search
Back to results

Treated Blood Cells, Cyclophosphamide, Fludarabine Phosphate, and Aldesleukin in Treating Patients With Cancer

Primary Purpose

Breast Cancer, Colorectal Cancer, Gastric Cancer

Status
Terminated
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes
aldesleukin
cyclophosphamide
fludarabine phosphate
laboratory biomarker analysis
pharmacological study
Sponsored by
Cancer Research UK
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring unspecified adult solid tumor, protocol specific, recurrent colon cancer, stage IIIA colon cancer, stage IIIB colon cancer, stage IIIC colon cancer, stage IV colon cancer, stage IVB colon cancer, recurrent rectal cancer, stage IIIA rectal cancer, stage IIIB rectal cancer, stage IIIC rectal cancer, stage IVA rectal cancer, stage IVB rectal cancer, recurrent gastric cancer, stage IV gastric cancer, recurrent pancreatic cancer, stage III pancreatic cancer, stage IV pancreatic cancer, recurrent breast cancer, stage IIIC breast cancer, stage IV breast cancer, extensive stage small cell lung cancer, recurrent non-small cell lung cancer, recurrent small cell lung cancer, stage IIIA non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer, recurrent ovarian epithelial cancer, recurrent ovarian germ cell tumor, stage IIIA ovarian epithelial cancer, stage IIIA ovarian germ cell tumor, stage IIIB ovarian epithelial cancer, stage IIIB ovarian germ cell tumor, stage IIIC ovarian epithelial cancer, stage IIIC ovarian germ cell tumor, stage IV ovarian epithelial cancer, stage IV ovarian germ cell tumor

Eligibility Criteria

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

DISEASE CHARACTERISTICS:

  • Histologically confirmed malignancy

    • Metastatic or unresectable disease
    • Standard curative or palliative measures do not exist, are no longer effective, have been completed, or have been refused
  • CEA-positive tumor (either by immunohistochemistry or as demonstrated by elevated CEA > 50 μg/L)
  • No primary brain tumor or brain metastases

PATIENT CHARACTERISTICS:

  • WHO performance status 0-1
  • Life expectancy ≥ 3 months
  • Hemoglobin ≥ 10 g/dL
  • Platelet count ≥ 100 x 10^9/L
  • Neutrophil count ≥ 2.0 x 10^9/L
  • Lymphocyte count ≥ 1.0 x 10^9/L
  • Serum bilirubin ≤ 1.5 times upper limit of normal (ULN)
  • ALT/AST ≤ 5 times ULN
  • Alkaline phosphatase ≤ 5 times ULN
  • Calculated creatinine clearance OR isotope clearance measurement ≥ 50 mL/min
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception 4 weeks prior to, during, and for 6 months after completion of study therapy (male patients must use barrier-method contraception)
  • LVEF ≥ 50% on MUGA scan (for patients receiving cyclophosphamide)
  • ECG and exercise ECG (or stress ECHO) normal (may be abnormal but not clinically significant)
  • Urine dipstick normal (may be abnormal but not clinically significant)
  • No medical high risk due to nonmalignant systemic disease including active uncontrolled infection
  • No known serologically positive hepatitis B, hepatitis C, HIV, or HTLV
  • No history of autoimmune disease
  • No inflammatory bowel disease
  • No concurrent congestive heart failure or prior history of NYHA class III-IV cardiac disease
  • No concurrent malignancies originating from other primary sites, except for adequately treated cone-biopsied carcinoma in situ of the cervix uteri or basal cell or squamous cell carcinoma of the skin
  • No other condition that, in the investigator's opinion, would make the patient an unsuitable candidate for the clinical trial

PRIOR CONCURRENT THERAPY:

  • At least 30 days since prior and no concurrent participation in another clinical trial
  • At least 4 weeks since prior and no concurrent radiotherapy (except for palliative reasons [i.e., control of bone pain])
  • At least 4 weeks since prior and no concurrent endocrine therapy, immunotherapy, or chemotherapy (6 weeks for nitrosoureas and mitomycin C)
  • No toxic manifestations of previous treatment, except for alopecia or certain grade 1 toxicities that, in the opinion of the investigator and CRUK (Cancer Research UK), would exclude the patient (e.g., grade 1 neuropathy or grade 1 fatigue)
  • No prior major thoracic and/or abdominal surgery from which the patient has not yet recovered
  • No prior bone marrow transplant or extensive radiotherapy to > 25% of bone marrow
  • No concurrent systemic steroids or other immunosuppressive therapy
  • No other concurrent anticancer therapy or investigational drugs

Sites / Locations

  • Christie Hospital

Outcomes

Primary Outcome Measures

Percentage of patients (goal is 50%) who are evaluable for MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes survival
Adverse event according to CTCAE version 3 criteria
Dose of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes that gives the highest frequency in the circulation as measured by the primary assays (recommended phase II dose)

Secondary Outcome Measures

Presence of cells with a functional chimeric immune receptor on bCEA binding assay
Partial response or complete response on CT scans at 6, 12, 24, and 52 weeks as defined by RECIST criteria
Long-term follow up for insertional mutagenesis

Full Information

First Posted
September 30, 2010
Last Updated
February 27, 2012
Sponsor
Cancer Research UK
search

1. Study Identification

Unique Protocol Identification Number
NCT01212887
Brief Title
Treated Blood Cells, Cyclophosphamide, Fludarabine Phosphate, and Aldesleukin in Treating Patients With Cancer
Official Title
A Cancer Research UK Phase I Trial of Adoptive Transfer of Autologous Tumor Antigen-Specific T Cells With Preconditioning Chemotherapy and Intravenous IL2 in Patients With Advanced CEA Positive Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
February 2012
Overall Recruitment Status
Terminated
Why Stopped
due to safety concerns and lack of efficacy
Study Start Date
August 2007 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
April 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cancer Research UK

4. Oversight

5. Study Description

Brief Summary
RATIONALE: Placing a gene into T cells may improve the body's ability to recognize cancer cells and build an immune response to fight cancer. Drugs used in chemotherapy, such as cyclophosphamide and fludarabine phosphate, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Biological therapies, such as aldesleukin, may stimulate the immune system in different ways and stop cancer cells from growing. Giving specially treated T cells together with cyclophosphamide, fludarabine phosphate, and aldesleukin may kill more tumor cells. PURPOSE: This phase I clinical trial is studying the side effects and best dose of treated T cells when given together with cyclophosphamide, fludarabine phosphate, and aldesleukin in treating patients with cancer.
Detailed Description
OBJECTIVES: Primary To evaluate the feasibility of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes in combination with preconditioning chemotherapy comprising cyclophosphamide and fludarabine phosphate plus aldesleukin in patients with CEA-positive tumors. To assess the toxicity of this regimen in these patients. To determine the dose of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes required to give optimal survival of these cells in the circulation (recommended phase II dose). Secondary To assess whether MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes isolated from the circulation are functional. To determine the preliminary tumor response to MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes. To evaluate the safety of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes. OUTLINE: This is a phase I, dose-escalation study of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes. Patients undergo leukapheresis 7-14 days before study therapy begins. Cells are then transduced with a retrovirus vector and expanded to produce MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes. Patients receive preconditioning chemotherapy comprising fludarabine phosphate IV over 15 minutes on days -5 to -1 or cyclophosphamide IV over 1 hour on days -7 to -6 and fludarabine phosphate IV over 15 minutes on days -5 to -1. They receive MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes IV over 30 minutes on day 0. Patients also receive high-dose aldesleukin IV over 15 minutes every 8 hours for up to 12 doses beginning on day 0, in the absence of disease progression or unacceptable toxicity. If there is evidence of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes survival, patients may receive additional high-dose aldesleukin. Patients undergo blood sample collection periodically for pharmacokinetic and pharmacodynamic studies. Some patients may undergo a tumor biopsy. After completion of study treatment, patients are followed up every 2 weeks for 6 weeks, every 4 weeks for 6 months, every 3 months for 1 year, and then every 6 months thereafter. Peer Reviewed and Funded or Endorsed by Cancer Research UK

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Colorectal Cancer, Gastric Cancer, Lung Cancer, Ovarian Cancer, Pancreatic Cancer, Unspecified Adult Solid Tumor, Protocol Specific
Keywords
unspecified adult solid tumor, protocol specific, recurrent colon cancer, stage IIIA colon cancer, stage IIIB colon cancer, stage IIIC colon cancer, stage IV colon cancer, stage IVB colon cancer, recurrent rectal cancer, stage IIIA rectal cancer, stage IIIB rectal cancer, stage IIIC rectal cancer, stage IVA rectal cancer, stage IVB rectal cancer, recurrent gastric cancer, stage IV gastric cancer, recurrent pancreatic cancer, stage III pancreatic cancer, stage IV pancreatic cancer, recurrent breast cancer, stage IIIC breast cancer, stage IV breast cancer, extensive stage small cell lung cancer, recurrent non-small cell lung cancer, recurrent small cell lung cancer, stage IIIA non-small cell lung cancer, stage IIIB non-small cell lung cancer, stage IV non-small cell lung cancer, recurrent ovarian epithelial cancer, recurrent ovarian germ cell tumor, stage IIIA ovarian epithelial cancer, stage IIIA ovarian germ cell tumor, stage IIIB ovarian epithelial cancer, stage IIIB ovarian germ cell tumor, stage IIIC ovarian epithelial cancer, stage IIIC ovarian germ cell tumor, stage IV ovarian epithelial cancer, stage IV ovarian germ cell tumor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Masking
None (Open Label)
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Biological
Intervention Name(s)
MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes
Intervention Type
Biological
Intervention Name(s)
aldesleukin
Intervention Type
Drug
Intervention Name(s)
cyclophosphamide
Intervention Type
Drug
Intervention Name(s)
fludarabine phosphate
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Type
Other
Intervention Name(s)
pharmacological study
Primary Outcome Measure Information:
Title
Percentage of patients (goal is 50%) who are evaluable for MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes survival
Title
Adverse event according to CTCAE version 3 criteria
Title
Dose of MFE23 scFv-expressing autologous anti-CEA MFEz T lymphocytes that gives the highest frequency in the circulation as measured by the primary assays (recommended phase II dose)
Secondary Outcome Measure Information:
Title
Presence of cells with a functional chimeric immune receptor on bCEA binding assay
Title
Partial response or complete response on CT scans at 6, 12, 24, and 52 weeks as defined by RECIST criteria
Title
Long-term follow up for insertional mutagenesis

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed malignancy Metastatic or unresectable disease Standard curative or palliative measures do not exist, are no longer effective, have been completed, or have been refused CEA-positive tumor (either by immunohistochemistry or as demonstrated by elevated CEA > 50 μg/L) No primary brain tumor or brain metastases PATIENT CHARACTERISTICS: WHO performance status 0-1 Life expectancy ≥ 3 months Hemoglobin ≥ 10 g/dL Platelet count ≥ 100 x 10^9/L Neutrophil count ≥ 2.0 x 10^9/L Lymphocyte count ≥ 1.0 x 10^9/L Serum bilirubin ≤ 1.5 times upper limit of normal (ULN) ALT/AST ≤ 5 times ULN Alkaline phosphatase ≤ 5 times ULN Calculated creatinine clearance OR isotope clearance measurement ≥ 50 mL/min Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception 4 weeks prior to, during, and for 6 months after completion of study therapy (male patients must use barrier-method contraception) LVEF ≥ 50% on MUGA scan (for patients receiving cyclophosphamide) ECG and exercise ECG (or stress ECHO) normal (may be abnormal but not clinically significant) Urine dipstick normal (may be abnormal but not clinically significant) No medical high risk due to nonmalignant systemic disease including active uncontrolled infection No known serologically positive hepatitis B, hepatitis C, HIV, or HTLV No history of autoimmune disease No inflammatory bowel disease No concurrent congestive heart failure or prior history of NYHA class III-IV cardiac disease No concurrent malignancies originating from other primary sites, except for adequately treated cone-biopsied carcinoma in situ of the cervix uteri or basal cell or squamous cell carcinoma of the skin No other condition that, in the investigator's opinion, would make the patient an unsuitable candidate for the clinical trial PRIOR CONCURRENT THERAPY: At least 30 days since prior and no concurrent participation in another clinical trial At least 4 weeks since prior and no concurrent radiotherapy (except for palliative reasons [i.e., control of bone pain]) At least 4 weeks since prior and no concurrent endocrine therapy, immunotherapy, or chemotherapy (6 weeks for nitrosoureas and mitomycin C) No toxic manifestations of previous treatment, except for alopecia or certain grade 1 toxicities that, in the opinion of the investigator and CRUK (Cancer Research UK), would exclude the patient (e.g., grade 1 neuropathy or grade 1 fatigue) No prior major thoracic and/or abdominal surgery from which the patient has not yet recovered No prior bone marrow transplant or extensive radiotherapy to > 25% of bone marrow No concurrent systemic steroids or other immunosuppressive therapy No other concurrent anticancer therapy or investigational drugs
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert E. Hawkins, MD
Organizational Affiliation
The Christie NHS Foundation Trust
Official's Role
Principal Investigator
Facility Information:
Facility Name
Christie Hospital
City
Manchester
State/Province
England
ZIP/Postal Code
M20 4BX
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Treated Blood Cells, Cyclophosphamide, Fludarabine Phosphate, and Aldesleukin in Treating Patients With Cancer

We'll reach out to this number within 24 hrs