Small Cell Lung Cancer Clinical Trial
Official title:
A Randomized Phase II Trial Using Dendritic Cells Transduced With an Adenoviral Vector Containing the p53 Gene to Immunize Patients With Extensive Stage Small Cell Lung Cancer in Combination With Chemotherapy With or Without All Trans Retinoic Acid
The purpose of this research study is to test a tumor (cancer) vaccine given along with chemotherapy to determine if this vaccine will increase the chances of the tumor shrinking and/or the amount of time that people who have this disease will live.
After initial diagnosis patients will be treated with a standard platinum/etoposide regimen.
This standard first-line chemotherapy may/will be administered to patients under the
direction of their primary medical oncologist inside or outside of the Moffitt Cancer Center.
Patients will receive the platinum drug on day 1 and etoposide on days 1-3 of each 21-day
cycle for 4-6 cycles. Patients who have progressive disease (PD) at this point are changed to
second line chemotherapy, and will not be eligible to participate in this clinical trial.
Patients who achieve a complete response (CR), partial response (PR), or stable disease (SD)
after standard first-line chemotherapy will be enrolled. Radiographic studies and tumor
measurements are repeated 3-6 weeks after the last dose of chemotherapy (+/- PCI) and may be
repeated after prophylactic cranial irradiation (PCI) at the discretion of the principal
investigator (PI) and treating physician.
PCI will be permitted at the discretion of the treating oncologist(s). The initial radiation
consultation and simulation should occur as soon as the final staging has occurred. Ideally,
treatment should commence 1-2 weeks after final staging has been confirmed and will be
administered in 10-15 fractions over a 2-3 week period, as recommended by the treating
radiation oncologist. Although steroid use is not prohibited, it is recommended and preferred
that they not be used during PCI (steroids will have to be discontinued ≥ 2 weeks before
first vaccination). PCI can also be considered between vaccines #4 and #5 or vaccine #5 and
#6 in those patients eligible for the second course of vaccinations. Systemic dose of
steroids will NOT be allowed in these cases unless strictly necessary and after discussion
with the PI.
Patients who achieve CR, PR or SD after the completion of first line chemotherapy +/- PCI
will be screened for initial registration. Screening tests and procedures will be performed
approximately 4-6 weeks after the completion of first line chemotherapy or 6-9 weeks after
completion of PCI. Ideally, screening should be completed 1-2 weeks prior to leukopheresis.
Patients who successfully complete the screening exams for initial registration will be
randomized into one of three study arms.
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