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Vaccine Therapy With or Without Interleukin-2 in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer

This study has been completed.

Sponsors and Collaborators: NCI - Center for Cancer Research-Medical Oncology
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00019591
  Purpose

RATIONALE: Vaccines may make the body build an immune response that will kill cancer cells. Combining vaccine therapy with interleukin-2 may kill more cancer cells.

PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy with or without interleukin-2 in treating patients who have locally advanced or metastatic colorectal cancer.


Condition Intervention Phase
Colorectal Cancer
Drug: aldesleukin
Drug: ras peptide cancer vaccine
Procedure: adjuvant therapy
Phase I
Phase II

MedlinePlus related topics:   Cancer    Colorectal Cancer   

Drug Information available for:   Aldesleukin    Interleukin-2   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment
Official Title:   A Phase I/II Trial of Vaccination With Mutant Ras Peptide-Pulsed Dendritic Cells in the Treatment of HLA A2.1 Positive Patients With Colorectal Cancer

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

Primary Outcome Measures:
  • Response rate every 3 months for up to a year after completion of study treatment [ Designated as safety issue: No ]

Study Start Date:   March 1999

Detailed Description:

OBJECTIVES:

  • Determine the frequency of immunologic response in patients with locally advanced or metastatic colorectal cancer treated with ras peptide-pulsed dendritic cell vaccine with or without interleukin-2.
  • Determine the tumor response and survival time in patients with metastatic colorectal cancer treated with vaccine plus interleukin-2.
  • Determine the time to progression in patients with locally advanced colorectal cancer treated with adjuvant vaccine.

OUTLINE: Patients are assigned to 1 of 2 treatment groups according to extent of disease. Patients with prior locally advanced disease are assigned to treatment group A, while those with metastatic disease are assigned to treatment group B.

  • Group A: Patients are vaccinated against influenza on day -6. Patients undergo collection of peripheral blood mononuclear cells (PBMC) on day -4. The PBMC are cultured with sargramostim (GM-CSF) and interleukin-4 for 5 days and CD40 ligand for 24 hours and then pulsed for 2 hours with the appropriate peptide to form a vaccine. Patients receive ras peptide-pulsed dendritic cell vaccine IV over 5 minutes on days 1, 15, 29, 43, and 57.
  • Group B: Patients undergo collection of PBMC and receive vaccination as in group A. Patients also receive interleukin-2 subcutaneously on days 2-6 and 9-13.

Treatment in both groups repeats every 2 weeks for up to 5 vaccinations in the absence of disease progression or unacceptable toxicity.

Patients are followed on days 75, 90, 120, and 365.

PROJECTED ACCRUAL: A total of 500 patients will be accrued for this study within 3 years.

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

Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed locally advanced or metastatic colorectal cancer
  • Metastatic disease must be radiologically proven
  • HLA-A2-1 positive
  • Locally advanced disease must have had prior resection or incomplete resection with poor prognosis
  • Locally advanced disease includes:

    • Stage III or IV colon cancer (T4 or any T, N2-3, M0)
    • Stage III or IV rectal cancer (T4 or T3, N1-3)
    • Resectable or unresectable T4 disease after radiotherapy, chemotherapy, and/or surgery
    • Absence of measurable disease but more than a 50% chance of recurrence
  • Completely resected or locally advanced disease may have had conventional therapy completed within 1-12 months (surgery alone, with or without adjuvant chemotherapy and/or radiotherapy) prior to study entry
  • Metastatic disease patients must have bidimensionally measurable disease

    • Bone lesions with well-demarcated borders allowed
    • Lesions seen only on bone scan, pleural effusions, ascites, and changes in carcinoembryonic antigen are not considered measurable disease

PATIENT CHARACTERISTICS:

Age:

  • Over 18

Performance status:

  • ECOG 0-1

Life expectancy:

  • Not specified

Hematopoietic:

  • Lymphocyte count at least 470/mm^3
  • Granulocyte count at least 1,000/mm^3
  • Platelet count at least 100,000/mm^3

Hepatic:

  • Bilirubin no greater than 2.0 mg/dL*
  • SGOT no greater than 4 times upper limit of normal (ULN) (2.5 times ULN for adjuvant patients)*
  • Albumin at least 3 g/dL
  • No active viral hepatitis
  • No evidence of chronic infection due to hepatitis C
  • Hepatitis B surface antigen negative NOTE: *Unless due to metastatic disease

Renal:

  • Creatinine no greater than 2.0 mg/dL

Cardiovascular:

  • No history of cardiac failure, significant arrhythmias, or coronary artery disease (metastatic disease patients only)

Other:

  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • HIV negative
  • No prior malignancy with a 50% chance of recurrence within 5 years except nonmelanomatous skin cancer or carcinoma in situ of the cervix
  • No medical or psychiatric condition that would preclude compliance
  • No serious medical condition that would preclude apheresis
  • No serious infection
  • No uncontrolled thyroid disease (metastatic disease patients only)
  • Patients with an allergy to eggs are allowed but are not vaccinated against influenza during study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • No prior immunologic therapy directed at the cellular immune system

Chemotherapy:

  • See Disease Characteristics
  • Prior chemotherapy for metastatic disease allowed
  • At least 4 weeks since prior chemotherapy
  • No concurrent chemotherapy or anticipated need for chemotherapy for 2 months after vaccinations

Endocrine therapy:

  • At least 4 weeks since prior supraphysiologic steroid therapy

Radiotherapy:

  • See Disease Characteristics
  • Prior radiotherapy for metastatic disease allowed
  • No concurrent radiotherapy

Surgery:

  • See Disease Characteristics
  • Prior surgery for metastatic disease allowed
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00019591

Locations
United States, Maryland
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support    
      Bethesda, Maryland, United States, 20892-1182
United States, Tennessee
Vanderbilt-Ingram Cancer Center    
      Nashville, Tennessee, United States, 37232-6838

Sponsors and Collaborators
NCI - Center for Cancer Research-Medical Oncology
National Cancer Institute (NCI)

Investigators
Study Chair:     John E. Janik, MD     NCI - Metabolism Branch;MET    
  More Information


Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site
 

Study ID Numbers:   CDR0000066874, NCI-99-C-0023L, NCI-T98-0034
First Received:   July 11, 2001
Last Updated:   October 18, 2008
ClinicalTrials.gov Identifier:   NCT00019591
Health Authority:   United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
stage III colon cancer  
stage IV colon cancer  
stage III rectal cancer  
stage IV rectal cancer
recurrent colon cancer
recurrent rectal cancer

Study placed in the following topic categories:
Digestive System Neoplasms
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Recurrence
Intestinal Neoplasms
Digestive System Diseases
Aldesleukin
Interleukin-2
Gastrointestinal Neoplasms
Rectal cancer
Colorectal Neoplasms

Additional relevant MeSH terms:
Anti-Infective Agents
Neoplasms
Anti-HIV Agents
Neoplasms by Site
Anti-Retroviral Agents
Antineoplastic Agents
Therapeutic Uses
Antiviral Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on November 30, 2008




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