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Vaccine Plus Montanide ISA-51 and Sargramostim in Treating Patients With Stage IV Breast Cancer

This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), June 2007

Sponsors and Collaborators: University of Pennsylvania
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00079157
  Purpose

RATIONALE: Vaccines may make the body build an immune response to kill tumor cells. Giving a vaccine with Montanide ISA-51 and sargramostim may cause a stronger immune response and kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of vaccine therapy when given together with Montanide ISA-51 and sargramostim in treating patients with stage IV breast cancer.


Condition Intervention Phase
Breast Cancer
Drug: incomplete Freund's adjuvant
Drug: sargramostim
Drug: telomerase: 540-548 peptide vaccine
Phase I

Genetics Home Reference related topics:   breast cancer   

MedlinePlus related topics:   Breast Cancer    Cancer   

ChemIDplus related topics:   Sargramostim    Granulocyte-macrophage colony-stimulating factor    Freund's adjuvant    Montanide ISA 51   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment
Official Title:   Phase I Study Of Telomerase Peptide Vaccination For Patients With Advanced Breast Cancer

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

Estimated Enrollment:   28
Study Start Date:   February 2004
Estimated Primary Completion Date:   May 2008 (Final data collection date for primary outcome measure)

Detailed Description:

OBJECTIVES:

Primary

  • Determine the safety of telomerase: 540-548 peptide vaccine emulsified in Montanide ISA-51 and sargramostim (GM-CSF) in patients with HLA-A2-expressing stage IV breast cancer.

Secondary

  • Compare the generation of human telomerase reverse transcriptase (hTERT) peptide-specific vs cytomegalovirus peptide-specific cytotoxic T-lymphocyte (CTL) immunity in patients treated with this regimen.
  • Correlate the dose level of this regimen with the generation of hTERT-specific CTL immunity and the development of hTERT-specific autoimmunity in these patients.
  • Determine the tumor response in patients treated with this regimen.

OUTLINE: This is a dose-escalation study of the telomerase: 540-548 peptide and CMV 495 peptide portions of the vaccine.

Patients receive telomerase: 540-548 peptide and CMV 495 peptide (as an immunological control) vaccine emulsified in Montanide ISA-51 subcutaneously (SC) followed by sargramostim (GM-CSF) SC on day 1 of weeks 1, 3, 5, 7, 11, 15, 19, and 27 (for a total of 8 vaccinations). Treatment continues in the absence of disease progression or unacceptable toxicity.

Cohorts of 5-8 patients receive escalating doses of telomerase: 540-548 peptide and CMV 495 peptide until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 5 or 2 of 8 patients experience dose-limiting toxicity. A total of 12 patients receive treatment at the MTD.

Patients are followed within 30 days and then at 6 and 12 months.

PROJECTED ACCRUAL: A total of 5-28 patients will be accrued for this study.

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

Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of stage IV breast cancer
  • Failed at least 1 prior conventional therapy for metastatic disease
  • Measurable or evaluable disease by clinical, radiographic, or laboratory assessment

    • Measurable lesions must be at least 1 dimension

      • At least 20 mm by conventional techniques OR at least 10 mm by spiral CT scan
    • The following are not considered measurable:

      • Pleural effusion
      • Bone lesions
      • Tumor markers
  • HLA-A2-expressing disease by human leukocyte antigen typing
  • No CNS metastases by contrast CT scan and/or MRI

    • No brain metastases within the past 4 years
  • Hormone receptor status:

    • Not specified

PATIENT CHARACTERISTICS:

Age

  • 18 and over

Sex

  • Not specified

Menopausal status

  • Not specified

Performance status

  • ECOG 0-1

Life expectancy

  • More than 6 months

Hematopoietic

  • WBC ≥ 3,000/mm^3
  • Platelet count ≥ 75,000/mm^3
  • Hemoglobin ≥ 10 g/dL

Hepatic

  • Bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • ALT and AST ≤ 2.5 times ULN
  • Hepatitis B negative
  • Hepatitis C negative

Renal

  • Creatinine ≤ 1.5 times ULN

Immunologic

  • HIV negative
  • Human T-cell lymphotrophic virus-1 negative
  • No active infection
  • No major autoimmune disorder that would preclude study participation

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 6 months after study participation
  • No alcohol abuse or illicit drug use within the past 12 months
  • No clinically significant comorbid disease or other underlying condition that would preclude study participation
  • No significant psychiatric disorder that would preclude giving informed consent or complying with study

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior allogeneic or autologous bone marrow or stem cell transplantation
  • More than 30 days since prior hematopoietic growth factors
  • More than 30 days since initiation of prior immunotherapy (e.g., trastuzumab [Herceptin])
  • Concurrent immunotherapy (e.g., trastuzumab) allowed provided regimen was initiated more than 30 days before study entry, disease is stable or progressive, and patient plans to continue immunotherapy for the duration of study participation
  • No other concurrent hematopoietic growth factors

Chemotherapy

  • More than 30 days since prior chemotherapy
  • No concurrent chemotherapy

Endocrine therapy

  • More than 30 days since prior glucocorticoids
  • More than 30 days since initiation of prior hormonal therapy (e.g., tamoxifen, anastrozole, or letrozole)
  • Concurrent hormonal therapy (e.g., tamoxifen, anastrozole, or letrozole) allowed provided regimen was initiated more than 30 days before study entry, disease is stable or progressive, and patient plans to continue hormonal therapy for the duration of study participation
  • No concurrent glucocorticoids

Radiotherapy

  • More than 30 days since prior radiotherapy
  • No concurrent radiotherapy

Surgery

  • Not specified

Other

  • More than 14 days since prior anticoagulants (e.g., warfarin, heparin, or enoxaparin)

    • Low-dose anticoagulants to maintain IV catheter patency allowed
  • More than 30 days since prior immunosuppressive drugs
  • More than 30 days since prior experimental therapy
  • No concurrent immunosuppressive drugs
  • No other concurrent investigational products
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00079157

Locations
United States, Pennsylvania
Abramson Cancer Center of the University of Pennsylvania     Recruiting
      Philadelphia, Pennsylvania, United States, 19104-4283
      Contact: Clinical Trials Office - Abramson Cancer Center of the Univers     800-474-9892        

Sponsors and Collaborators
University of Pennsylvania
National Cancer Institute (NCI)

Investigators
Principal Investigator:     Susan Domchek, MD     University of Pennsylvania    
  More Information


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

Study ID Numbers:   CDR0000354502, UPCC-11102
First Received:   March 8, 2004
Last Updated:   July 23, 2008
ClinicalTrials.gov Identifier:   NCT00079157
Health Authority:   Unspecified

Keywords provided by National Cancer Institute (NCI):
recurrent breast cancer  
stage IV breast cancer  

Study placed in the following topic categories:
Skin Diseases
Breast Neoplasms
Freund's Adjuvant
Breast Diseases
Recurrence

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Immunologic Factors
Physiological Effects of Drugs
Adjuvants, Immunologic
Pharmacologic Actions

ClinicalTrials.gov processed this record on October 07, 2008




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