Phase I/II Study of Immunization With In Vitro-Treated Autologous Tumor Cells and Dendritic Cells With Sargramostim (GM-CSF) in Patients With Stage III or IV or Recurrent Renal Cell Cancer
Alternate Title Basic Trial Information Objectives Entry Criteria Expected Enrollment Outcomes Outline Trial Contact Information Registry Information
Alternate Title
Vaccine Therapy in Treating Patients With Kidney Cancer
Basic Trial Information
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Phase
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Type
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Status
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Age
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Sponsor
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Protocol IDs
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Phase II, Phase I
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Treatment
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Closed
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16 and over
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Other
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HOAG-VACCINE-RN NCI-V01-1647, NCT00014131
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Objectives - Determine the safety of immunization with in vitro-treated autologous tumor cells and dendritic cells with sargramostim (GM-CSF) in patients with stage III or IV or recurrent renal cell cancer.
- Determine the frequency of conversion of delayed tumor hypersensitivity tests in these patients treated with this regimen.
- Determine the progression-free and overall survival of these patients treated with this regimen.
- Determine the objective tumor response rate in patients who still have measurable disease at the time they are treated with this regimen.
Entry Criteria Disease Characteristics:
- Histologically confirmed renal cell carcinoma
- Stage III or IV disease involving invasions beyond
Gerota's fascia, regional
lymph node involvement, or distant metastases
OR
- Recurrent disease involving lymph node metastases or
soft tissue nodules
- Measurable disease by anatomic-based radiological tests (unless no
evidence of
disease as documented by prior surgery)
- Planned resection of tumor to establish an autologous tumor cell line
- No active CNS metastases such as brain metastases, spinal cord
compression, or
leptomeningeal disease
- Prior brain metastases or spinal cord compression
allowed provided there is
radiographic evidence of lack of progression and no
requirement for
pharmacologic doses of corticosteroids
Prior/Concurrent Therapy:
Biologic therapy: - Other prior putative vaccines allowed
- Recovered from prior biologic therapy
- No concurrent biologic therapy except epoetin alfa for
patients with hematocrit less than 36%
Chemotherapy: - At least 3 weeks since prior chemotherapy and
recovered
- No concurrent chemotherapy
Endocrine therapy: - See Disease Characteristics
- No concurrent corticosteroids
Radiotherapy: - At least 3 weeks since prior radiotherapy (including
whole-brain radiotherapy) and recovered
- No concurrent radiotherapy
Surgery: - See Disease Characteristics
- Recovered from prior surgery
Other: - Concurrent bisphosphonates allowed for patients with lytic
bone metastases
- No concurrent digoxin or other medications designed to improve
cardiac output
- No other concurrent anticancer therapy or investigational
therapy
Patient Characteristics:
Age: Performance status: Life expectancy: Hematopoietic: - Hematocrit greater than 25%
- Platelet count greater than 100,000/mm3
- No ongoing transfusion requirements
- No active blood clotting or bleeding diathesis
Hepatic: - Bilirubin no greater than 2.0 mg/dL
- Albumin at least 3.0 g/dL
- No significant hepatic dysfunction
Renal: - Creatinine no greater than 2.0 mg/dL
- No significant renal dysfunction
Cardiovascular: - No underlying cardiac disease associated with New York Heart
Association class III or IV heart function
- No unstable angina related to atherosclerotic cardiovascular
disease
Other: - No other malignancy within the past 5 years except carcinoma
in situ, basal cell or localized squamous cell skin cancer, or localized
prostate cancer
- No active infection
- No other active medical condition that could be eminently life
threatening
- Not pregnant
- Fertile patients must use effective contraception
Expected Enrollment 80A total of 80 patients (40 per stratum) will be accrued for this study. Outcomes Primary Outcome(s)Conversion of the delayed-type hypersensitivity (DTH) skin test as measured by metric skin ruler at week 4 and month 6 during vaccine therapy Tumor response (partial response or complete response) as measured by RECIST at months 2 or 3 and 6 during study treatment, and 6 months after study completion Progression-free survival as measured by RECIST at months 2 or 3 and 6 during study treatment and every 6 months after study completion Event-free survival as measured by RECIST at months 2 or 3 and 6 during study treatment and every 6 months after study completion Overall survival beginning at the date of study entry
Outline Patients are stratified according to measurable disease at the time
vaccine therapy is initiated (yes vs no). Patients undergo tumor cell harvest. Patients with multiple persistent
sites of metastatic disease following harvest receive systemic therapy
(biologic therapy and/or chemotherapy) during tumor cell line expansion. Over
2-4 months, the tumor cell line is expanded, treated with interferon gamma,
and irradiated. Patients undergo leukapheresis to obtain peripheral blood mononuclear
cells (PBMC). The PBMC are incubated over 7 days with sargramostim (GM-CSF)
and interleukin-4 to produce dendritic cells (DC). The DC are incubated over
2-3 days with the irradiated tumor cells from the autologous tumor cell line
for antigen loading of the DC. Patients undergo delayed tumor hypersensitivity testing 1 week prior to
vaccination and again at week 4. Patients receive vaccine therapy comprising
autologous treated tumor cells and DC suspended in GM-CSF subcutaneously
weekly for 3 weeks. Vaccine therapy continues monthly for 5 months in the
absence of disease progression or unacceptable toxicity. Patients are followed every 2 months for 1 year and then every 3 months
for 4 years.
Trial Contact Information
Trial Lead Organizations Hoag Cancer Center at Hoag Memorial Hospital Presbyterian ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | Robert Dillman, MD, FACP, Protocol chair | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) |
Registry Information | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | Official Title | | Vaccine Biotherapy Of Cancer: Autologous Tumor Cells And Dendritic Cells As Active Specific Immunotherapy In Patients With Stage IV Renal Cell Carcinoma | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | Trial Start Date | | 2001-11-08 | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | Trial Completion Date | | 2009-12-01 (estimated) | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | Registered in ClinicalTrials.gov | | NCT00014131 | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | Date Submitted to PDQ | | 2001-01-24 | ![](https://webarchive.library.unt.edu/eot2008/20081014202155im_/http://www.cancer.gov/images/spacer.gif) | Information Last Verified | | 2008-08-20 |
Note: The purpose of most clinical trials listed in this database is to test new cancer treatments, or new methods of diagnosing, screening, or preventing cancer. Because all potentially harmful side effects are not known before a trial is conducted, dose and schedule modifications may be required for participants if they develop side effects from the treatment or test. The therapy or test described in this clinical trial is intended for use by clinical oncologists in carefully structured settings, and may not prove to be more effective than standard treatment. A responsible investigator associated with this clinical trial should be consulted before using this protocol. Back to Top |