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Small Cell Lung CancerPhase 2NCT00617409

To Immunize Patients With Extensive Stage SCLC Combined With Chemo With or Without All Trans Retinoic Acid

A Phase 2 study testing Paclitaxel, Drug: Ad.p53-DC vaccines and All -trans Retinoic Acid (ATRA) in people with Small Cell Lung Cancer, run by H. Lee Moffitt Cancer Center and Research Institute at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this research study is to test a tumor (cancer) vaccine given along with chemotherapy to determine if this vaccine will increase the chances of the tumor shrinking and/or the amount of time that people who have this disease will live. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Small Cell Lung Cancer
What is being tested?
Paclitaxel, Drug: Ad.p53-DC vaccines and All -trans Retinoic Acid (ATRA)
Type of treatment
Vaccines
Could I receive a placebo?
No, everyone receives an active treatment
How many people
69 participants
Where
1 siteUnited States
Study dates
2 Oct 2007to 31 Jan 2019
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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

Who may be able to join

  • Patients must have a histological confirmed diagnosis of Small Cell Lung Cancer (SCLC)
  • Must have extensive stage SCLC
  • Must have completed first line chemotherapy: 4-6 cycles of a standard platinum/etoposide regimen and PCI if chosen at the discretion of the treating Oncologist
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-2
  • Acceptable (adequate) organ function including:
  • White blood count (WBC) >2,500/mm³ and Absolute neutrophil count (ANC) >1,200/mm³
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  • Platelets > 75,000/mm³
  • Hematocrit > 24% OR Hemoglobin ≥8.5g/dl
  • Bilirubin < 2.0 mg/dl
  • Creatinine < 2.0 mg/dl
  • Aspartic transaminase (AST/SGOT) ≤2 x upper limit of normal (ULN)
  • Alkaline phosphatase ≤3 x ULN
  • Patients must have achieved responsive or non-progressive disease status (stable disease [SD], partial response [PR], or complete response [CR]) assessed 4-6 weeks after the last cycle of first line chemotherapy. SD, PR or CR may be confirmed after completion of prophylactic cranial irradiation (PCI) at the discretion of the principal investigator (PI) after discussion with the treating oncologist.
  • Males and Females of reproductive potential must agree to use effective contraception during the study and for at least 4 weeks after the last dose of ATRA. Patients are instructed and agree to notify the principal investigator should a pregnancy occur for themselves or their partner.
  • Willing and able to sign written informed consent and be able to comply with the study protocol for the duration of the study

Who cannot join

  • Patients with severe, uncontrolled intercurrent illness or infection
  • Anticipated requirement for systemic chronic steroid use at the time of vaccination, unless specifically indicated for dose supplementation or replacement of established corticosteroid insufficiency
  • Receiving systemic doses of corticosteroids should have them discontinued ≥ 2 weeks prior to starting vaccination (this include patients receiving steroids with PCI). Inhaled steroids should also be discontinued if at all possible. Chronic, stable doses of inhaled steroids for the treatment of chronic obstructive pulmonary disease (COPD), etc. are allowed if in the opinion of the treating physician(s) they cannot be stopped.
  • Any pre-existing immunodeficiency condition, or a known history of human immunodeficiency virus (HIV), Hepatitis B or Hepatitis C
  • Uncontrolled and/or symptomatic central nervous system (CNS) metastasis
  • Pregnant or lactating women. A pregnancy test-serum Beta human chorionic gonadotropin (bHCG) will be obtained during the screening process.
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  • Have received any chemotherapy other than the first line chemotherapy specified in the study protocol: standard platinum/etoposide regimen
  • Have received any prior investigational drugs including immunotherapy, gene therapy, hormone therapy, biologic therapy for treatment of SCLC
  • Any known pre-existing autoimmune disorder
  • History of a second malignancy within the previous 3 years. Exceptions include: non-melanoma skin cancers, any in-situ carcinomas and successfully treated early stage malignancies without evidence of recurrence for > 18 months.
  • Have not recovered from any chemotherapy-related or other therapy-related toxicity at study entry
  • Have had major surgery without full recovery or major surgery within 3 weeks of the start of vaccine treatment
  • Patients with other significant diseases or disorders that, in the Investigator's opinion, would exclude them from the study
  • Pre-Pheresis Criteria:
  • Patients must have had a successful harvest of peripheral blood mononuclear cell (PBMC) with leukopheresis at least 6-10 weeks after chemotherapy.
  • ECOG performance status of 0-2
  • The last dose of first line chemotherapy must have been administered at least 4 weeks prior to the first vaccine administration.
  • Patients who received radiation therapy: last dose of radiation must have been completed at least 2 weeks prior to the first vaccine administration and the patient must have recovered from the toxic effects of the treatment prior to study enrollment (except for alopecia)
  • Patients who received steroid therapy: last steroid dose must have been given at least 2 weeks prior to the first vaccine administration
  • Adequate organ function:
  • WBC > 2,500/mm³ and ANC >1,200/mm³
  • Platelets > 75,000/mm³
  • Hematocrit > 25%
  • Hemoglobin ≥9g/dl
  • Bilirubin < 2.0 mg/dl
  • Creatinine < 2.0 mg/dL
  • AST/SGOT ≤ 2 x ULN
  • Alkaline phosphatase < 3 x ULN
  • Patients must have signed informed consent at initial registration.
  • HLA-A*0201 Testing as determined by flow cytometry followed by molecular analysis of a peripheral blood specimen, however this result will not be an inclusion criterion
  • Pre-Paclitaxel Eligibility:
  • Progressive disease after observation (Arm A) or vaccinations (Arms B and C)
  • ECOG performance status of 0-2
  • Adequate organ function:
  • WBC > 2,500/mm³ and ANC >1,200/mm³
  • Platelets > 75,000/mm³
  • Hematocrit > 25%
  • Hemoglobin ≥9g/dl
  • Bilirubin < 2.0 mg/dl
  • Creatinine < 2.0 mg/dL
  • AST/SGOT ≤ 2 x ULN
  • Alkaline phosphatase < 3 x ULN

Trial locations and contacts

1 site in 1 country.

United States1 site
  • H. Lee Moffitt Cancer Center & Research Institute

    Tampa, Florida, 33612

Other trials in United States

About this study

Official title: A Randomized Phase II Trial Using Dendritic Cells Transduced With an Adenoviral Vector Containing the p53 Gene to Immunize Patients With Extensive Stage Small Cell Lung Cancer in Combination With Chemotherapy With or Without All Trans Retinoic Acid

The purpose of this research study is to test a tumor (cancer) vaccine given along with chemotherapy to determine if this vaccine will increase the chances of the tumor shrinking and/or the amount of time that people who have this disease will live.

Read the detailed description

After initial diagnosis patients will be treated with a standard platinum/etoposide regimen. This standard first-line chemotherapy may/will be administered to patients under the direction of their primary medical oncologist inside or outside of the Moffitt Cancer Center. Patients will receive the platinum drug on day 1 and etoposide on days 1-3 of each 21-day cycle for 4-6 cycles. Patients who have progressive disease (PD) at this point are changed to second line chemotherapy, and will not be eligible to participate in this clinical trial. Patients who achieve a complete response (CR), partial response (PR), or stable disease (SD) after standard first-line chemotherapy will be enrolled. Radiographic studies and tumor measurements are repeated 3-6 weeks after the last dose of chemotherapy (+/- PCI) and may be repeated after prophylactic cranial irradiation (PCI) at the discretion of the principal investigator (PI) and treating physician.

PCI will be permitted at the discretion of the treating oncologist(s). The initial radiation consultation and simulation should occur as soon as the final staging has occurred. Ideally, treatment should commence 1-2 weeks after final staging has been confirmed and will be administered in 10-15 fractions over a 2-3 week period, as recommended by the treating radiation oncologist. Although steroid use is not prohibited, it is recommended and preferred that they not be used during PCI (steroids will have to be discontinued ≥ 2 weeks before first vaccination). PCI can also be considered between vaccines #4 and #5 or vaccine #5 and #6 in those patients eligible for the second course of vaccinations. Systemic dose of steroids will NOT be allowed in these cases unless strictly necessary and after discussion with the PI.

Patients who achieve CR, PR or SD after the completion of first line chemotherapy +/- PCI will be screened for initial registration. Screening tests and procedures will be performed approximately 4-6 weeks after the completion of first line chemotherapy or 6-9 weeks after completion of PCI. Ideally, screening should be completed 1-2 weeks prior to leukopheresis.

Patients who successfully complete the screening exams for initial registration will be randomized into one of three study arms.

Being tested
Paclitaxel, Drug: Ad.p53-DC vaccines, All -trans Retinoic Acid (ATRA)
Keywords
SCLC, vaccine, immunize
Medical subject headings
Small Cell Lung Carcinoma

What participants receive

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

  • PaclitaxelDrug

    Also called Antitumor agent, Chemotherapy

    All groups wil receive paclitaxel as second line chemotherapy if their cancer spreads. At any point when a patient develops evidence of progressive disease, the patient will be treated with second-line chemotherapy. Paclitaxel will be given at a dose of 200 mg/m² on day 1 of 21 day cycles.

  • Drug: Ad.p53-DC vaccinesBiological

    Also called INGN 225

    Patients randomized to Arm B will receive vaccinations on 3 occasions, at 2 week intervals. 1-5x106 p53 positive DCs in 1 ml will be injected intradermally into 4 separate sites (0.25 ml injected at each site), in bilateral proximal upper and lower extremities (in the regions of the axillary and inguinal nodal basins). Patients will be restaged approximately 2-3 weeks after vaccine # 3 (first vaccine course). If patients show no sign of disease progression at restaging, then a second leukopheresis will be performed. Patients will then be vaccinated 3 more times (second vaccine course) at 4-week intervals, for a total of 6 possible vaccines. Restaging will occur 2-4 weeks after completing the second vaccine course. Patients in Arm C will receive vaccines at the same dose and schedule as described for patients in Arm B. In addition, they will receive 150 mg/m² of ATRA for 3 days prior to each vaccine administration (followed by vaccine administration on the fourth day).

  • All -trans Retinoic Acid (ATRA)Drug

    Also called tretinoin, Vesanoid, INGN 225

    The patients in Arm C will receive vaccines at the same dose and schedule as described for patients in Arm B. In addition, they will receive 150 mg/m² of ATRA for 3 days prior to each vaccine administration (followed by vaccine administration on the fourth day).

Study groups in NCT00617409
Study groupRoleWhat they receive
Standard of CareActive comparatorArm A - Active Comparator: Observation (Standard of Care) + Second Line Chemotherapy
Receives: Drug: Paclitaxel
Ad.p53-DC VaccinesExperimentalArm B - Experimental: Ad.p53-DC vaccines + Second Line Chemotherapy
Receives: Drug: Paclitaxel; Biological: Drug: Ad.p53-DC vaccines
Ad.p53-DC Vaccines + ATRAExperimentalArm C - Experimental: Ad.p53-DC vaccines + All -trans Retinoic Acid (ATRA) + Second Line Chemotherapy
Receives: Drug: Paclitaxel; Biological: Drug: Ad.p53-DC vaccines; Drug: All -trans Retinoic Acid (ATRA)

What is being measured

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

  1. Tumor Response Rate (RR)

    Overall Response: Complete Response (CR) + Partial Response (PR) + Stable Disease (SD). Efficacy of second line chemotherapy (single agent paclitaxel) after progression following the dendritic cell(DC)-based p53 vaccine (Ad.p53-DC vaccine), with (Arm C). To estimate the objective tumor response rate for each treatment group. Tumor response to be assessed via radiographic imaging after every 2 cycles of chemotherapy (paclitaxel). CR: Disappearance of all target lesions. PR: At least a 30% decrease in the sum of the longest diameter (LD) of target lesions, taking as reference the baseline sum LD. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for Progressive Disease (PD), taking as reference the smallest sum LD since the treatment started. PD: At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions.

    Measured: 12 months

Secondary outcomes (1)
  1. Overall Survival (OS)

    To evaluate the survival of all patients enrolled on an intent-to-treat basis. Overall survival per treatment arm.

    Measured: Up to 24 months

Timeline

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

  1. First posted18 Feb 2008 (estimated)
  2. Study start2 Oct 2007
  3. Primary completion21 Sep 2015
  4. Study completion31 Jan 2019

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Masking
None (open label)
Enrolment
69 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00617409
Sponsor's protocol ID
MCC-15206
Other IDs
105790, 0147NE, 0705-857
Status last verified
Nov 2019
First submitted
5 Feb 2008
Last updated
8 Nov 2019
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Paclitaxel, Drug: Ad.p53-DC vaccines and All -trans Retinoic Acid (ATRA) in people with Small Cell Lung Cancer, run by H. Lee Moffitt Cancer Center and Research Institute 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?

The sponsor lists 15 inclusion and 42 exclusion criteria. 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: finished, as of the sponsor's last update on 8 Nov 2019. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Nov 2016). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Tumor Response Rate (RR) (time frame: 12 months). 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 8 Nov 2019.

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