• Tumor response [ Designated as safety issue: No ]
  

• Time to progression [ Designated as safety issue: No ]
  
• Survival [ Designated as safety issue: No ]
  

OBJECTIVES:

Primary

• To evaluate tumor response rate in patients with stage IV lung cancer receiving vaccine therapy comprising allogeneic tumor cells and GM.CD40L in combination with tretinoin and cyclophosphamide.

Secondary

• To evaluate patients for the development of specific anti-tumor immune responses after immunization.
• To quantitate the dendritic cell (DC):immature myeloid cell (ImC) ratio before and after treatment with tretinoin, vaccine therapy comprising allogeneic tumor cells and GM.CD40L, and cyclophosphamide.
• To evaluate the survival of patients treated with this vaccine.

OUTLINE: Patients receive cyclophosphamide IV on days 1 and 57, vaccine (formulated by mixing allogeneic tumor cells and GM.CD40L) intradermally at 4 separate sites on days 4, 18, 32, 60, 88, and 116, and oral tretinoin three times daily on days 5-7 and days 61-63 in the absence of disease progression or unacceptable toxicity. Patients achieving stable disease, partial response, or complete response receive the vaccine every 3 months until disease progression.

Patients undergo blood collection periodically during treatment for immune response testing, including determination of dendritic cell (DC):immature myeloid cell (ImC) ratios by flow cytometry and ELISPOT analysis. Archived diagnostic biopsy tissue is analyzed for the expression of WT1, CEA, and hTERT by immunohistochemistry.

After completion of study treatment, patients are followed periodically.

DISEASE CHARACTERISTICS:

• Histologically confirmed adenocarcinoma of the lung

  • Metastatic disease

• Measurable metastatic tumor as defined by standard RECIST criteria

  • Lesions must be accurately measured in at least 1 dimension with the longest diameter ≥ 20 mm (≥ 10 mm in at least 1 dimension by spiral CT scan)
• Completed first-line chemotherapy
• No symptomatic brain metastases

PATIENT CHARACTERISTICS:

• ECOG performance status 0-1
• WBC > 3,000/mm³
• ANC > 1,500/mm³
• Platelets > 100,000/mm³
• Hematocrit > 25%
• Bilirubin < 2.0 mg/dL
• Creatinine < 2.0 mg/dL OR creatinine clearance > 60 mL/min
• No acute medical problems requiring active intervention
• No other pre-existing immunodeficiency condition (including known HIV infection)
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• No radiotherapy within 2 weeks of first vaccine administration
• No chemotherapy within 4 weeks of first vaccine administration
• No steroid therapy within 4 weeks of first vaccine administration
• No concurrent corticosteroids (other than replacement doses in patients who are hypoadrenal) or other immunosuppressive therapy