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Vaccine Therapy, Cyclophosphamide, and Cetuximab in Treating Patients With Metastatic or Locally Advanced Pancreatic Cancer

Primary Purpose

Pancreatic Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Cetuximab
Pancreatic tumor vaccine
Cyclophosphamide
Sponsored by
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring stage III pancreatic cancer, recurrent pancreatic cancer, duct cell adenocarcinoma of the pancreas, adenocarcinoma of the pancreas, stage IV pancreatic cancer

Eligibility Criteria

18 Years - 120 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

DISEASE CHARACTERISTICS: Histologically confirmed ductal adenocarcinoma of the pancreas Mixed adenocarcinoma tumors eligible provided the predominant invasive component of the tumor is adenocarcinoma The following histologic diagnoses are not eligible: Adenosquamous Squamous cell Colloid Islet cell Serous or mucinous cystadenoma or cystadenocarcinoma Carcinoid Small or large cell carcinoma Intraductal oncocytic papillary neoplasms Osteoclast-like giant cell tumors Acinar cell carcinoma Pancreatoblastoma Solid pseudopapillary tumors Undifferentiated small cell carcinoma Nonepithelial tumors (sarcoma, gastrointestinal stromal tumor, lymphoma) Adenocarcinomas of the ampulla, distal bile duct, or duodenum Metastatic or locally advanced disease that is refractory to standard therapy OR for which patient refused standard therapy Measurable disease defined as ≥ 1 lesion unidimensionally measured as ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral CT scan No nonmeasurable disease only including, but not limited to, the following: Bone lesions Leptomeningeal disease Ascites Pleural or pericardial effusion Inflammatory breast disease Lymphangitis cutis/pulmonis Abdominal masses that are not confirmed and followed by imaging techniques Cystic lesions No known active or untreated brain metastases PATIENT CHARACTERISTICS: ECOG performance status 0-1 WBC ≥ 3,500/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Hemoglobin ≥ 9 g/dL Platelet count ≥ 90,000/mm^3 Creatinine ≤ 2.0 mg/dL Bilirubin ≤ 2 mg/dL ALT and AST ≤ 5 times upper limit of normal (ULN) Alkaline phosphatase ≤ 5 times ULN No active infection No uncontrolled medical condition that would potentially increase the risk of toxicities or complications of study therapy No gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation No active peptic ulcer disease Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 4 weeks after completion of study treatment No other malignancy within the past 5 years except for nonmelanomatous skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix HIV negative No active autoimmune disease or prior autoimmune disease requiring medical treatment with systemic immunosuppressants including any of the following: Inflammatory bowel disease Systemic vasculitis Scleroderma Psoriasis Multiple sclerosis Hemolytic anemia or immune thrombocytopenia Rheumatoid arthritis Systemic lupus erythematosus Sjögren's syndrome Sarcoidosis Asthma or chronic obstructive pulmonary disease that does not require systemic corticosteroids or routine use of inhaled steroids allowed No known or suspected hypersensitivity to sargramostim (GM-CSF), cyclophosphamide, pentastarch, corn, or DMSO No prior severe infusion reaction (> grade 3) to a monoclonal antibody PRIOR CONCURRENT THERAPY: See Disease Characteristics More than 1 month since prior adjuvant chemotherapy More than 4 weeks since prior surgery except for minor procedures (e.g., dental work, skin biopsy) and biliary stent placement No prior surgical procedures affecting absorption More than 4 weeks since prior radiotherapy More than 1 month since prior participation in an investigational new drug study No unresolved chronic toxicity (except alopecia) from prior anticancer therapy More than 28 days since prior systemic steroids No concurrent systemic steroids or immunosuppressive drugs Topical, inhaled, and intra-articular steroids allowed No other concurrent anticancer vaccine therapy No other concurrent chemotherapy, immunotherapy, radiotherapy, gene therapy, biologic therapy, or investigational therapy

Sites / Locations

  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cyclophosphamide, Pancreatic Tumor Vaccine, Cetuximab

Arm Description

Outcomes

Primary Outcome Measures

Safety of Combining the Pancreatic Tumor Vaccine in Sequence With Cyclophosphamide and Erbitux. Safety is Defined as the Number of Treatment-related Grade 3 or 4 Adverse Events Observed in Greater Than 5% of the Patient Population

Secondary Outcome Measures

Full Information

First Posted
March 21, 2006
Last Updated
February 10, 2020
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00305760
Brief Title
Vaccine Therapy, Cyclophosphamide, and Cetuximab in Treating Patients With Metastatic or Locally Advanced Pancreatic Cancer
Official Title
A Safety and Efficacy Trial of Lethally Irradiated Allogeneic Pancreatic Tumor Cells Transfected With the GM-CSF Gene in Combination With Erbitux (Cetuximab) for the Treatment of Advanced Pancreatic Adenocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
December 2005 (Actual)
Primary Completion Date
March 2009 (Actual)
Study Completion Date
March 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
RATIONALE: Vaccines made from gene-modified tumor cells may help the body build an immune response to kill tumor cells. Drugs used in chemotherapy, such as cyclophosphamide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as cetuximab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Cetuximab may also stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving vaccine therapy together with cyclophosphamide and cetuximab may kill more tumor cells. PURPOSE: This phase II trial is studying how well vaccine therapy works when given together with cyclophosphamide and cetuximab in treating patients with metastatic or locally advanced pancreatic cancer.
Detailed Description
OBJECTIVES: Primary Determine the safety of pancreatic tumor vaccine, cyclophosphamide, and cetuximab in patients with metastatic or locally advanced adenocarcinoma of the pancreas. Secondary Determine the overall, progression-free, and event-free survival of patients treated with this regimen. Correlate specific in vivo parameters of immune response (e.g., mesothelin, prostate stem cell antigen [PSCA], mutated k-ras-specific T-cell responses) with clinical response in patients treated with this regimen. Correlate downstream targets of epidermal growth factor receptor (EGFR) signaling (e.g., intratumor expression of Akt, Stat 3 and 5, mesothelin, mutated k-ras, and PSCA) with inhibition by cetuximab in patients treated with this regimen. Correlate inhibition of EGFR signaling (e.g., Stat 3 and 5) with improved specific mesothelin, PSCA, and mutated k-ras-specific T-cell responses in patients treated with this regimen. OUTLINE: This is an open-label study. Patients receive cyclophosphamide IV on day 0, sargramostim plasmid DNA pancreatic tumor vaccine intradermally on day 1, and cetuximab IV over 1-2 hours on days 1, 8, and 15. Treatment repeats every 21 days for up to 6 courses in the absence of disease progression or unacceptable toxicity. Patients undergo blood collection and tumor biopsies periodically during study for biomarker correlative studies. At the completion of study treatment, patients are followed at 3 weeks and then every 4 weeks for 16 weeks. PROJECTED ACCRUAL: A total of 60 patients will be accrued for this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer
Keywords
stage III pancreatic cancer, recurrent pancreatic cancer, duct cell adenocarcinoma of the pancreas, adenocarcinoma of the pancreas, stage IV pancreatic cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cyclophosphamide, Pancreatic Tumor Vaccine, Cetuximab
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Cetuximab
Other Intervention Name(s)
Erbitux
Intervention Description
Cetuximab will be administered at an initial dose of 400 mg/m2, followed by weekly doses of 250 mg/m2 for a total of 6 cycles that last 3 weeks each.
Intervention Type
Biological
Intervention Name(s)
Pancreatic tumor vaccine
Other Intervention Name(s)
PANC 10.05 pcDNA-1/GM-Neo and PANC 6.03 pcDNA-1/GM-Neo vaccine, GVAX
Intervention Description
Vaccine will be administered one day after cyclophosphamide (day 1) every three weeks for 6 cycles.
Intervention Type
Drug
Intervention Name(s)
Cyclophosphamide
Other Intervention Name(s)
Cytoxan
Intervention Description
Cyclophosphamide 250 mg/m2 will be administered one day prior to vaccination (day 0) every three weeks for 6 cycles.
Primary Outcome Measure Information:
Title
Safety of Combining the Pancreatic Tumor Vaccine in Sequence With Cyclophosphamide and Erbitux. Safety is Defined as the Number of Treatment-related Grade 3 or 4 Adverse Events Observed in Greater Than 5% of the Patient Population
Time Frame
7 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
120 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed ductal adenocarcinoma of the pancreas Mixed adenocarcinoma tumors eligible provided the predominant invasive component of the tumor is adenocarcinoma The following histologic diagnoses are not eligible: Adenosquamous Squamous cell Colloid Islet cell Serous or mucinous cystadenoma or cystadenocarcinoma Carcinoid Small or large cell carcinoma Intraductal oncocytic papillary neoplasms Osteoclast-like giant cell tumors Acinar cell carcinoma Pancreatoblastoma Solid pseudopapillary tumors Undifferentiated small cell carcinoma Nonepithelial tumors (sarcoma, gastrointestinal stromal tumor, lymphoma) Adenocarcinomas of the ampulla, distal bile duct, or duodenum Metastatic or locally advanced disease that is refractory to standard therapy OR for which patient refused standard therapy Measurable disease defined as ≥ 1 lesion unidimensionally measured as ≥ 20 mm by conventional techniques or ≥ 10 mm by spiral CT scan No nonmeasurable disease only including, but not limited to, the following: Bone lesions Leptomeningeal disease Ascites Pleural or pericardial effusion Inflammatory breast disease Lymphangitis cutis/pulmonis Abdominal masses that are not confirmed and followed by imaging techniques Cystic lesions No known active or untreated brain metastases PATIENT CHARACTERISTICS: ECOG performance status 0-1 WBC ≥ 3,500/mm^3 Absolute neutrophil count ≥ 1,500/mm^3 Hemoglobin ≥ 9 g/dL Platelet count ≥ 90,000/mm^3 Creatinine ≤ 2.0 mg/dL Bilirubin ≤ 2 mg/dL ALT and AST ≤ 5 times upper limit of normal (ULN) Alkaline phosphatase ≤ 5 times ULN No active infection No uncontrolled medical condition that would potentially increase the risk of toxicities or complications of study therapy No gastrointestinal tract disease resulting in an inability to take oral medication or a requirement for IV alimentation No active peptic ulcer disease Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception during and for 4 weeks after completion of study treatment No other malignancy within the past 5 years except for nonmelanomatous skin cancer, superficial bladder cancer, or carcinoma in situ of the cervix HIV negative No active autoimmune disease or prior autoimmune disease requiring medical treatment with systemic immunosuppressants including any of the following: Inflammatory bowel disease Systemic vasculitis Scleroderma Psoriasis Multiple sclerosis Hemolytic anemia or immune thrombocytopenia Rheumatoid arthritis Systemic lupus erythematosus Sjögren's syndrome Sarcoidosis Asthma or chronic obstructive pulmonary disease that does not require systemic corticosteroids or routine use of inhaled steroids allowed No known or suspected hypersensitivity to sargramostim (GM-CSF), cyclophosphamide, pentastarch, corn, or DMSO No prior severe infusion reaction (> grade 3) to a monoclonal antibody PRIOR CONCURRENT THERAPY: See Disease Characteristics More than 1 month since prior adjuvant chemotherapy More than 4 weeks since prior surgery except for minor procedures (e.g., dental work, skin biopsy) and biliary stent placement No prior surgical procedures affecting absorption More than 4 weeks since prior radiotherapy More than 1 month since prior participation in an investigational new drug study No unresolved chronic toxicity (except alopecia) from prior anticancer therapy More than 28 days since prior systemic steroids No concurrent systemic steroids or immunosuppressive drugs Topical, inhaled, and intra-articular steroids allowed No other concurrent anticancer vaccine therapy No other concurrent chemotherapy, immunotherapy, radiotherapy, gene therapy, biologic therapy, or investigational therapy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel A. Laheru, MD
Organizational Affiliation
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21231-2410
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Vaccine Therapy, Cyclophosphamide, and Cetuximab in Treating Patients With Metastatic or Locally Advanced Pancreatic Cancer

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