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Vaccination With Dendritic Cell/Tumor Fusions With Autologous Stem Cell Transplants in Patients With Multiple Myeloma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT00458653
Recruitment Status : Completed
First Posted : April 11, 2007
Last Update Posted : July 8, 2020
Sponsor:
Collaborators:
Massachusetts General Hospital
Dana-Farber Cancer Institute
Brigham and Women's Hospital
Rambam Health Care Campus
Information provided by (Responsible Party):
David Avigan, MD, Beth Israel Deaconess Medical Center

Study Description
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Brief Summary:
The main purpose of this study is to test the safety and determine the type and severity of any side effects of the Dendritic Cell Fusion Vaccine given in combination with an autologous transplant for patients with multiple myeloma. Autologous stem cell transplantation is a standard therapy for multiple myeloma that is often successful in significantly decreasing the amount of cancer. However, it is not a cure because at some point the multiple myeloma generally begins to grow again. Cancer vaccines are investigational agents that try to stimulate the immune system to recognize and fight against cancer cells. One type of cancer vaccine uses an immune stimulating cell of the body known as a dendritic cell. Research has shown that these dendritic cells can stimulate an immune response against the tumor.

Condition or disease Intervention/treatment Phase
Multiple Myeloma Biological: Dendritic Cell Tumor Fusion Phase 1

Detailed Description:
  • The first group of participants on this study will receive up to 3 monthly doses of the study vaccine beginning about 1 month following the autologous transplant. If this is found to be safe, the next group will receive one additional study vaccine prior to the transplant and then up to 3 doses after the transplant.
  • If the screening tests determine that the participant is eligible for the study, they will undergo dendritic cell collection by a procedure called leukapheresis. Leukapheresis involves the collection of white blood cells from the blood. Dendritic cells are grown from these white blood cells in the laboratory. Tumor cells will also be collected from the bone marrow through a bone marrow aspirate/biopsy.
  • After cells have been collected for study vaccine generation, the participant may receive standard therapy to reduce the number of multiple myeloma cells in the body. The specific regimen will be determined by the participants multiple myeloma physician.
  • The first group of patients will receive the study vaccine only after the transplant. If this is found safe then the second group will receive a single study vaccine prior to the transplant.
  • Prior to the autologous stem cell transplant, we will harvest stem cells from the participants blood that will be used for the transplant later. G-CSF will be given as a daily injection beginning the day after the chemotherapy and GM-CSF injections will be started seven days after the chemotherapy. These injections will continue until after the stem cells are collected. Approximately 10 days after the chemotherapy, participants will undergo a leukapheresis procedure to collect the stem cells.
  • Within a few weeks of successful stem cell collection, the participant will be admitted to the hospital for high dose chemotherapy with autologous stem cell transplantation.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 45 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Vaccination With Dendritic Cell/Tumor Fusions in Conjunction With Autologous Stem Cell Transplant in Patients With Multiple Myeloma
Study Start Date : April 2005
Actual Primary Completion Date : April 2012
Actual Study Completion Date : July 2020

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Group A
Post-transplant vaccination
 Biological: Dendritic Cell Tumor Fusion

Post-Transplant (Groups A and B): Given under the skin every four weeks for three doses.

Pre-Transplant (Group B): Injected under the skin in upper part of leg or arm prior to stem cell collection for ASCT
Experimental: Group B
Pre- and post-transplant vaccination
 Biological: Dendritic Cell Tumor Fusion

Post-Transplant (Groups A and B): Given under the skin every four weeks for three doses.

Pre-Transplant (Group B): Injected under the skin in upper part of leg or arm prior to stem cell collection for ASCT


Outcome Measures
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Primary Outcome Measures :
  1. To assess the toxicity associated with vaccination of multiple myeloma patients with dendritic cell/myeloma fusions and GM-CSF prior to stem cell mobilization and following high dose chemotherapy with stem cell rescue. [ Time Frame: 5 years ]

Secondary Outcome Measures :
  1. To determine whether tumor specific cellular and humoral immunity can be induced by serial vaccination with DC/tumor cell fusions in conjunction with high dose chemotherapy with stem cell rescue [ Time Frame: 5 years ]
  2. To determine if vaccination with DC/tumor cell fusions results in clinical disease response in patients with evidence of residual disease post-transplant [ Time Frame: 5 years ]
  3. To determine the time to disease progression in this participant population.

Eligibility Criteria
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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with multiple myeloma who are potential candidates for high dose chemotherapy
  • Measurable disease as defined by a history of an elevated M component in plasma, urine, or free kappa/lambda light chains in the serum
  • 18 years of age or older
  • ECOG Performance Status of 0-1 with greater than a nine week life expectancy
  • Patients with > 20% bone marrow involvement or plasmacytoma amenable to resection under local anesthesia
  • Negative pregnancy test, and adequate contraception method
  • DLCO (adjusted)> 50%
  • Cardiac Ejection Fraction > 45%
  • Laboratory values within the ranges outlined in the protocol

Exclusion Criteria:

  • History of clinically significant venous thromboembolism
  • Clinically significant autoimmune disease
  • HIV positive
  • Serious intercurrent illness such as infection requiring IV antibiotics, or significant cardiac disease characterized by significant arrhythmia, ischemic coronary disease or congestive heart failure
  • Pregnant or lactating women
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00458653


Locations
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United States, Massachusetts
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02114
Dana-Farber Cancer Institute/Brigham & Women's Hospital
Boston, Massachusetts, United States, 02115
Massachusetts General Hospital
Boston, Massachusetts, United States, 02215
Israel
Rambam Medical Center
Haifa, Israel, 31096
Sponsors and Collaborators
Beth Israel Deaconess Medical Center
Massachusetts General Hospital
Dana-Farber Cancer Institute
Brigham and Women's Hospital
Rambam Health Care Campus
Investigators
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Principal Investigator: David Avigan, MD Beth Israel Deaconess Medical Center
More Information
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Responsible Party: David Avigan, MD, Principal Investigator, Beth Israel Deaconess Medical Center
ClinicalTrials.gov Identifier: NCT00458653    
Other Study ID Numbers: 04-098
First Posted: April 11, 2007    Key Record Dates
Last Update Posted: July 8, 2020
Last Verified: July 2020
Keywords provided by David Avigan, MD, Beth Israel Deaconess Medical Center:
DC/tumor cell fusions
GM-CSF
high dose chemotherapy
Additional relevant MeSH terms:
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Multiple Myeloma
Neoplasms, Plasma Cell
Neoplasms by Histologic Type
Neoplasms
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
 Paraproteinemias
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Lymphoproliferative Disorders
Immunoproliferative Disorders
Immune System Diseases