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Lung CancerPhase 1NCT00569296

Laboratory-Treated Autologous Lymphocytes, Aldesleukin, and GM-CSF in Treating Patients With Recurrent, Refractory, or Metastatic Non-Small Cell Lung Cancer

A Phase 1 study testing EGFRBi-armed autologous activated T cells, aldesleukin and sargramostim in people with Lung Cancer, run by Roger Williams Medical Center at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

RATIONALE: Giving autologous lymphocytes that have been treated in the laboratory with antibodies may stimulate the immune system to kill tumor cells. Aldesleukin may stimulate the lymphocytes to kill tumor cells. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Lung Cancer
What is being tested?
EGFRBi-armed autologous activated T cells, aldesleukin and sargramostim
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 siteUnited States
Study dates
Nov 2007to Mar 2015
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

DISEASE CHARACTERISTICS:

  • Histologically or cytologically confirmed non-small cell lung cancer (NSCLC)
  • Recurrent, refractory, or metastatic disease after ≥ 1 prior first-line regimen (chemotherapy or radiotherapy)
  • Documented EGFR-positive disease (any expression level) by immunohistochemistry (IHC) (may be based on archival sample)
  • Measurable or evaluable disease by radiograph, CT scan, MRI, and/or physical exam
  • Appropriate slides of the primary lesion must be available for review of IHC staining assessment by a central pathology team
  • No clinical evidence of active brain metastases
  • Patients with brain metastases are eligible provide they have received definitive radiotherapy or chemotherapy and/or have undergone surgical resection for brain metastases
  • No prior hematological malignancy

PATIENT CHARACTERISTICS:

  • Karnofsky performance status (PS) 60-100% OR ECOG PS 0-2
  • Life expectancy ≥ 3 months
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • Granulocytes ≥ 1,000/mm^3
  • Platelet count ≥ 50,000/mm^3
  • Hemoglobin ≥ 8 g/dL
  • BUN ≤ 2.0 times normal
  • Serum creatinine ≤ 2.0 mg/dL
  • Bilirubin ≤ 1.5 times normal
  • SGOT ≤ 1.5 times normal (with or without liver metastases)
  • Hepatitis B surface antigen and HIV negative
  • LVEF ≥ 45 % at rest (by MUGA)
  • No evidence of depressed left ventricular function
  • FEV_1, DLCO, and FVC ≥ 50% of the predicted value
  • No other malignancy, except for the following:
  • History of curatively treated in situ squamous cell carcinoma or basal cell carcinoma of the skin
  • History of other curatively treated malignancy (except those with a hematologic origin) for which the patient has remained in complete remission > 5 years after completing therapy (as documented by history, physical exams, tumor markers, and radiology scanning)
  • No serious medical or psychiatric illness that would preclude giving informed consent or receiving intensive treatment
  • No recent myocardial infarction (within the past year)
  • No current angina/coronary symptoms requiring medications
  • No clinical evidence of congestive heart failure requiring medical management (irrespective of MUGA results)
  • No systolic blood pressure (BP) ≥ 130 mm Hg or diastolic BP ≥ 80 mm Hg
  • Patients with elevated BP must have it controlled by anti-hypertensive medications for at least 7 days prior to the first infusion

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
  • More than 4 weeks since prior chemotherapy or radiotherapy
  • At least 4 weeks since prior cetuximab or small molecule EGFR-inhibitors including, but not limited to, gefitinib or erlotinib hydrochloride
  • No concurrent radiotherapy
  • No concurrent steroids except for treatment of adrenal failure, septic shock, or pulmonary toxicity or hormones for non-disease-related conditions (e.g., insulin for diabetes)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Roger Williams Medical Center

    Providence, Rhode Island, 02908-4735

Other trials in United States

About this study

Official title: A Phase I Study of Anti-CD3 x Cetuximab-Armed Activated T Cells, Low Dose IL-2, and GM-CSF for EGFR-Positive, Advanced Non-Small Cell Lung Cancer

RATIONALE: Giving autologous lymphocytes that have been treated in the laboratory with antibodies may stimulate the immune system to kill tumor cells. Aldesleukin may stimulate the lymphocytes to kill tumor cells. Colony-stimulating factors, such as GM-CSF, may increase the number of immune cells found in bone marrow or peripheral blood. Giving laboratory-treated autologous lymphocytes together with aldesleukin and GM-CSF may kill more tumor cells.

PURPOSE: This phase I trial is studying the side effects and best dose of laboratory-treated autologous lymphocytes when given together with aldesleukin and GM-CSF in treating patients with recurrent, refractory, or metastatic non-small cell lung cancer.

FUNDING SOURCE--FDA OOPD

Read the detailed description

OBJECTIVES:

Primary

  • Determine the safety and maximum tolerated dose of EGFRBi-armed autologous activated T-cells (ATC) when administered in combination with low-dose aldesleukin and sargramostim (GM-CSF) in patients with recurrent, refractory, or extensive (metastatic) non-small cell lung cancer (NSCLC).

Secondary

  • Assess clinical outcome based on tumor responses, overall survival, and progression-free survival.
  • Monitor changes in sera concentrations of the tumor marker in association with EGFRBi-armed ATC administration throughout the study and at time points thereafter in patients with elevated levels of carcinoembryonic antigen (CEA) prior to beginning the study.
  • Monitor patient sera for human anti-mouse antibodies (HAMA).
  • Evaluate immune response, which may reflect immune augmentation in response to EGFRBi-armed ATC infusions, in peripheral blood mononuclear cell (PBMC) samples as well as purified immune cell populations.
  • Investigate proliferation in response to ex vivo stimulation with NSCLC tumor-associated antigens, sera cytokine profiles (Th1 vs Th2), cytotoxicity of patient PBMC, and interferon gamma ELISPOTS as a surrogate marker for assessing generation of EGFR-specific cytotoxic T-lymphocytes (CTL).

OUTLINE: Peripheral blood mononuclear cells (PBMCs) are collected by 1 or 2 leukaphereses for the generation of activated T cells (ATCs). The PBMCs are activated with OKT3 (anti-CD3) and expanded in aldesleukin for up to 14 days. The ATCs are then armed with EGFRBi.

Patients receive EGFRBi-armed autologous ATCs IV over 30-60 minutes twice weekly for 4 weeks (a total of 8 infusions) in the absence of disease progression or unacceptable toxicity. Patients also receive low-dose aldesleukin subcutaneously (SC) once daily and sargramostim (GM-CSF) SC twice weekly beginning 3 days before the first ATC infusion and continuing for 1 week after the last ATC infusion.

After completion of study therapy, patients are followed periodically.

Conditions
Lung Cancer
Being tested
EGFRBi-armed autologous activated T cells, aldesleukin, sargramostim
Keywords
recurrent non-small cell lung cancer, stage IV non-small cell lung cancer
Medical subject headings
Lung Neoplasms, Carcinoma, Non-Small-Cell Lung

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • EGFRBi-armed autologous activated T cellsBiological

    Dose escalation, dosage depends on when entered in study. 8 infusions (twice a week over 4 weeks. Each infusion will be over at least 1 hour.

  • aldesleukinBiological

    Also called IL-2

    300,00IU/m2/day beginning 3 days before the first Activated T-cell infusion and ending 1 week after the last infusion

  • sargramostimBiological

    Also called GM-CSF

    250 micrograms/m2/twice weekly beginning 3 days before the first activated T-cell infusion and ending 1 week after the last Activated T-cell infusion

Study groups in NCT00569296
Study groupRoleWhat they receive
T-cellsExperimentalEGFRBi-armed autologous activated T cells
Receives: Biological: EGFRBi-armed autologous activated T cells; Biological: aldesleukin; Biological: sargramostim

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety

    Measured: 4 weeks

  2. Maximum tolerated dose of EGFRBi-armed autologous activated T-cells

    Measured: 4 weeks

  3. Determination of immunologic changes by evaluation of cytokine profiles obtained before and after stimulation with OKT3 in vitro

    Measured: 4 weeks

Secondary outcomes (6)
  1. Overall survival

    Measured: 2 years

  2. Progression-free survival

    Measured: 2 years

  3. Evaluation of tumor markers and human anti-mouse antibody responses as assessed by carcinoembryonic antigen (CEA) levels in serum samples and development of IgG and IgM anti-mouse antibody responses to the Bi-antibodies

    Measured: 4 weeks

  4. Determination of immunologic changes by evaluation of peripheral blood lymphocytes

    Measured: 4 weeks

  5. Determination of immunologic changes by evaluation of cytotoxic T-lymphocytes as measured by interferon gamma ELISPOTS directed at autologous tumor or lung cancer cell lines

    Measured: 4 weeks

  6. Determination of immunologic changes by evaluation of phenotypes of peripheral blood mononuclear cells before and after immunotherapy

    Measured: 4 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Dec 2007 (estimated)
  2. Study startNov 2007
  3. Primary completionDec 2014
  4. Study completionMar 2015

Why it stopped: Funding ended

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
5 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00569296
Sponsor's protocol ID
CDR0000577502
Other IDs
349-32, 3422
Status last verified
Mar 2015
First submitted
6 Dec 2007
Last updated
25 Mar 2015
Results posted
No
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing EGFRBi-armed autologous activated T cells, aldesleukin and sargramostim in people with Lung Cancer, run by Roger Williams Medical Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 25 Mar 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Funding ended). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety (time frame: 4 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Mar 2015.

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