Ovarian Cancer Clinical Trial
Official title:
A Phase I Clinical Trial of Autologous Dendritic Cell Vaccine Leaded With Autologous Tumor Cell Lysate for Recurrent Ovarian or Primary Peritoneal Cancer
This study is open to women with recurrent epithelial ovarian carcinoma or primary
peritoneal cancer. Subjects will be asked to donate either a piece of their tumor or
malignant effusion in order to make the first part of the vaccine or lysate. If enough of
the lystate had been collected to make the first part of the vaccine, then subjects may
enroll in the study as long as they meet the rest of the entry criteria.
After is determined that a subject is eligible to enroll into the study, you will have to
donate some blood in order to make the second part of the vaccine. After this, the blood and
vaccine are mixed together to make the vaccine called DCVax-L. You will be given two dose of
a drug called Avastin every other week (Avastin will be given through your vein) and a oral
chemotherapy called Cytoxan. One week after your last dose of oral Cytoxan, you will receive
3 vaccines given every other week for the next month. After the first two doses of vaccine,
you will also receive more Avastin. During the study you will be seeing your study team to
have physical exams, blood drawn in order to monitor your health and have blood drawn for
research. The study team will contact you for the next 5 years in order to determine how you
are doing.
Subjects with recurrent epithelial ovarian carcinoma or recurrent primary peritoneal cancer,
for whom autologous tumor or malignant effusion has been harvested and is available for
lysate preparation, are eligible, provided all other eligibility criteria are fulfilled.
Harvested tumor or malignant effusion will be shipped to Cognate BioServices (Sunnyvale, CA)
for preparation of lysate. If sufficient amount of lysate for vaccine can be generated,
subjects will be enrolled to the study.
Subjects will undergo apheresis on day -35 to -29 to harvest peripheral blood mononuclear
cells (PBMC). The apheresis product will be shipped to Cognate BioServices, where DC will be
prepared and pulsed with autologous lysate according to proprietary technology. Following
apheresis, subjects will receive two cycles of biological antiangiogenesis/immunomodulatory
therapy comprising intravenous bevacizumab at 10 mg/kg on day -28 and -14, which may be
followed by 7 days of oral metronomic cyclophosphamide at 50 mg daily (days -28 to -21, and
-14 to -7, respectively). Subjects will receive three doses of intradermal vaccination with
~5-10 x 106 dendritic cells (DCVax-L) on days 0, 14 and 28. Subjects will also receive
intravenous bevacizumab at 10 mg/kg concurrently with intradermal DCVax-L on day 0 and 14,
which may be followed by oral cyclophosphamide at 50 mg for 7 days (days 0 to 7, and 14 to
21, respectively). The last DCVax-L (day 28) may be followed by oral cyclophosphamide at 50
mg daily x 7 days (days 28 to 35), but no bevacizumab will be given on day 28. Prevnar, an
FDA approved seven-valent vaccine against Pneumococcus pneumoniae, will be given
intramuscularly on day 0 as positive control of immune responsiveness. Two weeks following
third vaccine dose (day 42), patients will undergo immune assessment.
Subjects will be contacted every 6 months for 5 years and then annually for survival.
Subject will have the option of enrolling in other combinatorial immunotherapy trials when
these are available, if they satisfy enrollment criteria. Subjects will have the option of
continuing vaccination every two months till exhaustion of DCVax-L or disease progression,
whichever occurs first.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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