Description:
This pilot early phase I trial studies the side effects of vaccine therapy in treating
patients with glioblastoma that has come back. Vaccines made from a person's white blood
cells mixed with tumor proteins from another person's glioblastoma tumors may help the body
build an effective immune response to kill tumor cells. Giving vaccine therapy may work
better in treating patients with glioblastoma.
Title
- Brief Title: Vaccine Therapy in Treating Patients With Recurrent Glioblastoma
- Official Title: Pilot Clinical Trial of Allogeneic Tumor Lysate-Pulsed Autologous Dendritic Cell Vaccination in Recurrent Glioblastoma
Clinical Trial IDs
- ORG STUDY ID:
MC1772
- SECONDARY ID:
NCI-2017-02159
- SECONDARY ID:
MC1772
- SECONDARY ID:
P30CA015083
- NCT ID:
NCT03360708
Conditions
- Giant Cell Glioblastoma
- Recurrent Glioblastoma
- Recurrent Gliosarcoma
Interventions
Drug | Synonyms | Arms |
---|
Malignant Glioma Tumor Lysate-Pulsed Autologous Dendritic Cell Vaccine | | Treatment (vaccine therapy) |
Purpose
This pilot early phase I trial studies the side effects of vaccine therapy in treating
patients with glioblastoma that has come back. Vaccines made from a person's white blood
cells mixed with tumor proteins from another person's glioblastoma tumors may help the body
build an effective immune response to kill tumor cells. Giving vaccine therapy may work
better in treating patients with glioblastoma.
Detailed Description
PRIMARY OBJECTIVES:
I. To determine the safety and feasibility of malignant glioma tumor lysate-pulsed autologous
dendritic cell vaccine (autologous dendritic cell [DC] / allogeneic glioblastoma multiforme
[GBM] culture lysate vaccination) in glioblastoma patients at first or second recurrence.
SECONDARY OBJECTIVES:
I. To document survival and progression-free survival in glioblastoma patients at first or
second recurrence receiving autologous DC / allogeneic GBM culture lysate vaccination and
compared to historical data.
TERTIARY OBJECTIVES:
I. Determine the ability of autologous DC / GBM culture lysate vaccination to generate
multiple tumor-associated antigen (TAA)-specific immune responses in GBM patients at first or
second recurrence.
II. Assess the relationship between ability tumor induced TAA-specific immune responses and
evidence of immunosuppression (peripheral blood immunophenotyping by flow cytometry)
following autologous DC / allogeneic GBM culture lysate vaccination in GBM patients at first
or second recurrence.
III. Assess the relationship between efficacy endpoints (survival, progression-free survival,
tumor response) and tumor-associated antigen immune response following autologous DC /
allogeneic GBM culture lysate vaccination
IV. Assess the relationship between efficacy endpoints (survival, progression-free survival,
tumor response) and evidence of immunosuppression at baseline and over time with autologous
DC / allogeneic GBM culture lysate vaccination.
OUTLINE:
Patients receive malignant glioma tumor lysate-pulsed autologous dendritic cell vaccine
intradermally (ID) on days 1, 3, and 5 of courses 2 and 3, and on day 1 of subsequent
courses. Treatment with malignant glioma tumor lysate-pulsed autologous dendritic cell
vaccine repeats every 21 days for up to 13 courses in the absence of disease progression or
unacceptable toxicity.
After completion of study treatment, patients are followed up periodically for up to 5 years.
Trial Arms
Name | Type | Description | Interventions |
---|
Treatment (vaccine therapy) | Experimental | Patients receive malignant glioma tumor lysate-pulsed autologous dendritic cell vaccine ID on days 1, 3, and 5 of courses 2 and 3, and on day 1 of subsequent courses. Treatment with malignant glioma tumor lysate-pulsed autologous dendritic cell vaccine repeats every 21 days for up to 13 courses in the absence of disease progression or unacceptable toxicity. | - Malignant Glioma Tumor Lysate-Pulsed Autologous Dendritic Cell Vaccine
|
Eligibility Criteria
Inclusion Criteria:
- First or second recurrence of previously histologically confirmed glioblastoma (grade
4 astrocytoma)
- NOTE: gliosarcomas and other grade 4 astrocytoma variants (e.g., giant cell) may
be included, primitive neuroectodermal tumor (PNET) variants are excluded; grade
4 oligodendrogliomas or oligoastrocytomas are specifically excluded
- Prior craniotomy and gross total or sub-total resection of tumor at this recurrence
NOTE: biopsy of this recurrence alone without attempt at resection does not meet this
inclusion criteria (i.e. craniotomy and resection is still required).
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2
- Absolute neutrophil count (ANC) >= 1500/uL
- Monocytes >= 300/uL
- Platelets (PLT) >= 100,000/uL
- Hemoglobin (HgB) >= 9.0 g/dL
- Total bilirubin =< 1.5 x upper limit of normal (ULN)
- Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 3
x ULN
- Creatinine =< 1.5 x ULN
- Negative pregnancy test done =< 7 days prior to registration, for persons of
childbearing potential only
- Ability to understand and willingness to sign written informed consent
- Willing to return to Mayo Clinic in Rochester, Minnesota for follow-up
- Willing to provide tissue and blood samples for mandatory correlative research
purposes
- Fixed or decreasing dose of corticosteroids (or no corticosteroids) >= 7 days prior to
registration
Exclusion Criteria:
- Prior treatment
- Current or prior treatment for this cancer with immunotherapy and/or any other
investigational agents
- Surgery =< 2 weeks prior to registration
- Radiotherapy =< 12 weeks prior to registration
- Treatment with bevacizumab or any cytotoxic chemotherapy =< 8 weeks prior to
registration
- Any of the following
- Pregnant persons
- Nursing persons
- Persons of childbearing potential who are unwilling to employ adequate
contraception
- Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment
of the investigator, would make the patient inappropriate for entry into this study or
interfere significantly with the proper assessment of safety and toxicity of the
prescribed regimens
- Immunocompromised patients (other than that related to the use of corticosteroids)
including patients known to be human immunodeficiency virus (HIV), human T-cell
lymphotropic virus (HTLV), hepatitis B (HepB), or hepatitis C (HepC) positive
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements
- History of other malignancy other than glioma
- EXCEPTIONS: non-melanotic skin cancer, carcinoma-in-situ of the cervix, or
systemic cancer that has been in documented remission for > 10 years
- NOTE: if there is a history or prior malignancy, they must not be receiving other
specific treatment for their cancer
- History of myocardial infarction =< 180 days (6 months), or congestive heart failure
requiring use of ongoing maintenance therapy for life-threatening ventricular
arrhythmias
- Active infection =< 5 days prior to registration or fever >/= 38 degrees Celsius (C)
within 5 days prior to registration
- History of tuberculosis or positive purified protein derivative (PPD) test
- Inability or unwillingness to have magnetic resonance imaging (MRI) scans performed
(e.g. cardiac pacemaker-dependent)
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Incidence of significant toxicity, defined as a dose limiting toxicity (DLT) that is possibly, probably, or definitely related to treatment as assessed by National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | Incidence of significant toxicity will be estimated by the number of patients with significant toxicity divided by the total number of evaluable patients. |
Secondary Outcome Measures
Measure: | Clinical benefit rate |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | The clinical benefit rate will be estimated by the number of patients with an overall survival for at least 6 months after enrollment or an objective status of CR or PR at any time divided by the total number of evaluable patients. Exact binomial 95% confidence intervals for the true clinical benefit rate will be calculated. |
Measure: | Duration of response |
Time Frame: | Date at which the patient?s objective status is first noted to be either a CR or PR to the earliest date progression is documented, assessed up to 5 years |
Safety Issue: | |
Description: | Duration of response will be summarized descriptively. |
Measure: | Feasibility |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | The feasibility of the regimen will be estimated by the number of patients who received at least one dose of dendritic cell (DC) injection divided by the total number of patients who received leukapheresis in that arm. |
Measure: | Overall response rate |
Time Frame: | Up to 5 years |
Safety Issue: | |
Description: | The overall response rate will be estimated by the number of patients with an objective status of complete response (CR) or partial response (PR) divided by the total number of evaluable patients. Exact binomial 95% confidence intervals for the true overall response rate will be calculated. |
Measure: | Overall survival |
Time Frame: | Time from study registration to progression and death due to any cause, assessed up to 5 years |
Safety Issue: | |
Description: | |
Measure: | Progression-free survival |
Time Frame: | Time from study registration to progression and death due to any cause, assessed up to 5 years |
Safety Issue: | |
Description: | |
Measure: | Time to response |
Time Frame: | Date of initiation of vaccination treatment to the date at which the patient?s objective status is first noted to be either a CR or PR, assessed up to 5 years |
Safety Issue: | |
Description: | Time to response will be summarized descriptively. |
Details
Phase: | Early Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Active, not recruiting |
Lead Sponsor: | Mayo Clinic |
Last Updated
July 12, 2021