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Experimental Therapeutic Cancer Vaccine Created In-situ in Patients With Stage II-Stage IV Cancer

Primary Purpose

Solid Tumors Stage II, Stage III and Stage IV, Breast Cancer, Colorectal Cancer

Status
Completed
Phase
Phase 1
Locations
Israel
Study Type
Interventional
Intervention
AlloStim
Cryoablation
AlloStim
AlloStim
AlloStim
AlloStim
AlloStim
Sponsored by
Michael Har-Noy
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Solid Tumors Stage II, Stage III and Stage IV focused on measuring breast cancer, colorectal cancer, prostate cancer, melanoma, ovarian cancer, GI cancer, Sarcoma, Renal Cell Carcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • 18 years or older
  • Stage II-IV including breast cancer, colorectal cancer, non-small cell lung cancer, ovarian or other gynecological cancer, prostate cancer, pancreatic or other GI cancer, melanoma, head or neck cancer or lymphoma/plasmacytoma.
  • Measurable disease determined upon review of abdominal and/or chest CT scan within 60 days of evaluation for study inclusion with a target tumor lesion for cryoablation or alcohol ablation located in liver, kidney, bone, lung, adrenal, pancreas, lymph node, skin, neck or prostate deemed to be accessible for percutaneous access or carcinomatosis or malignant ascites or malignant pleural effusion.
  • When applicable, acceptable cryoablation procedure technique risk: the target tumor for ablation must have adequate distance from adjacent vasculature and other organs to permit safe application of cryoprobe (generally, more than a 2.5cm clearance of the cryoprobe from any vital structure such as the bowel, inferior vena cava, or aorta). The safety assessment of the cryoprobe placement will be made an attending radiologist based on imaging studies.
  • Life expectancy >90 days
  • No bevacizumab (Avastin®) within 6 weeks of planned cryoablation procedure
  • ECOG status 0-2
  • No concurrent medication known to interfere with platelet function or coagulation (e.g., aspirin, ibuprofen, clopidogrel, or warfarin) unless such medications can be discontinued for an appropriate time period based on the drug half-life and known activity (e.g., aspirin for 7 days) prior to cryoablation procedure
  • No low molecular weight heparin preparations unless can be discontinued 8 hours prior to cryoablation
  • At least 2 weeks since prior cytotoxic chemotherapy
  • Absolute granulocyte count ≥ 1,200/mm3
  • Platelet count ≥ 100,000/mm3
  • PT/INR ≤ 1.5

    o INR correctable to ≤ 1.5 or a PT/PTT correctable to normal limits. Patients receiving anti-coagulation treatment with an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be monitored weekly prior to the cryoablation day to assure INR is stable. However, heparin or warfarin must be withheld prior to cryoablation such that the above criteria are met.

  • Hemoglobin ≥ 9 g/dL
  • Creatinine ≤ 1.5 mg/dL
  • Total bilirubin ≤ 1.5 times normal
  • Alkaline phosphatase ≤ 2.5 times normal (≤ 5 times normal if liver involvement)
  • Aspartate aminotransferase (AST) or (SGOT) ≤ 2.5 times ULN
  • Alanine aminotransferase (ALT) or (SGPT) ≤ 2.5 times ULN
  • Not pregnant or lactating
  • Patients with child bearing potential must agree to use adequate contraception
  • No psychiatric or addictive disorders or other condition that, in the opinion of the investigator, would preclude study participation
  • Study specific informed consent

Exclusion Criteria:

  • Taking anticoagulant medication for concomitant medical condition (unless can be safely discontinued for cryoablation procedure)
  • Prior allogeneic bone marrow/stem cell or solid organ transplant
  • Chronic use (> 2 weeks) of greater than physiologic doses of a corticosteroid agent (dose equivalent to > 10 mg/day of prednisone) within 30 days of the first day of study drug treatment

    o Topical and inhaled corticosteroids are permitted

  • Concomitant active autoimmune disease (e.g., rheumatoid arthritis, multiple sclerosis, autoimmune thyroid disease, uveitis)
  • Prior experimental cancer vaccine treatment (e.g., dendritic cell therapy, heat shock vaccine)
  • Immunosuppressive therapy, including: cyclosporine, antithymocyte globulin, or tacrolimus within 3 months of study entry
  • History of blood transfusion reactions
  • Known allergy to bovine products
  • Know allergy to murine products
  • Progressive viral or bacterial infection

    o All infections must be resolved and the patient must remain afebrile for seven days without antibiotics prior to being placed on study

  • Cardiac disease of symptomatic nature or cardiac ejection fraction < 45%
  • Symptomatic pulmonary disease or FEV1, FVC, and DLCO ≤ 50% predicted
  • History of HIV positivity or AIDS o HBV and/or HCV positivity is permitted

Sites / Locations

  • Hadassah-Hebrew University Medical Center

Outcomes

Primary Outcome Measures

The primary endpoint is the evaluation of any drug-related toxicity associated with AlloStimTM administration as well as the reversibility of such toxicity.

Secondary Outcome Measures

The secondary end-point is the evaluation of the anti-tumor effect of AlloStimTM administration.
The tertiary end-point is the evaluation of the immunological response to AlloStim-TM administration.

Full Information

First Posted
February 7, 2010
Last Updated
January 17, 2020
Sponsor
Michael Har-Noy
Collaborators
Hadassah Medical Organization
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1. Study Identification

Unique Protocol Identification Number
NCT01065441
Brief Title
Experimental Therapeutic Cancer Vaccine Created In-situ in Patients With Stage II-Stage IV Cancer
Official Title
A Phase I/II Study of an Experimental Therapeutic Cancer Vaccine Created In-situ in Patients With Stage II-Stage IV Cancers
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
December 2010 (Actual)
Primary Completion Date
December 2012 (Actual)
Study Completion Date
July 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Michael Har-Noy
Collaborators
Hadassah Medical Organization

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A Phase I/II study of an in-situ therapeutic cancer vaccine. Vaccines contain a source of antigen and and adjuvant. In this study the source of tumor antigen comes from the killing of a selected tumor by cryoablation (killing using extreme cold) and the adjuvant is intentionally mis-matched immune cells (AlloStim-TM) engineered to produce inflammatory cytokines.
Detailed Description
This is a Phase I/II clinical study to investigate the optimal protocol and indication for creating a personalized anti-tumor vaccine within the body of patients with cancer. The aim of the study is to evaluate the safety of administration and anti-tumor effect of a vaccine protocol that has three separate steps. Cancer patients generally present with an immune response to cancer biased to a Th2 response, while a Th1 response is considered necessary for mediating anti-tumor immunity. The first step of the study consists of multiple intradermal priming doses of AlloStimTM. The aim of this step is to create Th1 immunity to the alloantigens in AlloStimTM, thus increasing the number of Th1 cells in circulation. The second step of the protocol involves the cryoablation of a selected tumor lesion followed by an intratumoral AlloStimTM injection. The aim of this step is to generate tumor-specific CTL killer cells in the circulation. The final step is an intravenous infusion of AlloStimTM. The aim of this step is to activate circulating Th1 cells, killer cells, and natural killer cells. The further aim of this step is to create an inflammatory environment that can break-down the ability of the tumor to avoid an anti-tumor immune response. In patients with partial responses and recurrence of disease, additional intravenous "booster" infusions are utilized to reactivate the circulating immune cells.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Solid Tumors Stage II, Stage III and Stage IV, Breast Cancer, Colorectal Cancer, Prostate Cancer, Melanoma, Ovarian Cancer, Sarcoma, Non-small Cell Lung Cancer
Keywords
breast cancer, colorectal cancer, prostate cancer, melanoma, ovarian cancer, GI cancer, Sarcoma, Renal Cell Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
AlloStim
Intervention Description
Patients meeting eligibility criteria will be primed with at least three and up to nine intradermal AlloStim-TM injections at a frequency of every 2-8 days at doses between 1-4 x 10^7 cells
Intervention Type
Procedure
Intervention Name(s)
Cryoablation
Intervention Description
Percutaneous cryoablation of selected tumor lesion under CT or US guidance
Intervention Type
Biological
Intervention Name(s)
AlloStim
Intervention Description
intratumoral injection of AlloStim-TM into cryoablated tumor lesion at a dose of 1-6 x 10^7 cells
Intervention Type
Biological
Intervention Name(s)
AlloStim
Intervention Description
intravenous AlloStim-TM at doses between 1 x 10^7 to 1 x 10^9 cells
Intervention Type
Biological
Intervention Name(s)
AlloStim
Intervention Description
Intraperitoneal AlloStim-TM infusion in patients with peritoneal carcinomatosis and/or ascites
Intervention Type
Biological
Intervention Name(s)
AlloStim
Intervention Description
Patients with malignant pleural effusion may receive intrapleural AlloStim-TM infusion at a dose of 5-10 x 10^7 cells.
Intervention Type
Biological
Intervention Name(s)
AlloStim
Intervention Description
Patients with palpable tumors may receive alcohol ablation and intratumoral AlloStim-TM
Primary Outcome Measure Information:
Title
The primary endpoint is the evaluation of any drug-related toxicity associated with AlloStimTM administration as well as the reversibility of such toxicity.
Time Frame
90 days
Secondary Outcome Measure Information:
Title
The secondary end-point is the evaluation of the anti-tumor effect of AlloStimTM administration.
Time Frame
1 year
Title
The tertiary end-point is the evaluation of the immunological response to AlloStim-TM administration.
Time Frame
90 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 18 years or older Stage II-IV including breast cancer, colorectal cancer, non-small cell lung cancer, ovarian or other gynecological cancer, prostate cancer, pancreatic or other GI cancer, melanoma, head or neck cancer or lymphoma/plasmacytoma. Measurable disease determined upon review of abdominal and/or chest CT scan within 60 days of evaluation for study inclusion with a target tumor lesion for cryoablation or alcohol ablation located in liver, kidney, bone, lung, adrenal, pancreas, lymph node, skin, neck or prostate deemed to be accessible for percutaneous access or carcinomatosis or malignant ascites or malignant pleural effusion. When applicable, acceptable cryoablation procedure technique risk: the target tumor for ablation must have adequate distance from adjacent vasculature and other organs to permit safe application of cryoprobe (generally, more than a 2.5cm clearance of the cryoprobe from any vital structure such as the bowel, inferior vena cava, or aorta). The safety assessment of the cryoprobe placement will be made an attending radiologist based on imaging studies. Life expectancy >90 days No bevacizumab (Avastin®) within 6 weeks of planned cryoablation procedure ECOG status 0-2 No concurrent medication known to interfere with platelet function or coagulation (e.g., aspirin, ibuprofen, clopidogrel, or warfarin) unless such medications can be discontinued for an appropriate time period based on the drug half-life and known activity (e.g., aspirin for 7 days) prior to cryoablation procedure No low molecular weight heparin preparations unless can be discontinued 8 hours prior to cryoablation At least 2 weeks since prior cytotoxic chemotherapy Absolute granulocyte count ≥ 1,200/mm3 Platelet count ≥ 100,000/mm3 PT/INR ≤ 1.5 o INR correctable to ≤ 1.5 or a PT/PTT correctable to normal limits. Patients receiving anti-coagulation treatment with an agent such as warfarin or heparin may be allowed to participate. For patients on warfarin, the INR should be monitored weekly prior to the cryoablation day to assure INR is stable. However, heparin or warfarin must be withheld prior to cryoablation such that the above criteria are met. Hemoglobin ≥ 9 g/dL Creatinine ≤ 1.5 mg/dL Total bilirubin ≤ 1.5 times normal Alkaline phosphatase ≤ 2.5 times normal (≤ 5 times normal if liver involvement) Aspartate aminotransferase (AST) or (SGOT) ≤ 2.5 times ULN Alanine aminotransferase (ALT) or (SGPT) ≤ 2.5 times ULN Not pregnant or lactating Patients with child bearing potential must agree to use adequate contraception No psychiatric or addictive disorders or other condition that, in the opinion of the investigator, would preclude study participation Study specific informed consent Exclusion Criteria: Taking anticoagulant medication for concomitant medical condition (unless can be safely discontinued for cryoablation procedure) Prior allogeneic bone marrow/stem cell or solid organ transplant Chronic use (> 2 weeks) of greater than physiologic doses of a corticosteroid agent (dose equivalent to > 10 mg/day of prednisone) within 30 days of the first day of study drug treatment o Topical and inhaled corticosteroids are permitted Concomitant active autoimmune disease (e.g., rheumatoid arthritis, multiple sclerosis, autoimmune thyroid disease, uveitis) Prior experimental cancer vaccine treatment (e.g., dendritic cell therapy, heat shock vaccine) Immunosuppressive therapy, including: cyclosporine, antithymocyte globulin, or tacrolimus within 3 months of study entry History of blood transfusion reactions Known allergy to bovine products Know allergy to murine products Progressive viral or bacterial infection o All infections must be resolved and the patient must remain afebrile for seven days without antibiotics prior to being placed on study Cardiac disease of symptomatic nature or cardiac ejection fraction < 45% Symptomatic pulmonary disease or FEV1, FVC, and DLCO ≤ 50% predicted History of HIV positivity or AIDS o HBV and/or HCV positivity is permitted
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tamar Peretz, MD
Organizational Affiliation
Hadassah Medical Organization
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dr. Michael Har-Noy
Organizational Affiliation
Immunovative Therapies, Ltd.
Official's Role
Study Chair
Facility Information:
Facility Name
Hadassah-Hebrew University Medical Center
City
Jerusalem
ZIP/Postal Code
91120
Country
Israel

12. IPD Sharing Statement

Citations:
PubMed Identifier
18834631
Citation
Har-Noy M, Zeira M, Weiss L, Fingerut E, Or R, Slavin S. Allogeneic CD3/CD28 cross-linked Th1 memory cells provide potent adjuvant effects for active immunotherapy of leukemia/lymphoma. Leuk Res. 2009 Apr;33(4):525-38. doi: 10.1016/j.leukres.2008.08.017. Epub 2008 Oct 1.
Results Reference
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PubMed Identifier
18565579
Citation
Har-Noy M, Zeira M, Weiss L, Slavin S. Completely mismatched allogeneic CD3/CD28 cross-linked Th1 memory cells elicit anti-leukemia effects in unconditioned hosts without GVHD toxicity. Leuk Res. 2008 Dec;32(12):1903-13. doi: 10.1016/j.leukres.2008.05.007. Epub 2008 Jun 18.
Results Reference
background
PubMed Identifier
18054441
Citation
Har-Noy M, Slavin S. The anti-tumor effect of allogeneic bone marrow/stem cell transplant without graft vs. host disease toxicity and without a matched donor requirement? Med Hypotheses. 2008;70(6):1186-92. doi: 10.1016/j.mehy.2007.10.008. Epub 2007 Dec 3.
Results Reference
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Experimental Therapeutic Cancer Vaccine Created In-situ in Patients With Stage II-Stage IV Cancer

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