Allogeneic Natural Killer (NK) Cells in Patients With Advanced Metastatic Breast Cancer

Breast Cancer Clinical Trial

Official title:

Allogeneic Natural Killer Cells in Patients With Advanced Metastatic Breast Cancer

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00376805
• Other study ID #: UMN-2005LS033
• Secondary ID: UMN-0505M70037UM
• Status: Terminated
• Phase: Phase 2
• First received: September 13, 2006
• Last updated: December 3, 2017
• Start date: April 2006
• Est. completion date: January 2010

Study information

• Verified date: December 2017
• Source: Masonic Cancer Center, University of Minnesota
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

RATIONALE: Giving chemotherapy before a donor natural killer (NK) cell infusion helps stop the growth of tumor cells. It also helps stop the patient's immune system from rejecting the donor's cells. Giving NK cells from a related donor may kill the tumor cells.

PURPOSE: This study furthers the research of previous studies (MT2003-01 and MT2004-25) which were to determine a specific preparatory regimen (cyclophosphamide and fludarabine) could create an environment in which infused NK cells can grow and effectively treat patients with relapsed AML. This study will test the previous regimen in patients with breast cancer.

Description:

We believe that administration of related allogeneic (donor) natural killer cells along with IL-2, rather than autologous natural killer cells will provide the most effective anticancer therapy in this setting, and wish to test this approach. To do this, we will select a related donor who is partially HLA-matched with the study subject, to increase the likelihood that donor natural killer cells will kill the subject's cancer cells. We will also give chemotherapy drugs to increase the subject's tolerance for the donor natural killer cells. We will test the use of donor natural killer (NK) cell infusions. The immune system has a special way that it sees and identifies cancer cells or foreign agents (like viruses). The subject's own NK cells may not attack their cancer because NK cells see the tumor cells as "self" (a coating on the cell surface identifies a cell as "self" or "non-self"). We have reason to believe that NK cells may not kill cancer cells because NK cells have special receptors that "turn them off" when they encounter cancer cells (by seeing them as "self"). We may be able to get around this problem by using donor NK cells. Finally, subjects will receive a dose of subcutaneous IL-2 3 times a week (for 2 weeks) which has been proven safe in our previous studies to stimulate the natural killer cells.

Other known NCT identifiers

• NCT00167193

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 6
• Est. completion date: January 2010
• Est. primary completion date: September 2009
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion criteria:

• Diagnosis of metastatic breast cancer that has progressed on or failed at least one salvage chemotherapy regimen for metastatic disease and that meets the following disease specific related criteria:

• Measureable metastatic disease per Response Evaluation Criteria In Solid Tumor (RECIST) - bone only not eligible.

• Disease progression while receiving prior therapy with a hormonal agent (if estrogen/progesterone receptor-positive) and/or trastuzumab (Herceptin®) (if HER2-neu positive)

• Brain metastases allowed provided they are stable for = 3 months after prior treatment

• Related HLA-haploidentical natural killer cell donor available (by = class I serologic typing)

• Male or female

• Performance status 50-100%

• Platelet count = 80,000/mm³ (unsupported by transfusions)

• Hemoglobin = 9 g/dL (unsupported by transfusions)

• Absolute neutrophil count = 1,000/mm³ (unsupported by sargramostim [GM-CSF] or filgrastim [G-CSF])

• Creatinine = 2.0 mg/dL

• Liver function tests < 5 times normal

• Not pregnant or nursing

• Negative pregnancy test

• Fertile patients must use effective contraception

• LVEF > 40%*

• Pulmonary function > 50%* (DLCO corrected AND FEV_1)

• No active infection (i.e., afebrile, off antibiotics, and no uninvestigated radiologic lesions)

Exclusion Criteria:

• At least 3 days since prior prednisone or other immunosuppressive medications

• No other concurrent therapy for cancer

Related Conditions & MeSH terms

• Breast Cancer
• Breast Neoplasms

Intervention

Drug:
• Fludarabine
administered intravenously 25 mg/m^2 times 5 doses
• Cyclophosphamide
administered intravenously 60 mg/kg days times 2 doses.

Radiation:
• Total body irradiation
200 cGy (gray) on day -1

Other:
• Natural killer cell infusion
Infused cell dose is within the range of 1.5-8.0 x 10^7/kg. Cell counts are based on total cells infused after the activation culture and washing determined on the morning of infusion.

Biological:
• Interleukin-2
administered subcutaneously (10 MU) 3 times per week for 6 doses

Locations

Country	Name	City	State
United States	Masonic Cancer Center at University of Minnesota	Minneapolis	Minnesota

Sponsors (1)

Lead Sponsor	Collaborator
Masonic Cancer Center, University of Minnesota

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of Patients Who Had Expansion of Natural Killer Cells	Successful Natural Killer (NK) cell expansion is defined as detection of an absolute circulating donor-derived NK cell count of >100 cells/ul of whole blood 14 days after infusion with <5% donor T and B cells in mononuclear population (in metastatic breast cancer patients).	Day 14
Secondary	Number of Patients by Disease Response	Defined by the Response Evaluation Criteria in Solid Tumors (RECIST) criteria: Complete Response (CR: Disappearance of all target lesions; Partial Response (PR): At least a 30% decrease in the sum of the longest diameter (LD) of target lesions; Stable Disease (SD): Neither sufficient shrinkage to qualify for PR or sufficient increase to qualify for PD; Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions of appearance of one or more new lesions; of clinical benefit (CB; stable disease for greater than 6 months.	6 Months, 1 Year
Secondary	Number of Patients Who Died While on Study	Number of patients who died within 100 days and after 100 days of natural killer (NK) treatment with or without total body irradiation.	Within 100 days, After 100 days
Secondary	Overall Median Number of Days Patients Alive After Treatment	Calculated median number of days of survival (patients alive days after treatment).	First Day of Treatment Until Death