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Vaccine Therapy With or Without Interleukin-2 in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer

Primary Purpose

Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
aldesleukin
ras peptide cancer vaccine
adjuvant therapy
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring stage III colon cancer, stage IV colon cancer, stage III rectal cancer, stage IV rectal cancer, recurrent colon cancer, recurrent rectal cancer

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Histologically confirmed locally advanced or metastatic colorectal cancer Metastatic disease must be radiologically proven HLA-A2-1 positive Locally advanced disease must have had prior resection or incomplete resection with poor prognosis Locally advanced disease includes: Stage III or IV colon cancer (T4 or any T, N2-3, M0) Stage III or IV rectal cancer (T4 or T3, N1-3) Resectable or unresectable T4 disease after radiotherapy, chemotherapy, and/or surgery Absence of measurable disease but more than a 50% chance of recurrence Completely resected or locally advanced disease may have had conventional therapy completed within 1-12 months (surgery alone, with or without adjuvant chemotherapy and/or radiotherapy) prior to study entry Metastatic disease patients must have bidimensionally measurable disease Bone lesions with well-demarcated borders allowed Lesions seen only on bone scan, pleural effusions, ascites, and changes in carcinoembryonic antigen are not considered measurable disease PATIENT CHARACTERISTICS: Age: Over 18 Performance status: ECOG 0-1 Life expectancy: Not specified Hematopoietic: Lymphocyte count at least 470/mm^3 Granulocyte count at least 1,000/mm^3 Platelet count at least 100,000/mm^3 Hepatic: Bilirubin no greater than 2.0 mg/dL* SGOT no greater than 4 times upper limit of normal (ULN) (2.5 times ULN for adjuvant patients)* Albumin at least 3 g/dL No active viral hepatitis No evidence of chronic infection due to hepatitis C Hepatitis B surface antigen negative NOTE: *Unless due to metastatic disease Renal: Creatinine no greater than 2.0 mg/dL Cardiovascular: No history of cardiac failure, significant arrhythmias, or coronary artery disease (metastatic disease patients only) Other: Not pregnant or nursing Fertile patients must use effective contraception HIV negative No prior malignancy with a 50% chance of recurrence within 5 years except nonmelanomatous skin cancer or carcinoma in situ of the cervix No medical or psychiatric condition that would preclude compliance No serious medical condition that would preclude apheresis No serious infection No uncontrolled thyroid disease (metastatic disease patients only) Patients with an allergy to eggs are allowed but are not vaccinated against influenza during study PRIOR CONCURRENT THERAPY: Biologic therapy: No prior immunologic therapy directed at the cellular immune system Chemotherapy: See Disease Characteristics Prior chemotherapy for metastatic disease allowed At least 4 weeks since prior chemotherapy No concurrent chemotherapy or anticipated need for chemotherapy for 2 months after vaccinations Endocrine therapy: At least 4 weeks since prior supraphysiologic steroid therapy Radiotherapy: See Disease Characteristics Prior radiotherapy for metastatic disease allowed No concurrent radiotherapy Surgery: See Disease Characteristics Prior surgery for metastatic disease allowed

Sites / Locations

  • Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
  • Vanderbilt-Ingram Cancer Center

Outcomes

Primary Outcome Measures

Response rate every 3 months for up to a year after completion of study treatment

Secondary Outcome Measures

Full Information

First Posted
July 11, 2001
Last Updated
June 19, 2013
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00019591
Brief Title
Vaccine Therapy With or Without Interleukin-2 in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer
Official Title
A Phase I/II Trial of Vaccination With Mutant Ras Peptide-Pulsed Dendritic Cells in the Treatment of HLA A2.1 Positive Patients With Colorectal Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
November 2005
Overall Recruitment Status
Completed
Study Start Date
March 1999 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
November 2005 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Vaccines may make the body build an immune response that will kill cancer cells. Combining vaccine therapy with interleukin-2 may kill more cancer cells. PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy with or without interleukin-2 in treating patients who have locally advanced or metastatic colorectal cancer.
Detailed Description
OBJECTIVES: Determine the frequency of immunologic response in patients with locally advanced or metastatic colorectal cancer treated with ras peptide-pulsed dendritic cell vaccine with or without interleukin-2. Determine the tumor response and survival time in patients with metastatic colorectal cancer treated with vaccine plus interleukin-2. Determine the time to progression in patients with locally advanced colorectal cancer treated with adjuvant vaccine. OUTLINE: Patients are assigned to 1 of 2 treatment groups according to extent of disease. Patients with prior locally advanced disease are assigned to treatment group A, while those with metastatic disease are assigned to treatment group B. Group A: Patients are vaccinated against influenza on day -6. Patients undergo collection of peripheral blood mononuclear cells (PBMC) on day -4. The PBMC are cultured with sargramostim (GM-CSF) and interleukin-4 for 5 days and CD40 ligand for 24 hours and then pulsed for 2 hours with the appropriate peptide to form a vaccine. Patients receive ras peptide-pulsed dendritic cell vaccine IV over 5 minutes on days 1, 15, 29, 43, and 57. Group B: Patients undergo collection of PBMC and receive vaccination as in group A. Patients also receive interleukin-2 subcutaneously on days 2-6 and 9-13. Treatment in both groups repeats every 2 weeks for up to 5 vaccinations in the absence of disease progression or unacceptable toxicity. Patients are followed on days 75, 90, 120, and 365. PROJECTED ACCRUAL: A total of 500 patients will be accrued for this study within 3 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
stage III colon cancer, stage IV colon cancer, stage III rectal cancer, stage IV rectal cancer, recurrent colon cancer, recurrent rectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
aldesleukin
Intervention Type
Biological
Intervention Name(s)
ras peptide cancer vaccine
Intervention Type
Procedure
Intervention Name(s)
adjuvant therapy
Primary Outcome Measure Information:
Title
Response rate every 3 months for up to a year after completion of study treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed locally advanced or metastatic colorectal cancer Metastatic disease must be radiologically proven HLA-A2-1 positive Locally advanced disease must have had prior resection or incomplete resection with poor prognosis Locally advanced disease includes: Stage III or IV colon cancer (T4 or any T, N2-3, M0) Stage III or IV rectal cancer (T4 or T3, N1-3) Resectable or unresectable T4 disease after radiotherapy, chemotherapy, and/or surgery Absence of measurable disease but more than a 50% chance of recurrence Completely resected or locally advanced disease may have had conventional therapy completed within 1-12 months (surgery alone, with or without adjuvant chemotherapy and/or radiotherapy) prior to study entry Metastatic disease patients must have bidimensionally measurable disease Bone lesions with well-demarcated borders allowed Lesions seen only on bone scan, pleural effusions, ascites, and changes in carcinoembryonic antigen are not considered measurable disease PATIENT CHARACTERISTICS: Age: Over 18 Performance status: ECOG 0-1 Life expectancy: Not specified Hematopoietic: Lymphocyte count at least 470/mm^3 Granulocyte count at least 1,000/mm^3 Platelet count at least 100,000/mm^3 Hepatic: Bilirubin no greater than 2.0 mg/dL* SGOT no greater than 4 times upper limit of normal (ULN) (2.5 times ULN for adjuvant patients)* Albumin at least 3 g/dL No active viral hepatitis No evidence of chronic infection due to hepatitis C Hepatitis B surface antigen negative NOTE: *Unless due to metastatic disease Renal: Creatinine no greater than 2.0 mg/dL Cardiovascular: No history of cardiac failure, significant arrhythmias, or coronary artery disease (metastatic disease patients only) Other: Not pregnant or nursing Fertile patients must use effective contraception HIV negative No prior malignancy with a 50% chance of recurrence within 5 years except nonmelanomatous skin cancer or carcinoma in situ of the cervix No medical or psychiatric condition that would preclude compliance No serious medical condition that would preclude apheresis No serious infection No uncontrolled thyroid disease (metastatic disease patients only) Patients with an allergy to eggs are allowed but are not vaccinated against influenza during study PRIOR CONCURRENT THERAPY: Biologic therapy: No prior immunologic therapy directed at the cellular immune system Chemotherapy: See Disease Characteristics Prior chemotherapy for metastatic disease allowed At least 4 weeks since prior chemotherapy No concurrent chemotherapy or anticipated need for chemotherapy for 2 months after vaccinations Endocrine therapy: At least 4 weeks since prior supraphysiologic steroid therapy Radiotherapy: See Disease Characteristics Prior radiotherapy for metastatic disease allowed No concurrent radiotherapy Surgery: See Disease Characteristics Prior surgery for metastatic disease allowed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John E. Janik, MD
Organizational Affiliation
NCI - Metabolism Branch;MET
Official's Role
Study Chair
Facility Information:
Facility Name
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20892-1182
Country
United States
Facility Name
Vanderbilt-Ingram Cancer Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232-6838
Country
United States

12. IPD Sharing Statement

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Vaccine Therapy With or Without Interleukin-2 in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer

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