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Vaccine Therapy, Tretinoin, and Cyclophosphamide in Treating Patients With Metastatic Lung Cancer
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), August 2008
First Received: January 19, 2008   Last Updated: February 6, 2009   History of Changes
Sponsor: H. Lee Moffitt Cancer Center and Research Institute
Collaborator: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00601796
  Purpose

RATIONALE: Vaccines made from tumor cells may help the body build an effective immune response to kill tumor cells. Biological therapies, such as tretinoin and cyclophosphamide, may change the immune system in different ways and help the vaccine work better at stop tumor cells from growing.

PURPOSE: This phase II trial is studying how well giving vaccine therapy together with tretinoin and cyclophosphamide works in treating patients with metastatic lung cancer.


Condition Intervention Phase
Lung Cancer
Biological: GM.CD40L cell vaccine
Biological: allogeneic tumor cell vaccine
Drug: cyclophosphamide
Drug: tretinoin
Genetic: protein expression analysis
Other: flow cytometry
Other: immunoenzyme technique
Other: immunohistochemistry staining method
Phase II

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Combination Immunotherapy for Lung Cancer

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Tumor response [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Time to progression [ Designated as safety issue: No ]
  • Survival [ Designated as safety issue: No ]

Estimated Enrollment: 48
Study Start Date: October 2006
Estimated Primary Completion Date: March 2008 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • To evaluate tumor response rate in patients with stage IV lung cancer receiving vaccine therapy comprising allogeneic tumor cells and GM.CD40L in combination with tretinoin and cyclophosphamide.

Secondary

  • To evaluate patients for the development of specific anti-tumor immune responses after immunization.
  • To quantitate the dendritic cell (DC):immature myeloid cell (ImC) ratio before and after treatment with tretinoin, vaccine therapy comprising allogeneic tumor cells and GM.CD40L, and cyclophosphamide.
  • To evaluate the survival of patients treated with this vaccine.

OUTLINE: Patients receive cyclophosphamide IV on days 1 and 57, vaccine (formulated by mixing allogeneic tumor cells and GM.CD40L) intradermally at 4 separate sites on days 4, 18, 32, 60, 88, and 116, and oral tretinoin three times daily on days 5-7 and days 61-63 in the absence of disease progression or unacceptable toxicity. Patients achieving stable disease, partial response, or complete response receive the vaccine every 3 months until disease progression.

Patients undergo blood collection periodically during treatment for immune response testing, including determination of dendritic cell (DC):immature myeloid cell (ImC) ratios by flow cytometry and ELISPOT analysis. Archived diagnostic biopsy tissue is analyzed for the expression of WT1, CEA, and hTERT by immunohistochemistry.

After completion of study treatment, patients are followed periodically.

  Eligibility

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed adenocarcinoma of the lung

    • Metastatic disease
  • Measurable metastatic tumor as defined by standard RECIST criteria

    • Lesions must be accurately measured in at least 1 dimension with the longest diameter ≥ 20 mm (≥ 10 mm in at least 1 dimension by spiral CT scan)
  • Completed first-line chemotherapy
  • No symptomatic brain metastases

PATIENT CHARACTERISTICS:

  • ECOG performance status 0-1
  • WBC > 3,000/mm³
  • ANC > 1,500/mm³
  • Platelets > 100,000/mm³
  • Hematocrit > 25%
  • Bilirubin < 2.0 mg/dL
  • Creatinine < 2.0 mg/dL OR creatinine clearance > 60 mL/min
  • No acute medical problems requiring active intervention
  • No other pre-existing immunodeficiency condition (including known HIV infection)
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • No radiotherapy within 2 weeks of first vaccine administration
  • No chemotherapy within 4 weeks of first vaccine administration
  • No steroid therapy within 4 weeks of first vaccine administration
  • No concurrent corticosteroids (other than replacement doses in patients who are hypoadrenal) or other immunosuppressive therapy
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00601796

Locations
United States, Florida
H. Lee Moffitt Cancer Center and Research Institute at University of South Florida Recruiting
Tampa, Florida, United States, 33612-9497
Contact: Clinical Trials Office - H. Lee Moffitt Cancer Center and Rese     800-456-7121     canceranswers@moffitt.org    
Sponsors and Collaborators
H. Lee Moffitt Cancer Center and Research Institute
Investigators
Principal Investigator: Alberto Chiappori, MD H. Lee Moffitt Cancer Center and Research Institute
  More Information

Additional Information:
No publications provided

Study ID Numbers: CDR0000581417, MCC-14744, MCC-104490, MCC-0534-NE, NIH-OBA-0608-801
Study First Received: January 19, 2008
Last Updated: February 6, 2009
ClinicalTrials.gov Identifier: NCT00601796     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
adenocarcinoma of the lung
stage IV non-small cell lung cancer

Additional relevant MeSH terms:
Thoracic Neoplasms
Respiratory Tract Neoplasms
Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Physiological Effects of Drugs
Cyclophosphamide
Immunosuppressive Agents
Pharmacologic Actions
Keratolytic Agents
Neoplasms
Neoplasms by Site
Respiratory Tract Diseases
Lung Neoplasms
Therapeutic Uses
Lung Diseases
Myeloablative Agonists
Tretinoin
Antineoplastic Agents, Alkylating
Antirheumatic Agents
Dermatologic Agents
Alkylating Agents

ClinicalTrials.gov processed this record on November 27, 2009