patients or patients in complete remission are enrolled for vaccine administration in a therapeutic (i.e., no chemotherapy) window of three months during which the patient may not present with rapid clinical progression

    • Vaccine production for patients in complete remission can only be achieved if tumor cells have been collected before entering complete remission

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-2
  • Life expectancy ≥ 10 weeks
  • Absolute neutrophil count ≥ 500/µL
  • Absolute lymphocyte count ≥ 200/μL
  • Platelet count ≥ 50,000/μL
  • Hemoglobin ≥ 8 g/dL
  • Total bilirubin ≤ 1.5 mg/dL
  • SGOT ≤ 2 times normal
  • PTT normal
  • Creatinine < 3 times normal for age or creatinine clearance > 80 mL/min
  • No active infection
  • No HIV positivity
  • Not pregnant or nursing
  • Fertile patients must use effective contraception during and for 3 months after completion of study treatment
  • No autoimmune disease, including any of the following:

    • Active graft-versus-host disease
    • Refractory immune thrombocytopenia
    • Refractory autoimmune hemolytic anemia

PRIOR CONCURRENT THERAPY:

  • Recovered from toxic effects of all prior chemotherapy
  • More than 4 weeks since prior investigational agents
  • No concurrent antibiotics (except prophylactic trimethoprim sulfamethoxazole)
  • No concurrent immunosuppressive drugs
  • No concurrent cytotoxic therapy
Both
 
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00609076
 
CDR0000582397, BCM-H-11541, BCM-CLIMAT
Baylor College of Medicine
 
Study Chair: Malcolm K. Brenner, MD, PhD Baylor College of Medicine
National Cancer Institute (NCI)
April 2008

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