Acute Myelogenous Leukemia, AML
Conditions
Keywords
Dendritic Cell/AML vaccine, CT-011
Brief summary
Acute myelogenous leukemia (AML) arises from leukemia stem cells that are difficult to eradicate and serve as a reservoir for disease relapse following chemotherapy. A promising area of investigation is the development of immunotherapeutic approaches that stimulate the immune system to recognize leukemia stem cells as foreign and eliminate them. The purpose of this research study is to determine the safety of the Dendritic Cell AML Fusion Vaccine (DC AML vaccine) after participants have achieved a remission with chemotherapy. In this clinical trial, patients are treated with a tumor vaccine alone following standard of care chemotherapy. The DC AML vaccine is an investigational agent that tries to help the immune system to recognize and fight against cancer cells. It is hoped that DC AML vaccine will prevent or delay the disease from coming back.
Detailed description
* On this study participants will receive the DC AML vaccine and GM-CSF 4-8 weeks after completion of chemotherapy for acute myelogenous leukemia (AML). GM-CSF is a drug that stimulates white blood cells and is given with the DC AML Vaccine in an effort to enhance the effect of the vaccine. Participants will receive 2-3 doses of the vaccine at 4 week intervals. * All participants will undergo the following procedures: Isolation of tumor cells by either bone marrow biopsy or blood draw; Initial chemotherapy for AML with standard therapy; Leukopheresis (collection of white blood cells from the blood). * All participants will also have blood tests, a physical exam, and an electrocardiogram prior to each dose of vaccine. * Four weeks following the final vaccination, participants will undergo a skin test called "delayed-type hypersensitivity" (DTH). This is an injection of the tumor cells under the skin to measure how the immune system responds. The tumor cells are broken up and irradiated to prevent their growth.
Interventions
BIOLOGICALDC AML Vaccine
Group 1: 2-3 doses of the vaccine at 4 week intervals
Sponsors
Beth Israel Deaconess Medical Center
National Institutes of Health (NIH)
Medivation, Inc.
The Leukemia and Lymphoma Society
Dana-Farber Cancer Institute
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Screening: * Patients with AML at initial diagnosis or at first relapse * 18 years of age or older * ECOG Performance Status 0-2 * Life expectancy of greater than 9 weeks * Laboratory values within limits outlined in the protocol * Women of child-bearing potential and men must agree to use adequate contraception prior to study entry and for the duration of study participation Prior to Cell Collections for Dendritic Cell Generation: * Patients must have obtained complete remission with chemotherapy defined by the absence of circulating blasts, and less then 5% blasts on bone marrow examination following hematopoietic recovery * Resolution of all chemotherapy related Grade III-IV toxicity as per CTC criteria 4.0 * Laboratory values as outlined in the protocol * For patients with evidence of minimal residual disease prior to vaccination, assessment of minimal residual disease status by cytogenetics or FISH will be followed post vaccination Prior to Post-Chemotherapy Immunotherapy: * Resolution of all chemotherapy related grade III-IV toxicity * Laboratory values as outlined in the protocol * At least 2 doses of fusion vaccine produced
Exclusion criteria
Screening: * Active or history of autoimmune disorders/conditions including Type 1 diabetes. Type II diabetes, vitiligo or stable hyperthyroidism will not be considered
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Adverse Events Associated With DC/AML Tumor Vaccine | 6 months after the last vaccine, up to 9 months | Participants were assessed for adverse events associated with treating AML patients with DC/AML fusion cells in the post-chemotherapy setting. Adverse event monitoring occurred monthly through 6 months following the last vaccine (up to 9 months) or until time of disease progression (whichever occurred first.) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Immune Expansion After Vaccination | 6 months after last vaccine, up to 9 months | To explore immunological response by measuring fold increase in AML-specific t-cells in patients who have achieved a chemotherapy-induced remission. Leukemia-specific t-cell expansion was measured in the blood and bone marrow by comparing samples taken prior to vaccination to samples taken at 1, 3 and 6 months following vaccination. Change from baseline to 6 months post last vaccination is reported below. |
| Number of Patients Who Had Expansion of Leukemia-Specific CD4 and CD8 T-cells After Vaccination | 6 months after last vaccine, up to 9 months | To correlate levels of circulating activated and regulatory T cells (CD4 and CD8 t-cells) with immunologic response following vaccination |
| Disease Response | 2 years | To define anti-tumor effects by determining time to disease progression. Participants were monitored for progression and survival every 3 months through 2 years. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORJacalyn Rosenblatt, MD
Beth Israel Deaconess Medical Center
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 4 Participants |
| Age, Categorical Between 18 and 65 years | 13 Participants |
| Age, Continuous | 63 years |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants |
| Race (NIH/OMB) White | 14 Participants |
| Region of Enrollment United States | 17 participants |
| Sex: Female, Male Female | 10 Participants |
| Sex: Female, Male Male | 7 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 3 / 17 |
| other Total, other adverse events | 13 / 17 |
| serious Total, serious adverse events | 0 / 17 |
Outcome results
None listed