Autologous Dendritic Cells Pulsed With Autologous Apoptotic Tumor Cells Administered to Patients With Brain Tumors

Inclusion Criteria:

Screening to determine eligibility (with the exception of HLA haplotyping) will be completed within 45 days fo study entry.

1. Disease Characteristics

   Histologically confirmed brain cancers, reviewed at MSKCC. Pathologic examination will be of surgical resection specimens deemed of suitable quality for definitive diagnosis by the histopathologist.

   Primary Brain Tumors:

   • Anaplastic astrocytoma
   • Glioblastoma multiforme
   • Anaplastic oligodendroglioma
   • Malignant mixed oligoastrocytoma

   Secondary (metastatic) brain tumors - newly diagnosed or recurrent disease

   • All histological grade of disease accepted

   Surgically accessible tumor for which resection is indicated. Tumors may be from initial resections or re-resections. Recovery of a minimum of 1x10^7 tumor cells ex vivo is required.

   Patients with primary brain tumors must have been previously treated with conventional therapy.

2. Prior/Concurrent Therapy

   1. Recovered from toxicity of any prior therapy

   2. Biologic Therapy

      • No concurrent other immunotherapy and no prior immunotherapy with any of the components of the current regimen (autologous DCs, cancer cells, or KLH)

   3. Chemotherapy:

      • No concurrent immunomodulatory or chemotherapy therapy
      • Chemotherapy, including temozolomide and local chemotherapies such as Gliadel Wafers, must be deferred until after last post-vaccine leukapheresis

   4. Endocrine evaluation/therapy:

      • steroid dose no greater than 1mg daily dexamethasone (or equivalent)

   5. Radiotherapy:

      • No concurrent brain radiation

   6. Surgery:

      • Surgical resection must have been completed independently of this study, and suitable samples obtained for vaccine production

3. Patient Characteristics

   1. Age: 18 and over, able to give written informed consent. May be obtained through use of legal representation such as a health care proxy
   2. Performance status: Karnofsky 60-100%
   3. Life expectancy: at least 4-6 months

   4. Hematopoietic:

      • WBC greater than 3,800
      • Absolute lymphocytes greater than 500
      • Absolute neutrophil counter great than 1,500/mm^3
      • Platelets greater than 100,000/mm^3
      • Hb greater than or equal to 10g/dL
   5. Hepatic: bilirubin less than 2mg/dL OR SGOT less than 2x ULN
   6. Renal: Creatinine no greater than 2mg/dL

   7. Cardiovascular:

      • No NYHA class III/IV status
      • No active angina, uncontrolled clinically significant cardiac arrythmia, recent (6 months) myocardial infarction
   8. Pulmonary: No symptomatic pulmonary disease or pulse oximetry less than 93% on room air
   9. Endocrine: No history of autoimmune thyroid disease
   10. Radiographic: baseline contrast-enhanced MRI or CT scan of brain post surgical resection
   11. Coagulation: No unexplained INR >2

Exclusion criteria:

• No active infection requiring antibiotics
• No history of HIV, hepatitis B or hepatitis C virus infection, no history of high risk behavior for such infection (intravenous drug abuse, men having unprotected sex with men). Laboratory evaluation for HIV, hepatitis B, hepatitis C to be obtained prior to study entry
• No history of hypersensitivity to vaccine components
• No history of autoimmune or vasculitic disease (including but not limited to systemic lupus erythematosis, Hashimoto's thyroiditis, rheumatoid arthritis, systemic necrotizing vasculitides (polyarteritis nodosa group), hypersensitivity vasculitis, Wegener's granulomatosis), scleroderma, multiple sclerosis, juvenile-onset insulin-dependent diabetes
• No medical or psychiatric illness or social condition that, in the opinion of the investigator, would interfere with adherence to study requirements
• No alcohol or drug use or dependence that, in the opinion of the investigator, would interfere with adherence to study requirements