mesothelioma
Conditions
Interventions
Ten patients will be treated with DC immunotherapy (3 times with 2-weekly
interval). In de time inbetween an oral administration of one tablet of
cyclophosphamide is taken with a large amount of wat
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: As for our earlier study (MEC-2005-269):;Patients with clinically and histological or cytological confirmed newly diagnosed mesothelioma, that can be measured in two dimensions by a radiologic imaging study. Patients must be at least 18 years old and must be able to give written informed consent. Patients must be ambulatory (Karnofsky scale > 70, or WHO-ECOG performance status 0,1, or 2) and in stable medical condition. The expected survival must be at least 4 months. Patients must have normal organ function and adequate bone marrow reserve: absolute neutrophil count > 1.5*109/l, platelet count > 100*109/l, and Hb > 6.0 mmol/l. Positive delayed type hypersensitivity skin test (induration > 2mm after 48hrs) against at least one positive control antigen of MULTITEST CMI (Pasteur merieux). Stable disease or response after chemotherapy. Availability of sufficient tumor material of the patient. Ability to return to the Erasmus MC for adequate follow-up as required by this protocol. ;New for this study (in comparison to MEC-2005-269) are: Able to tolerate oral therapy No impairment of gastrointestinal (GI) function or GI disease that may affect or alter absorption of cyclophosphamide (e.g., mal-absorption syndrome, history of total gastrectomy/significant small bowel resection) No history of allergic reactions (>= grade 3 or 4) to compounds of similar chemical or biologic composition to cyclophosphamide (i.e., alkylating agents) No known intolerance or hypersensitivity reaction to cyclophosphamide
Exclusion criteria
Exclusion criteria: As for our earlier study (MEC-2005-269):;Conditions that make the patient unfit for chemotherapy or progressive disease after 4 cycles of chemotherapy. Pleurodesis at the affected side before the pleural fluid is obtained. Medical or psychological impediment to probable compliance with the protocol. Patients on steroid (or other immunosuppressive agents) are excluded on the basis of potential immune suppression. Patients must have had 6 weeks of discontinuation and must stop of any such treatment during the time of the study. No prior malignancy is allowed except for adequately treated basal cell or squamous cell skin cancer, superficial or in-situ cancer of the bladder or other cancer for which the patient has been disease-free for five years. Serious concomitant disease, no active infections. Patients with a history of autoimmune disease or organ allografts, or with active acute or chronic infection, including HIV and viral hepatitis. Patients with serious intercurrent chronic or acute illness such as pulmonary (asthma or COPD) or cardiac (NYHA class III or IV) or hepatic disease or other illness considered by the study coordinators to constitute an unwarranted high risk for investigational DC treatment. Patients with a known allergy to shell fish (contains KLH). Pregnant or lactating women. Patients with inadequate peripheral vein access to perform leukapheresis Concomitant participation in another clinical trial An organic brain syndrome or other significant psychiatric abnormality which would comprise the ability to give informed consent, and preclude participation in the full protocol and follow-up. Absence of assurance of compliance with the protocol. Lack of availability for follow-up assessment. ;No additiona exclusion criteria in comparison to MEC-2005-269
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| To determine if vaccination with DCs results in a detectable immune response To determine if low-dose cyclophosphamide leads to a decrease in regulatory T cells in the blood of patients To observe and document anti-cancer activity by clinical evaluation (CT-scan) | — |
Primary
| Measure | Time frame |
|---|---|
| To define the safety and toxicity of tumor lysate-pulsed dendritic cells (DCs) combined with a low dose cyclophosphamide in patients with malignant pleural mesothelioma | — |
Countries
Netherlands
Outcome results
None listed