Prostatic Neoplasms Clinical Trial
Official title:
Dendritic Cell Vaccination in Combination With Docetaxel for Patients With Cancer Prostate - a Randomized Phase II Study
This is a randomized phase II trial including 40 patients with castration resistant
metastatic cancer prostate (CRMPC).
Patients will be randomized between treatment with a dendritic cell vaccine plus docetaxel
and docetaxel alone.
The primary objective is to evaluate the vaccine specific immune response and patients will
be evlauated with blood tests and DTH reactions during the treatment course.
Secondary objectives are to evaluate clinical response by objective response
(RECIST-criteria, 18F-NaF-PET/CT scan), PSA response, pain response and finally we determine
time to progression and overall survival.
Treatment in details:
Dendritic cell (DC) vaccination The DC vaccine consists of adherent monocytes collected by
leukapheresis. Monocytes are stimulated with GM-CSF and IL-4, and IL-1β, TNFα, IL-6 and PGE2
are used for further maturation.
DCs are transfected with PSA, PAP, survivin and hTERT mRNA. DC vaccines will only be given
to patients in ARM A
Docetaxel:
Docetaxel will be given as an i.v. infusion every third week, 75 mg/m2 according to standard
treatment. Patients will be pretreated with prednisolon before infusion with Docetaxel.
Continuous treatment with prednisolon will not be administered.
Treatment schedule:
The DC vaccination will be administered once a week in two out of three weeks for the first
12 weeks. After 12 weeks the DC vaccination will be given once every three weeks as long as
Docetaxel is given. If the disease does not progress but the patient stop treatment with
Docetaxel (because of side effects) the vaccine treatment can continue until disease
progression.
Evaluation in details:
Immunological evaluation:
Blood tests:
100 ml blood will be drawn from the patient together with the first (baseline), the third
and the fourth infusion of Docetaxel, and every third month thereafter.
DTH:
DTH with 3 i.d. injections consisting of media (neg. test), naked DCs and mRNA transfected
DCs will be performed at baseline (together with 1st vaccine), together with the 5th vaccine
and after three months of treatment (8th vaccine). 48 hours after the DTH at 5th vaccine a
biopsy will be taken from the DTH area.
Clinical evaluation:
PSA:
Patients will be evaluated with PSA measurements during the treatment. All patients will
receive at least 4 treatments with Docetaxel even if PSA is rising.
18F-NaF ("bone") PET/CT scan: All patients will have a bone-PET/CT scan at baseline. For
patients with measurable lesions a PET/CT scan will be performed every three months.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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