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A Phase I/Ii Study Of Immunization With Lymphotactin And Interleukin 2 Gene Modified Neuroblastoma Tumor Cells After High-Dose Chemotherapy And Autologous Stem Cell Rescue In Patients With High Risk Neuroblastoma (CHESAT)
This study is currently recruiting participants.
Verified by Baylor College of Medicine, January 2009
First Received: June 20, 2008   Last Updated: January 27, 2009   History of Changes
Sponsors and Collaborators: Baylor College of Medicine
Texas Children's Hospital
Information provided by: Baylor College of Medicine
ClinicalTrials.gov Identifier: NCT00703222
  Purpose

We intend to test the safety, and immunologic and clinical efficacy of a combination of 2 allogeneic neuroblastoma tumor cell line vaccines, one of which has been genetically modified to secrete the cytokine/chemokine combination of IL-2 and lymphotactin, in patients undergoing chemotherapy for newly diagnosed, high risk neuroblastoma who receive single autologous stem cell rescue as consolidation therapy.

This protocol will be carried out as a Phase I/IIa study to evaluate the safety and toxicity of adding a previously unstudied, unmodified, irradiated neuroblastoma cell line (SKNLP) to a studied, safe dose of a gene modified, IL-2/Lptn secreting neuroblastoma cell line SJNB-JF-IL2/Lptn to be given as a vaccine to patients diagnosed with high risk neuroblastoma.

A 3+3, phase I dose-escalation trial will be employed to assess safety of two dose levels. 3-6 patients will be enrolled at each dose level and dose-escalation rules will proceed as specified in section 5.2. A 21-day window following the first vaccination will constitute the time period for DLT assessment. Dose limiting toxicity will be any grade 3 or 4 non-hematologic toxicity as per the CTCAE v3.0 or a grade 3 injection site toxicity per the CTCAE 3.0. Exception: Grade 3 rigors/chills will be tolerated for 48-72 hours if attributable to vaccine reaction. Under the phase Iia portion, additional patients will be accrued at the MTD from the phase I portion. Prior published studies showed a 6-fold increase (range 2 - 10-fold) in vaccine specific cytotoxic T-lymphocyte precursors (CTLp) from pre to post vaccination (Institutional data; manuscript in preparation). We will use ELISPOT from blood drawn at the timepoints indicated, to assess for a change in the number of vaccine specific CTLp from baseline to 1 year after vaccination . With a cohort of 10 patients treated at the MTD, we will have 80% power to detect an alternative hypothesis of a 3.5 fold increase in CTLp (SD = 2.4) vs. a null hypothesis of 1.0 based on a two-sided, one-sample t-test with 5% alpha. We expect accrue 1 to 2 patients per month.


Condition Intervention Phase
Neuroblastoma
Biological: SJNB-JF-IL2 and SJNB-JF-Lptn cells and SKNLP Unmodified Neuroblastoma Cell Lines
Phase I
Phase II

MedlinePlus related topics: Cancer Childhood Immunization Neuroblastoma
Drug Information available for: Interleukin-2
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study
Official Title: A Phase I/Ii Study Of Immunization With Lymphotactin And Interleukin 2 Gene Modified Neuroblastoma Tumor Cells After High-Dose Chemotherapy And Autologous Stem Cell Rescue In Patients With High Risk Neuroblastoma

Further study details as provided by Baylor College of Medicine:

Primary Outcome Measures:
  • Evaluate the safety of repeated immunization with gene-modified, IL-2/lymphotactin secreting SJNB-JF-IL2 and SJNB-JF-Lptn cells co-administered with the unmodified SKNLP neuroblastoma cell line. [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
  • Evaluate the immune response to these immunizations. [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]
  • Evaluate changes in minimal residual disease load by polymerase chain reaction pre- and post-vaccination. [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Estimate 3 year progression free survival (PFS) and overall survival (OS) in vaccinated patients. [ Time Frame: 3 years ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 24
Study Start Date: June 2008
Estimated Study Completion Date: July 2027
Estimated Primary Completion Date: July 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Vaccine and Dose Escalation: Experimental
Phase I Dose Escalation Component: While we do not suspect that addition of a second irradiated, unmodified neuroblastoma tumor cell line to the previously tested SJNB-JF gene modified cell line will affect the safety profile of the vaccine, as the SKNLP has not been tested previously in vaccine studies, we will perform an abbreviated dose escalation study of the combined vaccine to assess safety. We know that the vaccine we gave to the patients whose neuroblastoma came back was safe. The vaccine that was given to those patients was treated with the viruses to make cytokines. We have never used the 2nd cell group in patients. Because of this, we plan to treat 3 to 6 patients at a lower dose of cells to see if adding the second cell line is safe to give.
Biological: SJNB-JF-IL2 and SJNB-JF-Lptn cells and SKNLP Unmodified Neuroblastoma Cell Lines
  • SJNB-JF-IL2 and SJNB-JF-Lptn cells are each dosed at 1x10e7 cells/m2/vaccination

    • Dose Level 1 (3-6 patients) 1x10e6 cells/m2/vaccination dose of SKNLP Unmodified Neuroblastoma Cell Line Vaccine Component
    • Dose Level 2 (3-6 patients) 1x10e7 cells/m2/vaccination dose of SKNLP Unmodified Neuroblastoma Cell Line Vaccine Component

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   up to 20 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically proven, high-risk neuroblastoma at diagnosis (see Appendices A and B in Full Protocol attached in Section S.)
  • Anticipating single autologous stem cell rescue following high dose consolidation chemotherapy.
  • Meet all eligibility criteria for high dose chemotherapy with stem cell rescue per institutional standard
  • Age <21 years
  • HIV negative

Exclusion Criteria:

  • Patients must not be currently receiving any investigational agents or have received any tumor vaccines within the previous six months.
  • Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic heart failure, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Pregnant
  • HIV-positive patients regardless of treatment status
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00703222

Contacts
Contact: Chrystal Louis, MD 832-822-4809 clouis@bcm.tmc.edu
Contact: Malcolm Brenner, MB, PhD 832-824-4671 mkbrenne@txccc.org

Locations
United States, Texas
Texas Children's Hospital Recruiting
Houston, Texas, United States, 77030
Principal Investigator: Chrystal Louis, MD            
Sponsors and Collaborators
Baylor College of Medicine
Texas Children's Hospital
Investigators
Principal Investigator: Chrystal Louis, MD Baylor College of Medicine
  More Information

No publications provided

Responsible Party: BCM/CAGT ( Chrystal Louis )
Study ID Numbers: 22053
Study First Received: June 20, 2008
Last Updated: January 27, 2009
ClinicalTrials.gov Identifier: NCT00703222     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by Baylor College of Medicine:
high-risk neuroblastoma
single autologous stem cell rescue

Study placed in the following topic categories:
Neuroectodermal Tumors
Neuroectodermal Tumors, Primitive
Analgesics, Non-Narcotic
Interleukin-2
Neoplasms, Germ Cell and Embryonal
Neuroepithelioma
Peripheral Nervous System Agents
Analgesics
Neuroectodermal Tumors, Primitive, Peripheral
Neuroblastoma
Neoplasms, Glandular and Epithelial

Additional relevant MeSH terms:
Neuroectodermal Tumors, Primitive
Neoplasms by Histologic Type
Antineoplastic Agents
Physiological Effects of Drugs
Neoplasms, Nerve Tissue
Pharmacologic Actions
Neuroblastoma
Neuroectodermal Tumors
Neoplasms
Sensory System Agents
Analgesics, Non-Narcotic
Interleukin-2
Neoplasms, Germ Cell and Embryonal
Therapeutic Uses
Peripheral Nervous System Agents
Analgesics
Neoplasms, Neuroepithelial
Central Nervous System Agents
Neuroectodermal Tumors, Primitive, Peripheral
Neoplasms, Glandular and Epithelial

ClinicalTrials.gov processed this record on May 07, 2009