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A Vaccine Trial for Patients With Stage IIIB, IV, or Recurrent Non-Small Cell Lung Cancer (VTNSCLC)

Primary Purpose

Non-Small Cell Lung Cancer (NSCLC)

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
autologous dendritic cell adenovirus CCL21 vaccine
Sponsored by
VA Office of Research and Development
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-Small Cell Lung Cancer (NSCLC) focused on measuring Stages IIIB, IV, and recurrent NSCLC, Carcinoma, Non-small cell lung, Lung Neoplasms, Carcinoma, Bronchogenic, Thoracic Neoplasms, Neoplasms by Site, Neoplasms, Lung Diseases

Eligibility Criteria

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

Inclusion Criteria:

Screening, physical exams, blood draws, CT scans, and follow-up will be performed at VA Greater Los Angeles. All interventional procedures including leukapheresis, CT guided/bronchoscopic biopsies and vaccine injections will be performed at University of California Los Angeles (UCLA).

  • Adults over the age of 21 capable of giving informed consent
  • Pathologically confirmed non-small cell lung cancer (NSCLC)
  • Stage IIIB, IV or recurrent disease
  • Progressive disease despite one or more prior chemotherapy regimens as standard of care OR patient refusal of standard chemotherapy
  • Measurable metastatic disease by RECIST guidelines
  • Patients with a major endobronchial lesion in the segmental, lobar, or mainstem bronchus with complete obstruction of the airway may be eligible for bronchoscopic injection provided there is no evidence of respiratory failure (defined as SaO2 at least 90% on room air, PCO2 less than, or equal to 45 mm Hg, or FEV1 greater than 1.0L)
  • Patients with an endobronchial lesion in the segmental bronchus with variable stenosis (not completely obstructed) and not amenable to standard palliative airway treatments (i.e., laser and stenting) may be eligible for bronchoscopic injection if there is no indication of respiratory failure as defined above
  • Patient with bullous disease may undergo CT-guided transthoracic injection provided the targeted tumor has an intended needle path without crossing bullae
  • ECOG performance status 0-2
  • BUN less than or equal to 40 OR serum creatinine less than 2 Serum total bilirubin less than or equal to 1.5 OR serum transaminases less than or equal to 2.5 times upper limit of normal (ULN)
  • Negative pregnancy test (if applicable)
  • Fertile patients must use effective contraception
  • More than 14 days since prior acute therapy for viral, bacterial, or fungal infections
  • More than 30 days since prior and no concurrent corticosteroids
  • More than 15 days since prior radiotherapy
  • More than 30 days since prior chemotherapy, or non-cytotoxic investigational agents

Exclusion Criteria:

  • Active CNS metastases (i.e., progression of CNS disease during the past 30 days without intervention)
  • Evidence of coagulopathy, defined as PT and/or PTT more than 1.5 times ULN or platelets more than or equal to 100,000/mm3.
  • Evidence of leukoplakia, defined as absolute neutrophil count more than or equal to 1,500/mm3
  • Evidence of respiratory failure (defined as SaO2 less than 90% on room air, PCO2 more than 45 mm Hg, or FEV1 less than 1.0 L
  • NYHA class III-IV within the past year
  • Myocardial infarction within the past year
  • Comorbid disease or medical condition that would impair the ability of the patient to receive or comply with the study protocol
  • Acute viral, bacterial or fungal infection that requires specific therapy
  • HIV positive
  • Hypersensitivity to any reagents used in the study
  • Signs or sensitivity of acute adenoviral infection (i.e., conjunctivitis or documented adenoviral upper respiratory infection)
  • Pregnant or nursing
  • Prior organ allograft

Sites / Locations

  • VA Greater Los Angeles Healthcare System, West Los Angeles, CA

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Arm 1

Arm Description

Eligible patients will be assigned to a cohort and will receive intratumoral injections of Ad-CCL21-DC in conjunction with tumor sampling

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD)
Toxicity as measured by NCI Common Toxicity Criteria

Secondary Outcome Measures

Disease status at days 28 and 56 days
Immune response assessment by antigen-specific interferon gamma (IFNy) Enzyme-Linked ImmunoSpot (ELISPOT) assays on days 0, 28, and 56

Full Information

First Posted
March 28, 2012
Last Updated
January 16, 2018
Sponsor
VA Office of Research and Development
Collaborators
Jonsson Comprehensive Cancer Center, National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT01574222
Brief Title
A Vaccine Trial for Patients With Stage IIIB, IV, or Recurrent Non-Small Cell Lung Cancer
Acronym
VTNSCLC
Official Title
Intratumoral Genetic Therapy for Lung Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Terminated
Why Stopped
Estimated Primary Completion Date: March 2017 (Final data collection date for primary outcome measure)
Study Start Date
October 1, 2011 (Actual)
Primary Completion Date
March 1, 2017 (Actual)
Study Completion Date
March 1, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
VA Office of Research and Development
Collaborators
Jonsson Comprehensive Cancer Center, National Cancer Institute (NCI)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the dose that the vaccine can be given safely to patients when injected directly into the lung tumor, without any serious side effects.
Detailed Description
Primary - to determine the safety, toxicity, and Maximum Tolerated Dose (MTD) of autologous dendritic cell-adenovirus chemokine (C-C motif) ligand 21 (CCL21) vaccine administered as an intratumoral injection in treating patients with stage IIIB, IV, or recurrent non-small cell lung cancer Secondary to determine the biologic and clinical responses to therapy to determine treatment-related toxicity using the NCI Common Toxicity Criteria to identify the maximum tolerated dose (MTD) to monitor patients for evidence of autologous dendritic cell-adenovirus CCL21 vaccine-induced cytokines and antigen-specific immune responses to detect immune responses to tumor-associated antigens and vector to assess patients for objective signs of tumor regression (RECIST criteria)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-Small Cell Lung Cancer (NSCLC)
Keywords
Stages IIIB, IV, and recurrent NSCLC, Carcinoma, Non-small cell lung, Lung Neoplasms, Carcinoma, Bronchogenic, Thoracic Neoplasms, Neoplasms by Site, Neoplasms, Lung Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Masking Description
No masking
Allocation
N/A
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Experimental
Arm Description
Eligible patients will be assigned to a cohort and will receive intratumoral injections of Ad-CCL21-DC in conjunction with tumor sampling
Intervention Type
Biological
Intervention Name(s)
autologous dendritic cell adenovirus CCL21 vaccine
Other Intervention Name(s)
10-000039, UCLA-NCI 7888, 03-06-008
Intervention Description
Eligible patients will be assigned to a cohort and will receive intratumoral injections of Ad-CCL21-DC in conjunction with tumor sampling.
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Description
Toxicity as measured by NCI Common Toxicity Criteria
Time Frame
28 Days
Secondary Outcome Measure Information:
Title
Disease status at days 28 and 56 days
Description
Immune response assessment by antigen-specific interferon gamma (IFNy) Enzyme-Linked ImmunoSpot (ELISPOT) assays on days 0, 28, and 56
Time Frame
28 and 56 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Screening, physical exams, blood draws, CT scans, and follow-up will be performed at VA Greater Los Angeles. All interventional procedures including leukapheresis, CT guided/bronchoscopic biopsies and vaccine injections will be performed at University of California Los Angeles (UCLA). Adults over the age of 21 capable of giving informed consent Pathologically confirmed non-small cell lung cancer (NSCLC) Stage IIIB, IV or recurrent disease Progressive disease despite one or more prior chemotherapy regimens as standard of care OR patient refusal of standard chemotherapy Measurable metastatic disease by RECIST guidelines Patients with a major endobronchial lesion in the segmental, lobar, or mainstem bronchus with complete obstruction of the airway may be eligible for bronchoscopic injection provided there is no evidence of respiratory failure (defined as SaO2 at least 90% on room air, PCO2 less than, or equal to 45 mm Hg, or FEV1 greater than 1.0L) Patients with an endobronchial lesion in the segmental bronchus with variable stenosis (not completely obstructed) and not amenable to standard palliative airway treatments (i.e., laser and stenting) may be eligible for bronchoscopic injection if there is no indication of respiratory failure as defined above Patient with bullous disease may undergo CT-guided transthoracic injection provided the targeted tumor has an intended needle path without crossing bullae ECOG performance status 0-2 BUN less than or equal to 40 OR serum creatinine less than 2 Serum total bilirubin less than or equal to 1.5 OR serum transaminases less than or equal to 2.5 times upper limit of normal (ULN) Negative pregnancy test (if applicable) Fertile patients must use effective contraception More than 14 days since prior acute therapy for viral, bacterial, or fungal infections More than 30 days since prior and no concurrent corticosteroids More than 15 days since prior radiotherapy More than 30 days since prior chemotherapy, or non-cytotoxic investigational agents Exclusion Criteria: Active CNS metastases (i.e., progression of CNS disease during the past 30 days without intervention) Evidence of coagulopathy, defined as PT and/or PTT more than 1.5 times ULN or platelets more than or equal to 100,000/mm3. Evidence of leukoplakia, defined as absolute neutrophil count more than or equal to 1,500/mm3 Evidence of respiratory failure (defined as SaO2 less than 90% on room air, PCO2 more than 45 mm Hg, or FEV1 less than 1.0 L NYHA class III-IV within the past year Myocardial infarction within the past year Comorbid disease or medical condition that would impair the ability of the patient to receive or comply with the study protocol Acute viral, bacterial or fungal infection that requires specific therapy HIV positive Hypersensitivity to any reagents used in the study Signs or sensitivity of acute adenoviral infection (i.e., conjunctivitis or documented adenoviral upper respiratory infection) Pregnant or nursing Prior organ allograft
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven Dubinett, MD
Organizational Affiliation
VA Greater Los Angeles Healthcare System, West Los Angeles, CA
Official's Role
Principal Investigator
Facility Information:
Facility Name
VA Greater Los Angeles Healthcare System, West Los Angeles, CA
City
West Los Angeles
State/Province
California
ZIP/Postal Code
90073
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
28468947
Citation
Lee JM, Lee MH, Garon E, Goldman JW, Salehi-Rad R, Baratelli FE, Schaue D, Wang G, Rosen F, Yanagawa J, Walser TC, Lin Y, Park SJ, Adams S, Marincola FM, Tumeh PC, Abtin F, Suh R, Reckamp KL, Lee G, Wallace WD, Lee S, Zeng G, Elashoff DA, Sharma S, Dubinett SM. Phase I Trial of Intratumoral Injection of CCL21 Gene-Modified Dendritic Cells in Lung Cancer Elicits Tumor-Specific Immune Responses and CD8+ T-cell Infiltration. Clin Cancer Res. 2017 Aug 15;23(16):4556-4568. doi: 10.1158/1078-0432.CCR-16-2821. Epub 2017 May 3.
Results Reference
derived
Links:
URL
https://clinicaltrials.gov/ct2/show/NCT00601094
Description
Click here for more information about this study: Intratumoral genetic therapy for lung cancer

Learn more about this trial

A Vaccine Trial for Patients With Stage IIIB, IV, or Recurrent Non-Small Cell Lung Cancer

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