Colorectal Cancer
Conditions
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
Sponsors
Study design
Eligibility
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
| Measure | Time frame |
|---|---|
| Response rate every 3 months for up to a year after completion of study treatment | — |
Countries
United States