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Vaccine Therapy With or Without Interleukin-2 in Treating Patients With Locally Advanced or Metastatic Colorectal Cancer

A Phase I/II Trial of Vaccination With Mutant Ras Peptide-Pulsed Dendritic Cells in the Treatment of HLA A2.1 Positive Patients With Colorectal Cancer

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00019591
Enrollment
Unknown
Registered
2003-01-27
Start date
1999-03-31
Completion date
2005-11-30
Last updated
2013-06-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Colorectal Cancer

Keywords

stage III colon cancer, stage IV colon cancer, stage III rectal cancer, stage IV rectal cancer, recurrent colon cancer, recurrent rectal cancer

Brief summary

RATIONALE: Vaccines may make the body build an immune response that will kill cancer cells. Combining vaccine therapy with interleukin-2 may kill more cancer cells. PURPOSE: Phase I/II trial to study the effectiveness of vaccine therapy with or without interleukin-2 in treating patients who have locally advanced or metastatic colorectal cancer.

Detailed description

OBJECTIVES: * Determine the frequency of immunologic response in patients with locally advanced or metastatic colorectal cancer treated with ras peptide-pulsed dendritic cell vaccine with or without interleukin-2. * Determine the tumor response and survival time in patients with metastatic colorectal cancer treated with vaccine plus interleukin-2. * Determine the time to progression in patients with locally advanced colorectal cancer treated with adjuvant vaccine. OUTLINE: Patients are assigned to 1 of 2 treatment groups according to extent of disease. Patients with prior locally advanced disease are assigned to treatment group A, while those with metastatic disease are assigned to treatment group B. * Group A: Patients are vaccinated against influenza on day -6. Patients undergo collection of peripheral blood mononuclear cells (PBMC) on day -4. The PBMC are cultured with sargramostim (GM-CSF) and interleukin-4 for 5 days and CD40 ligand for 24 hours and then pulsed for 2 hours with the appropriate peptide to form a vaccine. Patients receive ras peptide-pulsed dendritic cell vaccine IV over 5 minutes on days 1, 15, 29, 43, and 57. * Group B: Patients undergo collection of PBMC and receive vaccination as in group A. Patients also receive interleukin-2 subcutaneously on days 2-6 and 9-13. Treatment in both groups repeats every 2 weeks for up to 5 vaccinations in the absence of disease progression or unacceptable toxicity. Patients are followed on days 75, 90, 120, and 365. PROJECTED ACCRUAL: A total of 500 patients will be accrued for this study within 3 years.

Interventions

BIOLOGICALaldesleukin
PROCEDUREadjuvant therapy

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Primary purpose
TREATMENT

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

DISEASE CHARACTERISTICS: * Histologically confirmed locally advanced or metastatic colorectal cancer * Metastatic disease must be radiologically proven * HLA-A2-1 positive * Locally advanced disease must have had prior resection or incomplete resection with poor prognosis * Locally advanced disease includes: * Stage III or IV colon cancer (T4 or any T, N2-3, M0) * Stage III or IV rectal cancer (T4 or T3, N1-3) * Resectable or unresectable T4 disease after radiotherapy, chemotherapy, and/or surgery * Absence of measurable disease but more than a 50% chance of recurrence * Completely resected or locally advanced disease may have had conventional therapy completed within 1-12 months (surgery alone, with or without adjuvant chemotherapy and/or radiotherapy) prior to study entry * Metastatic disease patients must have bidimensionally measurable disease * Bone lesions with well-demarcated borders allowed * Lesions seen only on bone scan, pleural effusions, ascites, and changes in carcinoembryonic antigen are not considered measurable disease PATIENT CHARACTERISTICS: Age: * Over 18 Performance status: * ECOG 0-1 Life expectancy: * Not specified Hematopoietic: * Lymphocyte count at least 470/mm\^3 * Granulocyte count at least 1,000/mm\^3 * Platelet count at least 100,000/mm\^3 Hepatic: * Bilirubin no greater than 2.0 mg/dL\* * SGOT no greater than 4 times upper limit of normal (ULN) (2.5 times ULN for adjuvant patients)\* * Albumin at least 3 g/dL * No active viral hepatitis * No evidence of chronic infection due to hepatitis C * Hepatitis B surface antigen negative NOTE: \*Unless due to metastatic disease Renal: * Creatinine no greater than 2.0 mg/dL Cardiovascular: * No history of cardiac failure, significant arrhythmias, or coronary artery disease (metastatic disease patients only) Other: * Not pregnant or nursing * Fertile patients must use effective contraception * HIV negative * No prior malignancy with a 50% chance of recurrence within 5 years except nonmelanomatous skin cancer or carcinoma in situ of the cervix * No medical or psychiatric condition that would preclude compliance * No serious medical condition that would preclude apheresis * No serious infection * No uncontrolled thyroid disease (metastatic disease patients only) * Patients with an allergy to eggs are allowed but are not vaccinated against influenza during study PRIOR CONCURRENT THERAPY: Biologic therapy: * No prior immunologic therapy directed at the cellular immune system Chemotherapy: * See Disease Characteristics * Prior chemotherapy for metastatic disease allowed * At least 4 weeks since prior chemotherapy * No concurrent chemotherapy or anticipated need for chemotherapy for 2 months after vaccinations Endocrine therapy: * At least 4 weeks since prior supraphysiologic steroid therapy Radiotherapy: * See Disease Characteristics * Prior radiotherapy for metastatic disease allowed * No concurrent radiotherapy Surgery: * See Disease Characteristics * Prior surgery for metastatic disease allowed

Design outcomes

Primary

MeasureTime frame
Response rate every 3 months for up to a year after completion of study treatment

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026