Kidney Cancer Clinical Trial
Official title:
A Phase II Pilot Study of Tumor-Loaded Dendritic Cells Alone or Following a Non-Myeloablative Conditioning Regimen in Patients With Metastatic Renal Cell Carcinoma
RATIONALE: Vaccines made from a person's tumor cells and white blood cells may make the body
build an immune response to kill tumor cells. Drugs used in chemotherapy, such as
fludarabine, work in different ways to stop tumor cells from dividing so they stop growing
or die. Combining vaccine therapy with fludarabine may kill more tumor cells.
PURPOSE: This randomized phase II trial is studying vaccine therapy and fludarabine to see
how well they work compared to vaccine therapy alone in treating patients with stage IV
kidney cancer.
OBJECTIVES:
Primary
- Compare the safety of vaccination comprising autologous dendritic cells loaded with
autologous tumor lysate and keyhole limpet hemocyanin with vs without non-myeloablative
fludarabine in patients with stage IV renal cell carcinoma.
- Compare, preliminarily, the efficacy of these regimens in these patients.
- Compare the overall survival of patients treated with these regimens.
Secondary
- Determine whether this vaccine induces tumor-reactive peripheral T-cell responses or
delayed-type hypersensitivity in these patients.
OUTLINE: This is a pilot, randomized study. Patients are randomized to 1 of 2 treatment
arms.
All patients undergo surgery to remove tumor at metastatic sites to generate autologous
tumor lysate. Patients then undergo leukapheresis to obtain peripheral blood mononuclear
cells for the generation of dendritic cells (DC). The DC are then exposed to autologous
tumor lysate and keyhole limpet hemocyanin (KLH).
- Arm I: Three weeks after leukapheresis, patients receive vaccination comprising DC
loaded with autologous tumor lysate and KLH (DC vaccine) intradermally once every 14
days for a total of 4 injections in the absence of disease progression or unacceptable
toxicity.
- Arm II: Two weeks after leukapheresis, patients receive fludarabine IV over 15-30
minutes once daily for 3 days. Beginning approximately 5 weeks after leukapheresis,
patients also receive DC vaccine as in arm I.
Patients are followed at 1, 3, and 7-9 weeks, at 4, 6, 9, and 12 months, and then every 6
months for 2 years.
PROJECTED ACCRUAL: A total of 28 patients (14 per treatment arm) will be accrued for this
study within 2-3 years.
;
Allocation: Randomized, Primary Purpose: Treatment
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