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p53 Vaccine in Treating Patients With Adenocarcinoma of the Ovary Who Have Either No Evidence of Disease or Elevated Biomarkers

This study has been completed.

Sponsors and Collaborators: NCI - Center for Cancer Research-Medical Oncology
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00019903
  Purpose

RATIONALE: Vaccines may make the body build an immune response to kill tumor cells.

PURPOSE: This phase I/II trial is studying the side effects of p53 vaccine therapy and to see how well it works in treating patients with adenocarcinoma of the ovary with either no evidence of disease or elevated biomarkers.


Condition Intervention Phase
Ovarian Cancer
Drug: aldesleukin
Drug: incomplete Freund's adjuvant
Drug: p53 peptide vaccine
Drug: sargramostim
Drug: therapeutic autologous dendritic cells
Procedure: in vitro-treated peripheral blood stem cell transplantation
Phase I
Phase II

MedlinePlus related topics:   Cancer    Ovarian Cancer   

Drug Information available for:   Aldesleukin    Sargramostim    Granulocyte-macrophage colony-stimulating factor    Freund's adjuvant    Montanide ISA 51   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Open Label
Official Title:   Vaccine Therapy With Tumor Specific p53 Peptides in Adult Patients With Low BurdenAdenocarcinoma of the Ovary

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Cellular immunity as measured by Elispot assay and 51 Cr-release assay at baseline and every 3 weeks [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Toxicity as measured by Common Toxicity Criteria v2.0 at baseline and every 3 weeks [ Designated as safety issue: Yes ]
  • Tumor response as measured by CT scans at baseline and every 3 months [ Designated as safety issue: No ]

Estimated Enrollment:   45
Study Start Date:   June 2000
Primary Completion Date:   December 2007 (Final data collection date for primary outcome measure)

Detailed Description:

OBJECTIVES:

Primary

  • Determine whether endogenous cellular immunity to p53 vaccine is present in patients with adenocarcinoma of the ovary who have no evidence of disease or marker disease only and whether vaccination with these peptides can induce or boost the cellular immunity of these patients.
  • Determine the type and characteristics of the cellular immunity generated by this regimen in these patients.

Secondary

  • Determine the toxicity of this regimen in these patients.
  • Correlate any immunologic response with any objective tumor response to this regimen in these patients.

OUTLINE: All patients undergo apheresis prior to therapy, prior to every other course, and 1 month after the last course.

Patients are assigned to one of two treatment arms.

  • Arm I: Patients receive p53 vaccine and sargramostim (GM-CSF) emulsified with Montanide ISA-51 subcutaneously (SC) on day 1.
  • Arm II: Autologous peripheral blood mononuclear cells are harvested and selected for monocytes on day -6. The monocyte fraction is cultured with GM-CSF and interleukin-4 for 7 days and then pulsed with p53 vaccine. Patients receive p53 vaccine-pulsed autologous dendritic cells IV over 5 minutes on day 1.
  • Both arms: Vaccine treatment repeats every 3 weeks for 4 doses. During courses 3 and 4, patients receive interleukin-2 SC 5 days a week for 2 weeks beginning on day 3. Patients with stable or responding disease may continue vaccine treatment for up to 2 years. Patients who progress on the original p53 vaccine may receive mutant p53 vaccine administered as in Arm I, beginning 4-12 weeks after the original vaccine and continuing for up to 2 years.

Patients are followed at 1 month. Patients who are off therapy are followed every 2-4 months for 2 years.

PROJECTED ACCRUAL: A total of 45 patients (9-16 per treatment arm) will be accrued for this study within 2 years.

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Criteria

DISEASE CHARACTERISTICS:

  • Histologically proven adenocarcinoma of the ovary

    • Marker only disease OR
    • No evidence of disease post therapy for initial ovarian cancer (stage III, IV or recurrent)
  • HLA-A2.1 positive
  • Tumor tissue available for determination of p53 protein expression and genetic mutation

    • p53 positive tumor by immunohistochemical analysis
  • No CNS metastases

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • ECOG 0 or 1

Life expectancy:

  • More than 3 months

Hematopoietic:

  • Platelet count at least 100,000/mm^3

Hepatic:

  • Bilirubin no greater than 2.0 mg/dL
  • SGOT or SGPT no greater than 4 times normal
  • Hepatitis B surface antigen negative
  • Hepatitis C antibody negative

Renal:

  • Creatinine no greater than 2.0 mg/dL

Cardiovascular:

  • No New York Heart Association class III or IV heart disease
  • No myocardial infarction within past 6 months
  • No prior congestive heart failure
  • No prior ventricular arrhythmias or other arrhythmias requiring therapy

Immunologic:

  • No prior autoimmune disease including, but not limited to, the following:

    • Autoimmune neutropenia, thrombocytopenia, or hemolytic anemia
    • Systemic lupus erythematosus, Sjögren's syndrome, or scleroderma
    • Myasthenia gravis
    • Goodpasture's syndrome
    • Addison's disease
    • Hashimoto's thyroiditis
    • Active Graves' disease
  • HIV negative
  • No underlying immune deficiency

Other:

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No second malignancy within past year except curatively treated carcinoma in situ of the cervix or basal cell skin cancer
  • No active infection requiring antibiotics

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • At least 4 weeks since prior immunotherapy and recovered
  • At least 1 year since prior bone marrow transplantation

Chemotherapy:

  • At least 4 weeks since prior chemotherapy and recovered

Endocrine therapy:

  • At least 4 weeks since prior systemic steroids and recovered
  • No concurrent systemic steroids

Radiotherapy:

  • At least 4 weeks since prior radiotherapy and recovered

Surgery:

  • Not specified

Other:

  • Chronic suppressive antibiotics allowed
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00019903

Locations
United States, Maryland
NCI - Center for Cancer Research    
      Bethesda, Maryland, United States, 20892
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support    
      Bethesda, Maryland, United States, 20892-1182

Sponsors and Collaborators
NCI - Center for Cancer Research-Medical Oncology
National Cancer Institute (NCI)

Investigators
Principal Investigator:     Samir N. Khleif, MD     NCI - Center for Cancer Research-Medical Oncology    
  More Information


Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site
 

Study ID Numbers:   CDR0000067278, NCI-99-C-0137, NCI-NMOB-9903, NCI-T99-0074
First Received:   July 11, 2001
Last Updated:   October 18, 2008
ClinicalTrials.gov Identifier:   NCT00019903
Health Authority:   United States: Federal Government

Keywords provided by National Cancer Institute (NCI):
stage I ovarian epithelial cancer  
stage II ovarian epithelial cancer  
stage III ovarian epithelial cancer  
stage IV ovarian epithelial cancer  
recurrent ovarian epithelial cancer  

Study placed in the following topic categories:
Ovarian cancer
Ovarian Neoplasms
Gonadal Disorders
Genital Neoplasms, Female
Endocrine System Diseases
Urogenital Neoplasms
Ovarian Diseases
Ovarian epithelial cancer
Recurrence
Genital Diseases, Female
Aldesleukin
Freund's Adjuvant
Endocrinopathy
Adenocarcinoma
Endocrine Gland Neoplasms

Additional relevant MeSH terms:
Anti-Infective Agents
Anti-HIV Agents
Immunologic Factors
Antineoplastic Agents
Physiological Effects of Drugs
Adjuvants, Immunologic
Antiviral Agents
Pharmacologic Actions
Adnexal Diseases
Neoplasms
Neoplasms by Site
Anti-Retroviral Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on October 31, 2008




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