Primary Outcome Measures:
- Maximum tolerated dose of autologous Epstein-Barr virus (EBV)-specific cytotoxic T-lymphocytes (CTL) in combination with anti-CD45 monoclonal antibody [ Designated as safety issue: Yes ]
- Safety [ Designated as safety issue: Yes ]
- Changes in laboratory data at baseline, 2, 4, 6, and 8 weeks and at 3 months [ Designated as safety issue: No ]
- Extent and duration of immune depletion at pre-antibody infusion, pre-CTL infusion, 4 hours after infusion on days 3 and 4, and at 1, 2, 4, 6, and 8 weeks post-CTL infusion [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Immunologic function as measured by interferon-gamma, percentage of tetramer-positive cells in peripheral blood, and EBV-DNA in plasma [ Designated as safety issue: No ]
- Frequency of T-cells specific for CMV antigens (or for adenovirus in CMV-seronegative individuals) and EBV antigens at each time point of follow-up [ Designated as safety issue: No ]
- Correlation between endogenously reconstituted versus adoptively transferred T-cells [ Designated as safety issue: No ]
- Overall response rate [ Designated as safety issue: No ]
OBJECTIVES:
Primary
- To determine the safety of autologous Epstein-Barr virus (EBV)-specific cytotoxic T-lymphocytes (CTL) in combination with anti-CD45 monoclonal antibody (Mab) in patients with nasopharyngeal cancer.
- To obtain information on the expression, persistence, and anti-tumor effects of EBV-specific CTL lines given after lymphodepletion with anti-CD45 Mab in these patients.
- To obtain preliminary information on the safety and response to an extended dosage regimen of EBV-specific CTL in patients who have stable disease or a partial response after the initial dose of EBV-specific CTL.
OUTLINE: This is a dose-escalation study of autologous Epstein-Barr virus (EBV)-specific cytotoxic T-lymphocytes (CTL).
Patients undergo peripheral blood collection for the generation of EBV-specific CTL. Patients receive anti-CD45 monoclonal antibody (Mab) IV over 6-8 hours on days 1-4. Approximately 2-4 days later (when the anti-CD45 Mab level is < 100 μg/mL), patients receive 1 dose (dose is escalated in different patient cohorts) of EBV-specific CTL IV over 1-10 minutes. Patients achieving stable disease or partial response at 8-weeks or subsequent evaluations are eligible to receive up to 6 additional doses of EBV-specific CTL at 6-12 week interval.
Patients undergo blood sample collection periodically for immune function studies and plasma free CD45 antibody levels.
After completion of study treatment, patients are followed every 2 weeks for 8 weeks and then at 3, 6, 9, and 12 months.