Phase 1 Trial of Ipilimumab and GVAX in Patients With Metastatic Castration-resistant Prostate Cancer

This study has been terminated.
(The study was terminated because Cell Genesys stopped all activities for GVAX.)
Sponsor:
Collaborators:
Cell Genesys
Medarex
Information provided by (Responsible Party):
A.J.M. van den Eertwegh, VU University Medical Center
ClinicalTrials.gov Identifier:
NCT01510288
First received: January 4, 2012
Last updated: January 10, 2012
Last verified: January 2012

January 4, 2012
January 10, 2012
November 2004
December 2007   (final data collection date for primary outcome measure)
Number of patients with adverse events [ Time Frame: 7 months ] [ Designated as safety issue: Yes ]
Same as current
Complete list of historical versions of study NCT01510288 on ClinicalTrials.gov Archive Site
  • number of patients that have a tumor/PSA response [ Time Frame: 7 months ] [ Designated as safety issue: No ]
  • number of patients that will develop a tumor-specific (e.g. PSMA, NY-ESO) antibody response as measured by ELISA [ Time Frame: 7 months ] [ Designated as safety issue: No ]
  • the number of patients that have activated T cells and dendritic cells as measured by FACS [ Time Frame: 7 months ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Phase 1 Trial of Ipilimumab and GVAX in Patients With Metastatic Castration-resistant Prostate Cancer
A Phase 1 Dose Escalation Trial of Ipilimumab in Combination With CG1940 and CG8711 in Patients With Metastatic Hormone-Refractory Prostate Cancer

Ipilimumab, an antibody that blocks cytotoxic T-lymphocyte antigen 4, and GVAX have demonstrated anti-tumor activity in prostate cancer. Pre-clinical studies with this combination have demonstrated potent synergy. The purpose of this study is to investigate, using a phase-I 3+3 dose escalation design followed by an expansion cohort, the safety and efficacy of combined treatment with GVAX and ipilimumab in castration-resistant metastatic prostate cancer (CRPC) patients.

A promising immunotherapeutic approach in prostate cancer is whole-cell vaccination. Irradiated allogeneic tumor cells expressing GM-CSF generate a long-lasting and specific anti-tumor immunity in preclinical models. Results from several phase I and II trials showed Prostate GVAX (GVAX) to be well tolerated and suggested improved survival. Cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) is a crucial immune checkpoint molecule that down-regulates T-cell activation and proliferation. Ipilimumab, a fully human monoclonal antibody (IgG1) that blocks CTLA-4, promotes antitumor immunity, and has been demonstrated in two phase III trials to improve overall survival in metastatic melanoma patients. Pre-clinical studies of the anti-CTLA-4 antibody in combination with GM-CSF secreting tumor cell vaccines demonstrated a potent synergy. In this phase I study the investigators examine in CRPC patients whether ipilimumab can be safely combined with GVAX. In addition, the investigators will treat an additional 16 patients at a dose level of 3•0 mg/kg to determine the safety profile and antitumor effects of GVAX and ipilimumab in patients with CRPC.

Interventional
Phase 1
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Prostate Cancer
Drug: GVAX and ipilimumab
All patients receive a 500 million cell priming dose of granulocyte-macrophage colony-stimulating factor-transduced allogeneic prostate cancer cells (GVAX) intradermally on day 1 followed by bi-weekly intradermal injections of 300 million cells for a 24 week period. The vaccinations are combined with monthly intravenous administrations of ipilimumab. The dose-escalation part of this study will be performed using the standard 3+3 phase-I trial design. Patients will be enrolled in cohorts of three; each cohort will receive an escalating dose of ipilimumab at 0•3, 1•0, 3•0 or 5•0 mg/kg. Sixteen patients will be treated in an expansion cohort with GVAX and 3•0 mg/kg ipilimumab.
Experimental: Ipilimumab and GVAX
Intervention: Drug: GVAX and ipilimumab
van den Eertwegh AJ, Versluis J, van den Berg HP, Santegoets SJ, van Moorselaar RJ, van der Sluis TM, Gall HE, Harding TC, Jooss K, Lowy I, Pinedo HM, Scheper RJ, Stam AG, von Blomberg BM, de Gruijl TD, Hege K, Sacks N, Gerritsen WR. Combined immunotherapy with granulocyte-macrophage colony-stimulating factor-transduced allogeneic prostate cancer cells and ipilimumab in patients with metastatic castration-resistant prostate cancer: a phase 1 dose-escalation trial. Lancet Oncol. 2012 May;13(5):509-17. doi: 10.1016/S1470-2045(12)70007-4. Epub 2012 Feb 10.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Terminated
28
November 2011
December 2007   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Males age 18-80 years
  • Histologic diagnosis of adenocarcinoma of the prostate
  • Metastatic prostate cancer deemed to be unresponsive or refractory to hormone therapy
  • Detectable metastases by bone scan, CT scan or MRI
  • Two consecutive rising PSA values obtained at least two weeks apart and both obtained at least 4-6 weeks after discontinuation of hormone therapy. Second PSA value must be > 5.0 ng/mL. LHRH agonist should not be discontinued.
  • Testosterone < 50 ng/dL. Must have had orchiectomy or is currently receiving an LHRH agonist.
  • WBC > 3.0 x 109/L, ANC > 1.5 x 109/L, hemoglobin > 6.2 mmol/L, and platelets > 100 x 109/L
  • Serum creatinine < 177 umol/L Bilirubin < 1.5 times the upper limit of normal AST < 3 times the upper limit of normal
  • ECOG performance status 0-2
  • Life expectancy of at least 6 months
  • If sexually active, willing to use barrier contraception during the treatment phase of the protocol
  • The ability to understand and willingness to sign a written informed consent

Exclusion Criteria:

  • Transitional cell, small cell, neuroendocrine, or squamous cell prostate cancer
  • Bone pain severe enough to require routine narcotic analgesia use
  • Clinical evidence of brain metastases or history of brain metastases
  • Seropositive for HIV, Hepatitis B antigen positive and/or Hepatitis C viremic
  • Prior chemotherapy or immunotherapy for prostate cancer
  • Radiation therapy within 4 weeks of the first treatment
  • Surgery within 4 weeks of the first treatment. Must have recovered from all side effects.
  • Flutamide within 4 weeks of the first treatment Megesterol acetate (Megace), finasteride (Proscar), bicalutamide (Casodex),nilutamide, aminoglutethimide, ketoconazole or diethylstilbestrol within 6 weeks of the first treatment.
  • Systemic corticosteroid use within 4 weeks of the first treatment
  • History of autoimmune disease
  • History of another malignancy, except for the following: adequately treated basal cell or squamous cell skin cancer, superficial bladder cancer, adequately treated Stage I or II cancer currently in complete remission or any other cancer that has been in complete remission for at least 5 years
Male
18 Years to 80 Years
No
Contact information is only displayed when the study is recruiting subjects
Netherlands
 
NCT01510288
G-0016
Yes
A.J.M. van den Eertwegh, VU University Medical Center
VU University Medical Center
  • Cell Genesys
  • Medarex
Principal Investigator: Winald Gerritsen, Prof. MD PhD VU University Medical Center
Principal Investigator: Fons van den Eertwegh, MD PhD VU University Medical Center
VU University Medical Center
January 2012

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