Non-small Cell Lung Cancer Clinical Trial
Official title:
An Open-label, Randomized Phase IIB/III Active Control Study of Second-line Tergenpumatucel-L (Hyper-Acute(R)-Lung ) Immunotherapy Versus Docetaxel in Progressive or Relapsed Non-Small Cell Lung Cancer
The purpose of this study is to assess overall survival of anti-tumor immunization using HyperAcute®-Lung immunotherapy versus Docetaxel in patients with progressed or relapsed non-small cell lung cancer (NSCLC) that have been previously treated.
Non-small cell lung cancer (NSCLC) remains the leading cause of cancer death in men and women
in the United States. Despite advances in the treatment of advanced NSCLC in the last decade,
survival outcomes remain poor. Treatment benefit from cytotoxic chemotherapy has reached a
plateau and further progress will depend upon identifying novel methods to target tumor
cells.
Harnessing the human immune system to target lung cancer could result in the development of
effective treatment options against lung cancer and potentially enhance the effect of
cytotoxic chemotherapy. Lung cancer cells produce a number of abnormal proteins or abnormal
amounts of certain proteins found in normal lung cells. In some cancers, the abnormal protein
expression may lead to an immune response against the cancer cells much in the way the immune
system responds to an infection. In progressive lung cancer however, the immune system fails
to identify or respond to these abnormalities and the cancer cells are not attacked or
destroyed for reasons not yet fully understood. This clinical trial proposes a novel method
to stimulate the immune system to recognize the abnormal components found in lung cancer
cells and to stimulate an immune response that destroys or blocks the growth of the cancer.
This new method of treatment helps the immune system of lung cancer patients to "identify"
and target the cancerous tissue. As an example, patients who receive an organ transplant to
replace a damaged kidney or heart are treated with special drugs to supress their immune
response from destroying or "rejecting" the transplanted organ. This "rejection" occurs when
the patient's immune system responds to differences between the cells of the transplanted
organ and their own immune system by attacking the foreign tissue in the same way as it would
attack infected tissue. When the differences between foreign tissues and the patient's body
are even larger, perhaps like differences between organs from pigs and the immune system
cells of humans, the rejection is very rapid, highly destructive and the immunity it
generates is long-lasting. This is called hyperacute rejection and the medicine used to
immunize patients in this protocol tries to harness this response to teach a patient's immune
system to fight their lung cancer just as the body would learn to reject a transplanted organ
from an animal.
To do this, we have placed a mouse gene into cultured human lung cancer cell lines. These
cells will express a sugar that will stimulate a strong immune response in humans. These
cancer cells are irradiated to prevent any growth and then injected along with chemotherapy
to patients with lung cancer. The presence of the sugar will stimulate the patient's immune
system to kill the injected immunotherapy cells. As part of the process of destroying the
immunotherapy cells, the patient's immune system is stimulated to identify as many
differences between these cancer cells and normal human cells. This extra stimulation is
thought to encourage immune responses against the lung cancer in the patient based on shared
abnormalities of lung cancer immunotherapy cells and the patient's lung cancer cells.
In this experimental therapy, patients are given docetaxel or injections of an immunotherapy
consisting of three types of modified lung cancer cells. We propose to test these treatments
in patients with lung cancer who have progressed after initial chemotherapy to demonstrate
that treatment of immunotherapy results in improved tumor stabilization or response and could
potentially improve the patient's overall survival.
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