A PHASE I TRIAL OF RECOMBINANT VACCINIA VIRUS THAT EXPRESSES PSA IN PATIENTS WITH ADENOCARCINOMA OF THE PROSTATE
recombinant viral vaccine therapy
+ sargramostim
Enfermedades Urogenitales+6
+ Enfermedades Genitales
+ Enfermedades Genitales Masculinas
Estudio de Tratamiento
Resumen
Fecha de inicio: 1 de diciembre de 1996
Fecha en la que se inscribió al primer participante.OBJECTIVES: I. Assess the toxicity associated with repeated vaccination with recombinant vaccinia virus expressing prostate-specific antigen (rV-PSA) in patients with metastatic adenocarcinoma of the prostate. II. Determine the optimal dose of rV-PSA given at monthly intervals based on cellular and hormonal immunity. III. Determine whether vaccination with rV-PSA is associated with anti-tumor activity. IV. Determine whether granulocyte-macrophage colony-stimulating factor (GM-CSF) has an effect on cellular and humoral immunity different from rV-PSA, and whether the addition of GM-CSF has enhanced antitumor effect compared to rV-PSA alone. OUTLINE: This is an open label, dose escalation study. Patients in cohorts of 3-6 receive 3 vaccinations with rV-PSA at 4-week intervals (days 1, 29, 57, and 85) in the absence of disease progression or unacceptable toxicity. Response assessment is performed at eight weeks. Patients who discontinue therapy prior to eight weeks are considered unevaluable for response. If dose limiting toxicity is observed in 2 of 6 patients entered at a dose level, no further patients are entered at that level and the MTD is defined as the preceding dose level. Ten additional patients are treated at the MTD and receive granulocyte-macrophage colony-stimulating factor (GM-CSF) administered subcutaneously on day -1 through day 2 of each cycle. Patients who are HLA-A2 positive, have received all 3 rV-PSA vaccinations without unacceptable toxicity, and have been off study for at least 30 days due to disease progression may continue treatment with rV-PSA at the highest dose level and the addition of GM-CSF. Patients are followed monthly for 6 months.
Protocolo
Esta sección proporciona detalles del plan del estudio, incluyendo cómo está diseñado y qué se está evaluando.Se reclutarán 46 pacientes
Número total de participantes que el ensayo clínico espera reclutar.Estudio de Tratamiento
Elegibilidad
Los investigadores buscan pacientes que cumplan ciertos criterios, conocidos como criterios de elegibilidad: estado general de salud o tratamientos previos.Hombre
Sexo biológico de los participantes elegibles para inscribirse.A partir de 18 años
Rango de edades de los participantes que pueden unirse al estudio.Voluntarios sanos no permitidos
Indica si personas sanas, sin la condición que se estudia, pueden participar.Condiciones
Patología
Criterios
DISEASE CHARACTERISTICS: Histologically proven adenocarcinoma of the prostate with evidence of metastatic disease based on any of the following: Lymph node positive and PSA at least 10 ng/mL Bone scan positive and PSA at least 10 ng/mL PSA at least 2 ng/mL and rising following radical prostatectomy PSA at least 10 ng/mL following radiotherapy No symptomatic metastatic disease (bony pain) PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ECOG 0 or 1 WBC greater than 2,000/mm3 Platelet count greater than 100,000/mm3 Bilirubin less than 2.0 mg/dL AST less than 4 times normal Creatinine less than 2.0 mg/dL Must be type HLA-A2 Prior vaccinia (smallpox) exposure required At least normal delayed type hypersensitivity to mumps and Candida At least normal CD4:CD8 ratio (greater than 1) At least normal lymphocyte proliferation testing (to Con A) At least normal immunoglobulin levels No evidence of altered immune responsiveness or autoimmune syndromes (e.g., scleroderma, systemic lupus erythematosus) No HIV antibody No prior splenectomy No known allergy to eggs No active extensive skin disorders (e.g, psoriasis, burns, impetigo, disseminated zoster) No other serious intercurrent illness No active infections unless cleared and at least 3 days since antibiotic therapy No close contact for 2 weeks after each vaccination with the following people: Children less than 3 years old Pregnant women Individuals with eczema or skin conditions listed above Immunosuppressed individuals PRIOR CONCURRENT THERAPY: No concurrent biologic therapy No prior chemotherapy for metastatic disease No prior hormone therapy for metastatic disease Neoadjuvant hormone therapy prior to prostatectomy or radiotherapy allowed No concurrent steroids or hormonal medications Prior radiotherapy allowed Prior surgery allowed
Plan de Estudio
Conoce todos los tratamientos administrados en este estudio, su descripción detallada y en qué consisten.Un solo grupo de intervención está designado en este estudio
0% de probabilidad de ser asignado al grupo placebo
Grupos de Tratamiento
Grupo I
ExperimentalCentros del Estudio
Estos son los hospitales, clínicas o centros de investigación donde se lleva a cabo el estudio. Puedes encontrar la ubicación más cercana a ti y su estado de reclutamiento.Este estudio tiene 3 ubicaciones
Massachusetts General Hospital Cancer Center
Boston, United StatesAbrir Massachusetts General Hospital Cancer Center en Google MapsBrigham and Women's Hospital
Boston, United StatesDana-Farber Cancer Institute
Boston, United States