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Vaccine Therapy in Treating Patients With Myelodysplastic Syndromes

Primary Purpose

Myelodysplastic Syndromes

Status
Terminated
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
K562/GM-CSF cell vaccine
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 Myelodysplastic Syndromes focused on measuring refractory anemia with excess blasts, refractory anemia with ringed sideroblasts, refractory anemia, refractory cytopenia with multilineage dysplasia, de novo myelodysplastic syndromes, previously treated myelodysplastic syndromes, secondary myelodysplastic syndromes

Eligibility Criteria

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

DISEASE CHARACTERISTICS: Pathologically confirmed myelodysplastic syndromes (MDS), including any of the following: Refractory anemia (RA) RA with ringed sideroblasts Refractory cytopenias with multilineage dysplasia (RCMD) RCMD with ringed sideroblasts RA with excess blasts 1 (5-9% blasts) RA with excess blasts 2 (10-19% blasts) Must have poor-risk MDS, defined by the following: At least 2 lineages involved Unfavorable cytogenetics (i.e., abnormalities of chromosome 5 or 7, 11q23, t[6;9], trisomy 8, inv3, or multiple/complex karyotype) Transfusion requirement of > 2 units of packed red blood cells monthly No chronic myelomonocytic leukemia No transformation to acute myeloid leukemia PATIENT CHARACTERISTICS: ECOG performance status 0-2 Creatinine < 2.5 mg/dL Bilirubin < 2.5 mg/dL (unless due to Gilbert's syndrome) Room air oxygen saturation ≥ 94% at rest Fertile patients must use effective contraception Negative pregnancy test No other malignancy within the past 5 years except in situ cervical cancer or adequately treated nonmelanoma skin cancer No active autoimmune disease or history of autoimmune disease requiring systemic immunosuppressants including, but not limited to, any of the following: Autoimmune hemolytic anemia Idiopathic thrombocytopenia purpura Inflammatory bowel disease Vasculitis Thyroiditis Rheumatic illnesses No known HIV serum antibody positivity No other disease requiring long-term corticosteroids or other immunosuppressants, such as severe chronic obstructive pulmonary disease or asthma PRIOR CONCURRENT THERAPY: At least 2 weeks since prior systemic corticosteroids or other immunosuppressants (e.g., cyclosporine, azathioprine, tacrolimus, or mycophenolate mofetil) At least 3 weeks since prior growth factors At least 2 months since prior azacitidine for MDS No prior bone marrow or other organ transplantation No concurrent cytotoxic-based therapy for MDS No other concurrent growth factors, including epoetin alfa, filgrastim (G-CSF), or sargramostim (GM-CSF)

Sites / Locations

  • Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

K562/GM-CSF cell vaccine

Arm Description

Vaccinations of 1x10^8 cells are given to participants at weeks 0, 3, 6, 9, and 17.

Outcomes

Primary Outcome Measures

Hematologic Response Rate as Assessed by Number of Participants Achieving a Major Hematologic Response
A major hematologic response is defined as any of the following: hemoglobin increase >= 2 g/dL from baseline; platelet increase >= 30k/mcL from baseline; or neutrophil increase >= 100% or >= 500/mcL from baseline.
Cytogenetic Response Rate as Assessed by Number of Participants Achieving a Cytogenetic Response
Cytogenetic response is defined as normalization of pretreatment cytogenetic abnormalities.

Secondary Outcome Measures

Immune Response Rate as Assessed by Number of Participants Who Exhibit Induced Immune Response to WT-1, Survivin, or Proteinase-3
Immune response to WT-1, survivin, or proteinase-3 as defined by a 30% increase from baseline in cytotoxic T cells measured by Elispot analysis.
Combined Immune and Clinical Response Rate
Number of participants who exhibited both an immune response as defined by Outcome 3 and a hematologic or cytogenetic response as defined by Outcomes 1 and 2, respectively.

Full Information

First Posted
August 4, 2006
Last Updated
March 21, 2023
Sponsor
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Collaborators
National Cancer Institute (NCI), Alliance for Cancer Gene Therapy
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1. Study Identification

Unique Protocol Identification Number
NCT00361296
Brief Title
Vaccine Therapy in Treating Patients With Myelodysplastic Syndromes
Official Title
K562/GM-CSF Vaccination in Patients With Myelodysplastic Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Terminated
Why Stopped
Loss of funding
Study Start Date
September 2007 (Actual)
Primary Completion Date
October 2009 (Actual)
Study Completion Date
January 2010 (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), Alliance for Cancer Gene Therapy

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
RATIONALE: Vaccines made from cancer cells may help the body build an effective immune response to kill abnormal cells. PURPOSE: This clinical trial is studying how well vaccine therapy works in treating patients with myelodysplastic syndromes (MDS).
Detailed Description
OBJECTIVES: Primary Determine the safety of GM-K562 cell vaccine in patients with myelodysplastic syndromes. Determine the hematologic and cytogenetic response in patients treated with this vaccine. Secondary Determine if vaccination with GM-K562 cell vaccine can induce an immune response to common myeloid antigens (e.g., Wilms' tumor-1 [WT-1], survivin, or proteinase-3), as defined by a 30% increase from baseline in specific cytotoxic T-cells measured by Elispot assay, in patients with myelodysplastic syndromes. Determine if immune response correlates with any clinical responses (e.g., hematologic response, resolution of cytogenetic abnormalities, or decrease in other parameters, such as WT-1 mRNA levels). OUTLINE: This is an open-label study. Patients receive GM-K562 cell vaccine subcutaneously once in weeks 0, 3, 6, 9, and 17 in the absence of disease progression or unacceptable toxicity. Blood and tissue samples are collected periodically for correlative and biomarker studies. Samples are analyzed by cytogenetic studies, fluorescent in situ hybridization (FISH), and flow cytometry. Elispot is used to quantify cellular cytotoxic T-cell response to Wilms' tumor-1 (WT-1), survivin, and proteinase 3. After completion of study treatment, patients are followed every 3 months for 1 year. PROJECTED ACCRUAL: A total of 15 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
Myelodysplastic Syndromes
Keywords
refractory anemia with excess blasts, refractory anemia with ringed sideroblasts, refractory anemia, refractory cytopenia with multilineage dysplasia, de novo myelodysplastic syndromes, previously treated myelodysplastic syndromes, secondary myelodysplastic syndromes

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
K562/GM-CSF cell vaccine
Arm Type
Experimental
Arm Description
Vaccinations of 1x10^8 cells are given to participants at weeks 0, 3, 6, 9, and 17.
Intervention Type
Biological
Intervention Name(s)
K562/GM-CSF cell vaccine
Primary Outcome Measure Information:
Title
Hematologic Response Rate as Assessed by Number of Participants Achieving a Major Hematologic Response
Description
A major hematologic response is defined as any of the following: hemoglobin increase >= 2 g/dL from baseline; platelet increase >= 30k/mcL from baseline; or neutrophil increase >= 100% or >= 500/mcL from baseline.
Time Frame
Baseline, week 21 post-intervention
Title
Cytogenetic Response Rate as Assessed by Number of Participants Achieving a Cytogenetic Response
Description
Cytogenetic response is defined as normalization of pretreatment cytogenetic abnormalities.
Time Frame
Week 21
Secondary Outcome Measure Information:
Title
Immune Response Rate as Assessed by Number of Participants Who Exhibit Induced Immune Response to WT-1, Survivin, or Proteinase-3
Description
Immune response to WT-1, survivin, or proteinase-3 as defined by a 30% increase from baseline in cytotoxic T cells measured by Elispot analysis.
Time Frame
Baseline, week 21 post-intervention
Title
Combined Immune and Clinical Response Rate
Description
Number of participants who exhibited both an immune response as defined by Outcome 3 and a hematologic or cytogenetic response as defined by Outcomes 1 and 2, respectively.
Time Frame
Week 21 post-intervention

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
DISEASE CHARACTERISTICS: Pathologically confirmed myelodysplastic syndromes (MDS), including any of the following: Refractory anemia (RA) RA with ringed sideroblasts Refractory cytopenias with multilineage dysplasia (RCMD) RCMD with ringed sideroblasts RA with excess blasts 1 (5-9% blasts) RA with excess blasts 2 (10-19% blasts) Must have poor-risk MDS, defined by the following: At least 2 lineages involved Unfavorable cytogenetics (i.e., abnormalities of chromosome 5 or 7, 11q23, t[6;9], trisomy 8, inv3, or multiple/complex karyotype) Transfusion requirement of > 2 units of packed red blood cells monthly No chronic myelomonocytic leukemia No transformation to acute myeloid leukemia PATIENT CHARACTERISTICS: ECOG performance status 0-2 Creatinine < 2.5 mg/dL Bilirubin < 2.5 mg/dL (unless due to Gilbert's syndrome) Room air oxygen saturation ≥ 94% at rest Fertile patients must use effective contraception Negative pregnancy test No other malignancy within the past 5 years except in situ cervical cancer or adequately treated nonmelanoma skin cancer No active autoimmune disease or history of autoimmune disease requiring systemic immunosuppressants including, but not limited to, any of the following: Autoimmune hemolytic anemia Idiopathic thrombocytopenia purpura Inflammatory bowel disease Vasculitis Thyroiditis Rheumatic illnesses No known HIV serum antibody positivity No other disease requiring long-term corticosteroids or other immunosuppressants, such as severe chronic obstructive pulmonary disease or asthma PRIOR CONCURRENT THERAPY: At least 2 weeks since prior systemic corticosteroids or other immunosuppressants (e.g., cyclosporine, azathioprine, tacrolimus, or mycophenolate mofetil) At least 3 weeks since prior growth factors At least 2 months since prior azacitidine for MDS No prior bone marrow or other organ transplantation No concurrent cytotoxic-based therapy for MDS No other concurrent growth factors, including epoetin alfa, filgrastim (G-CSF), or sargramostim (GM-CSF)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
B. Douglas Smith, 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
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29616857
Citation
Robinson TM, Prince GT, Thoburn C, Warlick E, Ferguson A, Kasamon YL, Borrello IM, Hess A, Smith BD. Pilot trial of K562/GM-CSF whole-cell vaccination in MDS patients. Leuk Lymphoma. 2018 Dec;59(12):2801-2811. doi: 10.1080/10428194.2018.1443449. Epub 2018 Apr 4.
Results Reference
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Vaccine Therapy in Treating Patients With Myelodysplastic Syndromes

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