Autologous Dendritic Cells in Treating Patients With Metastatic Kidney Cancer
Primary Purpose
Clear Cell Renal Cell Carcinoma, Recurrent Renal Cell Cancer, Stage IV Renal Cell Cancer
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AdGMCAIX-transduced autologous dendritic cells
therapeutic autologous dendritic cells
laboratory biomarker analysis
Sponsored by
About this trial
This is an interventional treatment trial for Clear Cell Renal Cell Carcinoma
Eligibility Criteria
Inclusion Criteria:
- Histologically or cytologically confirmed clear cell renal cell carcinoma (ccRCC); pathology report from the original diagnosis of renal cell carcinoma is acceptable; the component of conventional clear cell type > 50% is mandatory
- Evidence of metastatic disease with measurable lesion(s) as defined by RECIST guideline version 1.1 to permit tumor response evaluation; subjects with unresected primary tumors may be enrolled as long as evidence of measurable metastatic disease is also present
- Signed informed consent
- Eastern Cooperative Oncology Group (ECOG) =< 1
- Expected life expectancy >= 6 months
- Serum creatinine < 2 mg/dL
- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2.5 X upper limit of normal (ULN)
- Total bilirubin < 2 X ULN (except for subjects with documented Gilbert's syndrome who can have total bilirubin < 3.0 mg/dl)
- Hemoglobin >= 10 g/dL
- Absolute neutrophil count >= 1.5 X 10^9 cells/L
- Platelets >= 100 X 10^9/L
- Having recovered from prior surgery, radiation, chemotherapy (cytotoxic and noncytotoxic) to toxicity grade =< 1 or returned to baseline; previous treatment with immunotherapies, cytotoxic drugs, or other targeted agents is permitted; if cytotoxic chemotherapy was previously received, the last dose must be >= 1 month before leukapheresis; for other agents, the last dose must be >= 14 days before leukapheresis
- Negative serum pregnancy test within 7 days prior to enrollment in female subjects with reproductive potential
Exclusion Criteria:
- Rapidly progressing cancer likely to require palliative systemic intervention within 8 weeks after study entry
- Presence of untreated/active central nervous system (CNS) metastases
- For subjects with metastatic RCC who have had no prior systemic treatment for RCC and are considered a poor risk according to Motzer criteria, defined by having >= 3 of the following 5 risk factors for short survival: Karnofsky performance score < 80%, lactate dehydrogenase (LDH) > 1.5 X of ULN, hemoglobin < lower limit of normal (LLN), corrected serum calcium > 10 mg/dL (2.5mM), a time from initial diagnosis of RCC to initiation of systemic therapy of < 1 year
- Non-clear cell or predominantly (> 50%) sarcomatoid histology
- Concurrent major medical conditions, such as uncontrolled hypertension, diabetes mellitus, ischemic heart disease, chronic obstructive pulmonary disease, autoimmune disease, adrenal insufficiency, or prior allogeneic organ transplant requiring chronic immunosuppressive therapy, including systemic glucocorticoid treatment or replacement therapy
- Active or chronic systemic infection, including viral hepatitis, human immunodeficiency virus (HIV), mycobacteria, tuberculosis (TB), or other opportunistic infections
- Having received systemic immune suppressive therapy within 30 days prior to leukapheresis
- Having received an investigational agent within 30 days prior to the first dose of study treatment
- Female subjects who are lactating, pregnant or both male and female subjects with reproductive potential who refuse to practice medically accepted methods for contraception over the period from study consent to 90 days following the last dose of study treatment
- Other malignancy within 3 years, except for adequately treated non-melanoma skin cancer, non-invasive cancers such as cervical or breast carcinoma in situ, or superficial bladder cancer without local recurrence
- Social or psychological conditions that the investigator judges may compromise study compliance
Sites / Locations
- Jonsson Comprehensive Cancer Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment (autologous dendritic cells)
Arm Description
Patients receive AdGMCAIX-transduced autologous dendritic cells ID on days 1, 15, and 29.
Outcomes
Primary Outcome Measures
Incidence of adverse events including all grade 3 and grade 4 adverse events regardless of causality, treatment-related adverse events, dose limiting toxicities (DLT), and adverse events leading to discontinuation of study treatment
Graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.03
Secondary Outcome Measures
CAIX-specific immune response
Measured by ELISpot analysis of T cells from blood and cytokine profiling in T cell cultural supernatants.
Objective response (CR, PR) according to RECIST guideline version 1.1
Duration of progression-free survival
Clinical benefit rate (CR, PR, and SD) greater than or equal to 12 weeks
Disease response (CR, PR, stable disease [SD], and progressive disease [PD]) according to RECIST guideline version 1
Duration of response according to RECIST guideline version 1
Time to disease progression
Full Information
NCT ID
NCT01826877
First Posted
April 4, 2013
Last Updated
July 28, 2021
Sponsor
Jonsson Comprehensive Cancer Center
Collaborators
Kite, A Gilead Company
1. Study Identification
Unique Protocol Identification Number
NCT01826877
Brief Title
Autologous Dendritic Cells in Treating Patients With Metastatic Kidney Cancer
Official Title
A Phase I, Open Label, Dose Escalation and Cohort Expansion Study to Evaluate the Safety and Immune Response to Autologous Dendritic Cells Transduced With Ad-GMCAIX in Patients With Metastatic Renal Cell Carcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
July 2021
Overall Recruitment Status
Completed
Study Start Date
January 14, 2013 (Actual)
Primary Completion Date
July 3, 2018 (Actual)
Study Completion Date
May 27, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jonsson Comprehensive Cancer Center
Collaborators
Kite, A Gilead Company
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This phase I trial studies the side effects and best dose of autologous dendritic cells in treating patients with metastatic kidney cancer. Vaccines made from a person's tumor cells and white blood cells may help the body build an effective immune response to kill tumor cells.
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the safety and tolerability of dendritic cell (DC)-AdGM carbonic anhydrase IX (CAIX) administered by intradermal injections at study doses and schedule.
SECONDARY OBJECTIVES:
I. To evaluate clinical antitumor effects following study treatment according to Response Evaluation Criteria in Solid Tumors (RECIST) guideline version 1.1. Parameters include objective response (complete response [CR], partial response [PR]), duration of response in patients with objective response, and time to disease progression.
II. To evaluate immune responses to DC-AdGMCAIX vaccination by enzyme-linked immunospot (ELISpot) for numeric determination of CAIX specific T cells in blood.
III. To evaluate immune responses to DC-AdGMCAIX vaccination by cytokine profiling of T cell culture supernatants for characterization of the immune response in subjects with demonstrated immune activation may be performed.
IV. To evaluate immune responses to DC-AdGMCAIX vaccination by anti-sargramostim (GM-CSF) antibody response.
V. To evaluate tumor biopsies for immune cell infiltrates.
OUTLINE: This is a dose-escalation study.
Patients receive AdGMCAIX-transduced autologous dendritic cells intradermally (ID) on days 1, 15, and 29.
After completion of study treatment, patients are followed up every 2-3 months for at least 6 months.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Clear Cell Renal Cell Carcinoma, Recurrent Renal Cell Cancer, Stage IV Renal Cell Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Treatment (autologous dendritic cells)
Arm Type
Experimental
Arm Description
Patients receive AdGMCAIX-transduced autologous dendritic cells ID on days 1, 15, and 29.
Intervention Type
Biological
Intervention Name(s)
AdGMCAIX-transduced autologous dendritic cells
Other Intervention Name(s)
DC-AdGMCAIX, dendritic cells transduced with AdGMCA9 expressing GM-CSF-carbonic anhydrase IX fusion protein
Intervention Description
Given ID
Intervention Type
Biological
Intervention Name(s)
therapeutic autologous dendritic cells
Other Intervention Name(s)
ADC, autologous dendritic cells
Intervention Description
Given ID
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Incidence of adverse events including all grade 3 and grade 4 adverse events regardless of causality, treatment-related adverse events, dose limiting toxicities (DLT), and adverse events leading to discontinuation of study treatment
Description
Graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4.03
Time Frame
Up to day 57
Secondary Outcome Measure Information:
Title
CAIX-specific immune response
Description
Measured by ELISpot analysis of T cells from blood and cytokine profiling in T cell cultural supernatants.
Time Frame
Up to 3 years
Title
Objective response (CR, PR) according to RECIST guideline version 1.1
Time Frame
Up to 3 years
Title
Duration of progression-free survival
Time Frame
Up to 3 years
Title
Clinical benefit rate (CR, PR, and SD) greater than or equal to 12 weeks
Time Frame
Up to 3 years
Title
Disease response (CR, PR, stable disease [SD], and progressive disease [PD]) according to RECIST guideline version 1
Time Frame
Up to 3 years
Title
Duration of response according to RECIST guideline version 1
Time Frame
Up to 3 years
Title
Time to disease progression
Time Frame
Up to 3 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically or cytologically confirmed clear cell renal cell carcinoma (ccRCC); pathology report from the original diagnosis of renal cell carcinoma is acceptable; the component of conventional clear cell type > 50% is mandatory
Evidence of metastatic disease with measurable lesion(s) as defined by RECIST guideline version 1.1 to permit tumor response evaluation; subjects with unresected primary tumors may be enrolled as long as evidence of measurable metastatic disease is also present
Signed informed consent
Eastern Cooperative Oncology Group (ECOG) =< 1
Expected life expectancy >= 6 months
Serum creatinine < 2 mg/dL
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 2.5 X upper limit of normal (ULN)
Total bilirubin < 2 X ULN (except for subjects with documented Gilbert's syndrome who can have total bilirubin < 3.0 mg/dl)
Hemoglobin >= 10 g/dL
Absolute neutrophil count >= 1.5 X 10^9 cells/L
Platelets >= 100 X 10^9/L
Having recovered from prior surgery, radiation, chemotherapy (cytotoxic and noncytotoxic) to toxicity grade =< 1 or returned to baseline; previous treatment with immunotherapies, cytotoxic drugs, or other targeted agents is permitted; if cytotoxic chemotherapy was previously received, the last dose must be >= 1 month before leukapheresis; for other agents, the last dose must be >= 14 days before leukapheresis
Negative serum pregnancy test within 7 days prior to enrollment in female subjects with reproductive potential
Exclusion Criteria:
Rapidly progressing cancer likely to require palliative systemic intervention within 8 weeks after study entry
Presence of untreated/active central nervous system (CNS) metastases
For subjects with metastatic RCC who have had no prior systemic treatment for RCC and are considered a poor risk according to Motzer criteria, defined by having >= 3 of the following 5 risk factors for short survival: Karnofsky performance score < 80%, lactate dehydrogenase (LDH) > 1.5 X of ULN, hemoglobin < lower limit of normal (LLN), corrected serum calcium > 10 mg/dL (2.5mM), a time from initial diagnosis of RCC to initiation of systemic therapy of < 1 year
Non-clear cell or predominantly (> 50%) sarcomatoid histology
Concurrent major medical conditions, such as uncontrolled hypertension, diabetes mellitus, ischemic heart disease, chronic obstructive pulmonary disease, autoimmune disease, adrenal insufficiency, or prior allogeneic organ transplant requiring chronic immunosuppressive therapy, including systemic glucocorticoid treatment or replacement therapy
Active or chronic systemic infection, including viral hepatitis, human immunodeficiency virus (HIV), mycobacteria, tuberculosis (TB), or other opportunistic infections
Having received systemic immune suppressive therapy within 30 days prior to leukapheresis
Having received an investigational agent within 30 days prior to the first dose of study treatment
Female subjects who are lactating, pregnant or both male and female subjects with reproductive potential who refuse to practice medically accepted methods for contraception over the period from study consent to 90 days following the last dose of study treatment
Other malignancy within 3 years, except for adequately treated non-melanoma skin cancer, non-invasive cancers such as cervical or breast carcinoma in situ, or superficial bladder cancer without local recurrence
Social or psychological conditions that the investigator judges may compromise study compliance
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alexandra Drakaki, MD
Organizational Affiliation
Jonsson Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Jonsson Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
32925563
Citation
Faiena I, Comin-Anduix B, Berent-Maoz B, Bot A, Zomorodian N, Sachdeva A, Said J, Cheung-Lau G, Pang J, Macabali M, Chodon T, Wang X, Cabrera P, Kaplan-Lefko P, Chamie K, Belldegrun AS, Pantuck AJ, Drakaki A. A Phase I, Open-label, Dose-escalation, and Cohort Expansion Study to Evaluate the Safety and Immune Response to Autologous Dendritic Cells Transduced With AdGMCA9 (DC-AdGMCAIX) in Patients With Metastatic Renal Cell Carcinoma. J Immunother. 2020 Nov/Dec;43(9):273-282. doi: 10.1097/CJI.0000000000000336.
Results Reference
derived
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Autologous Dendritic Cells in Treating Patients With Metastatic Kidney Cancer
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