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p53 Vaccine for Ovarian Cancer

Primary Purpose

Ovarian Neoplasm

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
aldesleukin
incomplete Freund's adjuvant
p53 peptide vaccine
sargramostim
therapeutic autologous dendritic cells
in vitro-treated peripheral blood stem cell transplantation
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ovarian Neoplasm focused on measuring Immunotherapy, Cancer, Oncogenes, T-cells, Vaccine Therapy, p53 Peptide, Ovarian Cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

INCLUSION CRITERIA: Patients must be 18 years of age or older. Histologic diagnosis of adenocarcinoma of the ovary. Tumor tissue availability for determination of p53 protein expression and genetic mutation (paraffin block, or fresh tissue). Immunohistochemical analysis of the tumor must demonstrate positive p53 staining. Patients should have ovarian cancer with marker only disease or patients with stage III, IV or recurrent who are NED post therapy. ECOG performance status of 1 or 0. Expected survival of more than 3 months. The patients should not have received chemotherapy, radiation therapy, immunotherapy or systemic doses of steroids for at least 4 weeks prior to starting vaccination. And the patient should have recovered from all acute toxicities of previous treatment. Patients who received bone marrow transplantation within a year will not be eligible for the trial. Patients must understand and sign an informed consent document that explains the neoplastic nature of his/her disease, the procedures to be followed, the experimental nature of the treatment, alternative treatments, and potential risks and toxicities. Patients should have HLA-A2.1 haplotype. EXCLUSION CRITERIA: Any condition that does not fit with the eligibility criteria. Any of the following: Platelets less than 100K/mm(3) Creatinine greater than 2.0 mg/dl Serum Bilirubin greater than 2.0 mg/dl, SGOT, or SGPT greater than 4 times normal HIV or Hepatitis B or C (i.e. detectable HBS Antigen or HC Ab) since these conditions might have an effect on the immune system. Pregnant women or nursing mothers are ineligible since the effect of this investigational treatment on the health of the embryo is not known. Women with reproductive potential must have negative pregnancy test and must use adequate contraception. Patients with active ischemic heart disease (i.e. Class III or IV cardiac disease-New York Heart Association), a recent history of myocardial infarction (within the last 6 months), history of congestive heart failure, ventricular arrythmias or other arrythmias requiring therapy. Second malignancy (within the past 2 years) other than curatively treated carcinoma in-situ of cervix or basal cell carcinoma of the skin. These patients will be excluded for the possibility of the existence of a different mutation in the other primary malignancy. History of CNS metastases. Patients with underlying immune deficiency or history of autoimmune disease e.g. (autoimmune neutropenia, thrombocytopenia, or hemolytic anemia; systemic lupus erythematosus, Sjogren syndrome, or scleroderma; myasthenia gravis; Goodpasture syndrome; Addison's disease, Hashimoto's thyroiditis, active Graves' disease, or other diseases which qualify as autoimmune in origin). Patients with active infections requiring antibiotics. Patients requiring chronic suppressive antibiotics will be eligible for the trial. If, in the opinion of the principal or associate investigators, it is not in the best medical interest of the patient to enter this study, the patient will be ineligible.

Sites / Locations

  • National Institutes of Health Clinical Center, 9000 Rockville Pike

Outcomes

Primary Outcome Measures

Cellular immunity as measured by Elispot assay and 51 Cr-release assay at baseline and every 3 weeks.

Secondary Outcome Measures

Toxicity as measured by Common Toxicity Criteria v2.0 at baseline and every 3 weeks.

Full Information

First Posted
November 3, 1999
Last Updated
October 5, 2017
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00001827
Brief Title
p53 Vaccine for Ovarian Cancer
Official Title
Vaccine Therapy With Tumor Specific p53 Peptides in Adult Patients With Low Burden Adenocarcinoma of the Ovary
Study Type
Interventional

2. Study Status

Record Verification Date
January 25, 2013
Overall Recruitment Status
Terminated
Study Start Date
July 26, 1999 (undefined)
Primary Completion Date
December 17, 2007 (Actual)
Study Completion Date
January 25, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
This study will examine whether vaccination with a p53 peptide can boost an immune response to ovarian cancer and what the side effects are of the vaccine. Many patients with ovarian cancer have an altered (mutated) gene called p53 that causes the production of abnormal proteins found in their tumor cells. The body s immune system may try, unsuccessfully, to fight these abnormal proteins. In this study, ovarian cancer patients with a p53 abnormality will be vaccinated with a p53 peptide a part of the same abnormal protein found in their tumor to try to boost their body s immune response to the cancer. Patients will be divided into two groups. Group A will have four p53 peptide vaccinations three weeks apart, injected under the skin. The injection will include a drug called ISA-51, which increases the effect of the vaccine. This group will also receive two other drugs that boost the immune system, IL-2 and GM-CSF. Group B will have four p53 peptide vaccinations three weeks apart. The peptide will be mixed with the patient s own blood cells and infused into a vein. This group will also receive IL-2, but not GM-CSF. All study candidates will be tested to see if their cancer has a p53 abnormality and if their immune system mounted a defense against it. These tests may include a tumor biopsy (removal of a small part of the tumor for microscopic examination); lymphapheresis (a procedure to take blood, remove white blood cells called lymphocytes, and return the red cells); and an immune response test similar to a skin test for tuberculosis. During the study, patients will have additional skin tests and blood tests.
Detailed Description
P53 is the most commonly mutated gene in human cancers; it has been found to be mutated in almost 50% of ovarian cancers. Genetic mutation of p53 results in stabilization and increase in the level of the protein. In some cases, overexpression of p53 protein could also occur in tumors without detectable mutation in the open reading frame. Therefore, p53 could function as an antigen through two different mechanisms, as a mutant "foreign" protein and as a selfoverexpressed protein. The p53:264 - 272 wild type peptide has been shown to have high affinity for HLA-A2. It has also been shown to be naturally processed and endogenously presented by HLA-A2 in different types of tumor cell lines for CTL recognition. These CTL were able to lyse tumor cells overexpressing wild type or mutant p53 protein and failed to lyse normal cells expressing normal levels of wild type p53. In this protocol we will be vaccinating HLA-A2+ ovarian cancer patients who carry tumors which overexpress p53 with the wild type p53 peptide (264-272). This will be given either subcutaneously admixed with ISA-51 and GM-CSF adjuvants, or intravenously pulsed on dendritic cells along with low dose subcutaneous IL-2. In addition, those patients who express mutant p53 may also be vaccinated with a mutant p53 peptide, which corresponds to the mutation they harbor in their tumor, should the patients progress on the p53 (264-272) peptide.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ovarian Neoplasm
Keywords
Immunotherapy, Cancer, Oncogenes, T-cells, Vaccine Therapy, p53 Peptide, Ovarian Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Masking
None (Open Label)
Enrollment
21 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
aldesleukin
Intervention Type
Biological
Intervention Name(s)
incomplete Freund's adjuvant
Intervention Type
Biological
Intervention Name(s)
p53 peptide vaccine
Intervention Type
Biological
Intervention Name(s)
sargramostim
Intervention Type
Biological
Intervention Name(s)
therapeutic autologous dendritic cells
Intervention Type
Procedure
Intervention Name(s)
in vitro-treated peripheral blood stem cell transplantation
Primary Outcome Measure Information:
Title
Cellular immunity as measured by Elispot assay and 51 Cr-release assay at baseline and every 3 weeks.
Secondary Outcome Measure Information:
Title
Toxicity as measured by Common Toxicity Criteria v2.0 at baseline and every 3 weeks.

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: Patients must be 18 years of age or older. Histologic diagnosis of adenocarcinoma of the ovary. Tumor tissue availability for determination of p53 protein expression and genetic mutation (paraffin block, or fresh tissue). Immunohistochemical analysis of the tumor must demonstrate positive p53 staining. Patients should have ovarian cancer with marker only disease or patients with stage III, IV or recurrent who are NED post therapy. ECOG performance status of 1 or 0. Expected survival of more than 3 months. The patients should not have received chemotherapy, radiation therapy, immunotherapy or systemic doses of steroids for at least 4 weeks prior to starting vaccination. And the patient should have recovered from all acute toxicities of previous treatment. Patients who received bone marrow transplantation within a year will not be eligible for the trial. Patients must understand and sign an informed consent document that explains the neoplastic nature of his/her disease, the procedures to be followed, the experimental nature of the treatment, alternative treatments, and potential risks and toxicities. Patients should have HLA-A2.1 haplotype. EXCLUSION CRITERIA: Any condition that does not fit with the eligibility criteria. Any of the following: Platelets less than 100K/mm(3) Creatinine greater than 2.0 mg/dl Serum Bilirubin greater than 2.0 mg/dl, SGOT, or SGPT greater than 4 times normal HIV or Hepatitis B or C (i.e. detectable HBS Antigen or HC Ab) since these conditions might have an effect on the immune system. Pregnant women or nursing mothers are ineligible since the effect of this investigational treatment on the health of the embryo is not known. Women with reproductive potential must have negative pregnancy test and must use adequate contraception. Patients with active ischemic heart disease (i.e. Class III or IV cardiac disease-New York Heart Association), a recent history of myocardial infarction (within the last 6 months), history of congestive heart failure, ventricular arrythmias or other arrythmias requiring therapy. Second malignancy (within the past 2 years) other than curatively treated carcinoma in-situ of cervix or basal cell carcinoma of the skin. These patients will be excluded for the possibility of the existence of a different mutation in the other primary malignancy. History of CNS metastases. Patients with underlying immune deficiency or history of autoimmune disease e.g. (autoimmune neutropenia, thrombocytopenia, or hemolytic anemia; systemic lupus erythematosus, Sjogren syndrome, or scleroderma; myasthenia gravis; Goodpasture syndrome; Addison's disease, Hashimoto's thyroiditis, active Graves' disease, or other diseases which qualify as autoimmune in origin). Patients with active infections requiring antibiotics. Patients requiring chronic suppressive antibiotics will be eligible for the trial. If, in the opinion of the principal or associate investigators, it is not in the best medical interest of the patient to enter this study, the patient will be ineligible.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jay A Berzofsky, M.D.
Organizational Affiliation
National Cancer Institute (NCI)
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Institutes of Health Clinical Center, 9000 Rockville Pike
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
2789433
Citation
Takahashi H, Merli S, Putney SD, Houghten R, Moss B, Germain RN, Berzofsky JA. A single amino acid interchange yields reciprocal CTL specificities for HIV-1 gp160. Science. 1989 Oct 6;246(4926):118-21. doi: 10.1126/science.2789433.
Results Reference
background
PubMed Identifier
1979160
Citation
Chiba I, Takahashi T, Nau MM, D'Amico D, Curiel DT, Mitsudomi T, Buchhagen DL, Carbone D, Piantadosi S, Koga H, et al. Mutations in the p53 gene are frequent in primary, resected non-small cell lung cancer. Lung Cancer Study Group. Oncogene. 1990 Oct;5(10):1603-10.
Results Reference
background
PubMed Identifier
1311061
Citation
Mitsudomi T, Steinberg SM, Nau MM, Carbone D, D'Amico D, Bodner S, Oie HK, Linnoila RI, Mulshine JL, Minna JD, et al. p53 gene mutations in non-small-cell lung cancer cell lines and their correlation with the presence of ras mutations and clinical features. Oncogene. 1992 Jan;7(1):171-80.
Results Reference
background

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p53 Vaccine for Ovarian Cancer

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