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Vaccine Therapy in Treating Young Patients Who Are Undergoing Surgery for Malignant Glioma

Primary Purpose

Brain and Central Nervous System Tumors

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
therapeutic autologous dendritic cells
Sponsored by
Jonsson Comprehensive Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring childhood high-grade cerebral astrocytoma, recurrent childhood cerebral astrocytoma, childhood oligodendroglioma

Eligibility Criteria

1 Year - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Histologically confirmed* WHO grade III or IV malignant glioma of 1 of the following subtypes: Anaplastic astrocytoma Anaplastic oligodendroglioma Glioblastoma multiforme NOTE: *Must be confirmed after surgery Newly diagnosed OR recurrent disease Bidimensionally measurable disease by contrast-enhancing pre-operative MRI Surgically accessible tumor for which surgical resection is indicated at the time of initial pre-operative evaluation Must have undergone standard surgery* AND either radiotherapy* or chemoradiotherapy* Objective evidence of disease by contrast-enhanced brain MRI after completion of standard therapy NOTE: *Completed after study entry but before assignment to study treatment cohorts Age 1 to 18 Performance status Karnofsky 60-100% Hematopoietic Hemoglobin ≥ 10 g/dL Absolute granulocyte count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic SGPT and SGOT ≤ 2 times normal Alkaline phosphatase ≤ 2 times normal Bilirubin ≤ 1.5 mg/dL Hepatitis B and C negative Renal BUN ≤ 1.5 times normal OR Creatinine ≤ 1.5 times normal Immunologic HIV negative Syphilis negative At least 2 weeks since prior radiotherapy and recovered Negative pregnancy test Fertile patients must use effective contraception More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas) and recovered No chemotherapy during and for 4 weeks* after the final dose of study vaccine No corticosteroids for at least 10 days before leukapheresis No concurrent corticosteroids More than 72 hours since prior systemic antibiotics No antihistamines for 5 days before and for 5 days after administration of study vaccine Exclusion Criteria: history of immunodeficiency or autoimmune disease that may be exacerbated by immunotherapy, including any of the following: Rheumatoid arthritis Systemic lupus erythematosus Vasculitis Polymyositis Dermatomyositis Scleroderma Multiple sclerosis Juvenile-onset insulin-dependent diabetes active infection fever allergy to study reagents pregnant or nursing other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, localized prostate cancer, or carcinoma in situ of the cervix unstable or severe medical or psychiatric condition, as determined by the investigator underlying condition that would preclude study participation concurrent radiotherapy prior organ allograft concurrent strong painkillers other concurrent immune-suppressing medications other concurrent investigational agents other adjuvant treatment for 4 weeks* after the final dose of study vaccine NOTE: *Unless there is evidence of tumor progression necessitating additional clinically-indicated treatment; patients requiring treatment due to tumor progression are removed from the study

Sites / Locations

  • Jonsson Comprehensive Cancer Center at UCLA

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Vaccine

Arm Description

Outcomes

Primary Outcome Measures

Dose-limiting toxicity of adjuvant vaccination with autologous tumor lysate-pulsed dendritic cells after surgical resection in pediatric patients with malignant glioma.

Secondary Outcome Measures

survival
survival with this vaccine

Full Information

First Posted
April 5, 2005
Last Updated
August 3, 2020
Sponsor
Jonsson Comprehensive Cancer Center
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1. Study Identification

Unique Protocol Identification Number
NCT00107185
Brief Title
Vaccine Therapy in Treating Young Patients Who Are Undergoing Surgery for Malignant Glioma
Official Title
Phase I Dose Escalation Study of Autologous Tumor Lysate-Pulsed Dendritic Cell Immunotherapy for Malignant Gliomas in Pediatric Patients
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Completed
Study Start Date
January 2005 (undefined)
Primary Completion Date
October 2009 (Actual)
Study Completion Date
March 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jonsson Comprehensive Cancer Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Vaccines made from a person's white blood cells and tumor cells may help the body build an effective immune response to kill tumor cells. Giving vaccine therapy after surgery may be a more effective treatment for malignant glioma. PURPOSE: This phase I trial is studying the side effects and best dose of vaccine therapy in treating young patients who are undergoing surgery for malignant glioma.
Detailed Description
OBJECTIVES: Primary Determine the dose-limiting toxicity of adjuvant vaccination with autologous tumor lysate-pulsed dendritic cells after surgical resection in pediatric patients with malignant glioma. Determine the maximum tolerated dose of this vaccine in these patients. Secondary Determine, preliminarily, the survival of patients treated with this vaccine. Determine, preliminarily, the time to tumor progression in patients treated with this vaccine. Determine cellular immune response in patients treated with this vaccine. Determine age-dependent differences in response to this vaccine, in terms of immunocompetence, in these patients. OUTLINE: This is a dose-escalation study. Patients undergo surgical resection to obtain tumor tissue for production of tumor lysate. Patients then undergo leukapheresis to obtain peripheral blood mononuclear cells (PBMC) for generation of dendritic cells (DC). DC are pulsed with tumor lysate to produce an autologous dendritic cell vaccine. Approximately 10-30 days after leukapheresis, patients receive vaccination with autologous tumor lysate-pulsed dendritic cells intradermally on days 0, 14, and 28 in the absence of disease progression or unacceptable toxicity. Cohorts of 3-6 patients receive escalating doses of vaccine until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. After completion of study treatment, patients are followed at 2 weeks and then every 2 months for 1 year. PROJECTED ACCRUAL: A total of 3-18 patients will be accrued for this study within 2-4.5 years.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain and Central Nervous System Tumors
Keywords
childhood high-grade cerebral astrocytoma, recurrent childhood cerebral astrocytoma, childhood oligodendroglioma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Vaccine
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
therapeutic autologous dendritic cells
Primary Outcome Measure Information:
Title
Dose-limiting toxicity of adjuvant vaccination with autologous tumor lysate-pulsed dendritic cells after surgical resection in pediatric patients with malignant glioma.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
survival
Description
survival with this vaccine
Time Frame
1 year
Other Pre-specified Outcome Measures:
Title
time to progression
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Year
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically confirmed* WHO grade III or IV malignant glioma of 1 of the following subtypes: Anaplastic astrocytoma Anaplastic oligodendroglioma Glioblastoma multiforme NOTE: *Must be confirmed after surgery Newly diagnosed OR recurrent disease Bidimensionally measurable disease by contrast-enhancing pre-operative MRI Surgically accessible tumor for which surgical resection is indicated at the time of initial pre-operative evaluation Must have undergone standard surgery* AND either radiotherapy* or chemoradiotherapy* Objective evidence of disease by contrast-enhanced brain MRI after completion of standard therapy NOTE: *Completed after study entry but before assignment to study treatment cohorts Age 1 to 18 Performance status Karnofsky 60-100% Hematopoietic Hemoglobin ≥ 10 g/dL Absolute granulocyte count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic SGPT and SGOT ≤ 2 times normal Alkaline phosphatase ≤ 2 times normal Bilirubin ≤ 1.5 mg/dL Hepatitis B and C negative Renal BUN ≤ 1.5 times normal OR Creatinine ≤ 1.5 times normal Immunologic HIV negative Syphilis negative At least 2 weeks since prior radiotherapy and recovered Negative pregnancy test Fertile patients must use effective contraception More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas) and recovered No chemotherapy during and for 4 weeks* after the final dose of study vaccine No corticosteroids for at least 10 days before leukapheresis No concurrent corticosteroids More than 72 hours since prior systemic antibiotics No antihistamines for 5 days before and for 5 days after administration of study vaccine Exclusion Criteria: history of immunodeficiency or autoimmune disease that may be exacerbated by immunotherapy, including any of the following: Rheumatoid arthritis Systemic lupus erythematosus Vasculitis Polymyositis Dermatomyositis Scleroderma Multiple sclerosis Juvenile-onset insulin-dependent diabetes active infection fever allergy to study reagents pregnant or nursing other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer, localized prostate cancer, or carcinoma in situ of the cervix unstable or severe medical or psychiatric condition, as determined by the investigator underlying condition that would preclude study participation concurrent radiotherapy prior organ allograft concurrent strong painkillers other concurrent immune-suppressing medications other concurrent investigational agents other adjuvant treatment for 4 weeks* after the final dose of study vaccine NOTE: *Unless there is evidence of tumor progression necessitating additional clinically-indicated treatment; patients requiring treatment due to tumor progression are removed from the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph L. Lasky, MD
Organizational Affiliation
Jonsson Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Jonsson Comprehensive Cancer Center at UCLA
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-1781
Country
United States

12. IPD Sharing Statement

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Vaccine Therapy in Treating Young Patients Who Are Undergoing Surgery for Malignant Glioma

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