Breast Cancer Clinical Trial
Official title:
MUC1/HER-2/Neu Peptide Based Immunotherapeutic Vaccines for Breast Adenocarcinomas
RATIONALE: Vaccines made from peptides may help the body build an effective immune response
to kill tumor cells. It is not yet known which vaccine is most effective in treating breast
cancer.
PURPOSE: This randomized clinical trial is studying the side effects of three different
vaccine therapies and comparing the vaccines to see how well they work in treating patients
with previously treated stage II or stage III breast cancer.
OBJECTIVES:
Primary
- To determine the safety and immunization efficacy of MUC1 and HER-2/neu peptide vaccines
combined with CpG oligodeoxynucleotide, sargramostim (GM-CSF), or both, as immune
adjuvants suspended in Freund's incomplete adjuvant in patients with previously treated
stage II or III adenocarcinoma of the breast.
Secondary
- To describe the impact of immunization on clinical outcomes in patients with
MUC1-positive breast cancer in terms of disease-free survival and overall survival.
OUTLINE: Patients are stratified according to Her-2/neu status (positive vs negative).
Patients are randomized to 1 of 3 treatment arms.
- Arm A: Patients receive a vaccine comprising incomplete Freund's adjuvant, MUC1 antigen
vaccine, two Her-2/neu peptide-based vaccines, and sargramostim (GM-CSF) subcutaneously
(SC) on day 1.
- Arm B: Patients receive a vaccine comprising incomplete Freund's adjuvant, MUC1 antigen
vaccine, two Her-2/neu peptide-based vaccines (one of them different than in arm A), and
CpG oligodeoxynucleotide SC on day 1.
- Arm C: Patients receive a vaccine comprising incomplete Freund's adjuvant, MUC1 antigen
vaccine, two Her-2/neu peptide-based vaccines (one of them different than in arm A; the
same as in arm B), GM-CSF, and CpG oligodeoxynucleotide SC on day 1.
In all arms, treatment repeats every 4 weeks for 6 courses in the absence of disease
progression or unacceptable toxicity. Patients who complete 6 courses of treatment without
disease recurrence or a second primary or intolerable toxicity will go to the observation
phase of the study for up to 2 years. Patients who develop recurrent disease during the
observational phase will go to the event monitoring phase for up to 2 years.
Blood samples are collected periodically. Blood samples and tissue samples from the patient's
most recent surgery are used for correlative studies including immune responses to T helper
and CTL epitopes by Elispot and tetramer analysis; and antigenic profiling by expression
analysis of class I HLA antigens, MUC1, and HER-2 in tumor tissue.
After completion of study treatment, patients are followed periodically until disease
recurrence or for up to 2 years.
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