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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00398138
Other study ID # 06-085
Secondary ID P30CA008748P01CA
Status Completed
Phase Phase 1
First received November 9, 2006
Last updated February 2, 2016
Start date October 2006
Est. completion date June 2009

Study information

Verified date February 2016
Source Memorial Sloan Kettering Cancer Center
Contact n/a
Is FDA regulated No
Health authority United States: Food and Drug Administration
Study type Interventional

Clinical Trial Summary

RATIONALE: Vaccines made from peptides may help the body build an effective immune response to kill cancer cells. Biological therapies, such as GM-CSF, may stimulate the immune system in different ways and stop cancer cells from growing. Giving vaccine therapy together with GM-CSF may kill more cancer cells.

PURPOSE: This phase I trial is studying the side effects of vaccine therapy and GM-CSF in treating patients with acute myeloid leukemia, myelodysplastic syndromes, non-small cell lung cancer, or mesothelioma.


Description:

OBJECTIVES:

Primary

- Determine the safety and immunogenicity of the Wilms tumor-1 analog peptide vaccine in patients with acute myeloid leukemia, myelodysplastic syndromes, non-small cell lung cancer, or mesothelioma.

Secondary

- Determine the antitumor effects of this vaccine in these patients.

OUTLINE: This is a pilot study. Patients are stratified according to disease type (acute myeloid leukemia [AML] or myelodysplastic syndromes [MDS] vs non-small cell lung cancer or mesothelioma).

Patients receive vaccine comprising Wilms-tumor 1 (WT-1) analog peptide emulsified in Montanide ISA-51 subcutaneously (SC) once in weeks 0, 4, 6, 8, 10, and 12 and sargramostim (GM-CSF) SC twice in weeks 0, 4, 6, 8, 10, and 12 (on the day of and 2 days prior to each vaccination). Patients who have an immunologic response and have no disease progression may receive up to 6 more vaccinations approximately 1 month apart.

Blood samples are collected at baseline, week 8, and week 14. Samples are examined by polymerase chain reaction (PCR) to measure levels of WT-1 and by T-cell proliferative response, delayed-type hypersensitivity against WT-1 peptides, or ELISPOT to measure immune response.

Bone marrow samples are collected from patients with AML or MDS at baseline and week 14. Samples are examined by PCR to measure levels of WT-1 and by multiparameter flow cytometry to measure residual disease.


Recruitment information / eligibility

Status Completed
Enrollment 22
Est. completion date June 2009
Est. primary completion date June 2009
Accepts healthy volunteers No
Gender Both
Age group 18 Years to 120 Years
Eligibility DISEASE CHARACTERISTICS:

- Cytologically or histologically confirmed diagnosis of 1 of the following:

- Acute myeloid leukemia, meeting the following criteria:

- Documented Wilms tumor-1 (WT-1)-positive disease demonstrated by WT-1 protein on a pretreatment bone marrow biopsy OR detectable disease with real-time quantitative reverse transcriptase-polymerase chain reaction (RQ-PCR)

- Completed induction chemotherapy, achieved clinical remission, and completed postremission therapy OR achieved clinical remission and have no plans for further postremission chemotherapy (= 65 years of age)

- Myelodysplastic syndromes, meeting the following criteria:

- Documented WT-1-positive disease demonstrated by WT-1 protein on a pretreatment bone marrow biopsy OR detectable disease by RQ-PCR

- International Prognostic Scoring System (IPSS) score of = Int-2

- Not a candidate for cytotoxic chemotherapy

- Non-small cell lung cancer, meeting the following criteria:

- Positive tumor staining for WT-1 in > 10% of cells

- Stage III or IV disease

- Completed chemotherapy, surgery, and/or radiotherapy

- Mesothelioma, meeting the following criteria:

- Positive tumor staining for WT-1 in > 10% of cells

- Unresectable or relapsed disease

- Chemo-naive or received 1 prior chemotherapy regimen

- Malignant pleural mesothelioma or peritoneal mesothelioma

- No leptomeningeal disease

- No CNS involvement

PATIENT CHARACTERISTICS:

- Karnofsky performance status 70-100%

- Absolute neutrophil count = 1,000/mm³

- Platelet count > 50,000/mm³ (except for myelodysplastic syndromes where parameter is > 20,000/mm³ and not transfusion dependent)

- Bilirubin = 2.0 mg/dL

- AST and ALT = 2.5 times upper limit of normal

- Creatinine = 2.0 mg/dL

- Not pregnant or nursing

- Negative pregnancy test

- Fertile patients must use effective contraception

- No active infection requiring systemic antibiotics, antiviral, or antifungal treatments

- No serious unstable medical illness

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- At least 4 weeks since prior chemotherapy or radiotherapy

- No concurrent systemic corticosteroids

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment


Intervention

Biological:
WT-1 analog peptide vaccine

incomplete Freund's adjuvant

sargramostim

Genetic:
polymerase chain reaction

Other:
flow cytometry

immunoenzyme technique


Locations

Country Name City State
United States Memorial Sloan Kettering Cancer Center New York New York

Sponsors (3)

Lead Sponsor Collaborator
Memorial Sloan Kettering Cancer Center Innovive Pharmaceuticals, National Cancer Institute (NCI)

Country where clinical trial is conducted

United States, 

References & Publications (1)

Maslak PG, Dao T, Krug LM, Chanel S, Korontsvit T, Zakhaleva V, Zhang R, Wolchok JD, Yuan J, Pinilla-Ibarz J, Berman E, Weiss M, Jurcic J, Frattini MG, Scheinberg DA. Vaccination with synthetic analog peptides derived from WT1 oncoprotein induces T-cell r — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Safety Toxicities will be tabulated according to the NCI Common Toxicity (version 3.0). 2 years Yes
Primary Immune Response Immune reactivity to the peptides will be measured in the same fashion for patients with hematologic or thoracic malignancies. Immune responses will be measured by T cell proliferative response and DTH against WT-1 peptides. In patients with adequate samples, T cell gamma interferon release as measured by ELISPOT will be performed as well. 2 years No
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